• What is HIV and AIDS?

• Stages of development of HIV and AIDS

• Ways of transmission of the virus

4. Measures to prevent the development of HIV infection

OBJ teacher

Kovalev Alexander Prokofievich

Secondary School No. 2

Mozdok

In addition to well-known venereal diseases, which include syphilis, gonorrhea, genital herpes, chlamydia and others in the early 80s. in the USA, and 2-3 years later, a previously unknown disease began to spread in Western Europe and a number of other countries.

Studies have shown that this disease is characterized by a slowly progressive deficiency of the human immune system, leading to the death of a person from secondary lesions.

The disease is named acquired immunodeficiency syndrome (AIDS)

FROM – syndrome (picture of the disease);

P – acquired (obtained by infection)

AND – And mmunno - (immunity, protection against infections)

D – deficit (deficiency, not enough)

AIDS - it is the final stage of an infectious disease caused by the human immunodeficiency virus (HIV) and transmitted through sexual contact and blood.

The number of people living with HIV is 39.5 million (34.1-47.1 million), of which:

• - adults - 37.2 million(32.1-44.5 million);
• -women- 17.7 million(15.1-20.9 million);
• - children under 15 years old - 2.3 million(1.7-3.5 million).
• Of the total number of people infected, two thirds (63% - 24.7 million) of all adults and children with HIV in the world live in Africa.
• The Russian Federation and Ukraine account for about 90% of all HIV infections in Eastern Europe and Central Asia, where the use of contaminated injecting drug equipment remains the main route of HIV transmission (70%).
• in Russia, the total number of infections documented since the beginning of the epidemic is almost 350000.

However, official data only take into account people who have direct contact with the Russian HIV registration system. The actual number of people is estimated at 560,000 to 1.6 million.

Cases of HIV infection have been registered in 88 subjects of the Russian Federation.

If the epidemic is not prevented, by 2020 in Russia will be from 5 to 15 million. HIV-infected.

The majority of HIV-infected people (80%) are young people aged 15 to 30 (20% are young people under the age of 20, about 60% are young people aged 21 to 30).

The number of people infected with HIV as a result of homo- and heterosexual contacts has increased by almost 4 times.

The number of children born to HIV-infected parents has increased.

The causative agent of HIV infection

AIDS virus

(HIV) ,

one of the most dangerous viruses for humans.

HIV belongs to the group of RNA-containing retroviruses of the lentivirus family.

HIV can be found in all biological fluids of the body, but its content in them is different.

Virus concentration

very high low

Blood, - saliva,

Sperm, tear fluid,

cerebrospinal fluid, urine,

breast milk, sweat,

Vaginal secret. - Vomit masses.

As a result of the entry of the virus into the body

1) the immune system is affected, the body becomes defenseless against pathogens of various infections that do not pose a danger to healthy people;

2) tumors develop;

3) the nervous system is almost always affected, which leads to impaired brain activity and the development of dementia.

1) Incubation.

2) Stage of primary manifestations:

Acute fever phase

asymptomatic phase,

Persistent generalized

lymphadenopathy.

3) Stage of secondary changes.

4) Terminal stage.

Through the blood

From mother to

Before, during and after

During feeding

breastfeeding baby.

When transfusing in-

infected blood;

When transplanting

organs and tissues;

Through the infected

nye medical in-

tools.

Sexual contact without

use

condom

Very often drug addicts inject drugs with contaminated syringes and needles.

• having sex with casual or unknown partners without the correct use of a condom;
• those who use drugs or medicinal substances intravenously using non-sterile syringes and needles;
• having sex with intravenous drug users or people who have multiple sexual partners;
• having other sexually transmitted diseases - syphilis, herpes, etc.

1) when shaking hands, hugging and kissing, talking;

2) when using the toilet, bathroom, door handles;

3) through dishes, household items, bedding, money;

4) through tears, sweat, coughing and sneezing;

5) through cats and dogs.

Blood-sucking insects, contrary to popular belief, cannot transmit HIV.

• After HIV enters the body, antibodies begin to be produced to fight the virus, which reveals blood test (test) for HIV .
• Antibodies are determined only 3-6 months after infection. The period when the virus is already in the body, and antibodies to it have not yet been determined, is called grey-negative window. At this time, an HIV-infected person's blood tests for HIV are negative.
• Reliable HIV test results can be obtained no earlier than 3 months after infection.

Heat can kill the virus circulatory system up to + 56 about C within 50 minutes. Since no one can withstand this procedure, we can say that it is impossible to cure this disease. By the way, it is also very difficult to identify the disease. It may not manifest itself for a long time, and it can only be detected in laboratory conditions using a special technique.

• had sex without a condom,
• been raped,
• sharing a needle, injecting drugs, getting a tattoo or piercing,
• contracted an STI.

The test will relieve unnecessary fear or allow you to get help in a timely manner.

• By law, HIV testing is voluntary. Test results are confidential and not subject to public disclosure. If you wish, you can take the test anonymously.
• In the case of a positive HIV test, in order to avoid errors, it should be retaken.

HIV testing limits the spread of infection and allows timely treatment, prolonging the lives of large numbers of people.

• Providing information about the possibility and ways of contracting sexually transmitted infections (STIs), including HIV.
• Promotion of fidelity to one partner or reduction in the number of sexual partners, as well as safe sexual relationships (use of condoms).
• Create conditions for early detection and appropriate treatment of STIs, the presence of which increases the likelihood of HIV infection.
• The fight against drug addiction, the complete rejection of drugs.
• Ensuring the safety of medical procedures, as well as creating the necessary guarantees to ensure that generally accepted measures for the prevention of nosocomial infections are observed in all medical and preventive institutions.

your style of behavior, type of sexual relationship, age of onset of sexual activity,

young men and women should remember that the early onset of sexual activity brings with it:

early pregnancy,

Infertility,

Diseases that are transmitted

sexually (hepatitis,

chlamydia, syphilis, gonorrhea…)

forced marriages,

Unfulfilled hopes and

unfulfilled plans

Interruption of further education.

There is currently no vaccine to protect against HIV infection. There is also no radical treatment. This disease is incurable and inevitably leads to death.

It remains only to observe preventive measures. Only those who observe the elementary rules of personal hygiene, the basic principles of a healthy lifestyle, do not use alcohol and drugs, adhere to the moral norms of gender relations, cultivate a firm attitude to prepare for family life and create a happy family life can protect themselves from AIDS.

Many public prohibitions of morality in the relationship of the sexes have ceased to operate, but they must remain in the person himself.

Homework § 8.3 pp. 164-165

AIDS is Acquired Immunodeficiency Syndrome. This disease is caused by the human immunodeficiency virus (HIV). The human immunodeficiency virus weakens the immune system, causing the body to lose its ability to resist various diseases. The term AIDS denoted the final stage of HIV infection; it is characterized by damage to the human immune system, against which concomitant diseases of the lungs, organs of the gastrointestinal tract, and the brain develop. The disease ends in death.

The abbreviation AIDS stands for: Acquired Immunodeficiency Syndrome.

FROM syndrome - this means that the infected person has many different signs, symptoms, characteristic of various diseases.

P acquired - this means that a person acquires a disease during his life as a result of infection, and does not receive it by inheritance.

AND immunodeficiency - this means that the disease affects the body's immune system, which protects the body from various diseases.

D deficiencies - this means that the immune system stops working properly

The human immunodeficiency virus (HIV) infects living cells (lymphocytes) and develops in them. Living cells are used as an "incubator" in which viruses divide and multiply. The dimensions of HIV are very small: about 100,000 virus particles can fit on a 1 cm long line. The virus causes a slowly ongoing disease with a long latent (incubation) period (from the moment of infection to the appearance of signs of the disease). Therefore, having penetrated into the human body, HIV at first does not manifest itself in any way. Months and sometimes years pass before AIDS develops.

Thus, HIV infection is the pathogen that causes AIDS, that is, the state of the body from infection to the destruction of the immune system and the onset of other diseases. Unlike most diseases, AIDS does not show the same symptoms in all people. As a result of insufficient functioning of the immune system, diseases develop from which a person can die. But with a healthy immune system, the body usually copes with these diseases.

The Acquired Immune Deficiency Syndrome, or AIDS, has been dubbed the “plague of the 20th century” for a reason, because so far no one knows for sure either the origin of this disease or effective methods of its treatment or prevention. Nevertheless, now, when only about 20 years have passed since the first recorded cases of the disease, scientists have no doubt about the extreme danger that AIDS poses to all mankind. If earlier it was believed that AIDS only threatened the underdeveloped countries of Africa or the “decaying” capitalist countries, now it has become obvious that AIDS knows no borders, is indiscriminate in relation to political regimes, and is merciless to the poor and the rich. Some religious figures argue that AIDS was sent to mankind by the Lord God on the eve of the new Last Judgment in order to punish people who are mired in debauchery and to carry out something harmful in the selection of those who live righteously and will be saved and doomed to death sinners. However, this turned out to be unfair, because even a “righteous person” can become infected with the immunodeficiency virus through non-sterile medical instruments, blood transfusions, etc.

HIV is the abbreviation for the human immunodeficiency virus, i.e. a virus that attacks the immune system. HIV lives and multiplies only in the human body.

When infected with HIV, most people do not experience any sensations. Sometimes a few weeks after infection, a flu-like condition develops (fever, skin rashes, swollen lymph nodes, diarrhea). For many years after infection, a person may feel healthy. This period is called the latent (latent) stage of the disease. However, it is wrong to think that nothing happens in the body at this time. When any pathogen, including HIV, enters the body, the immune system mounts an immune response. She is trying to neutralize the pathogen and destroy it. To do this, the immune system produces antibodies. The antibodies bind to the pathogen and help destroy it. In addition, special white blood cells (lymphocytes) also begin to fight the pathogen. Unfortunately, in the fight against HIV, all this is not enough - the immune system cannot neutralize HIV, and HIV, in turn, gradually destroys the immune system.

The fact that a person has contracted a virus, i.e. became HIV-infected does not mean that he has AIDS. Before AIDS develops, it usually takes a long time (average 10-12 years).

AIDS

The virus gradually destroys the immune system, reducing the body's resistance to infections. At a certain point, the body's resistance becomes so low that a person can develop such infectious diseases that other people practically do not get sick or get sick very rarely. These diseases are called "opportunistic".

AIDS is spoken of when a person infected with HIV develops infectious diseases due to the inefficient functioning of the immune system destroyed by the virus.

AIDS is the last stage in the development of HIV infection.

AIDS is Acquired Immunodeficiency Syndrome.

Syndrome- this is a stable combination, a combination of several signs of the disease (symptoms).
Acquired- means that the disease is not congenital, has developed during life.
Immunodeficiency- a condition in which the body cannot resist various infections.

Thus, AIDS is a combination of diseases caused by insufficient work of the immune system due to infection with HIV.

Where did the virus come from?

Unfortunately, there is no single answer to this question. There are only hypotheses. Each of them has its own justification, but in the scientific world they all continue to be just assumptions - possible and, for some, very controversial versions of what happened.

The very first hypothesis of the origin of HIV is associated with monkeys. It was expressed more than 20 years ago by the American researcher B. Corbett. According to this scientist, HIV first entered the human blood in the 30s of the last century from a chimpanzee - perhaps when an animal bites or when a person cuts a carcass. There are serious arguments in favor of this version. One of them is that a rare virus was indeed found in the blood of chimpanzees, capable of causing a condition similar to AIDS when it enters the human body.

According to another researcher, Professor R. Garry, AIDS is much older: its history spans from 100 to 1000 years. One of the most serious arguments confirming this hypothesis is Kaposi's sarcoma, described at the beginning of the 20th century by the Hungarian physician Kaposi as a "rare form of malignant neoplasm", testified to the presence of an immunodeficiency virus in a patient.

Many scientists consider Central Africa to be the birthplace of AIDS. This hypothesis, in turn, is divided into two versions. According to one of them, HIV has long existed in areas isolated from the outside world, for example, in tribal settlements lost in the jungle. Over time, as population migration increased, the virus broke out and began to spread rapidly. The second version is that the virus arose as a result of an increased radioactive background, which is registered in some areas of Africa rich in uranium deposits.

Relatively recently, another hypothesis has appeared, owned by the English researcher E. Hupeor: the virus appeared in the early 50s of the twentieth century due to the mistake of scientists working on the creation of a vaccine against polio. The mistake was that the vaccine was produced using chimpanzee liver cells, which supposedly contained a virus similar to HIV. One of the strongest arguments in favor of this hypothesis is the fact that the vaccine was tested precisely in those parts of Africa where the highest level of infection with the immunodeficiency virus has been recorded to date.

Stages of development of HIV infection

Incubation period of HIV infection

The period from the moment of infection to the appearance of clinical manifestations of the disease. It lasts from 2 weeks to 6 or more months. At this stage, the virus may not even be detected by testing, but HIV infection can already be transmitted from an infected person to other people.

Stage "Primary manifestations"

This stage may be asymptomatic or accompanied by fever, swollen lymph nodes, stomatitis, spotted rash, pharyngitis, diarrhea, enlarged spleen, and sometimes encephalitis. This usually lasts from a few days to 2 months.

Latent stage

The disease may not manifest itself in any way, but HIV continues to multiply (the concentration of HIV in the blood increases), and the body is no longer able to produce the required number of T-lymphocytes - their number is slowly decreasing. The latent stage can last from 2-3 to 20 or more years, on average - 6-7 years.

Stage of secondary diseases

Due to the continued active increase in the concentration of the virus in the blood and the decrease in T-lymphocytes, the patient begins to develop a variety of opportunistic diseases that the immune system is no longer able to resist due to the rapidly decreasing number of T-lymphocytes.

Terminal stage (AIDS)

The last and final stage of HIV infection. The number of defender cells (T-lymphocytes) reaches a critically low number. The immune system can no longer resist infections and they quickly deplete the body. Viruses and bacteria infect vital organs, including the musculoskeletal system, the respiratory system, digestion, and the brain. A person dies from opportunistic diseases that become irreversible. The AIDS stage lasts from 1 to 3 years.

The course and prognosis of HIV infection

When a person finds out they have HIV infection or AIDS, the first questions they most often ask are: “How much longer do I have to live?” and “How will my illness proceed?”.

Since HIV infection and AIDS are different for everyone, these questions cannot be answered unambiguously. But you can highlight some general information.

People living with HIV and AIDS are now living much longer than they used to.

The treatment of HIV infection and AIDS is becoming more and more successful. On the background of treatment, people with HIV infection feel healthy for a longer time, and AIDS patients live longer and, compared to previous years, not only have fewer manifestations of the disease, but it is much easier.

At the beginning of the epidemic (1981-1986), AIDS developed in patients on average 7 years after infection with the virus. After that, a person could live for about 8-12 months. Since the introduction of combination antiretroviral therapy in 1996, the lives of HIV-infected people and people with AIDS have become much longer. Some people who develop AIDS can live 10 years or more.

First of all, such progress is provided by drugs that act on the virus itself - antiretroviral drugs.

Life is also extended due to the fact that with the help of combination therapy it is possible to prevent the development of many opportunistic infections that are the direct cause of death in HIV infection.

The search for new treatments continues. There is no doubt that even more drugs effective in the fight against this infection will soon appear.

Introduction

The purpose of my independent work is to study and reveal the main links that make up the pathogenesis of HIV infection and AIDS.

Currently, HIV infection has acquired the scope of a large-scale pandemic, covering many countries of the world.

The pandemic of infection caused by the human immunodeficiency virus is the largest event in the history of mankind at the end of the 20th century, which can be put on a par with two world wars both in terms of the number of victims and the damage it causes to world society. Its contagiousness, rapid spread and incurability have earned the disease the fame of the “plague of the 20th century”.

Despite the efforts made, HIV continues to spread, covering new countries, causing great damage to people's health and the economy of states.

According to official statistics based on the registration of identified cases, as of February 1, 2011, 15,908 HIV-infected people were registered in the Republic of Kazakhstan. (6).

Due to the above facts, the proof of the relevance of the study of this topic exhausts itself.

General concepts of HIV infection and AIDS

1.1 Definition. Brief historical outline

HIV infection is a disease caused by a retrovirus that affects the immune system. Clinical and laboratory changes are fully developed in the final stage, known as acquired immunodeficiency syndrome (AIDS).

For the first time, a new disease called acquired immunodeficiency syndrome (AIDS) was reported in 1981 in Atlanta in homosexual men who were diagnosed with unusual pneumonia. Further studies of this disease revealed that in addition to pneumocystis pneumonia and Kaposi's sarcoma, infections caused by opportunistic microorganisms often develop. All these facts testified to some kind of disease based on immunodeficiency, so in 1982 the name Acquired immunodeficiency syndrome (AIDS) was assigned to it - acquired immunodeficiency syndrome. (one).

1.2 Etiology

pathogenesis of hiv infection

The immunodeficiency virus refers to viruses whose genome can be integrated into the genome of human cells. When HIV enters a cell, the RNA of the virus, under the influence of reversease, turns into DNA, which is integrated into the DNA of the host cell, producing new viral particles, remaining in the cell for life. The virus contains the gp120 protein, which determines the attachment of the virus to human cells that have a receptor, the CD4+ protein. Currently, 2 types of HIV are known that have some antigenic differences: HIV-1 and HIV-2. (one). The virus enters the body with blood, cells during organ and tissue transplants, with blood transfusions from AIDS patients, with sperm, and also through the placenta from mother to child.

Since 1998 to 2003 48 HIV-infected women registered 56 pregnancies, of which 5 ended in spontaneous miscarriages, 18 had urgent deliveries, medical abortions were performed in 32 women after obtaining informed consent. Out of 18 children born to HIV-infected mothers, only one child had a perinatal HIV infection, but at the age of 2.5 years, he was removed from the dispensary registration due to the absence of HIV infection. (3).

1.3 Epidemiology

As of February 1, 2011, 15,908 HIV-infected people were registered in the Republic of Kazakhstan, which is 99.9 per 100,000 population, of which 71.2% are men and 28.8% are women. From 1.01.2010-2011 there is a decrease in the incidence in Akmola. West Kazakhstan, Atyrau regions. Karaganda, South Kazakhstan and Zhambyl oblasts remain areas with a high number of HIV-infected people.

In the Republic of Kazakhstan, where HIV infection is on the rise every year, 80% of those infected are injecting drug users (6).

There are "vulnerable" contingents, i.e. individuals at high risk of infection. These include homo- and bisexuals, drug addicts, hemophiliacs and sex workers. Along with them, the risk group includes persons who were in penitentiary institutions. (one).

In Kazakhstan, every 4th HIV carrier is or was in penitentiary institutions. (4).

Now in the world, perhaps, there is no adult who would not know what HIV infection is. The "plague of the 20th century" has confidently stepped into the 21st century and continues to progress. The prevalence of HIV is now the nature of a real pandemic. HIV infection has captured almost all countries. In 2004, there were about 40 million people living with HIV in the world - about 38 million adults and 2 million children. In the Russian Federation, the prevalence of HIV-infected people in 2003 was 187 people per 100,000 population.

According to statistics, about 8,500 people are infected every day in the world, and at least 100 in Russia.

Basic concepts:

HIV The human immunodeficiency virus is the causative agent of HIV infection.
is an infectious disease caused by HIV and resulting in AIDS.
AIDS Acquired Immune Deficiency Syndrome is the final stage of HIV infection, when a person's immune system is so affected that it becomes unable to resist any type of infection. Any infection, even the most harmless, can lead to serious illness and death.

History of HIV infection

In the summer of 1981, the US Centers for Disease Control published a report describing 5 cases of pneumocystis pneumonia and 26 cases of Kaposi's sarcoma in previously healthy homosexual men from Los Angeles and New York.

Over the next few months, cases were reported among injecting drug users, and shortly thereafter in people who had undergone blood transfusions.
In 1982, the diagnosis of AIDS was formulated, but the causes of its occurrence were not established.
In 1983, it was first identified HIV from cell culture of a sick person.
In 1984 it was found that HIV is the reason AIDS.
In 1985, a diagnostic method was developed HIV infections using enzyme-linked immunosorbent assay (ELISA), which detects antibodies to HIV in blood.
In 1987 the first case HIV infections registered in Russia - it was a homosexual man who worked as an interpreter in African countries.

Where did HIV come from?

In search of an answer to this question, many different theories have been proposed. Nobody can answer it exactly.

However, it is known that during the first studies of the epidemiology of HIV infection, it was found that the maximum prevalence of HIV occurs in the region of Central Africa. In addition, a virus capable of causing AIDS in humans has been isolated from the blood of great apes (chimpanzees) living in this area, which may indicate the possibility of infection from these monkeys - possibly by biting or butchering carcasses.

There is an assumption that HIV existed for a long time among the tribal settlements of Central Africa, and only in the twentieth century, as a result of increased population migration, spread throughout the world.

AIDS virus

HIV (human immunodeficiency virus) belongs to a subfamily of retroviruses called lentiviruses (or "slow" viruses). This means that a long period of time, sometimes several years, passes from the moment of infection to the appearance of the first signs of the disease, and even more so to the development of AIDS. Half of those infected with HIV have an asymptomatic period of about 10 years.

There are 2 types of HIV - HIV-1 and HIV-2. HIV-1 is the most common in the world, HIV-2 is closer in morphology to the simian immunodeficiency virus - the one that was found in the blood of chimpanzees.

When it enters the bloodstream, HIV selectively attaches to the blood cells responsible for immunity, which is due to the presence on the surface of these cells of specific CD 4 molecules that HIV recognizes. Inside these cells, HIV actively multiplies and even before the formation of any immune response, it quickly spreads throughout the body. First of all, it affects the lymph nodes, since they contain a large number of immune cells.

Throughout the illness, an effective immune response to HIV is never formed. First of all, this is due to the defeat of immune cells and the insufficiency of their function. In addition, HIV has a pronounced variability, which leads to the fact that immune cells simply cannot “recognize” the virus.

With the progression of the disease, HIV leads to the defeat of an increasing number of immune cells - CD 4 lymphocytes, the number of which gradually decreases, eventually reaching a critical number, which can be considered the beginning of AIDS.

How can you get HIV infection

• During sexual contact.

Sexual contact is the most common way of HIV transmission worldwide. Sperm contains a large amount of the virus; apparently, HIV tends to accumulate in semen, especially in inflammatory diseases - urethritis, epididymitis, when semen contains a large number of inflammatory cells containing HIV. Therefore, the risk of HIV transmission increases with concomitant sexually transmitted infections. In addition, concomitant genital infections are often accompanied by the appearance of various formations that violate the integrity of the genital mucosa - ulcers, cracks, vesicles, etc.

HIV is also found in the discharge of the vagina and cervix.

One should also keep in mind the criminal liability (Article 122 of the Criminal Code of the Russian Federation) that an HIV-positive partner bears by placing the other in a situation that is dangerous from the point of view of contracting HIV infection. In the same art. 122, a note was added, on the basis of which a person is released from criminal liability if the partner was warned in a timely manner about the presence of HIV infection and voluntarily agreed to take actions that created the risk of infection.

During anal intercourse, the risk of transmission of the virus from semen through the thin mucous membrane of the rectum is extremely high. In addition, during anal sex, the risk of injury to the rectal mucosa increases, which means that direct contact with blood is formed.

In heterosexual intercourse, the risk of infection from a man to a woman is about 20 times higher than from a woman to a man. This is due to the fact that the duration of contact of the vaginal mucosa with infected sperm is much longer than the duration of contact of the penis with the vaginal mucosa.

During oral sex, the risk of infection is much lower than during anal sex. However, it has been reliably proven that this risk exists!

Condom use reduces but does NOT eliminate HIV infection.

• When using only syringes or needles among injecting drug users.
• When transfusing blood and its components.

It is impossible to become infected with the introduction of normal immunoglobulin and specific immunoglobulins, since these drugs are specially processed to completely inactivate the virus. After the introduction of mandatory testing of donors for HIV , the risk of infection is significantly reduced; however, the presence of a “blind period”, when the donor is already infected, but antibodies have not yet been formed, does not completely protect recipients from infection.

• From mother to child.

Infection of the fetus can occur during pregnancy - the virus is able to cross the placenta; as well as during childbirth. The risk of infecting a child from an HIV-infected mother is 12.9% in European countries and reaches 45-48% in African countries. The risk depends on the quality of medical care and treatment of the mother during pregnancy, the health of the mother, and the stage of HIV infection.

In addition, there is a clear risk of infection through breastfeeding. The virus has been found in the colostrum and breast milk of HIV-infected women. That's why is a contraindication for breastfeeding.

• From patients to medical staff and vice versa.

The risk of infection when injured with sharp objects contaminated with the blood of HIV-infected people is about 0.3%. The risk of contact with mucous membranes and damaged skin of infected blood is even lower.

The risk of HIV transmission from an infected healthcare worker to a patient is theoretically difficult to imagine. However, in 1990, a report was published in the United States about the infection of 5 patients from an HIV-infected dentist, but the mechanism of infection remained a mystery. Subsequent observations of patients who were treated by HIV-infected surgeons, gynecologists, obstetricians, dentists did not reveal a single fact of infection.

How not to get HIV

If there is an HIV-infected person in your environment, you must remember that you cannot get infected HIV at:

• Coughing and sneezing.
• Handshake.
• Hugs and kisses.
• Eating shared food or drinks.
• In pools, baths, saunas.
• Through "injections" in transport and the subway. Information about the possible infection through infected needles that HIV-infected people put on the seats or try to prick people in the crowd with them is nothing more than myths. The virus persists in the environment for a very short time, in addition, the content of the virus at the tip of the needle is too small.

Saliva and other bodily fluids contain too little virus to cause infection. There is a risk of infection if body fluids (saliva, sweat, tears, urine, feces) contain blood.

HIV symptoms

Acute febrile phase

The acute febrile phase appears approximately 3-6 weeks after infection. It does not occur in all patients - approximately 50-70%. In the rest, after the incubation period, the asymptomatic phase immediately begins.

Manifestations of the acute febrile phase are nonspecific:

• Fever: fever, more often subfebrile condition, i.e. not higher than 37.5ºС.
• Sore throat.
• Enlarged lymph nodes: the appearance of painful swelling on the neck, armpits, groin.
• Headache, eye pain.
• Pain in muscles and joints.
• Drowsiness, malaise, loss of appetite, weight loss.
• Nausea, vomiting, diarrhea.
• Skin changes: rash on the skin, ulcers on the skin and mucous membranes.
• Serous meningitis can also develop - damage to the membranes of the brain, which is manifested by headache, photophobia.

The acute phase lasts from one to several weeks. In most patients, this is followed by an asymptomatic phase. However, approximately 10% of patients have a fulminant course of HIV infection with a sharp deterioration in the condition.

Asymptomatic phase of HIV infection

The duration of the asymptomatic phase varies widely - in half of HIV-infected people it is 10 years. The duration depends on the rate of reproduction of the virus.

During the asymptomatic phase, the number of CD 4 lymphocytes progressively decreases, a drop in their level below 200/µl indicates the presence of AIDS.

The asymptomatic phase may not have any clinical manifestations.

Some patients have lymphadenopathy - i.e. enlargement of all groups of lymph nodes.

Advanced stage of HIV - AIDS

At this stage, the so-called opportunistic infections- these are infections caused by opportunistic microorganisms that are normal inhabitants of our body and, under normal conditions, are not capable of causing disease.

There are 2 stages of AIDS:

A. Decrease in body weight by 10% compared with the original.

Fungal, viral, bacterial lesions of the skin and mucous membranes:

• Candidiasis stomatitis: thrush - white cheesy plaque on the oral mucosa.
• Hairy leukoplakia of the mouth - white plaques covered with grooves on the lateral surfaces of the tongue.
• Shingles is a manifestation of the reactivation of the varicella zoster virus, the causative agent of chickenpox. It is manifested by sharp soreness and rashes in the form of bubbles on large areas of the skin, mainly the trunk.
• Repeated frequent phenomena of herpetic infection.

In addition, patients constantly endure pharyngitis (sore throat), sinusitis (sinusitis, phronitis), otitis media (inflammation of the middle ear).

Bleeding gums, hemorrhagic rash (hemorrhage) on the skin of the hands and feet. This is due to developing thrombocytopenia, i.e. a decrease in the number of platelets - blood cells involved in clotting.

B. Decrease in body weight by more than 10% of the original.

At the same time, others join the above infections:

• Unexplained diarrhea and/or fever for more than 1 month.
• Tuberculosis of the lungs and other organs.
• Toxoplasmosis.
• Helminthiasis of the intestine.
• Pneumocystis pneumonia.
• Kaposi's sarcoma.
• Lymphomas.

In addition, there are severe neurological disorders.

When to suspect HIV infection

• Fever of unknown origin for more than 1 week.
• An increase in various groups of lymph nodes: cervical, axillary, inguinal - for no apparent reason (absence of inflammatory diseases), especially if lymphadenopathy does not go away within a few weeks.
• Diarrhea for several weeks.
• The appearance of signs of candidiasis (thrush) of the oral cavity in an adult.
• Extensive or atypical localization of herpetic eruptions.
• Sudden weight loss for any reason.

Who is at higher risk of contracting HIV

• injection drug addicts.
• Homosexuals.
• Prostitutes.
• Persons who practice anal sex.
• Persons with multiple sexual partners, especially if they do not use condoms.
• Persons suffering from other sexually transmitted diseases.
• Persons in need of transfusions of blood and its components.
• Persons in need of hemodialysis ("artificial kidney").
• Children whose mothers are infected.
• Health care workers, especially those in contact with HIV-infected patients.

Prevention of HIV infection

Unfortunately, no effective vaccine against HIV has been developed to date, although many countries are now conducting thorough research in this area, on which great hopes are placed.

However, so far, the prevention of HIV infection is reduced only to general preventive measures:

• Safe sex and a constant, reliable sexual partner.

Using condoms helps reduce the risk of infection, but even when used correctly, a condom is never 100% protective.

Rules for using a condom:

• the condom must be the right size.
• It is necessary to use a condom from the very beginning of sexual intercourse until completion.
• the use of condoms with nonoxynol-9 (spermicide) does not reduce the risk of infection, since it often leads to irritation of the mucous membrane, and, consequently, to microtrauma and cracks, which only contributes to infection.
• air must not remain in the receptacle - this may contribute to the rupture of the condom.

If sexual partners want to be sure that there is no risk of infection, they should both be tested for HIV.

• Refusal to use drugs. If coping with addiction is not possible, use only disposable needles and never share needles or syringes
• HIV-infected mothers should avoid breastfeeding.

Medical prophylaxis has been developed for suspected HIV infection. It consists in taking antiretroviral drugs, as in the treatment of patients with HIV, only in different dosages. The course of preventive treatment will be prescribed by the doctor of the AIDS center at an internal appointment.

HIV test

Early diagnosis of HIV is essential for successful treatment and prolongation of life in these patients.

When should I get tested for HIV?

• after sexual intercourse (vaginal, anal or oral) with a new partner without a condom (or if the condom breaks).
• after sexual assault.
• if your sexual partner has had sex with someone else.
• if your current or past sexual partner is HIV positive.
• after using the same needles or syringes for injecting drugs or other substances, or for tattoos and piercings.
• after any contact with the blood of an HIV-infected person.
• if your partner used someone else's needles or was exposed to any other risk of infection.
• after detection of any other sexually transmitted infection.

Most often, the diagnosis of HIV infection is carried out by methods that determine antibodies to HIV in the blood - i.e. specific proteins that are formed in the body of an infected person in response to a virus. The formation of antibodies occurs within 3 weeks to 6 months after infection. Therefore, an HIV test becomes possible only after this period of time, the final analysis is recommended to be performed 6 months after the alleged infection. Standard method for the determination of antibodies to HIV called enzyme immunoassay (ELISA) or ELISA. This method is very reliable, with a sensitivity of over 99.5%. Test results may be positive, negative, or questionable.

If the result is negative and there is no suspicion of recent (within the last 6 months) infection, the HIV diagnosis can be considered unconfirmed. If there is a suspicion of a recent infection, a re-examination is carried out.

There is a problem with so-called false positive results, so when a positive or doubtful answer is received, the result is always checked by a more specific method. This method is called immunoblotting. The result can also be positive, negative or questionable. Upon receipt of a positive result, the diagnosis of HIV infection is considered confirmed. If the answer is doubtful, a second study is required after 4-6 weeks. If the result of the repeated immunoblot remains doubtful, the diagnosis of HIV infection is unlikely. However, for its final exclusion, immunoblotting is repeated 2 more times with an interval of 3 months or other diagnostic methods are used.

In addition to serological methods (i.e. detection of antibodies), there are methods for direct detection of HIV, which can be used to determine the DNA and RNA of the virus. These methods are based on PCR (polymerase chain reaction) and are very accurate methods for diagnosing infectious diseases. PCR can be used for early diagnosis of HIV - 2-3 weeks after doubtful exposure. However, due to the high cost and high number of false-positive results due to contamination of the test samples, these methods are used in cases where standard methods do not allow for the diagnosis or exclusion of HIV with certainty.

Video about what HIV tests you need to take and why:

Drug treatment of HIV infection and AIDS

Treatment consists in the appointment of antiviral - antiretroviral therapy; and in the treatment and prevention of opportunistic infections.

After establishing the diagnosis and registering, a series of studies are carried out to determine the stage and activity of the disease. An important indicator of the stage of the process is the level of CD 4 lymphocytes - the very cells that affect HIV, and the number of which is progressively decreasing. When the number of CD 4 lymphocytes is less than 200/µl, the risk of opportunistic infection, and, therefore, AIDS becomes significant. In addition, to determine the progression of the disease, the concentration of viral RNA in the blood is determined. Diagnostic studies should be carried out regularly, because the course HIV infections difficult to predict, and early diagnosis and treatment of concomitant infections is the basis for prolonging life and improving its quality.

Antiretrovirals:

The appointment of antiretroviral agents and the choice of a particular drug is the decision of a specialist doctor, which he takes depending on the patient's condition.

• Zidovudine (Retrovir) is the first antiretroviral drug. Currently, zidovudine is prescribed in combination with other drugs when the CD 4 lymphocyte count is below 500/µl. Zidovudine monotherapy is prescribed only for pregnant women to reduce the risk of fetal infection.

Side effects: impaired hematopoietic function, headache, nausea, myopathy, liver enlargement

• Didanosine (Videx) - used at the first stage of treatment HIV and after prolonged treatment with zidovudine. More often, didanosine is used in combination with other agents.

Side effects: pancreatitis, peripheral neuritis with severe pain, nausea, diarrhea.

• Zalcitabine (Khivid) - is prescribed for the ineffectiveness or intolerance of zidovudine, as well as in combination with zidovudine at the initial stage of treatment.

Side effects: peripheral neuritis, stomatitis.

• Stavudin - used in adults in advanced stages HIV infections.

Side effects: peripheral neuritis.

• Nevirapine and delavirdine: given in combination with other antiretrovirals in adults with signs of progression HIV infections.

Side effects: maculopapular rash, which usually resolves on its own and does not require discontinuation of the drug.

• Saquinavir is a drug belonging to the group of protease inhibitors. HIV. The first drug from this group, approved for use. Saquinavir is used in advanced stages HIV infections in combination with the above antiretroviral agents.

Side effects: headache, nausea and diarrhea, increased liver enzymes, increased blood sugar levels.

• Ritonavir is approved for use both as monotherapy and in combination with other antiretroviral drugs.

Side effects: nausea, diarrhea, abdominal pain, lip paresthesia.

• Indinavir - used to treat HIV infections in adult patients.

Side effects: urolithiasis, increased blood bilirubin.

• Nelfinavir is approved for use in both adults and children.

The main side effect is diarrhea, which occurs in 20% of patients.

Antiretrovirals should be provided to patients registered with the AIDS Center free of charge. In addition to antiretroviral drugs, treatment HIV infections consists in an adequate selection of antimicrobial, antiviral, antifungal, and antitumor agents for the treatment of manifestations and complications AIDS.

Prevention of opportunistic infections

Prevention of opportunistic infections helps to increase the duration and improve the quality of life of patients AIDS m.

• Prevention of tuberculosis: for the timely detection of persons infected with mycobacterium tuberculosis, all HIV-infected persons undergo an annual Mantoux test. In case of a negative reaction (i.e., in the absence of an immune response to tuberculin), it is recommended to take anti-tuberculosis drugs for a year.
• Prevention of pneumocystis pneumonia is carried out in all HIV-infected patients with a decrease in CD 4 lymphocytes below 200 / μl, as well as with a fever of unknown origin with a temperature above 37.8 ° C that persists for more than 2 weeks. Prevention is carried out with biseptol.

Opportunistic infections- these are infections caused by opportunistic microorganisms that are normal inhabitants of our body, and under normal conditions are not capable of causing disease.

• Toxoplasmosis is caused by Toxoplasma gondii. The disease is manifested by toxoplasmic encephalitis, i.e. damage to the substance of the brain, with the development of epileptic seizures, hemiparesis (paralysis of half of the body), aphasia (lack of speech). In addition, confusion, stupor, coma are possible.
• Intestinal helminthiasis - pathogens are many helminths (worms). In patients AIDS can lead to severe diarrhea and dehydration.
• Tuberculosis . Mycobacterium tuberculosis is common even among healthy individuals, but they can cause disease only if the immune system is impaired. That is why the majority of HIV-infected people are prone to the development of active tuberculosis, including its severe forms. Approximately 60-80% of HIV-infected tuberculosis occurs with damage to the lungs, in 30-40% - with damage to other organs.
• Bacterial pneumonia . The most common pathogens are Staphylococcus aureus and pneumococcus. Often pneumonia is severe with the development of generalized forms of infection, i.e. ingestion and reproduction of bacteria in the blood - sepsis.
• Intestinal infections – salmonellosis, dysentery, typhoid fever. Even mild forms of the disease, which in healthy people pass without treatment, in HIV-infected people proceed for a long time with numerous complications, prolonged diarrhea and generalization of the infection.
• Syphilis – in HIV-infected people, such complex and rare forms of syphilis as neurosyphilis, syphilitic nephritis (kidney damage) are more common. Complications of syphilis develop faster in AIDS patients, sometimes even with intensive treatment.
• Pneumocystis pneumonia . The causative agent of pneumocystis pneumonia is a normal inhabitant of the lungs, however, with a decrease in immunity, it can cause severe pneumonia. The causative agent is usually attributed to fungi. Pneumocystis pneumonia develops at least once in 50% of HIV-infected people. Typical symptoms of Pneumocystis pneumonia are: fever, cough with little sputum, chest pain that worsens with inspiration. Subsequently, shortness of breath may occur during physical exertion, weight loss.
• Candidiasis is the most common fungal infection in HIV-infected people, since the causative agent, Candida albicans, is normally found in large numbers on the mucous membranes of the mouth, nose, and urinary tract. In one form or another, candidiasis occurs in all HIV-infected patients. Candidiasis (or thrush) manifests itself as a white cheesy coating on the palate, tongue, cheeks, pharynx, in vaginal discharge. In the later stages of AIDS, candidiasis of the esophagus, trachea, bronchi and lungs is possible.
• Cryptococcosis is the leading cause of meningitis (inflammation of the lining of the brain) among HIV-infected patients. The causative agent - a yeast fungus - enters the body through the respiratory tract, but in most cases it affects the brain and its membranes. The manifestations of cryptococcosis are: fever, nausea and vomiting, impaired consciousness, headache. There are also pulmonary forms of cryptococcal infection - which are accompanied by cough, shortness of breath, hemoptysis. In more than half of patients, the fungus penetrates and multiplies in the blood.
• herpetic infection. HIV-infected people are characterized by frequent recurrences of herpes of the face, oral cavity, genital organs and perianal region. As the disease progresses, the frequency and intensity of relapses increases. Herpetic lesions do not heal for a long time, leading to extremely painful and extensive damage to the skin and mucous membranes.
• Hepatitis – more than 95% of HIV-infected people are infected with hepatitis B virus, many of them also have co-infection with hepatitis D virus. Active hepatitis B is rare in HIV-infected people, but hepatitis D in these patients is severe.

Neoplasms in HIV infection

In addition to an increased susceptibility to infections, patients AIDS the tendency to form both benign and malignant tumors increases, since the control of neoplasms is also carried out by the immune system, in particular CD4 lymphocytes.

• Kaposi's sarcoma is a vascular tumor that can affect the skin, mucous membranes and internal organs. The clinical manifestations of Kaposi's sarcoma are varied. Initial manifestations appear as small red-purple nodules rising above the surface of the skin, which occur most often in exposed areas most exposed to direct sunlight. With progression, the nodes can merge, disfiguring the skin and, if located on the legs, limiting physical activity. Of the internal organs, Kaposi's sarcoma most often affects the gastrointestinal tract and lungs, but sometimes the brain and heart.
• Lymphomas are late manifestations HIV infections. Lymphomas can affect both the lymph nodes and internal organs, including the brain and spinal cord. Clinical manifestations depend on the location of the lymphoma, but are almost always accompanied by fever, weight loss, and night sweats. Lymphomas can be manifested by rapidly growing volumetric formations in the oral cavity, epileptic seizures, headache, etc.
• Other malignancies - in HIV-infected people occur with the same frequency as in the general population. However, in patients HIV they have a rapid course and are difficult to treat.

Neurological disorders

• AIDS-dement syndrome;

Dementia- this is a progressive decline in intelligence, which is manifested by a violation of attention and the ability to concentrate, memory impairment, difficulty in reading and solving problems.

In addition, manifestations of AIDS-dementia syndrome are motor and behavioral disorders: impaired ability to maintain a certain posture, difficulty walking, tremor (twitching of various parts of the body), apathy.

In the later stages of AIDS-dementia syndrome, urinary and fecal incontinence may join, in some cases a vegetative state develops.

Severe AIDS-dementia syndrome develops in 25% of HIV-infected people.

The cause of the syndrome has not been definitively established. It is believed that it is due to the direct effect of the virus on the brain and spinal cord.

• epileptic seizures;

The causes of epileptic seizures can be both opportunistic infections that affect the brain, and neoplasms or AIDS dementia syndrome.

The most common causes are: toxoplasma encephalitis, cerebral lymphoma, cryptococcal meningitis and AIDS dementia syndrome.

• neuropathy;

A common complication of HIV infection that can occur at any stage. Clinical manifestations are varied. In the early stages, it can occur in the form of progressive muscle weakness, a slight impairment of sensitivity. In the future, manifestations can progress, burning pains in the legs join.

Living with HIV

Positive HIV test… What to do about it? How to react? How to live on?

First, try to overcome the panic as quickly as possible. Yes, AIDS fatal disease, but before development AIDS You can live 10 or even 20 years. In addition, now scientists around the world are actively engaged in the search for effective drugs, many recently developed drugs really significantly prolong life and improve the well-being of patients. AIDS. No one knows what science will reach in this area in 5-10 years.

FROM HIV you need to learn how to live. Unfortunately, life will never be the same again. For a long time (perhaps many years) no signs of illness may occur, a person feels completely healthy and full of strength. But do not forget about infection.

First of all, you need to protect your loved ones - they must know about the infection. It can be very difficult to tell parents, a loved one about HIV-positive analysis. But no matter how difficult it may be, loved ones should not be at risk, so the partner (s) (both current and former) must be informed of the result of the analysis.

Any sex, even with a condom, can be dangerous in terms of transmission of the virus, even if sometimes the danger is extremely small. Therefore, when a new partner appears, you need to give a person the opportunity to make his own choice. It must be remembered that not only vaginal or anal sex can be dangerous, but also oral.

Medical supervision:

Despite the fact that there may be no signs of the disease, regular monitoring of the condition is required. Usually this control is carried out in specialized AIDS-centers. Timely detection of disease progression and the onset of development AIDS, and, therefore, timely treatment is the basis for successful treatment in the future and slowing down the progression of the disease. Usually, the level of CD 4 lymphocytes is monitored, as well as the level of virus replication. In addition, the general condition of the patient is assessed, the possible presence of opportunistic infections. Normal indicators of the state of immunity allow to exclude the presence of AIDS, which means they allow you to lead a normal life and not be afraid of any cold.

Pregnancy:

Most people get infected HIV In young age. Many women want to have children. They feel absolutely healthy and able to give birth and raise a child. No one can forbid the birth of a child - this is a personal matter for the mother. However, before planning a pregnancy, you need to weigh the pros and cons. After all, HIV is most likely transmitted through the placenta, as well as during childbirth through the birth canal. Is it worth exposing a child to a congenital HIV carrier, growing under constant medical supervision, taking toxic drugs? Even if the child does not get infected, he runs the risk of being left without parents before reaching the age of majority ... If, nevertheless, the decision is made, you need to take the planning of pregnancy and bearing with all responsibility and, even before pregnancy, contact the doctor of the AIDS center, who will direct your actions and review treatment.

Life with AIDS:

When the level of CD 4 lymphocytes falls below 200/μL, an opportunistic infection appears or any other signs of a reduced immune response are diagnosed. AIDS. Such people should follow a number of rules.

• Proper nutrition: you should not follow any diet, any malnutrition can be harmful. Nutrition should be high-calorie and balanced.
• Give up bad habits: alcohol and smoking
• Moderate exercise can positively influence the immune status of HIV-infected people
• You should discuss with your doctor the possibility of getting vaccinated against certain infections. Not all vaccines can be used in HIV-infected people. In particular, live vaccines should not be used. However, killed vaccines, as well as vaccines that are particles of microorganisms, are suitable for many people with HIV, depending on their immune status.
• It is always necessary to pay attention to the quality of food and water consumed. Fruits and vegetables must be thoroughly washed with boiled water, food must be thermally processed. Untested water must be disinfected, in some countries with a hot climate, even tap water is contaminated.
• Communication with animals: it is better to exclude any contact with unfamiliar (especially homeless) animals. At the very least, be sure to wash your hands after contact with an animal, even your own. You need to watch your pet especially carefully: try not to allow him to communicate with other animals and not to allow him to touch the garbage on the street. After a walk, be sure to wash, and it is better to wear gloves. It is also better to clean up after the animals with gloves.
• Try to limit your contact with sick, cold people. If you need to communicate, you should use a mask, wash your hands after contact with sick people.