HIV (human immunodeficiency virus)

HIV (human immunodeficiency virus) is a virus that causes AIDS. This virus can infect humans and cause the immune system (immunity) of the body, so the body becomes weak in fighting infection. In other words, the presence of this virus in the body will cause a deficiency (lack of) immune system.

History of HIV

In 1983, Jean Claude Chermann and Françoise Barré-Sinoussi of France managed to isolate HIV for the first time from a patient with lymphadenopathy syndrome. At first, it is called ALV virus (lymphadenopathy-associated virus). Together with Luc Montagnier, they proved that the virus is the cause of AIDS. In early 1984, Robert Gallo of the United States is also researching on the virus that causes AIDS, called HTLV-III. After further investigation, proved that the ALV and HTLV-III is the same virus and in 1986, a term used to describe the virus is HIV, or more specifically called HIV-1. Not long after HIV-1 is found, a new subtype is found in Portugal from patients originating from West Africa and later called HIV-2.  Through cloning and sequence analysis (genetic makeup), HIV-2 has a difference of 55% of HIV-1 and are antigenically distinct. The biggest difference between the two other strains (strain) virus glycoprotein is located on a sheath. However, further research estimates that HIV-2 originated from SIV (retrovirus that infects primates) because of the similarity of sequences and cross-reaction between antibodies against both types of virus. 

Signs of HIV

When someone starts contracting the HIV virus, When someone starts contracting the HIV virus of AIDS, there are many signs of HIV-AIDS which appeared in the person of the sufferer. To recognize the signs of HIV-AIDS, the authors will describe some of the stages when the virus began to spread to arise signs of HIV-AIDS.

Signs of HIV-AIDS Phase one

At this stage, the HIV virus enters the body, and HIV antibodies in the blood. At this early stage, there was no sign of special HIV-AIDS. Patients still looked healthy and he still felt fine. In fact, when done testing for HIV, the HIV virus has not been detected. This phase is called the window period, which usually lasts between 2 weeks-6 months.

Signs of HIV-AIDS Phase two

Positive HIV (without symptoms) on average lasts for 5-10 years. At this stage, the HIV virus has evolved and spread in the body, antibodies are formed and grow stronger. However, there are still specific signs, and people with HIV still look healthy and feel healthy. At this stage, when performed laboratory tests, the HIV virus can be detected because antibodies against this virus have been formed in the body. However, in general, patients still looks healthy and it lasts for 5-10 years, depending on stamina. The average condition will become weaker after 8 years.

Signs of HIV-AIDS Phase three

HIV Positive (symptoms).  At this stage, signs of HIV-AIDS began to appear. People with immune systems weakened and the HIV virus has started spreading and getting stronger. Began to appear signs of HIV-AIDS in the form of opportunistic infections, such as swollen lymph glands throughout the body, continuous diarrhea, flu, and other diseases are easy to attack and can not be cured. In general, the symptoms last for more than a month, depending on stamina.

Signs of HIV-AIDS Phase four

At this stage, the immune system is very weak.  Signs of HIV-AIDS is felt at this stage is arguably already has a very critical, because many other diseases (opportunistic infections) will be more severe. In addition, complications of other diseases had been much developed. Complications of this disease that can ultimately kill the patient.

Although the disease is difficult to detect, but there are signs of HIV-AIDS a more general nature that you can look at. The following are some signs of common HIV-AIDS can be recognized easily.

• Weight plummeted more than 10% in a month, or become thin suddenly without obvious cause.
•  Suffering from chronic diarrhea that lasts more than a month, this causes the body weak and dehydrated.
• Prolonged fever for more than a month.
• Decreased consciousness and neurological disorders.  
• Dementia / HIV encephalopathy.

As for signs of HIV-AIDS in particular, can be observed as follows.

• Strong cough and continuously for more than a month.
• Zostermultisegmental herpes zoster and recurrent herpes.
• Occur also a progressive chronic herpes simplex.
• There is a fungal infection repeatedly on a woman's genitals.
• Generalized dermatitis.
• Oropharyngeal candidiasis.
• Generalized lymphadenopathy.
• Cytomegalovirus retinitis.

Early detection by observing the signs of HIV AIDS both general and specific that can be seen and felt as described above, is an early warning to our immediate check-up or total medical examination to the laboratory to ascertain whether we are infected with the HIV virus or not.

Detection of HIV

Generally, there are three types of HIV detection, the PCR test, HIV antibody testing, and HIV antigen test. Polymerase chain reaction test (PCR) is a nucleic acid-based detection techniques (DNA and RNA) that can detect the presence of HIV genetic material in the human body. These tests are often known as the viral load test or nucleic acid amplification tests (HIV NAAT).  Normal DNA PCR is a qualitative method that can only detect the presence or absence of viral DNA. Meanwhile, for the detection of viral RNA can be performed with real-time PCR method which is a quantitative method. Detection of nucleic acids can detect the presence of HIV in 11-16 days from initial infection occurs. This test is usually used to detect HIV in newborns, but rarely used in adult individuals as the cost of PCR tests are expensive and are difficult to manage and interpret the results of these tests was higher when compared to other tests.

To detect HIV in adults, more commonly used HIV antibody tests are inexpensive and accurate. A person infected with HIV will produce antibodies to fight infection. HIV antibody test detects the antibodies that form in blood, saliva (spit), and urine. Since 2002, has developed a rapid test to detect HIV antibodies from the blood droplets or saliva samples (saliva) humans. Samples from the patient's body will be mixed with certain solutions. Then, pieces of test equipment (test strip) is inserted and when to show positive results will display two bands of reddish purple. The accuracy of this test equipment reached 99.6%, but all positive results should be confirmed again by ELISA. In addition to ELISA, other HIV antibody tests that can be used for further examination is the Western blot.

Antigen tests can detect antigen (p24 protein) which triggers a response in HIV antibodies. In the early stages of HIV infection, p24 is produced in high amounts and can be found in the blood serum. Antibody tests and antigen tests are used on an ongoing basis to provide results more accurate detection and early. This test is rarely used alone because of low sensitivity and can only work before HIV antibodies are formed.

Transmission and Prevention

HIV can be transmitted through direct injection into the bloodstream, as well as contact mucous membranes or tissues that get hurt badly by certain body fluids from patients with HIV. Certain fluids that include blood, semen, vaginal secretions, and breast milk. Several routes of transmission of HIV is already known is through sexual intercourse, from mother to child (perinatal), intravenous drug use, transfusion and transplantation, as well as exposure to the work.

sexual intercourse

According to WHO data, in the year 1983-1995, as many as 70-80% of HIV transmission through heterosexual contact, whereas 50-10% occurred through homosexual relations. Sexual contact through vaginal and anal intercourse have a greater risk for transmitting HIV than oral sex contacts. Several other factors that may increase the risk of transmission through sexual intercourse is the presence of sexually transmitted diseases, viral load quantity, the use of douches. A person suffering from other sexually transmitted diseases (eg syphilis, herpes genitali, gonorrhea, etc..) will more easily receive and transmit HIV to others who have sex with him. Viral load is the amount of active virus in the body. HIV transmission is highest during early and late HIV infection because the high viral load at that time. At vulnerable times, some people just show few symptoms or even none at all. The use of douches may increase the risk of HIV transmission because it destroys the good bacteria in the vagina and anus which has a protective function. In addition, the use of douches after intercourse can suppress disease-causing bacteria enter the body and cause infection.

Prevention of HIV through sexual intercourse can be done with no multiple partners and using condoms. Another preventive way is by having sex without incurring exposure to body fluids. To lower the viral load in the genital tract and blood, can be used anti-retroviral therapy.

Mother to child (perinatal transmission)

HIV transmission from mother to child can occur through infection in utero, at delivery, and through breast-feeding. Some maternal and other external factors can affect the transmission of HIV to babies, among them many viruses and immune cells during the first trimester, premature birth, and others. Decrease in immune cells (CD4 +) and high maternal viral RNA can increase the risk of HIV transmission from mother to child. In addition, a study in pregnant women in Malawi and the U.S. also mentions that vitamin A deficiency may increase the risk of HIV infection. The risk of perinatal transmission can be done with a cesarean delivery, do not give milk, and provision of zidovudine during late pregnancy and after childbirth. In most developing countries, prevention of breast feeding of people with HIV / AIDS to infants facing difficulties because of the price of formula milk as a substitute for relatively expensive. In addition, mothers also need to have access to clean water and understand how to prepare infant formula right.

Other

Another effective way to spread this virus is through the use of needles or syringes contaminated, especially in countries with difficulties in sterilizing medical equipment. For intravenous drug users (inserted through a blood vessel), HIV can be prevented by using needles and syringes are clean. HIV transmission through transplantation and transfusion is only a minority of cases the cause of HIV in the world (3-5%). This can be prevented by inspecting blood products and transplants before donor and avoid donor with a high risk of HIV infection.

Transmission from patient to health care workers who cared for him also very rare (<0.0001% of all cases in the world). This is prevented by giving out instruction or education to health workers, use of protective clothing, gloves, and disposal of equipment and materials that have been contaminated in accordance with the procedure. perform circumcision in the context of HIV prevention. But according to the WHO, precaution is still too early to recommend it.

There are several routes of transmission had feared could spread HIV, through saliva, mosquito bites, and daily contact (shaking hands, exposed to coughing and sneezing of people with HIV, using the toilet, and cutlery together, hugging). However, the CDC (Center for Disease Control and Prevention) states that such activity does not result in HIV transmission. Several other activities are very rare cause of HIV transmission is through bite humans and some specific types of kisses.

Sub-Sahara Africa remains the region worst affected by HIV among pregnant women at age 15-24 years in some countries there. is thought to be caused by a number of venereal disease, practice incise the body, blood transfusions, and poor levels of health and nutrition in there.

Source: from many sources