Wikipedia:WikiProject Aids/Draft

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AIDS (Acquired Immunodeficiency Syndrome or Acquired Immune Deficiency Syndrome, sometimes written Aids) is a global, human epidemic. The World Health Organization and UNAIDS estimated that between 2.8 and 3.5 million people with AIDS died in 2004 [1]. An estimated 23 million people with AIDS have died since 1981. These global estimates of AIDS are based on HIV antibody testing of small samples of pregnant women at selected clinics rather than actual reported AIDS cases.

An estimated 60% of people with AIDS live in sub-Saharan Africa, where poor economic conditions leading to the use of dirty needles in healthcare clinics and no effective screening of blood transfusions may contribute to high rates of AIDS. [2] [3].

After 1993-94 the number of new cases of AIDS fell significantly in the United States and Europe.

The Red Ribbon symbol is used internationally to represent the fight against AIDS.
The Red Ribbon symbol is used internationally to represent the fight against AIDS.

Contents

[edit] Definition

AIDS is defined as occurring in people with antibodies to a retrovirus called Human Immunodeficiency Virus (HIV), which is thought to have originated in the chimpanzee and passed to human populations in west equatorial Africa during the twentieth century. A diagnosis of AIDS is made when a person with HIV antibodies has either a CD4 cell count below 200 or one of a list of AIDS defining illnesses, which are unusual in a person with a healthy immune system. [4]

[edit] History

In 1982 the term AIDS (acquired immunodeficiency syndrome) was proposed on July 27, at a meeting in Washington of gay-community leaders, federal bureaucrats and the Centers for Disease Control and Prevention (CDC). [5] The identified risk factors for AIDS were hemophilia, Haitian, male homosexual, or intravenous drug abuser.

In 1985 the definition of AIDS was restricted to exclude people who did not have antibodies to HIV. A conference of public health officials including representatives of the Centers for Disease Control and World Health Organization met in Bangui to develop a definition of AIDS for use in countries where testing for HIV antibodies was not available. They developed the Bangui definition which defines AIDS as, "prolonged fevers for a month or more, weight loss of over 10% and prolonged diarrhoea". Several studies have reported that about half the people diagnosed with AIDS based on the Bangui definition do not have antibodies to HIV. A study on Zaire published in 1993 found that of 465 patients with clinical signs of AIDS, 39.4% had antibodies to HIV . see Epidemiology and clinical manifestation of HIV infection in northern Zaire.Strecker W, Gurtler L, Schilling M, Binibangili M, Strecker K. Eur J Epidemiol. 1994 Feb;10(1):95-8. The Bangui definition is fundamentally different from the definitions used in Europe and the United States. As recently as 2003, the AIDS diagnosis strategy used in developed countries, based on an immunoblot confirmatory test, could be used on a large scale in developing countries because of its cost. [6]

In 1993 the CDC expanded the definition for use in the United States to include people with antibodies to HIV who had at least one CD4 cell count below 200. This resulted in many healthy people with a normal CD4 cell count being classified as AIDS.

[edit] Treatment

AIDS is a chronic medical condition that can be treated, but not yet cured. There are effective means of preventing complications.

The current guidelines for antiretroviral therapy from the World Health Organization reflect the changes to the guidelines to defer retroviral treatment in patients with no AIDS defining illnesses who have a CD4 cell count above 350 and viral load under 100,000.

Antiretroviral regimens are complex, have serious side effects, pose difficulty with adherence, and carry serious potential consequences from the development of viral resistance because of nonadherence to the drug regimen or suboptimal levels of antiretroviral agents. Patient education and involvement in therapeutic decisions are critical. Treatment should usually be offered to all patients with AIDS. Panel on Clinical Practices for Treatment of HIV. September 2002

A vaccine is being developed for the treatment of people with HIV antibodies to prevent progression to AIDS [7]

[edit] Prevention

Current strategies to prevent AIDS are directed at preventing the transmission of HIV.

HIV is transmitable through sexual acts involving the exchange of bodily fluids, through blood needle sharing, blood transfusions from infected donors and from mother to infant transmission during birth and breastfeeding. UNAIDS transmison.

[edit] Blood screening

Blood tranfusions remain a major source of new HIV infections worldwide. WHO estimated in 2000, between 15% and 20% of new HIV infections worldwide were the result of blood transfusions, where the donors were not screened or inadequately screened for HIV. In those countries where improved donor selection and antibody tests have been introduced, the risk of transmitting HIV infection to blood transfusion recipients has been effectively eliminated.

[edit] Universal precautions in health clinics

Health clinics in some countries are responsible for as much as 30% of HIV transmission worldwide. reference There is an urgent need to address medical transmission as a priority in these countries. see HIV transmission in the medical setting.

Medical workers who follow universal precautions or body substance isolation such as wearing latex gloves when giving injections or handling bodily wastes or fluids, and washing the hands frequently, can prevent the spread of HIV from patients to workers, and from patient to patient.

[edit] Condom

Stop AIDS Project marchers at San Francisco Pride 2004.
Stop AIDS Project marchers at San Francisco Pride 2004.

The use of a condom as a harm reduction practice intended to reduce the spread of AIDS is promoted by health experts around the world. A condom is used to cover the penis during sexual activity. Correct use of a condom and water based lubricant provides dramatic risk reduction, not complete risk elimination.

The Vatican opposes the use condoms. [8].

[edit] Single use syringe

HIV can be transmitted via the sharing of needles by users of intravenous drugs, and this is remains one of the most common methods of transmission in the United States. All AIDS-prevention organisations advise drug-users not to share needles and to use a new or properly sterilized needle for each injection. In the United States and other western countries, clean needles are available free in some cities, at needle exchanges or safe injection sites.

[edit] Origin of AIDS

Studies [9] have suggested that a retrovirus, SIVcpz (simian immunodeficiency virus) from the common chimpanzee Pan troglodytes, may have passed to human populations in west equatorial Africa during the twentieth century and developed into various types of HIV.

Suggested methods of transmisison of the chimpanzee retrovirus to humans include, the bush meat trade (the hunting, butchery and eating of chimpanzees by human populations) and the oral polio vaccination program that took place in the late 1950s of Africa. Professor Robin Weiss, Britain’s leading retrovirologist, organised the Royal Society meeting on The Origins of HIV and the AIDS epidemic in September 2000, to respond to the information and analysis presented in The River, that live polio vaccines prepared in chimpanzee tissue cultures (at least some of which were almost certainly contaminated with chimpanzee SIV) were administered to up to one million African "volunteers" in the 1957-1960 period. The specific populations where the vaccine was given were the first in the world to experience HIV-1 infections and AIDS some five to twenty years later. [10]

[edit] Current medical understanding of AIDS

In January 2005, Anthony S. Fauci, M.D., director of NIAID said, "Individual risk of acquiring HIV and experiencing rapid disease progression is not uniform within populations". NIH press release

Patterns of HIV transmission vary in different parts of the world. In Africa, which accounts for an estimated 60% of new HIV infections worldwide, controversy rages over the respective contribution of medical procedures, heterosexual sex and the bush meat trade. In the United States, sex between men and injecting drug use remain the main sources of new HIV infections.

[edit] Chemokines

In 1996, Robert Gallo published his discovery that chemokines, a class of naturally occurring compounds, can block HIV and halt the progression of AIDS. This was heralded as by Science magazine as one of the top scientific breakthroughs within the same year of his publication, but has yet to result in any actual therapetic benefits. reference

The role of protection chemokines plays for controlling progression of HIV infection to AIDS has been influencing medical thinking on how AIDS works against the human body. Alfredo Garzino-Demo, Ronald B. Moss, Joseph B. Margolick, Farley Cleghorn, Anne Sill, William A. Blattner, Fiorenza Cocchi, Dennis J. Carlo, Anthony L. DeVico, and Robert C. Gallo (October 1999). "Spontaneous and antigen-induced production of HIV-inhibitory β-chemokines are associated with AIDS-free status". Proc Natl Acad Sci U S A 96 (21): 11986–11991. 


[edit] Scientific Reappraisal of the HIV-AIDS Hypothesis

The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis question the connection between HIV and AIDS, or the existence of HIV, or the validity of current testing methods. For explanation and history of the Group's four sentence letter calling for reappraisal of the HIV=AIDS hypothesis and suitable independently controlled studies; 10 sceintific reasons that dispute HIV as the Cause of AIDS, and suggestions that identify what could be the real causes of AIDS, go to video documentary.http://www.hiv-aids-factorfraud.com

[edit] See also

[edit] AIDS defining illnesses

v • d • e
HIV/AIDS related topics
HIV HIV • AIDS • HIV structure and genome • HIV test • CDC Classification System for HIV Infection • HIV disease progression rates • HIV vaccine • WHO Disease Staging System for HIV Infection and Disease • AIDS dementia complex • Antiretroviral drug
History AIDS origin • AIDS pandemic • AIDS Museum • Timeline of AIDS • Oral polio vaccine AIDS hypothesis • Reappraisal of HIV–AIDS Hypothesis • Duesberg hypothesis
Culture International AIDS Conference • International AIDS Society • World AIDS Day • Treatment Action Campaign • UNAIDS • PEPFAR • NAMES Project AIDS Memorial Quilt • HIV and AIDS misconceptions • List of HIV-positive people • With AIDS Self-Empowerment Movement • HIV–positive fictional characters
AIDS pandemic in Sub-Saharan Africa (South Africa) • Asia (China • India • Myanmar • Pakistan • Taiwan • Japan) • Latin America (Brazil) • Caribbean • Eastern Europe and Central Asia • Western Europe • United States • List of countries by HIV/AIDS adult prevalence rate

[edit] External links and references

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