Speed Symptoms
AIDS is a disease that threatens the existence of mankind. The final fatal stage of an infectious disease that occurs as a result of infection with the human immunodeficiency virus( HIV).A virus that enters the bloodstream, sperm and other body fluids, spreads and destroys a particular type of white blood cells, CD4 lymphocytes, which are the main component of the human immune system. The virus is transmitted mainly through sexual contact( homosexual or heterosexual), through the needle of drug addicts, as well as from an infected woman to her child.
After the first exposure, the virus spreads over several weeks, sometimes causing fever, fatigue, sore throat, skin rash and other symptoms similar to those that occur when a mononucleosis infection occurs. These symptoms last only one or two weeks. After this, the patient may not experience symptoms for 5-10 years or more, although the virus is constantly spreading, and the person remains infected. As the amount of CD4 virus lymphocytes destroyed by the virus increases, symptoms such as inflammation of the glands, sweating at night, diarrhea, and weight loss may appear.
AIDS develops when the immune system is damaged very severely( when CD4 lymphocytes remain below 200 per microliter) and / or when opportunistic diseases that do not develop in the body with a healthy immune system or unusual types of cancer( Kaposi angiomatosis or lymphoma).In the absence of treatment, death from opportunistic disease occurs quickly. Although AIDS is incurable, new strong medicines against HIV have significantly reduced mortality among the sick. These drugs reduce the number of viruses in the blood and often increase the number of CD4 + cells. To date, AIDS is spread all over the world, it has infected more than 30 million people. New about AIDS here.
The first reports of a new deadly disease appeared in the US in mid-1981.Among young homosexual men in New York and in Los Angeles, 5 cases of unusual pneumonia caused by pneumocysts were detected. In addition, this same group of people often had Kaposi's sarcoma - a malignant tumor, which was usually rare in young people. The number of patients began to increase sharply. The disease was called & lt; AIDS - SYNDROME OF THE ACQUIRED IMMUNODEFICIENCY ".
Already in 1983 in France Luke Montagnier first discovered the causative agent of the disease. It was a virus isolated from enlarged lymph nodes of the patient. Soon Montagnier's discovery was confirmed by the American virologist Robert Gallo, who studied the properties and structure of the virus. The dispute over the primacy in this discovery between Montagnier and Gallo, as well as their supporters has not abated until now. Obviously, this prevents him from awarding the Nobel Prize to his author.
In 1986, the virus was called HIV( English - human immunodeficiency virus), in translation into Russian - the human immunodeficiency virus( HIV).Hence the name - "HIV infection".
In 1982 - 1983 years.cases of HIV infection have already been registered in many regions of all continents. During these same years, the structure of the virus, the ways of its transmission, the mechanism of the development of the disease, the clinical picture, the methods of laboratory diagnostics were studied. In 1984, the antiviral effect of AZT( azidothymidine) was detected.
In 1986, in some countries in Africa, another type of virus was identified, which was called HIV-2( originally designated as HIV-1).
Most scientists believe that HIV cases occurred before 1981, but they were not diagnosed.
Currently, there are specialists who generally deny the link between immunodeficiency( AIDS) and detected viruses, including the microbiologist from California, Professor Peter Dusberg: he also denies the connection of HIV with AIDS to in his book "The Fictitious AIDS Virus".Approximately the same views are shared by Professor Timofey Partizan( Ukraine).
According to most scientists, the place of the initial occurrence of HIV infection is the African continent. Many species of African monkeys have a virus that is similar to the human immunodeficiency virus and is called SIV, a virus of the immunodeficiency of monkeys.
A number of scientists suggest the possibility of some kind of mutational changes in the monkey virus and its transition to man in the 40-50s of the 20th century.
The spread of the disease in the 70s of the XX century was promoted by the so-called sexual revolution, which led to the growth of prostitution, homosexuality, group types of sex, the "rise" in drug addiction, and the ever-growing migration of the population.
• AIDS is caused by the human immunodeficiency virus( HIV), which is contained in any body fluid( blood, semen, female genital secretions, saliva and breast milk) of an infected person. The virus gradually destroys human immunity, and it becomes vulnerable to many potentially deadly diseases or cancer.
• HIV is transmitted through the exchange of fluids between organisms during sexual intercourse with an infected partner or when contaminated blood enters the body. This is observed among drug addicts using intravenous drugs and using a single needle, or among patients with hemophilia who are repeatedly exposed to blood transfusions( recently, an improvement in the blood test reduced the risk of contracting HIV with blood transfusions).An infected woman can transmit the virus to her child before giving birth or breastfeeding. HIV is a very unstable virus and can not exist long outside the body. It is impossible to catch it with short contacts, such as hugs, an easy kiss, and drinking from a glass of an infected person.
Penetrating into the human body, the immunodeficiency virus affects the immune system, damaging, in the main, T-lymphocytes - helpers, which help B-lymphocytes produce antibodies against various microbes.
Having penetrated into T-lymphocytes and other cells of the immune system, HIV multiplies at first slowly, but after a while its amount becomes so huge that the number of T-helpers due to the harmful effects of the virus can decrease by a factor of 10.This is a latent, or latent, period of AIDS, which has a different duration for different people( from several months to 10 or more years).The reason for such a different duration of the latent period has not been fully elucidated until now. Obviously, the virulence( aggressiveness) of the virus, the state of the host organism, primarily its immune system, the presence of concomitant diseases( for example, when viruses from the herpes group are infected at the same time, the reproduction of HIV in the body is accelerated).
Joining of so-called HIV-associated diseases sharply accelerates the development of the infection itself. With the development of AIDS, the body becomes defenseless against many infections that are harmless to healthy people. Because of the defeat of T-helpers in the body, there is a sharp decrease in the production of protective immunoglobulins( antibodies).At the same time, the number of so-called autoantibodies - antibodies directed against the tissues of their own organism - increases. Gradually, there is a complete depletion of the cells of the immune system, its paralysis. Progressive reproduction of the virus leads, finally, to the death of almost all the protective mechanisms of the body. In addition to the death of cells of the immune system, many nerve cells die. A sharp decrease in the protective role of the immune system leads to the multiplication not only of numerous parasites, but also to the development of malignant tumors( Kaposi's sarcoma, malignant lymphoma, etc.).
Now - about ways of infection of a HIV.
1. The sexual way. It can be ordinary( heterosexual) and homosexual. In the latter case, the virus enters the body through a single-layered epithelium of the rectum, which is much more dangerous than passing through the multilayered epithelium of the vagina. In addition, with homosexual intercourse enough
often occurs, an eruption of the rectum. Therefore, the probability of infection with normal sexual contact with HIV-infected people is several times lower than in homosexual.
At present, over 80% of the total number of infections is accounted for by sex in the world, with 70% due to usual heterosexual contacts. Especially the risk of infection increases with multiple contacts with different partners and group sex. Significantly increases the risk and the phenomenon of prostitution. There are cases when AIDS infected intentionally, as a sign of revenge, infected one partner after another, for which they were brought to criminal responsibility.
The probability of infection of a woman from an infected man is higher than in the opposite case. With homosexual contacts, the passive partner suffers more.
In Africa, people are most often infected with normal heterosexual intercourse. The homosexual way was common in the US and European countries.
Infection is facilitated by the presence of inflammatory foci, ulceration of the genitals, other sexually transmitted diseases, sexual acts during menstruation, etc. The likelihood of infection sharply decreases the use of condoms during sexual intercourse.
2. Parenteral infection. Under such a contagion, there are cases when the viruses enter the blood directly: blood transfusions, injections( often intravenous), etc. The likelihood of intravenous parenteral infection from an HIV-infected person is close to 100%.Teenagers are often the victims of AIDS.
3. There are known cases of infection of many hundreds of hemophilia patients due to the introduction of medicinal preparations prepared from the blood of people who were not well tested for HIV and found themselves carriers of HIV infection. Many remember the trial in France in connection with the massive infection there of patients with hemophilia. One can imagine the horror of parents whose child is already very seriously ill, and in the medical institution receives instead of help another dangerous disease.
4. There is a certain risk of HIV infection in dental procedures due to inadequate sterile medical instruments.
5. Cases of infection of medical workers with careless manipulation( contaminated blood on unprotected skin surfaces, mucous membranes, accidental injections, etc.) are described.
6. Vertical transmission mechanism. Infection occurs from a person infected with HIV through the placenta or during childbirth. The likelihood of transmission increases with subsequent pregnancies( from 20 to 30% for the first pregnancy, up to 50 to 60% for the subsequent pregnancies).
The possibility of infecting a newborn from an infected mother during breastfeeding is not excluded, which in these cases is best not to practice at all. V. Pokrovsky described the case of infection of the mother in Elista from HIV-infected infants with breastfeeding( the mother had nipple cracks, and the child had ulcerous changes in the oral cavity).
At-risk groups for AIDS:
Of the listed risk groups, HIV can be entered into treatment facilities, families, etc.
HIV resistance in the external environment is not too high: at 25 ° C the infectiousness of the virus persists to 15 days, with 37° C - 11 days, at room temperature, HIV remains contagious in the dried state for 4 to 7 days. At minus temperature, it can be stored in the external environment for several months.
Disinfectants act on HIV very effectively( 1-3% solution of chloramine, 0.5% solution of sodium hypochlorite, 4-6% solution of hydrogen peroxide, 70% alcohol solution, etc.).Boiling kills HIV within a few minutes.
Currently, it is not proven that HIV is not transmitted through insect bites. It is impossible to get infected with HIV in normal household contacts, because the virus does not excrete with feces, urine, is absent in sweat, teardrop, is not secreted by breathing and coughing. Due to the low concentration of the virus in saliva, it is very unlikely that HIV will be infected with kisses. You can not get AIDS through a joint meal, conversation, handshake, travel in transport, etc. Meanwhile, because of their ignorance, people often avoid being eschewed by those infected with the AIDS virus. Although we must treat them not with contempt, but with compassion. As the Bible says: "Do not judge and you will not be judged."
To diagnose as early as possible, you first need to gather information regarding a possible infection: whether there was sexual contact with an unknown person, whether the patient is a drug addict, whether he received a blood transfusion, whether he underwent surgery, etc.
Let's turnto the classification of AIDS, proposed by the Russian scientist, Professor VI Pokrovsky. According to her illness in its current has 4 stages:
I stage - incubation. It starts from the moment of infection and continues until the appearance of the first clinical signs or( in their absence) before the appearance of specific antibodies in the blood. This stage can last from two weeks to 3 years.
II stage - primary manifestations of .In 10 - 50% of cases, antibodies against the AIDS virus can be detected in the blood without any clinical manifestations of the disease. But in 50 - 90% of cases, the first clinical signs appear simultaneously: it is either acute infection or generalized lymphadenopathy( ubiquitous enlargement of the lymph nodes).Acute infection is usually characterized by a so-called mononucleosis-like syndrome( or less often influenza-like): fever, weakness, headache, sore throat, especially when swallowing. Often a small spot or spotted rash appears on the body. The submaxillary, cervical, sometimes axillary, inguinal lymph nodes are enlarged. In some patients, there is an increase in the liver and spleen. Characteristic herpetic, or fungal, rashes( in the form of thrush) in the mouth. There may be pain in the muscles and joints.
Many patients with a blood test have already seen a slight decrease in T-lymphocyte-helpers. This stage of the disease rarely lasts more than 2 weeks. Then all the symptoms usually subside without any treatment. However, with a detailed examination, you can see a general increase in lymph nodes, many patients also have increased fatigue, poor sleep, night sweats, pustular skin lesions and fungal nails, aphthous stomatitis.
III stage - secondary diseases. It is characterized by a loss of body weight of less than 10%, viral, bacterial, fungal infections of the skin and mucous membranes, shingles( itching, painful rashes along the nerves on the skin of the lateral surfaces of the chest), frequent sinusitis, pharyngitis.
In the future, the patient continues to lose weight, he has fever( more than one month), prolonged diarrhea, changes in the oral mucosa, repeated manifestations of herpes zoster, localized Kalosha sarcoma, signs of pulmonary tuberculosis.
With the progression of the disease, there are generalized, severe infectious diseases of the viral, bacterial, fungal, parasitic nature - esophageal candidiasis( fungal infection), extrapulmonary tuberculosis, widespread Kaposi's sarcoma, central nervous system disorders, pneumocystis pneumonia and other
AIDS-associated( provokedAIDS) lesions, as well as cachexia( severe thinning), etc.
In the case of an unfavorable course of the disease and its progression or ineffectivenessThe treatment undergoes IV stage of disease - terminal, resulting in death of the patient. With modern full-fledged therapy, the course of HIV infection is more favorable and may not go on in subsequent stages.
For accurate diagnosis of AIDS, laboratory confirmation is required. However, even without laboratory data, there are signs of a disease that are likely to lead to the suspected HIV infection.
The so-called "big signs":
"Small signs":
The diagnosis of HIV infection is most likely when there are at least two large symptoms and one small.
In the case of a favorable course, between the second and the third stage of AIDS, there may be a period of long( up to 10 years or more) latency, when patients have satisfactory well-being and working capacity. In some patients, such a prolonged latent period can begin immediately after infection and proceed without acute events. There have already been cases when latency lasts more than 20 years, and scientists hope that, perhaps, some HIV-infected patients will not show any serious signs of the disease.
Unfortunately, from the side of the immune system in special studies, the process of destructive influence of the virus on lymphoid cells is revealed - the number of T-lymphocytes-helpers( from 600 to 200 -100 to 50 in 1 μl of blood) is reduced mainly.
It is usually believed that if the number of T-lymphocytes passes the lower limit of 200 cells per 1 μl, the disease takes an especially severe course due to AIDS-associated diseases. The causative agents of these diseases for healthy people are in most cases no danger. Moreover, some of them are organisms that freely live in water, soil, etc. A healthy immune system reliably confronts them, and for AIDS patients in whom it is destroyed, these organisms from neutral agents turn into the worst enemies. The US Infectious Disease Control Center has proposed that all patients who do not have a CD4-lymphocyte count of 200 cells / mm3 are considered AIDS patients. All other cases attributed to AIDS-associated diseases.
Among AIDS-associated diseases, there are mushrooms( candidiasis, cryptococcosis, aspergillosis, histoplasmosis), protozoa and helminths: toxoplasmosis, pneumocystis, cryptosporidiosis, blastocystosis, strongyloidiasis, etc. Among the virus diseases, most often there are cytomegalovirus infections, shingles, etc.
Influence of HIV infection increases the incidence of tuberculosis, which is often unfavorable in AIDS patients. Increased infection with helminths, leading to the seeding of all organs and, as a rule, wearing masks of cancer.
In many cases, the cause of severe AIDS is pneumocystis pneumonia( pneumonia caused by pneumocystis).In healthy people, a parasite living in the pulmonary alveoli does not cause disease. However, in people with reduced immunity, it causes severe pulmonary pathology: increased parasite development in the alveoli disrupts the absorption of oxygen, and severe respiratory failure develops. In the future, there are symptoms of pneumonia, emphysema, etc. This is how the disease develops in people with AIDS.Only timely diagnosis( X-ray examination, bronchoscopy, laboratory tests) and intensive treatment( biseptol, etc.) delay the inflammatory process. Unfortunately, due to AIDS-induced immunosuppression, recurrences of the disease occur, often with severe consequences.
Very often, AIDS is associated with a cytomegalovirus infection( CMV), caused by parasitizing the herpesvirus virus - cytomegalovirus in the body. And again - in healthy people, the presence of CMV in leukocytes, salivary gland cells, kidneys, etc., often does not cause any painful symptoms. However, in pregnant women, the virus can penetrate the placenta and cause damage to the fetus.
In people with immune deficiency, the virus causes multiple pathologies. They are severely affected by the gastrointestinal tract( up to complete exhaustion), the central nervous system, the respiratory tract, the membranes of the eyes. Only fast antiviral therapy( acyclovir, ganciclovir, etc.) can slow down this process.
In newborns born to HIV-infected mothers, it is impossible to differentiate HIV antibodies detected in the blood( at least up to 1.5 years) with antibodies passively passed through the placenta from the mother's blood, because during this time they remain in her body. Therefore, newborn examinations should be carried out repeatedly, and the dynamics of the antibody titer can be used to judge their origin. But it is better to determine the virus itself using PCR( polymerase chain reaction - see the section "New technologies of laboratory genodiagnostics" in the third part of the book).Helps diagnose AIDS in neonates detecting early clinical signs. They, unlike adults, they appear quite early and quickly progress. In the conduct of drug prevention in infected pregnant women, the risk of infection of newborns is significantly reduced.
• Although HIV can not be completely destroyed, a combination of drugs( a protease inhibitor, a nucleoside and a non-nucleoside) prevents the virus from multiplying and allows for a more normal functioning of the immune system. Anyone who takes these medicines should be constantly monitored by a doctor.
• It is necessary to start taking medications when the immunity and / or the content of the virus in the blood is compromised. Treatment at an early stage can prevent a danger to the immune system for many years. Even patients who are at a late stage of AIDS development can feel a significant improvement in immunity, accompanied by a decrease in the number of diseases.
• Antibiotics may be prescribed to prevent the development of certain infectious diseases.
• Pregnant women should use a set of drugs that reduce the risk of HIV transmission to a child by 70-80 percent.
• Vaccines and antibiotics can be used to prevent the development of opportunistic diseases, such as pneumococcal pneumonia and Pneumocystis carinii pneumonia, which are potentially life-threatening illnesses that affect people with AIDS.
• Diagnosis of HIV infection often leads to emotional devastation. Psychological counseling, support groups and assistance from friends and relatives are invaluable support.
• Contact your doctor if you think you were at risk of contracting HIV infection, or if you have found yourself with a symptom of HIV infection or AIDS.
• Take a survey if you have the slightest reason to suspect that you were infected with HIV.Many clinics conduct confidential and anonymous tests.
• All pregnant women should consider taking an HIV test.
Treatment of HIV infection includes the use of drugs directed against the AIDS virus itself, as well as anti-AIDS-associated infections. As for the first group of drugs, there are still a lot of problems. The first anti-viral drug AZT( Azidothymidine), or zidovidin, which was used soon after the first AIDS patients were identified, had only a temporary effect, softened the clinical picture, but could not radically affect the reproduction of viruses in the body.
In the future, a number of similar drugs with a similar mechanism of action were created. At present, they include: zidovudine( its domestic counterpart - thymoside), didanosine, zalcitabine, stavudine, lamivudine. All of them block an enzyme important for the virus - the so-called transcriptase. In addition, drugs that block the protease of the virus( that is, enzymes that break down proteins) are used. Among them: saquinavir, ritonavir, indinavir( krixevan), nelfinavir( viracept).Unfortunately, all these drugs quite often have side effects, which is their significant drawback, given the need for their long-term use.
In 1996, American scientist David Ho was declared the "Person of the Year" for his proposed triple therapy of HIV infection. The combined treatment consists of two drugs blocking the reverse transcriptase( AZT and lamivudine) and one antiprotease drug( cryxevan).
This therapy should be used for a long time before the onset of AIDS symptoms. It allows prolonging the life of patients, dramatically reducing the number of viruses in the body, but completely without destroying them. In addition, this expensive treatment can not afford all, especially since you need to be treated for many years.
In addition to drugs that block HIV, doctors recommend taking drugs against the most likely HIV-associated diseases, even with the slightest suspicion of their occurrence, and even for purely preventive purposes. This is especially important for the prevention of pneumocystis pneumonia, cytomegalovirus infection and toxoplasmosis( they are usually infected with up to 50-90% of the population, and if in healthy adults toxoplasmosis is most often asymptomatic, then with AIDS it takes an extremely heavy, septic course).
In the future - the development of more effective and less expensive drugs to treat AIDS.In the press, information appears annually on the allegedly successful application of some unusual folk remedies, herbal preparations, etc., for this purpose, but all these reports have not yet been confirmed by serious research.
In our time, AIDS prevention is an important state task in any country. In each country and even a specific region, it is necessary to take into account the prevailing pathways of infection. For African countries, where infection prevails during normal heterosexual intercourse, preventive measures should be taken to ensure that they are as safe as possible. However, this is not so easy: multiple sexual contacts with a negative attitude towards the use of condoms have become part of the mentality here. Even the threat of economic collapse and the extinction of the population can not yet stop the disastrous process. In addition, prostitution has become for many women the main way to earn a livelihood. Promoting the widespread and compulsory use of condoms yields some positive results: in Nigeria, for example, the frequency of condom use has increased five-fold in recent years, thereby reducing the spread of AIDS.
Measures are being taken to "cut off" and other ways of contracting HIV( combating drug addiction, disinfecting medical instruments, examining donors, etc.).A large number of infected women lead to infection of newborns during pregnancy and childbirth - preventive medication is recommended to reduce the risk of HIV-infected pregnant women.
In the US, European and other countries where homosexuality is widespread, there is propaganda aimed at excluding group forms of sex, as well as mandatory Condom use. Undoubtedly, one of the main tasks is the fight against drug addiction and prostitution. The problem of careful HIV testing for donors remains a topical issue.
For Russia, the prevention of the spread of HIV among drug users is paramount. In our country, more than 3 million people regularly use drugs and psychotropic substances. Addicts get infected not only when using shared syringes, but even common utensils, from where each takes a narcotic mixture.
At present, Russia has adopted a new program to combat AIDS, aimed at "reducing harm from drug use."It is already being implemented in many regions of Russia with the assistance of international organizations( the joint UNAIDS program).The program includes educating drug addicts about HIV transmission routes, free replacement of used syringes for sterile, free distribution of condoms. And, as they say, by and large, its purpose is to convince drug addicts everywhere to treat addiction and, in the end, to give up drugs.
As for the creation of an effective vaccine, this is a matter of the future. And, probably, not the nearest. Although work in this regard is ongoing: currently created by scientists vaccines are tested in Thailand and some other countries.
World Day for the Remembrance of AIDS Deaths is established on our planet. On this day, the living remember people, usually young, often - very talented and famous. Let us also recall the names of some of them: Rudolf Nureyev, ballet soloist( France, born in the USSR);Freddie Mercury, rock singer( USA);Miles Davis, jazz trumpeter( USA);Anthony Perkins, film actor( Great Britain);Herve Gibert, writer( France);Klaus Welle, activist of the anti-slip movement( France);Arne Khuzdal, activist of the movement for the rights of HIV-infected people( Norway).