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What is AIDS?

AIDS (Acquired Immuno-Deficiency Syndrome) is an infection caused by Human Immunodeficiency Virus (HIV). The virus exists in two distinct forms, HIV-1 and HIV-2. HIV-1 causes AIDS in the United States, Europe and Central Africa, while HIV-2 is common in West Africa. Specific tests are available to detect both HIV-1 and HIV-2. HIV is a retrovirus belonging to the group Lentiviridae.

The AIDS virus uses special mechanisms to attack the immune system and the central nervous system (brain and spinal cord). AIDS patients thus suffer from severe immunodeficiency and have a variety of central nervous system disorders. This virus cannot be transmitted by casual personal contact in the house, workplace or school. The modes of transmission of this virus are discussed below.

How is AIDS transmitted?

As explained above, AIDS cannot be transmitted by casual personal contact. The only modes of transmission of HIV are:

Sexual Transmission
Sexual Transmission is clearly the most important mode of transmission of AIDS infection and accounts for 75 percent of cases of AIDS globally. AIDS could be transmitted by both heterosexual and homosexual transmission.Heterosexual transmission is the dominant mode of transmission of AIDS infection in India, Asia and Africa. Females are commonly infected this way, as sexual partners of HIV positive male intravenous drug abuses

Homosexual transmission of AIDS is another mode of sexual transmission and occurs when a male has anal intercourse with another male. As this virus is carried in the semen, if one male is already having AIDS, the second male contacts this disease. This mode of transmission is more common in Europe and United States as compared to Asia and Africa.

Transmission via needles and blood products
These comprise an important group in the chain of transmission of HIV. Drug abusers usually inject a variety of substances into the blood and often use or share the same needle. If any one of the drug abusers has HIV, this virus is transmitted to all those who use the same syringe and needle. Also as the drug abusers get infected and they pass this infection to their spouse. Thus a male drug abuser who has AIDS can infect his wife, she in turn infects the children born after she has contracted AIDS. Thus the whole family could be involved, if either the husband or wife abuses drugs.

Transmission of AIDS by transfusion of blood or blood products
This occurs when infected HIV positive blood is transfused into a normal patient. Many blood products in common use today such as platelet concentrates, factor VIII concentrate, etc. also can transmit the virus. Therefore it is important to screen all blood for presence of HIV before transfusion is given. All blood banks now implement various methods to prevent HIV transmission by this route, including:

  • Screening of all blood and donated plasma for antibody to HIV
  • Heat treatment of clotting factor concentrate
  • Screening of donors for history of drug abuse, sexual contacts and blood transfusions. All donors should undergo HIV testing
  • All blood given for donation should be HIV free and carry such labels. Blood not carrying such labels of being HIV negative should be rejected.
  • Sharing of transfusion needles sets should never be done and once blood is transfused the transfusion set and needle should be destroyed.

Mother to infant transmission
This is the most common cause of pediatric AIDS (AIDS in children). An infected mother who is HIV positive can transmit HIV to the offspring by three methods:

  • When the fetus is in the uterus through placenta
  • During delivery as the fetus comes out in the birth canal
  • After birth via breast milk.

How common is AIDS?

AIDS cases detected in India up to 29th February 1996.

Males - 1881

Females - 631

Total - 2512

By 1987, 70-80 per cent of adult hemophiliacs in Europe and USA had become seropositive for HIV1. HIV infection or AIDS is a global health problem and affects virtually every country in the world. As on January 1997, according to WHO reports, the total number of people having AIDS is approximately 22 million, out of these 1 million are children. The global projection by the year 2000 is about 40 to 100 million cases.

Children – It is estimated that in 1996, of 1.5 million people who died of AIDS globally, 350,000 (23%) were children below 15 years of age. About 400,000 children became infected with HIV during the same period. Of the 23 million people worldwide living with HIV, 8,30,000 (3.6%) are children.2

What should you do to prevent getting and spreading AIDS?

  • Do not have a sexual intercourse with a person whose HIV status is unknown. Do not have sex with a stranger. Remember it is dangerous to have sex with prostitutes, as many of them may be HIV positive.
  • Have sex with your wife or your husband and do not change partners
  • Do not abuse drugs. Do not share needles if you are a drug abuser; contact a de-addiction center if you want to stop using drugs.
  • Use condoms if you want to have sex. This decreases the chances of AIDS, and other sexually transmitted diseases. Safe sex is the best way to protect yourself from AIDS.
  • If you are a drug abuser and you are HIV positive, do not have sex with your spouse, as he or she would also contract the disease. Remember AIDS is a fatal disease and the best way to control this disease is to prevent it.
  • If you are mother who is HIV positive, consult your doctor on the issue of having babies. Your baby can have AIDS and consult your doctor on prevention. Aids id a difficult disease to cure.
  • Never use blood for transfusion unless HIV status is not clear; use only HIV-1 and HIV-2 negative blood for transfusion.
  • Never share transfusion sets for blood transfusion; destroy all transfusion sets or needles once they have been used. This is important in hospitals, nursing homes and private clinics.
  • Destroy all needles once they have been used (for injections, to collect samples or used for blood transfusion). Insist that the needles be destroyed in needle crushers in hospitals and nursing homes. (and see to it that they are done!)

What are the symptoms of AIDS?

  • Fever
  • Weight loss
  • Loss of appetite
  • Headache
  • Malaise and lethargy
  • Nausea and/or vomiting
  • Pain in the eyes or behind them
  • Diarrhea
  • Pain in the joints (athralgias)
  • Pain in the muscles (myalgias)
  • Pharyngitis or sore throat
  • Meningitis: inflammation of the coverings of the brain
  • Encephalitis: inflammation of the brain itself
  • Skin rashes
  • Ulcers around the mouth, anus and in vagina
  • Intermediate stage: (Early symptomatic Disease)

After the early phase, the patient enters a latency period for as long as 10 years during which there are no clinical symptoms. Still HIV virus would infect more and more cells in the body and rapidly increasing in number. Average CD4+ T cell count falls by about 50 cells per year.

Generalized lymphadenopathy: Lymph nodes throughout the body enlarge: some may become larger than 1 cm and be visible at sites like the neck, groin, armpit, etc.

Thrush: White colored raised patches appear inside the mouth on the palate. This is actually due to infection with Candida, a fungus and denotes immunodeficiency.

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