Human Immunodeficiency Virus Infectious Disease
Disease Details
Family Health Simplified
- Description
- Human immunodeficiency virus (HIV) is a virus that attacks the body's immune system, specifically the CD4 cells (T cells), leading to a progressive failure of the immune system and increasing the risk of opportunistic infections and certain cancers.
- Type
- Human Immunodeficiency Virus (HIV) is an infectious disease caused by a retrovirus. In terms of genetic transmission, HIV is not inherited genetically but is instead transmitted through exposure to infected bodily fluids such as blood, semen, vaginal fluids, and breast milk.
- Signs And Symptoms
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Human immunodeficiency virus (HIV) infection can be divided into different stages, with varying signs and symptoms:
**Acute HIV Infection (Primary Infection)**
- Flu-like symptoms (fever, sore throat, headache)
- Swollen lymph nodes
- Rash
- Muscle and joint pain
- Night sweats
- Diarrhea
**Clinical Latency Stage (Chronic HIV)**
- Often asymptomatic
- Generalized swollen lymph nodes
- Persistent inflammation may lead to minor symptoms like skin rashes, fatigue, or slight weight loss
**AIDS (Acquired Immunodeficiency Syndrome)**
- Rapid weight loss
- Recurring fever or profuse night sweats
- Extreme and unexplained fatigue
- Prolonged swelling of the lymph glands in the armpits, groin, or neck
- Diarrhea that lasts for more than a week
- Sores of the mouth, anus, or genitals
- Pneumonia
- Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
- Memory loss, depression, and other neurologic disorders
In the absence of treatment, HIV can progress to AIDS over time. - Prognosis
- The prognosis for individuals with human immunodeficiency virus (HIV) has significantly improved with advancements in antiretroviral therapy (ART). People on effective ART can expect to live near-normal lifespans, provided they adhere to their treatment regimen and maintain good health practices. Early diagnosis and prompt treatment are crucial for better health outcomes. Without treatment, HIV can progress to acquired immunodeficiency syndrome (AIDS), which can be life-threatening. Regular monitoring and healthcare are essential to manage the disease effectively.
- Onset
- The onset of human immunodeficiency virus (HIV) infection can vary. After initial exposure, some individuals may experience acute HIV infection or seroconversion illness within 2 to 4 weeks, characterized by flu-like symptoms such as fever, sore throat, and swollen lymph nodes. However, many people are asymptomatic during this early stage. If untreated, the virus progresses through clinical stages over several years, leading eventually to acquired immunodeficiency syndrome (AIDS), characterized by significant immune system damage and opportunistic infections.
- Prevalence
- The prevalence of HIV (Human Immunodeficiency Virus) varies widely by region, population group, and available healthcare infrastructure. Globally, as of the latest data, approximately 38 million people are living with HIV. Highest prevalence rates are observed in sub-Saharan Africa, where some countries report adult prevalence rates exceeding 20%. In high-income countries, the prevalence is generally lower but concentrated in specific high-risk groups such as men who have sex with men, intravenous drug users, and sex workers.
- Epidemiology
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The epidemiology of Human Immunodeficiency Virus (HIV) infection includes:
1. **Prevalence**: HIV has a global presence, with the highest burden in sub-Saharan Africa, but significant numbers are also found in North America, Southeast Asia, and Europe.
2. **Incidence**: Millions of new infections occur each year. Globally, there were approximately 37.7 million people living with HIV at the end of 2020.
3. **Transmission**: The virus is primarily spread through unprotected sexual contact, sharing of contaminated needles, transfusion of infected blood products, and from mother to child during childbirth or breastfeeding.
4. **Risk Groups**: High-risk populations include men who have sex with men, intravenous drug users, sex workers, and individuals with multiple sexual partners.
5. **Mortality and Morbidity**: HIV significantly increases the risk of opportunistic infections and cancers due to immunodeficiency, which can lead to AIDS (Acquired Immunodeficiency Syndrome) and increased mortality.
Prominent public health measures include education, testing, antiretroviral therapy (ART), and preventive measures like PrEP (pre-exposure prophylaxis) and safe sex practices. - Intractability
- Human immunodeficiency virus (HIV) is currently considered an intractable disease because there is no cure. However, it is manageable with antiretroviral therapy (ART), which can control the virus, reduce the viral load to undetectable levels, and significantly improve the quality of life and life expectancy for those infected. Despite rigorous ongoing research, a definitive cure remains elusive.
- Disease Severity
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The severity of the disease caused by the human immunodeficiency virus (HIV) can vary greatly among individuals and depends on various factors including the stage of infection, access to treatment, and overall health of the individual. HIV infection progresses through several stages:
1. **Acute HIV Infection**: This initial stage occurs 2-4 weeks after infection, characterized by flu-like symptoms and high levels of virus in the blood.
2. **Clinical Latency Stage**: Also known as chronic HIV infection, during this stage, the virus is less active and individuals may not experience symptoms. This stage can last for several years with proper treatment.
3. **AIDS (Acquired Immunodeficiency Syndrome)**: This is the most severe phase of HIV infection, marked by a significantly weakened immune system, making the body vulnerable to opportunistic infections and cancers.
Without treatment, HIV can progress to AIDS, which is often fatal. However, with effective antiretroviral therapy (ART), individuals can manage the virus, maintain a good quality of life, and have a near-normal life expectancy. - Healthcare Professionals
- Disease Ontology ID - DOID:526
- Pathophysiology
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Human Immunodeficiency Virus (HIV) primarily targets the immune system, specifically CD4+ T cells, macrophages, and dendritic cells. The virus binds to the CD4 receptor and co-receptors (CCR5 or CXCR4) on these cells, facilitating entry. Inside the host cell, HIV reverse transcriptase converts viral RNA into DNA, which integrates into the host genome via the viral enzyme integrase.
The integrated viral DNA, called a provirus, can remain latent or be actively transcribed and translated into viral proteins. New virions are assembled and released through budding, which can infect other immune cells. This process leads to a progressive depletion of CD4+ T cells, weakening the immune system and impairing the body's ability to fend off opportunistic infections and certain cancers, characteristic of Acquired Immunodeficiency Syndrome (AIDS).
Chronic immune activation and inflammation due to continuous viral replication and cell death also contribute to HIV pathogenesis, affecting various organs and leading to systemic complications. - Carrier Status
- For human immunodeficiency virus (HIV) infectious disease, there is no carrier status in the traditional sense. People who are infected with HIV actively have the virus in their bodies, which can be detected through blood tests. They may be asymptomatic for many years but are still able to transmit the virus to others. Therefore, an HIV-infected individual is considered to have the infection rather than being a mere "carrier."
- Mechanism
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Human Immunodeficiency Virus (HIV), the causative agent of AIDS (Acquired Immunodeficiency Syndrome), primarily targets the immune system, specifically CD4+ T cells, macrophages, and dendritic cells.
**Mechanism:**
1. **Entry:** HIV binds to CD4 receptors and co-receptors (CCR5 or CXCR4) on host cells via its envelope glycoprotein gp120. Fusion and entry are mediated by gp41, another envelope protein.
2. **Reverse Transcription:** Once inside the host cell, the viral RNA genome is reverse-transcribed into complementary DNA (cDNA) by the viral enzyme reverse transcriptase.
3. **Integration:** The cDNA is transported into the host cell's nucleus, where the viral integrase enzyme integrates it into the host genome, creating a provirus.
4. **Replication:** The provirus is transcribed and translated by the host cell's machinery to produce viral RNA and proteins.
5. **Assembly:** New virions are assembled at the host cell membrane.
6. **Budding and Maturation:** Immature virions bud off from the host cell. The viral protease enzyme processes viral proteins to produce mature, infectious virions.
**Molecular Mechanisms:**
1. **Reverse Transcriptase Inhibition:** Antiretroviral drugs target this enzyme to prevent the conversion of viral RNA into DNA.
2. **Integrase Inhibition:** Drugs block this enzyme to prevent the integration of viral DNA into the host genome.
3. **Protease Inhibition:** Inhibitors prevent the processing of viral polypeptides into functional proteins, producing non-infectious virions.
4. **Fusion/Entry Inhibition:** Drugs like maraviroc (CCR5 antagonist) and enfuvirtide (fusion inhibitor) block viral entry into host cells.
5. **Transcription Regulation:** HIV's Tat protein enhances the efficiency of viral transcription, while the Rev protein facilitates the export of unspliced and singly spliced viral RNAs from the nucleus to the cytoplasm.
Understanding these mechanisms is essential for developing effective treatments and managing the disease. - Treatment
- The primary treatment for Human Immunodeficiency Virus (HIV) is antiretroviral therapy (ART). This typically involves a combination of antiretroviral drugs that work to reduce the viral load, maintain immune function, and prevent the progression to Acquired Immunodeficiency Syndrome (AIDS). ART is a lifelong treatment and requires strict adherence to be effective. Regular monitoring by healthcare providers is essential to manage and adjust the therapy as needed.
- Compassionate Use Treatment
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Compassionate use treatment for HIV, also known as expanded access, allows patients with life-threatening conditions or serious diseases who have no other treatment options to gain access to investigational drugs or therapies. This is often considered when standard treatments have failed, are not suitable, or are unavailable. Physicians must typically request these treatments through regulatory bodies such as the FDA in the United States.
Off-label treatments for HIV involve the use of FDA-approved drugs in a manner not specified in the drug's official labeling. For instance, certain antiviral medications developed for other viral infections might be used off-label to treat HIV, based on a physician's clinical judgment and emerging evidence.
Experimental treatments for HIV include new drugs and therapies currently under investigation in clinical trials. These may encompass novel antiretroviral drugs, immune-based therapies, gene editing technologies like CRISPR, and therapeutic vaccines. Participation in clinical trials is an option for patients interested in accessing these experimental treatments, offering the potential for cutting-edge therapy while contributing to scientific research. - Lifestyle Recommendations
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For individuals living with HIV (Human Immunodeficiency Virus), lifestyle recommendations include:
1. **Adherence to Antiretroviral Therapy (ART)**: Consistently take prescribed medications to maintain viral suppression and improve overall health.
2. **Regular Medical Check-ups**: Regular visits to a healthcare provider for monitoring and management of HIV and any related conditions.
3. **Healthy Diet**: Consume a balanced diet rich in fruits, vegetables, whole grains, and lean protein to maintain immune function and overall health.
4. **Exercise**: Engage in regular physical activity to boost the immune system, reduce stress, and improve cardiovascular health.
5. **Avoiding Substance Abuse**: Refrain from using recreational drugs, excessive alcohol, and smoking, as these can weaken the immune system.
6. **Safe Sex Practices**: Use condoms consistently and correctly to prevent the transmission of HIV and other sexually transmitted infections (STIs).
7. **Mental Health**: Seek support for mental health issues, such as depression or anxiety, through counseling or support groups.
8. **Infection Prevention**: Take precautions to avoid infections by practicing good hygiene, getting vaccinated, and avoiding exposure to people with contagious illnesses.
9. **Partner Notification and Testing**: Inform sexual partners about your HIV status and encourage them to get tested and seek medical advice if needed.
Implementing these lifestyle recommendations can help manage HIV effectively and improve quality of life. - Medication
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For HIV (Human Immunodeficiency Virus) treatment, the standard approach involves a regimen known as antiretroviral therapy (ART). ART typically consists of a combination of at least three medications from different drug classes to effectively suppress the virus and prevent the progression to AIDS. Key classes of antiretroviral drugs include:
1. **Nucleoside Reverse Transcriptase Inhibitors (NRTIs):** e.g., Tenofovir, Emtricitabine, Abacavir.
2. **Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs):** e.g., Efavirenz, Rilpivirine.
3. **Protease Inhibitors (PIs):** e.g., Atazanavir, Darunavir.
4. **Integrase Strand Transfer Inhibitors (INSTIs):** e.g., Dolutegravir, Bictegravir.
5. **Entry Inhibitors:** e.g., Maraviroc.
6. **Fusion Inhibitors:** e.g., Enfuvirtide.
Combination pills like Atripla, Truvada, and Biktarvy have been developed for easier adherence by reducing the pill burden. Regular monitoring and adherence to prescribed medication are critical for effective management of HIV. - Repurposable Drugs
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For the treatment of HIV (Human Immunodeficiency Virus), several drugs initially developed for other conditions have shown potential for repurposing. These include:
1. **Minocycline**: An antibiotic used to treat bacterial infections, it's been studied for its potential to reduce HIV reservoirs and inflammation.
2. **Disulfiram**: Traditionally used to treat chronic alcoholism, it may reactivate latent HIV, making the virus more susceptible to current antiretroviral therapies.
3. **Valproic Acid**: An anticonvulsant and mood-stabilizing drug used in epilepsy and bipolar disorder, it has been investigated for its potential to reduce the latent HIV reservoir.
4. **Metformin**: A common medication for type 2 diabetes, it is being explored for its anti-inflammatory properties and possible effects on HIV comorbidities.
These drugs are still under investigation, and their efficacy and safety profiles need thorough evaluation in the context of HIV treatment. - Metabolites
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Human immunodeficiency virus (HIV) infection impacts the host’s metabolism in various ways. Metabolites affected in patients with HIV include:
- Increased levels of certain amino acids (e.g., tryptophan degradation to kynurenine)
- Altered lipid profiles (e.g., elevated triglycerides, decreased HDL cholesterol)
- Changes in carbohydrate metabolism (e.g., insulin resistance, altered glucose levels)
These metabolic alterations can contribute to complications such as cardiovascular disease, diabetes, and cachexia in HIV-infected individuals. - Nutraceuticals
- There is no strong scientific evidence to support the use of nutraceuticals as a standalone treatment for HIV/AIDS. Some nutraceuticals might help enhance overall health or manage certain symptoms, but they should not replace conventional antiretroviral therapies (ART). Always consult a healthcare provider before adding any supplements to your regimen.
- Peptides
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Peptides can play a significant role in the context of Human Immunodeficiency Virus (HIV) infectious disease. They are often used in various aspects such as:
1. **Inhibitors**: Peptides can act as inhibitors that prevent the virus from entering host cells. Fusion inhibitors, like enfuvirtide, target the HIV-1 gp41 transmembrane protein, blocking the fusion of the viral and cellular membranes.
2. **Vaccines**: Peptides are utilized in vaccine development, where they help stimulate an immune response against HIV by mimicking parts of the viral proteins.
3. **Diagnostic Tools**: Synthetic peptides are used in diagnostic assays to detect HIV antibodies in the blood, aiding in the diagnosis of HIV infection.
4. **Therapeutics**: Research is ongoing to develop peptide-based therapeutic agents that target various stages of the HIV lifecycle.
Nanotechnology could offer transformative methods for managing and understanding HIV/AIDS:
1. **Drug Delivery**: Nanoparticles can be used to deliver antiretroviral drugs more effectively, targeting specific cells, reducing side effects, and improving drug stability and half-life.
2. **Diagnostics**: Nanosensors and nanodevices can be applied for early and precise detection of HIV, potentially at lower costs and higher efficiencies.
3. **Vaccine Development**: Nanoparticles can act as carriers for HIV antigens, enhancing the immune response in vaccine formulations.
4. **Gene Editing and Therapy**: Nanotechnology facilitates the delivery of gene-editing tools (like CRISPR/Cas9) to HIV-infected cells, potentially leading to novel treatments aimed at eradicating the virus.
The integration of peptides and nanotechnology holds promise for advancing the treatment, diagnosis, and prevention of HIV/AIDS.