Major role for genes in AIDS progression

Variations in two key genes help determine how swiftly an individual infected with HIV progresses to AIDS, according to a new study. The finding challenges quarter-century-old wisdom that what chiefly drives the advance to AIDS is "viral load," the amount of HIV in the blood, whose relentless rise bludgeons the immune system, according to a study in the British journal Nature Immunology. Instead, the authors argue, the situation is more complex. An individual's genetic profile can greatly affect replication of the human immunodeficiency virus (HIV) as well as the body's response to the intruder.

Benign to lethal

The interaction between the virus and the immune system switches "an otherwise benign infection to a lethal one," they said. The genes in question are called CCR5 and CCL3L1, although other genes, still not fully explored, may also play a part. CCR5 controls a key receptor, or docking point, on the surface of the CD4 immune cell onto which HIV latches. CCL3L1, meanwhile, controls an immune system signalling molecule called a chemokine that prevents the virus attaching itself to the CCR5 receptor. Previous work has already established that certain genetic variants in CCR5 appear to give a shield against viral entry. 

Disease progression

The viral load at the early stages of infection accounted for only nine percent of the difference in speed at which HIV-infected people progressed to AIDS. Just as important was the sort of combination of the two genes. "The genetic variations contribute nearly as much to the extent of inter-individual variability in AIDS progression rates as does HIV-1 viral load.

The CCR5-CCL3L1 profile also has an effect on the immune responses among healthy people, which suggest that this combination might play a role in how the body responds to other infectious diseases, the paper suggests. Similar research in the field of genetic variation and HIV has looked at differences among three genes that control signalling molecules called human leucocyte antigens (HLA), which tag an intruder for destruction by the immune system.

HIV Virus

To start putting together a story for the script and story board I am researching the life cycle of HIV and breaking it down into key processes it goes through to create a simple structure I can follow. Looking through a couple of websites a came across this PDF that breaks the cycle down into 6 stages. Its has been extremely useful to me to get my head around the whole process to form a logical structure. Taking this into account, following the sci-fi mission log idea, I could structure it as mission phases around these key processes.  

 

Stages: 

 

1. Binding and Fusion
    
2. Reverse Transcription
    
3. Integration
    
4. Transcription
    
5. Assembly
    
6. Budding/ Virus Release
    
    
   
   
   
   
   
    

How the HIV virus attack?

The HIV virus was first discovered in 1981  when homosexual men first had symptoms of a disease that were quite different from other viral infections. Full blown symptoms of the disease which are now indicative of AIDS were first described along with an unusual type of lung infection, weird skin tumors and upon laboratory testing of their blood samples, have revealed a significant decrease in CD4 cells which are useful in fighting infections. The HIV virus was soon seen in many countries in Europe and in Africa and by the year 1983 researchers have described the make-up of the virus that causes AIDS plus the actual definition of AIDS which is the “development of a low CD4 count  or any one of a long list of complications of HIV infection”

One of the biggest shocks of our time is the emergence and rapid spread of "disease Century" - AIDS. Today the name of this virus is not gone from the pages of newspapers, TV and sound with radios: in our country faced the problem of disposable syringes, make demands polls checking with AIDS, set up various funds to fight the virus and allocated huge sums of money to inspect and search medications. 

In other countries made similar studies, and so far the AIDS virus studied very well, but a vaccine against it could not be found. Recently, some Western scientists studying AIDS (human immunodeficiency virus), are not so much finding a vaccine, but rather explore the causes of the devastating effects of the virus in the human immune system. 

The properties of human blood, including the features available on individual species and racial groups. Perhaps as a result of these studies will find answers to the concerns of our questions: - Why only a small fraction of infected fall ill and die? - How are based on racial origin DIG sick? - Why did the bulk of sick and the dead are in Africa and the USA? This raises another, at first sight paradoxical, but a very important question: Is AIDS a real danger to our people?

The South African weekly "Patriot" reports that some data from several studies of Western scholars, suggesting that AIDS is acting strictly selective and destroys the immune system, resulting in the deaths of only those people whose veins runs the blood type of black people. That is, AIDS is a danger only to blacks, mulatto, Jews and Roma representatives whites kinds of people can be carriers of AIDS, but never ill if their immune system is not weakened by outside influences (drug addiction, alcoholism, homosexuality, etc.).

This hypothesis is based on the fact that the blood of black and white type of people varies greatly in their qualities of immunological and biochemical indicators. When you mix black and white type of people (even through the centuries and generations) remains black blood biochemical indicators. This was demonstrated as far back as 1925 by soviet scientists who discovered the chemical reaction that gives the opportunity to find racial differences in blood. During the experiment, they took the blood of Russians (type of white people) and Jewish blood (black and white hybrid), produced from each response and got different results. 

This reaction identified Jews in 91.7% of all cases, that is enough for scientific and forensic evidence. All this allows to argue about the biochemical difference between Russian and Jewish blood. On the racial specificity of certain diseases, wrote in the 20's of the famous Soviet scientist BAN Peevishness (in his works dealt with, in particular malaria). Scientific studies have refuted demand proverb - "the blood of all the same - red. Blood is different for different types of people.

Our blood, the blood of white people, not such as the blood of blacks, mulatto and Jews. And should the hypothesis is confirmed, we can not be afraid of AIDS and boldly argued: AIDS is not dangerous white PEOPLE! Examples of indirectly supporting this hypothesis, many of them. Take the least sensational story with children, infected in children's hospitals city Alistair. 

The newspapers he predicted quick death, demanding placed in isolation. Who knows how much emotional pain experienced mother, listening to tales of mortal danger to their children and feeling ill of others? But time has passed, children grows up, strengthened and now his joyous laughter destroys the myth about AIDS. Nominated hypothesis Western researchers claimed: "danger to our health is not" But under the influence of public relations, many color, not knowing about these studies are afraid of AIDS

The symptoms of aids

Acquired immune deficiency syndrome is known as AIDS and represents the part of infections and symptoms resulting from the harm to the human immune system caused by the human immunodeficiency virus (HIV). This structure constantly decreases the value of the immune system and leaves individuals in position to become infected with tumors and infections. 

HIV is spread through direct contact of a mucous membrane or the blood circulation with a physical fluid containing HIV, such as blood, seminal fluid, presentational fluid, vaginal fluid and mother's milk.The symptoms of AIDS are found as a result of infected immune system. Viruses, bacterias, parasites or fungi are the main reason for causing conditions that develop AIDS and are usually controlled by the elements of the immune system that HIV damages.

The symptoms of AIDS can be found in almost every part and every organ of the human body. In the early stage when first infected with AIDS, there is a good possibility of not having any signs and symptoms of infection, but there is a chance of flu-like condition two to four weeks after becoming infected. 

Some of the early symptoms include: pyroxene (fever), headache, rash, swollen lymph glands and sore throat (pharyngitis). Even if the person does not have these symptoms, he can transmit the virus to the people surrounding him. The virus is reproducing in lymph nodes and gradually starts to break down the helper T cells which have the role of managing the complete immune system.

Ten or more years after the first AIDS infection, this virus becomes very critical and expands into the latest phase of infection when more serious symptoms can be found. The number of CD4 lymphocyte is less than 200 while normal count varies from 800 to 1,200. In this period the immune system of the person infected by the virus is much damaged, making it very sensitive to similar infections. 

 The signs and symptoms of some of these infections may contain: headaches, weight reduction, chronic diarrhea, soaking night sweats, dry cough and difficulty in breathing, blurred and distorted vision, steady white spots or unusual lesions on the tongue or in the mouth, shaking chills or fever higher than 38 C for several weeks.

Alarming Facts!

Exposure to the HIV virus cannot be determined accurately by individuals; because as people do so many things, meet a lot of people, and live a fast-paced life, the brain gets loaded with too much information that small details, such as having a one-night stand over a couple of beers, might be forgotten. Moreover, there are no symptoms of AIDS that are evident at the onset of the infection.

There is no way for a person to know whether one has AIDS or not than to go to the nearest hospital or testing center and get tested for AIDS. This is due to the fact that one characteristic of the AIDS virus which is the Human Immunodeficiency Virus (HIV) has a latency period. 

This means that the virus stays dormant for weeks. This is also the reason why it takes at least 12 weeks for the AIDS test to show whether it is negative or positive. As such, symptoms of AIDS are not clearly manifested until such time that HIV has fully taken over the immune system.

If HIV infection produces no signs and symptoms this is referred to as asymptomatic infection. But most number of people experience symptoms similar to that of a flu accompanied by fever and rashes, swollen lymph nodes and sore throat two weeks after exposure. All these have been considered as symptoms of AIDS in its early stage. 

Apparently, all of these symptoms are the results of the weakening of the immune system as the human immunodeficiency virus continues to ravage a person's protective system. After these series of symptoms which is collectively known as the acute retro viral syndrome, latency period begins; this is the second stage. The virus lays dormant for a period of time. No symptom or illness is seen and the person may even appear healthy even if tests show positive for HIV.

The Centers for Disease Control and Prevention defines the person as having an AIDS T-cell count of less than 200, wherein the normal count is between 600-1,500 T-cells; and manifesting at least 1 of the 21 AIDS defining infections characterized as opportunistic.

Symptoms of AIDS appear in 5 ways: as pulmonary infections, gastrointestinal infections, neurological and psychiatric episodes, tumors and malignancies and other opportunistic infections. Symptoms of AIDS become apparent and more pronounced during the late stages of the disease.

Prevention is clearly better than cure as the old maxim goes. True, there is still no cure for AIDS but people can always help those inflicted with the disease make their condition bearable; and for those who are free of the virus, it is better to take precautions especially in the area of sexual practices. 

Sexual promiscuity should be avoided. Drug dependents should stay away from drugs and start getting clean; and people in need of blood products should only go to accredited and licensed blood banks and similar establishments.

If you are not certain whether you have AIDS or not you may gather information through reading various materials, talking to friends and family or doctors who are experts in the study of venereal disease; but the best way to make sure if you have

What symptoms are present in the later stage on infection ?

As the HIV virus continues to multiply in the host's body it destroys the person's immunity completely and makes him prone to attacks by not only very serious debilitating diseases, but very mild infections as well.

The count of the helper T cells (CD4 lymphocytes), which are typically in the range of 600 to 1,000, drop below 200 after which the person begins to show other serious signs of the disease.

With the person's immunity system completely damaged, he becomes easily susceptible to opportunistic infections and may frequently experience the more serious symptoms of AIDS such as the following:

1. Severe fatigue

2. Soaking night sweats and high fever is very common among HIV positive patients.

3. Frequent episodes of chronic diarrhea

4. Shortness of breath is very commonly experienced by HIV positive patients.

5. Swelling and hardening of lymph nodes which persists for more than three months

6. Excessive weight loss which is not deliberately achieved through increased physical exercises or through dieting

7. Severe persistent headache

8. The presence of a slightly purple or faded growth over the skin or inside the mouth is very common among HIV positive patients.

9. HIV positive children's growth is poor, usually characterized by poor weight gain, trouble in walking, and slow mental development. Such children are also very susceptible to infections such as those relating to the ear, nose and throat like ear infection (otitis media), pneumonia or tonsillitis. They are also easily prone to more bruising and bleeding than their healthy and normal counterparts.

10. Apart from these physiological symptoms, it is also very common to find certain mental and behavioral disorders such as personality changes, deterioration of cognitive abilities of a person and degenerated memory in HIV positive patients.

Economic Impact

HIV and AIDS slows economic growth by destroying the man with the ability of production (human capital).  Without proper nutrition, health facilities and medicines in developing countries, people in these countries became victims of AIDS. They not only can not work, but will also require adequate health facilities. Forecast that this will lead to economic collapse and relationships in the region. In areas heavily infected, the epidemic has left many orphans are cared for by grandparents who were old.

The higher rate of death (mortality) in a region will lead to shrinking working population and those skilled. Fewer workers will be predominantly young, with knowledge and experience fewer employment so that productivity will decrease. Increased worker leave to see family members who are sick or on leave due to illness will also reduce productivity.

Increased mortality will also weaken the mechanisms of production and human resource investment (human capital) in the community, which is due to loss of income and the death of the parents. Because of AIDS caused the death of many young adults, it weakens the population of taxpayers, reduce public funding such as education and health facilities that are not associated with AIDS.

This puts pressure on state finances and slow economic growth. Effects slowing growth in the number of taxpayers will increasingly be felt in case of increased spending for the handling of the sick, training (to replace sick workers), the replacement cost of illness, and care of AIDS orphans. This is especially likely to occur if the sharp increase in adult mortality lead to displacement of responsibility and blame, from family to government, to deal with the orphans.

At the household level, AIDS caused the loss of revenue and increase health spending by a household. Decreased income leads to reduced expenditure, and there are also effects the transfer of education expenditure towards health and funeral expenses. Research in Côte d'Ivoire showed that households with HIV / AIDS patients to pay twice as much for medical care than for other household expenses.

The stigma of AIDS can be further divided into three categories:

* Instrumental AIDS Stigma - the reflection of fear and concern for matters related to deadly and infectious diseases.
* Stigma symbolic AIDS - namely the use of HIV / AIDS to express attitudes toward social groups or a particular lifestyle that is considered associated with the disease.
* Courtesy stigma of AIDS - the social penalties for those dealing with issues of HIV / AIDS or HIV positive people.

The stigma of AIDS is often expressed in one or more stigma, especially related to homosexuality, bisexuality, prostitution, and drug use by injection.

In many developed countries, there is a connection between AIDS and homosexuality or bisexuality, which correlates with the level of sexual prejudice is higher, such as anti-homosexual attitudes.  Similarly, there is a perceived association between AIDS and sexual relations between men, including when the relationship between uninfected partners.

Alternative medicine

Various forms of alternative medicine used to treat symptoms or alter the direction of progression of the disease.  Acupuncture has been used to overcome some of the symptoms, such as the edge of nervous disorders (peripheral neuropathy), such as leg cramps, tingling or pain; but does not cure HIV infection.

Tests randomized clinical trials on the effects of herbal medicines show that there is no evidence that medicinal plants are having an impact on the progression of the disease, but instead the possibility of giving a variety of serious negative side effects.

Some data show that multivitamin and mineral supplements to reduce the possibility of progression of HIV disease in adults, although there is no convincing evidence that the death rate (mortality) will be reduced in people who have good nutritional status.  Vitamin A supplementation in children children may also have some benefits.  The use of selenium dose daily routine can lower HIV viral load pressure through an increase in CD4 count. Selenium can be used as a complementary therapy to a variety of standard antiviral treatment, but can not be used alone to reduce mortality and morbidity.

Recent investigation showed that the treatment therapy alteratif have little effect on mortality and morbidity of this disease, but can improve the quality of life for individuals suffering from AIDS. Psychological benefits of various alternative therapies that really is the most important benefits from its use.

But the research that revealed the presence of simtoma hipotiroksinemia in patients with AIDS who contracted HIV-1 virus, some experts suggest intake of hormone therapy with thyroxine.  The hormone thyroxine is known to increase basal metabolic rate of eukaryotic cells and improve the pH gradient in mitochondria.

Handling of experimental and advice

There has been the opinion that the vaccine was only suitable to withstand the global epidemic (pandemic) vaccine because the cost is cheaper than the cost of other treatments, so that developing countries are able to enable it and patients do not require daily maintenance. However, after more than 20 years of research , HIV-1 remains a difficult target for vaccines.

Various research to improve care, including efforts to reduce the side effects of drugs, simplification of combination of drugs to facilitate usage, and determining the best sequence of treatment combinations to the face of drug resistance.

Several studies have shown that preventive measures can be useful opportunistic infection when treating patients with HIV infection or AIDS. Vaccination for hepatitis A and B is recommended for patients who are not infected with this virus and the risk for infection.

Patients who experience immune suppression is also suggested that large receive preventive therapy (prophylactic) for pneumococcal pneumonia, as well as patients with toxoplasmosis and cryptococcal meningitis many who would benefit from such prophylactic therapy.

Antiviral therapy

Current handling of HIV infection is highly active antiretroviral therapy (highly active antiretroviral therapy, HAART abbreviated).  This therapy has been very beneficial to people who are infected with HIV since 1996, ie after HAART initially became available protease inhibitors.

Current optimal HAART options, a combination of at least three drugs (so-called "cocktail), which consists of at least two kinds (or" classes ") antiretroviral materials. Typical is a nucleoside analogue reverse transcriptase inhibitors (or NRTIs) with protease inhibitor, or with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Because HIV disease progress faster in children than in adults, it was more aggressive treatment recommendations for children than for adults.

In the state- developing countries that provide HAART treatment, a doctor will consider the quantity of viral load, CD4 reduced speed, and mental readiness of patients, while choosing the time to start treatment early.

HAART allows stable maintenance of symptoms and viremia (the large number of viruses in the blood) in patients, but it does not cure or eliminate the symptoms of HIV.

HIV-1 in a high level are often resistant to HAART and the symptoms return after treatment is stopped.  Moreover, it takes more than a lifetime to clear HIV infection using HAART. Many people with HIV experience a great improvement in general health and quality of life, resulting in a drastic reduction of morbidity (morbidity) and death rate (mortality) due to HIV.

Without HAART treatment, changes in HIV infection into AIDS occurs at a mean (median) between nine to ten years, and subsequent survival time after contracting AIDS was 9.2 months. The application of HAART is thought to increase the survival time of patients for 4 to 12 years. For several other patients, whose numbers may be more than fifty percent, HAART treatment gives results far from optimal.

This is because of side effects / impact of treatment can not be tolerated, previous antiretroviral therapy is not effective, and certain infections are drug resistant HIV. Noncompliance and irregularities in implementing antiretroviral therapy is the main reason why most individuals fail to benefit from the application of HAART.

There are various reasons for the attitude of disobedience and irregular for the application of HAART. Psychosocial issues is the lack of access to primary health facilities, lack of social support, mental illness and drug abuse. HAART treatment is also complex, due to various combinations of the number of pills, dosing frequency, meal restrictions, and others who should be run regularly.  A variety of side effects that also lead to reluctance to regularly in the application of HAART, include lipodystrophy, dislipidaemia, insulin resistance, increased risk of cardiovascular system, and congenital abnormalities in babies born.

 Anti-retroviral drugs were expensive, and the majority of individuals infected in the world does not have access to treatment and care for HIV and AIDS.

Transmission from mother to child

Studies indicate that antiretroviral drugs, caesarean section, and formula feeding reduce the chances of HIV transmission from mother to child (mother-to-child transmission, MTCT).  If replacement feeding is acceptable, feasible, affordable, sustainable , and safe, HIV-infected mothers are advised not to breastfeed their children.

 However, if these things can not be met, exclusive breastfeeding is recommended during the first months and then stopped as soon as possible. In 2005, approximately 700,000 children under 15 years of contracting HIV, mainly through maternal transmission to children; 630 000 infections of which occur in Africa. Of all the children who allegedly are now living with HIV, 2 million children (nearly 90%) live in Sub-Saharan Africa.

Infected body fluid contamination

Medical workers who follow universal precautions, like wearing latex gloves when injecting, and always wash your hands, can help prevent HIV infection.

All AIDS-prevention organizations advise drug users to not share needles and other materials necessary to prepare and take drugs (including syringes, cotton balls, spoons, water-thinning drug, straws, etc.). People need to use a new needle for each injection and sterilized. Information on cleaning needles using bleach is provided by healthcare facilities and needle exchange programs.

In some developed countries, clean needles are free in some cities, at needle exchange or safe injection sites. Many countries have legalized the possession of needles and injecting equipment allows the purchase from pharmacies without a prescription.

Sexual Relations

The majority of HIV infection from unprotected sexual relations between individuals one of whom has HIV. Heterosexual intercourse is the main mode of HIV infection in the world.  During sexual intercourse, only the male condom or female condom can reduce the likelihood of HIV infection and other sexually transmitted diseases as well as the possibility of pregnancy.

The best current evidence indicates that condom use reduces the risk of transmission of HIV prevalent until approximately 80% in the long run, although this benefit is greater if condoms are used correctly on every occasion.

Male condoms made from latex, if used correctly without oil-based lubricants, is the single most effective technology today to reduce the sexual transmission of HIV and other sexually transmitted diseases. Parties condom manufacturers recommend that oil-based lubricants like petroleum jelly, butter, and lard not be used with latex condoms because these materials can dissolve latex condoms and make holes. If necessary, the manufacturers recommend using water-based lubricants. Used oil-based lubricants with polyurethane condoms.

The female condom is an alternative to male condoms made of polyurethane, which allows it to be used with oil-based lubricants. Female condoms are larger than the male condom has an open end and ring-shaped hard, and are designed to be inserted into the vagina.

 The female condom has a ring inside that makes the condom remains inside the vagina - to insert the female condom, the ring must be pressed. Obstacles is that now the female condom is still rarely available and the price is not affordable for large numbers of women. Preliminary research indicates that with the availability of female condoms, sexual relations with a protective overall increase relative to unprotected intercourse, so that the female condom is an important HIV prevention strategy.

Research on the one infected partner show that with consistent condom use, the rate of HIV infection to an uninfected partner are below 1% per year.  The strategy of prevention has been well recognized in developed countries.

However, behavioral and epidemiological research on in Europe and North America showed the presence of minority groups of young people who still do high-risk activities despite knowing about HIV / AIDS, thus ignoring the risks they face on HIV infection. However, HIV transmission antarpengguna drugs has decreased, and HIV transmission by blood transfusion is becoming quite rare in developed countries.


 In December 2006, research using randomized controlled trials confirmed that male circumcision reduces the risk of HIV infection in heterosexual African men by about 50%. It is hoped this approach will be promoted in many countries are infected with HIV is most severe, although its application will be faced with a number of issues in relation to practicality, culture, and behavior. Some experts are concerned that the perception of a lack of susceptibility of HIV in male circumcision, may increase risky sexual behavior, thereby reducing the impact of these prevention efforts.

HIV Testing

Many people do not realize that they are infected with the HIV virus. Less than 1% of urban population in Africa are sexually active has been tested for HIV, and the percentage is even less in rural areas. In addition, only 0.5% of women who came to contain urban public health facilities to obtain guidance on AIDS, underwent the examination, or receive their test results. This figure is even smaller in rural public health facilities.  Thus, the blood of donors and blood products used for treatment and medical research, should always be examined HIV contamination.

Common HIV tests, including HIV enzyme imunoasai and Western blot testing, performed to detect HIV antibodies in serum, plasma, oral fluid, dried blood, or urine of patients. However, the period between infection and the development of infection-fighting antibodies that can detect (window period) for each person may vary. This is why it takes 3-6 months to determine seroconversion and positive test results. There are also commercial tests to detect other HIV antigens, HIV-RNA, and HIV-DNA, which can be used to detect HIV infection despite the development of antibodies can not be detected. Although these methods are not specifically approved for the diagnosis of HIV infection, but has been used routinely in developed countries.

CDC classification system

There are two definitions of AIDS, both of which are issued by the Centers for Disease Control and Prevention (CDC). Initially the CDC does not have an official name for this disease; that AIDS was referred to the name of the diseases associated with it, for example, is lymphadenopathy.

The discoverer of HIV even in the first name with the name of the AIDS virus. The CDC started using the word AIDS in September 1982, and defines the disease. In 1993, the CDC expanded their definition of AIDS to include all people the number of CD4 + T cells below 200 per mL of blood or 14% of all limfositnya as people with HIV positive.  The majority of AIDS cases in developed countries use both these definitions, both the CDC definition and the pre-1993 past. A diagnosis of AIDS is maintained, although the number of CD4 + T cells increased over 200 per mL of blood after treatment of diseases or signs that there had been cured of AIDS.

Perinatal transmission

Transmission of HIV from mother to child can occur through the womb (in utero) during the perinatal period, ie the last weeks of pregnancy and during labor. If not treated, the rate of transmission from mother to child during pregnancy and childbirth is 25%. However, if the mother had access to antiretroviral therapy and gave birth by cesarean, the rate of transmission is only 1%.  A number of factors may influence the risk of infection, especially viral load in the mother during delivery (the higher the viral load, the higher risk). Breastfeeding increases the risk of transmission of 4%.

Contamination of blood-borne pathogens

Routes of transmission is primarily associated with injecting drug users, hemophiliacs, and recipients of blood transfusions and blood products. Sharing and reusing syringes (syringe) containing blood contaminated by biological disease-causing organisms (pathogens), not only is the main risk for HIV infection, but also hepatitis B and hepatitis C.

Sharing the use of syringes is the cause of one third of all new HIV infections and 50% of hepatitis C infection in North America, People's Republic of China, and Eastern Europe. Risk of being infected with HIV from a single prick with a needle used HIV-infected people suspected of approximately 1 in 150. Post-exposure prophylaxis with anti-HIV drugs can further reduce that risk.

 Workers' health facilities (nurses, laboratory workers, doctors, etc.) are also feared, although less frequently. Routes of transmission may also occur in people who give and receive a tattoo and body piercing. Universal precautions are often not adhered to both in sub-Saharan Africa and Asia because of lack of resources and inadequate training. 

WHO estimates that 2.5% of all HIV infections in sub-Saharan Africa are transmitted through injection at the health facilities that are not safe.  Therefore, the General Assembly of the United Nations, supported by general medical opinion on the issue, encouraging state- countries in the world to implement universal precautions to prevent HIV transmission through health facilities.

The risk of HIV transmission to recipients of blood transfusions is very small in developed countries. In developed countries, improved donor selection and HIV conducted observations. However, according to the WHO, the majority of the world's population lack access to safe blood and "between 5% and 10% of 

HIV infections worldwide occur through transfusion of infected blood".

Sexual transmission

Transmission (transmission) of HIV is sexually occurs when there is contact between the secretion of vaginal fluids or fluids preseminal someone with rectum, genitals, or mucous membranes of the mouth of her partner. Receptive unprotected sexual intercourse is more risky than unprotected insertive intercourse, anal intercourse and the risk is greater than usual risk sex and oral sex.

Oral sex does not mean no risk because HIV can enter through both insertive and receptive oral sex.  Sexual violence in general increased the risk of HIV transmission is not generally used as a protective and often physical trauma to the vaginal cavity which facilitates the transmission of HIV.

Sexually transmitted diseases increase the risk of HIV transmission because it can cause the disruption of normal epithelial tissue as a result of genital ulcers, and also because of the accumulation of HIV-infected cells (lymphocytes and makrofaga) in semen and vaginal secretions.

Epidemiological studies from Sub-Saharan Africa, Europe and North America showed that there were approximately four times greater risk of becoming infected with HIV as a result of genital ulcers such as those caused by syphilis and / or chancroid.

Risk is also increased significantly, although much smaller, by the presence of sexually transmitted diseases like gonorrhea, chlamydia infection and trichomoniasis which cause local accumulations of lymphocytes and makrofaga.

Transmission of HIV depends on the infectiousness of people with and susceptibility of the uninfected partner. Infectivity seems to vary at different stages of the disease and not constant between individuals. Plasma viral load that can not be detected does not necessarily mean that low viral load in semen or genital secretions.

Every 10 times increase in the number of blood plasma HIV RNA is proportional to the 81% increase in the rate of HIV transmission.  Women are more susceptible to HIV-1 infection due to hormonal changes, vaginal microbial ecology and physiology, and greater vulnerability to sexual diseases .  People who are infected with HIV can still be infected with other virus types are more deadly.

Cause aids

AIDS is the worst form for the consequences of HIV infection. HIV is a retrovirus that usually attacks the vital organs of the human immune system, such as CD4 + T cells (a type of T cells), makrofaga, and dendritic cells. HIV damages the CD4 + T cells directly and indirectly, whereas CD4 + T cells needed for immune system to function properly. When HIV has killed CD4 + T cells to the number shrinks to less than 200 per microliter (mL) of blood, then the immunity at the cellular level will be lost, and the result is a condition called AIDS. Acute HIV infection will progress to clinically latent infection, and symptoms of early HIV infection, and eventually AIDS, which is identified by examining the number of CD4 + T cells in the blood and the presence of certain infections.

Without antiretroviral therapy, the average duration of progression of HIV infection to AIDS is nine to ten years, and the average survival time after AIDS is only about 9.2 months.  However, the rate of progression of the disease in each person varies greatly , that is from two weeks to 20 years. Many factors influence it, such is the strength of the body to defend against HIV (such as immune function) from an infected person. Parents generally have a weaker immunity than younger people, so more at risk of disease progression rapid. Less access to health care and the presence of other infections such as tuberculosis, can also accelerate the progression of this disease.  genetic heritage infected person also plays an important role. Some people are naturally resistant to some HIV variants.  HIV has some genetic variation and a variety of different forms, which will cause the rate of progression of clinical disease are different also.  Highly active antiretroviral therapy will be able to extend the average time berkembangannya AIDS , and the average time the ability of patients to survive.

Other opportunistic infections

AIDS patients usually suffer from opportunistic infections with non-specific symptoms, especially low-grade fever and weight loss. These opportunistic infections including infections with Mycobacterium avium-intracellulare and cytomegalovirus. Cytomegalovirus can cause inflammation of the colon (colitis) as described above, and disturbances in retinal inflammation (cytomegalovirus retinitis), which can cause blindness. Infections caused by the fungus Penicillium marneffei, or called Penisiliosis, opportunistic infections now are the third most common (after tuberculosis and cryptococcosis) in HIV positive people in endemic areas of Southeast Asia.

Neurological disease and major psychiatric

HIV infection can cause a range of behavioral disorders due to neurological disorders (neuropsychiatric sequelae), which is caused by infection with organisms of the nervous system that have become vulnerable, or as a direct result of the disease itself.

Toxoplasmosis is a disease caused by a single-celled parasites, called Toxoplasma gondii. This parasite usually infects the brain and causes acute encephalitis (Toxoplasma encephalitis), but it can also infect and cause disease in the eyes and lungs. 

Cryptococcal meningitis is an infection of the meninges (membranes covering the brain and spinal cord) by the fungus Cryptococcus neoformans. It can cause fever, headache, fatigue, nausea, and vomiting. Patients also may experience convulsions and confusion, which if untreated can be deadly.

Leukoensefalopati is progressive multifocal demyelinating disease, which is a disease that destroys nerve sheath (myelin) that covers nerve cell fibers (axons), thus damaging the delivery of nerve impulses. It is caused by the JC virus, which contained 70% of the population in the human body in a latent condition, and cause disease only when the immune system is weakened, as occurs in AIDS patients. The disease is growing rapidly (progressive) and spread (multilokal), so that usually causes death within a month after diagnosis. 

AIDS dementia complex is a disease of mental decline (dementia) that occur because of decreased brain cell metabolism (metabolic encephalopathy) caused by HIV infection, and driven also by the occurrence of immune activation by macrophages and microglia in the brain that become infected with HIV, so that secrete neurotoxins.

Damage to the nerve specific, abnormalities appear in the form of cognitive, behavioral, and motor, which appeared many years after HIV infection occurs. This is related to the low state of CD4 + T cell counts and high viral loads in blood plasma. Figures occurrence (prevalence) in Western countries is around 10-20%,  but in India only occurs in 1-2% of people with HIV infection.  This difference may occur because of different HIV subtypes in India.

AIDS is one of the deadliest diseases

AIDS is one of the deadliest diseases that has spread all over the globe like an epidemic within a very short time span of 50 - 60 years. Official statistics indicate that the AIDS pandemic claimed approximately 3.1 million lives in 2005, of which 570,000 deaths were of innocent children afflicted with this disease. 

This does not include the large number of unreported cases from all over the globe owing to the stigma associated with it, which causes the development of shame, guilt, and hopelessness to set in.

The early symptoms of HIV infection, which develops within 3 to 6 weeks of exposure to the HIV virus, is similar to that of flu and the person may experience mild fever, a dull headache, severe exhaustion, a persistent vomiting sensation, episodes of diarrhea, sore throat and enlarged lymph nodes, accompanied by body rash. 

However, these symptoms are short lived and disappear within a week or maximum within a month of contacting the infection. Thereafter, the person experiences no symptoms at all.

Since the first reported case of AIDS some 25 years ago, the disease has already become one of the most feared all over the world. Twenty-five million people have already died of AIDS since the virus first appeared. There are approximately 38.6 million people who are afflicted with HIV (or human immunodeficiency virus), which is also the main cause of AIDS. 

HIV damages the cells that make up the immune system, thus resulting in the body's inability to ward off fungi, viruses and bacteria that set off diseases. Upon the first infection of HIV, there might not immediately be AIDS symptoms at all. 

In fact, there are even cases of HIV infections that show absolutely zero symptoms of any kind. However, it is also common for those with HIV infections to experience flu-like symptoms that commonly appear up to six weeks after the initial infection. 

But, as these symptoms like swollen lymph glands, headaches, rashes, fever and sore throat are similar to those exhibited by other illnesses, a person may not realize that they have been infected with HIV until it is too late. 

Even if a person does not have AIDS or show HIV symptoms yet, he is still capable of transmitting this illness to persons that he might come in contact with sexually. It has to be remembered that once this virus gets into the body, there really is no turning back because it will immediately attack the body's immune system.

While a person who has contracted HIV infection could experience no symptoms at all for as long as ten years or more, this does not mean that the virus has stopped in growing in numbers and in destroying the immune cells of the body. 

The person may only experience some chronic symptoms or mild infections that they may only see as not serious. These include diarrhea, fever, shortness of breath or cough and swollen lymph nodes.

Getting such an infection usually means that the immune system of the victim is already very much destroyed by the HIV virus.

Symptoms of AIDS and Sex life

The most common cause of AIDS is considered to be the unprotected sex. Sex without taking proper precaution like condom is very much responsible for AIDS. AIDS is generally transmitted through the semen. It is estimated that more than three million people round the globe had died through AIDS. 

During the prenatal stage also it is found that the mother will transmit the disease to the fetus before it is born. AIDS is transferred to the blood through the means of transfusion of blood into another’s body cell. Besides these, AIDS can also be caused through the use of injections which are not properly sterilized in the process of taking drugs or blood into the veins.

Symptoms of AIDS are not visible at the early stage. But at least after a period of 3 to 6 weeks the symptoms of AIDS can be noticed through certain flu like sickness. Besides these, symptoms like headache, nausea, fever, fatigue, diarrhea, etc. are also considered as other AIDS symptoms. 

But it can be mentioned out here though these symptoms occur in an AIDS patient; it lasts for only a temporary period of time after which it disappears. Sometimes acute AIDS symptoms also cannot be considered as the symptoms of AIDS, as they may also be found to be very much common to other forms of diseases.  

Thus symptoms either mild or severe cannot be considered as solely the symptoms of AIDS as other forms of sickness or diseases also witness the similar symptoms. But however, when the disease reaches its critical stage, the symptoms become very much acute thus leading to loss of weight, recurrent fever and also occurrence of certain fatal diseases. 

AIDS thus totally destroys the immune system of the body totally. AIDS is thus a deadly disease which is the result of unprotected sex, hence to prevent it is to avoid unprotected sex.

Twenty-five million people have already died of AIDS since the virus first appeared. There are approximately 38.6 million people who are afflicted with HIV (or human immunodeficiency virus), which is also the main cause of AIDS. HIV damages the cells that make up the immune system, thus resulting in the body's inability to ward off fungi, viruses and bacteria that set off diseases.

Upon the first infection of HIV, there might not immediately be AIDS symptoms at all. In fact, there are even cases of HIV infections that show absolutely zero symptoms of any kind. However, it is also common for those with HIV infections to experience flu-like symptoms that commonly appear up to six weeks after the initial infection. But, as these symptoms like swollen lymph glands, headaches, rashes, fever and sore throat are similar to those exhibited by other illnesses, a person may not realize that they have been infected with HIV until it is too late.

Even if a person does not have AIDS or show HIV symptoms yet, he is still capable of transmitting this illness to persons that he might come in contact with sexually. It has to be remembered that once this virus gets into the body, there really is no turning back because it will immediately attack the body's immune system. 

While a person who has contracted HIV infection could experience no symptoms at all for as long as ten years or more, this does not mean that the virus has stopped in growing in numbers and in destroying the immune cells of the body. 

The person may only experience some chronic symptoms or mild infections that they may only see as not serious. These include diarrhea, fever, shortness of breath or cough and swollen lymph nodes.

ED and AIDS virus

Erectile dysfunction refers to difficulty in getting the penis erect or maintaining it in the erect position for substantial periods. Men with erectile dysfunction are able to ejaculate, but the satisfaction of intercourse is minimal. 

Besides, penile problems can indicate much serious conditions such as diabetes, cardiovascular problems and nervous disorders. Men need to realize that an erectile dysfunction disorder is nothing to be ashamed of and that it can be cured in almost every situation.

 The first course of action that most men adopt for erectile dysfunction is the drug Sildenafil, popularly called Viagra. However, in nearly a third of the cases, the patients do not respond to Viagra. Moreover, Viagra can be potentially lethal to men with cardiovascular disease and hence the drug cannot be prescribed to all. 

 Nonetheless, there are various other solutions to dysfunction problems, but before a treatment can be finalized the underlying cause for the dysfunction needs to be identified. Sometimes, men cannot achieve erection because of performance anxiety and such an issue can be resolved in a few sessions with a psychologist.

  Many individuals don't realize that AIDS is a virus. The full name is acquired immune deficiency syndrome. It is a disease that affects the immune system of the human being. There is such a stigma attached to this condition that it creates a whole gambit of emotions and responses from the person suffering from it. To begin with, they do not want to be classed as being sexually promiscuous.

What happens in the body is as time progresses with the individual afflicted from this is the immune system becomes weaker and weaker because of this virus, which means in the long run the individual becomes more susceptible to all other types of afflictions and health problems.

AIDS is the most advanced part of HIV. Over the last several years, we've come a long way in being able to slow it down but to date there is still no cure.

It's been pretty well determined that the condition can be spread through sex, or hypodermic needles for example but basically it comes down to direct contact with any mucous membrane or the bloodstream or any body fluid that contains the HIV virus.

Most people have generally accepted the causes of the way of contracting the disease but there is still a handful who believes that there are other methods that it can be picked up as well such as a door handle or public washrooms for example.

There is no one part of the body that is safe from the effects of AIDS. Most often individuals go to their doctor complaining of just general poor health then through this investigation of the problem AIDS will often show up as being the culprit.

Based on this many people are afraid to go to the doctor because they are concerned about being diagnosed. There are thousands of people that walk around every day with HIV and don't even know they have it and this is what makes it dangerous in respect to sexual acts of those who are unsuspecting of the AIDs virus.

Global Problem - Yes or No?

Many countries have learned to combat the spread of HIV, statistics show that Turkey still suffers from a large number of diseases, and the Turks - of ignorance in this area.

"For high school students do not draw any educational sessions on HIV and AIDS, and yet, many of them already have sex,".

"Around 5000 people in Turkey were infected with HIV in 2011, according to official data, whereas last year the number of infected people was 4525. And the hotbed of the disease has more than 25 million tourists a year,. No discrimination against HIV infected patients, nor the number of patients has not decreased in recent years in Turkey, unlike other developed countries. The Ministry of Health is not serious to the problem. "

According to the World Health Organization, the actual number of AIDS patients is ten times higher than official statistics. Many patients deliberately do not go to hospitals to avoid possible discrimination. With such discrimination faced by all HIV-infected people in Turkey.

Despite the growing number of newly infected, the Ministry of Health in Turkey has not taken any effective steps to address this problem. Officially, we have a National Commission on HIV, but in fact she was not going to never in the past three years.

Aids and their handling

Until now, hear the words HIV / AIDS as a terrible scourge. In fact, if understood in a logical, HIV / AIDS can be easily avoided. How is that? 

Prevalence of HIV / AIDS in Indonesia has been moving at a very alarming rate. In 1987, HIV / AIDS cases are found for the first time only on the island of Bali. While the present (2007), almost all provinces in Indonesia have discovered cases of HIV / AIDS. 

The problem of HIV / AIDS has long since become common issue that continues to siphon attention of various circles, especially the health sector. But in fact still a lot of information and understanding of these health problems are still unknown even further by the community. 

HIV is the virus that causes AIDS. HIV present in a person's body fluids such as blood, genital fluids (semen or vaginal fluids of an infected) and breast milk that has been infected.  

While AIDS is a syndrome of decreased immunity caused by HIV. People who develop AIDS very easily infected by various diseases because the immune system of patients had.

HIV can be transmitted to others through:

    * Sexual intercourse (anal, oral, vaginal) unprotected (without condoms) with men who have been infected with HIV.
    * Syringe / piercings / tattoos are not sterile and are used interchangeably

    * Obtain a blood transfusion containing HIV virus

    * Mother-to-child HIV-positive patients when in the womb, during birth or through breast milk (milk) 

Transmission
HIV is not transmitted through normal social relationships such as handshakes, touching, kissing usual, hugging, eating and drinking use of equipment, mosquito bites, swimming pools, use the bathroom or WC / toilet which is equal to or lived in the same house with people living with HIV / AIDS ( PLWHA). PLWHA are living with HIV or AIDS. While OHIDA (People living with HIV or AIDS), namely the family (children, wife, husband, father, mother) or friends of people living with HIV or AIDS. 

More than 80% of HIV infection affects mainly the productive age group of men, but the proportion of female HIV patients tend to increase. Infection in infants and children, 90% occurred from mother with HIV. Until a few years, a person with HIV do not show clinical symptoms of HIV infection, however, that person can pass on to others. After that, AIDS began to grow and show signs or symptoms. 

Clinical signs of AIDS patients: 

  1. Body weight decreased by more than 10% within 1 month
   2. Chronic diarrhea lasting more than 1 month
   3. Fever lasting more than 1 month
   4. Impairment of consciousness and neurological disorders
   5. Dementia / HIV encephalopath
Minor symptoms:

   1. A cough settled more than 1 month
   2. Generalized dermatitis is itchy
   3. The existence of multisegmental Herpes zoster and recurrent
   4. Recurring fungal infection in a woman's genitals

HIV and AIDS can affect anyone. But on the vulnerable groups have a great risk of contracting HIV causes AIDS, namely:

   1. People who behave sexually with multiple partners without using condoms
   2. Injecting drug users who use needles together
   3. Sexual partners of injecting drug users
   4. Infants whose mothers are HIV positive

HIV can be prevented by the chain of transmission, namely, using a condom at every risk sex, not using needles bersam together, and where possible not to give milk to the child if the mother is HIV positive. Until now there is no medicine that can cure AIDS, but that there is a drug to suppress the development of the HIV virus so that the quality of life for people living with HIV is increasing. This medicine must be taken throughout life. 

Screening With Modern Technology
Most HIV tests are antibody tests that measure antibodies made by the body to fight HIV. He takes time for the immune system to produce enough antibodies to be detected by antibody tests. This time period can vary from one person to another.

This period is usually diseput as a 'window period'. Most people will develop detectable antibodies within 2 to 8 weeks. However, there is the possibility that some individuals will require more time to develop antibodies that can be detected. So, if the initial negative HIV test performed within 3 months after possible exposure to germs, repeated tests should be done about 3 months later, to avoid the possibility of false negative results. 97% of men will develop antibodies in the first 3 months after HIV infection occurs. In very rare cases, it will take 6 months to develop antibodies to HIV.

Another type of test is a test of RNA, which can detect HIV directly. The time between HIV infection and detection of RNA is between 9-11 days. This test, which is more expensive and used less often than antibody tests, have been used in several areas in the United States.

In most cases the EIA (enzyme immunoassay) was used on blood samples taken from a vein, is the most common screening test to detect HIV antibodies. EIA positive (reactive) should be used with conformation like Western Blot test to confirm a positive diagnosis.  

There are several types of EIA tests that use other body fluids for antibodies to HIV.

They are :

    *

      Oral Fluid Test. Using oral fluid (not saliva) collected from the mouth using a special tool. This is an EIA antibody test similar to blood tests by EIA. Test conformation with Western blot method performed with the same sample.

    *

      Urine Test. Using the urine, not blood. Sensitivity and specificity of this test is not as good as blood tests and oral fluid. It also needs test conformation with Western blot method with the same urine samples.

If a patient is HIV-positive results, it does not mean that her life partner is also positive. HIV can not be transmitted every time there was a sexual relationship. The only way to know whether these patients have a life partner HIV positive or not is to perform HIV tests.

Test HIV during pregnancy is important, because anti-viral therapy can improve maternal health and reduce the likelihood of an HIV-positive pregnant women to transmit HIV to her child on before, during, or after birth. Therapy should be initiated as early as possible in pregnancy.