Acquired Immunodeficiency Syndrome
|Acquired Immunodeficiency Syndrome|
| Part of a series on the AIDS Pandemic
Acquired Immune Deficiency Syndrome (usually referred to as AIDS) is an (at present) incurable disease caused by long-term infection with theHuman Immunodeficiency Virus. In September 2010, Reuters reported: "Nearly one in five gay and bisexual men in 21 major U.S. cities are infected with HIV, and nearly half of them do not know it". A September 2010 report of the Centers for Disease Control and Prevention (CDC) declared : "Gay, bisexual, and other men who have sex with men (MSM) represent approximately 2% of the US population, yet are the population most severely affected by HIV and are the only risk group in which new HIV infections have been increasing steadily since the early 1990s. In 2006, MSM accounted for more than half (53%) of all new HIV infections in the United States..." In August 2009, LifeSiteNews reported: "An official with the Centers for Disease Control and Prevention (CDC) announced the CDC's estimate Monday that in the United States AIDS is fifty times more prevalent among men who have sex with men ('MSM') than the rest of the population."
- CD4 count less than 200 or
- CD4 percentage less than 14% of total lymphocytes or
- Any of the following illnesses: pulmonary TB, recurrent pneumonia, invasive cervical cancer.
- Expanded definition including 23 clinical conditions published elsewhere
The World Health Organization uses a different staging method for HIV disease.
It should be noted that there are a large number of types and subtypes of HIV, some of which are extremely rare in most countries, such as HIV-2, and HIV-1 Group O, and as a result, routine screening tests in some countries may not be designed to test for those particular, extremely rare, variations.
See also: Gay bowel syndrome
The illness was first recognized in the early 1980s as homosexual men presented to their doctors with a rare lung disease called Pneumocystis carinii pneumonia (PCP). Early on, the "gay disease" took on a variety of names, including "gay cancer" and "Gay-related immune deficiency" (GRID). The Centers for Disease Control noticed an increase in requests for drugs needed to treat this illness and launched an epidemiological investigation.
Although the first cases of the disease probably go back to the 1950s, the epidemic was not recognized until the early 1980s. The early epidemic occurred in two main branches; in the US and other developed countries, and in sub-Saharan Africa. In the US, the early epidemic was primarily spread by homosexual sex, intravenous drug use, and blood transfusions (prior to the introduction of testing). In Africa, transmission was almost exclusively by heterosexual sex. Currently, most new infections worldwide are spread by promiscuous heterosexual sex and prostitution.
"We owe it to Ryan to make sure that the fear and ignorance that chased him from his home and his school will be eliminated. We owe it to Ryan to open our hearts and our minds to those with AIDS. We owe it to Ryan to be compassionate, caring and tolerant toward those with AIDS, their families and friends. It's the disease that's frightening, not the people who have it." —Former U.S. President Ronald Reagan, April 11, 1990 in regards to the case of Ryan White.
After infection with HIV, the virus quickly replicates in lymphatic tissue and travels through the blood to infect most areas of the body. The largest consequence of this is the "hijacking" of certain immune cells, especially so-called T-Helper, or CD-4, cells. Early in the infection, the immune system holds the infection at bay, often causing "Acute Retroviral Syndrome", a flu-like illness. Patients often have swollen lymph nodes. After approximately 8–10 years of infection, the immune system begins to lose its battle. This is primarily seen in the loss of numbers of CD4 cells, however the changes are somewhat more complex. When the CD4 cell level drops low enough, AIDS becomes apparent. The first symptoms of the illness are generally night sweats, weight loss, and oral thrush.
Opportunistic Infections (OIs)
The hallmark of AIDS is the appearance of opportunistic infections, meaning infections with organisms that do not usually cause human disease, unless given the right "opportunity". This opportunity is the reduction in cell-mediated immunity, first seen in patients with certain cancers or on anti-rejection drugs for organ transplantation. These infections include:
- Candida albicans. Caused by the candida fungi, resulting in thrush (mouth) and vaginal yeast infections. Most common HIV-related fungus infection.
- Cryptoccoccal Menigitis. A yeast-like fungus infection that usually involves the brain and lungs, although it can affect almost any organ. Most often occurs when a person's CD4+ T cell count falls below 100 cells per cubic millimeter of blood.
- Cryptococcus neoformans (a cause of meningitis).
- Cytomegalovirus. Virus can affect the entire body, but it commonly affects the eye's retina, causing blurry vision and in severe cases, blindness. Most likely to occur when a person’s CD4+ T cell count falls below 100.
- Epstein Barr virus (leads to a type of lymphoma).
- Human herpesvirus-8 (causes Kaposi's sarcoma). Results in reddish purple lesions that usually appear on the skin.
- Liver Disease. One of the leading causes of death among AIDS patients,
- Mycobacterium avium complex (atypical mycobacterium). Bacterial infection that can cause persistent fever, night sweats, fatigue, weight loss, anemia, abdominal pain, dizziness, diarrhea and weakness. Most likely occurs when the CD4+T cell count falls below 50.
- Mycobacterium tuberculosis (TB).
- Pneumocystis jiroveci, previously Pneumocystis carinii. Condition occurs when a fungus infects the lungs. Symptoms may include night sweats and fatigue, fever, cough, difficulty breathing, weight loss. Most likely to occur when the CD4+ T cell count falls below 200.
- Progressive Multifocal Leukoencephalopathy (PML) Rare disorder of the nervous system caused by a common human polyomavirus, JC virus. Can occur when the CD4+T cell count falls below 200.
- Recurrent Pneumonia. Most likely to occur when the CD4+ T cell count falls below 200
- Staphylococcus aureus (primarily causes skin infections).
- Streptococcus pneumoniae (the primary cause of pneumonia in AIDS patients).
- Toxoplasma gondii. Condition occurs when a parasite infects the brain. Symptoms include confusion or delusional behavior, severe headaches, fever, seizures and coma. Most likely occurs when the CD4+ T cell count falls below 100.
Among many medical professionals and biologists, there is general agreement that HIV causes AIDS. In this, those of Koch's postulates that apply to viral diseases have been clearly fulfilled, and basic science research has shown the same. Specific drugs have been developed that treat HIV infection and AIDS, helping show the causal relationship. That being said, there is a vocal minority of people, scientists and non-scientists alike, who do not believe that HIV causes AIDS. Foremost among these is Dr. Peter Duesberg. Details about these "re-thinkers" and their arguments can be found at several websites, but not in any reliable peer-reviewed journals. This viewpoint has also received some official support from the government of South Africa, where a nurtitional policy based on beetroot and garlic sources has found effective in combating the county's severe AIDS problem, despite a concerted effort by liberal scientific groups and the pharmacuetical industry (who would stand to benefit financially from continued association of AIDS with HIV) to discredit it. It is estimated that over $1 trillion has been siphoned off from health care worldwide for antiretroviral drugs to treat AIDS, despite growing evidence that a good general diet can be just as effective.
Progress In Combating The Disease
While there has been no announcement to the end of AIDS, it seems scientists have successfully treated a baby born with HIV. Further studies will be needed to see if the baby in fact has been successfully treated in the long term.
- Some Questions the Media Won't Ask Today About AIDS, Robert Knight, NewsBusters, December 1, 2007
- Infections Associated with AIDS, University of California, San Francisco
- http://www.merckmedicus.com/ppdocs/us/hcp/content/merck/hiv/hivaids/aidsdefi.htmAIDS is defined
- New England Journal of Medicine, Volume 344:1764-1772 June 7, 2001 Number 23
- Pneumocystis pneumonia -- Los Angeles. MMWR Morb Mortal Wkly Rep 1981;30:250-252)
- Infections Associated with AIDS, UCSF Medical Center.
- Peter Duesberg on AIDS - Duesberg.com - HIV/AIDS research website for Peter H. Duesberg http://www.duesberg.com/