Update: 28 Aug. 2021
In the late 1970s and early 80s young men started dying from a mysterious disease. All were gay. Clinical exams showed all died because of acquired immunodeficiency due to a loss of CD4 + lymphocytes, a WBC that protects us from simple infections like colds. And, since the disease was acquired and no direct cause, it was named Acquired Immunodeficiency Syndrome (a Syndrome is a group of signs & symptoms the cause undiscovered) and the name became AIDS. But the cause was soon found to be a retrovirus that infects apes like Chimpanzees but only gives them a mild illness. Somehow it had crossed the species to humans in southern Africa in the 1950s and gradually spread so that by 1976 the first cluster of cases appeared in NYC. It was named Human Immunodeficiency Virus and we know it as HIV and the disease is usually writ AIDS/HIV (but may be referred to simply as “AIDS” or “HIV”.
At first it was one virus but soon its twin was found, so we had HIV-1 and HIV-2, both causing AIDS and both giving the same response on the diagnostic blood test (The conventional test uses blood and takes 3 to 10 days and is 99.9 percent sensitive and specific; in 2012 the rapid self help test OraQuick became available; it uses an oral swab and takes 20 minutes and can be got OTC, it is one of two home tests now available OTC).
Initiation of Infection and Clinical Course
HIV is present in blood, semen, cervical & vaginal secretions, and, to a lesser extent, in saliva, tears, breast milk, and the spinal fluid of the infected. It is most often transmitted thru penis/vagina sexual intercourse or the transfer of infected blood as in shared needles. A less frequent but important transmission is through pregnancy and breast milk to the newborn. Once in the body of the newly infected, the virus targets CD4+ lymphocytes and after binding to the lympho the HIV injects its RNA which is copied and incorporated into the genes of the lympho and converts the lympho into a factory for newly produced HIV. The infected person’s body mounts an immune defense that is partly successful but eventually (C. 8 to 11years) the CD4 lymphos numbers fall to low levels and clinical AIDS begins. The initial stage of infection has two possible fates. In most cases the HIV is enough in number and pathogenicity and the Host’s WBC killer cell defense not effective enough to eradicate all the HIV. So an HIV infection is established. But if the infective HIV are too few (A needle accident) the killer cells of the host (The body fluid’s initial defense against infection; not the immune response which comes later) eradicate every HIV and no infection occurs. We do not know how often this latter event but it explains the rare case where a previously HIV neg person has sex with an HIV + and does not catch AIDS. But it must be very rare and best to consider HIV totally pathogenic from one connection.
Let’s take the usual case, maybe me, an HIV neg guy contacting HIV+ blood (by sex or an accidental needle stick, as happens with doctors drawing blood from patients). The infecting HIV overwhelm my killer cell early defense barrier and a new HIV infection may be started. It is important to mention here that if I knew or suspected immediately that I had just got connected with HIV and quickly took an appropriate dose of anti-HIV medication (Non-occupational PEP —- post exposure prophylaxis —- in USA the hotline is 1 888 448 4911, from 9am to 8 pm M — F, ET, and 11 to 8 on W/ends and holidays), I might well prevent contracting AIDS/HIV.
And thus HIV infection is initiated and must almost always end in the death of the newly infected from AIDS.
After infection is initiated the body mounts an immune response against HIV and this is the basis of the HIV blood test. Also it is partly effective in eradicating the HIV infection, explaining the often long hiatus between initiation of HIV infection and clinical signs and symptoms of AIDS. Those who test positive have HIV in their bodies with the potential to transmit it; but they may feel and look normal. But a negative test could still occur within 1 year from initiation of infection so one negative test within 1 year of the initial contact cannot be used for reassurance. In the usual case, so called “seroconversion” (from HIV neg to HIV+) occurs 6 to 12 weeks after initiation of infection.
Clinical studies show the virus causes a barely observable, brief flu-like illness after the first few weeks in 30 percent and then years pass without symptoms. But inside the body a war is going on between the newly infective HIV and the infectee’s CD4 WBC (white blood cells). And, as years pass, the HIV is winning the war by reproducing billions of new HIV and killing off the CD4. And, as the CD4 numbers drop below normal, AIDS commences. There are many sub-syndromes, ranging from reactivating of herpes zoster, to serious brain infections, to death-dealing pneumonia’s, to just wasting away, mentioning only a few of the terrible consequences. And before the advent of good anti-HIV treatment every infected persons was dead from the AIDS by 15 years after initial contact.
But today in 2021, relatively effective anti-HIV treatment has changed things: AIDS/HIV can now be analogized to diabetes mellitus: a chronic lifelong potentially good quality life (if one takes medication).
About anti-HIV medication: a growing list of agents that act at different points to limit HIV replication has raised the hope that HIV might be eradicated from the body and although this has not yet been achieved, the success to date has, as just mentioned, changed AIDS/HIV from an invariably deadly infection to a lifetime disease one can live productively and happily with. Presently the anti HIV medications are 5 types and in most advanced centers one type of each class of medication is combined with the others so that the AIDS/HIV patient may now take a single dose a day (for life). This is referred to as “highly active antiretroviral therapy (HAART). There are side effects and fine points that the reader may learn about from www.nccc.ucsf.edu or by telephoning AIDS information hotline daytimes at 1 800 448 0440 or the night line 1 800 628 9240. Also AIDS/HIV management phone consultation: 1 800 933 3413, M-Fri, 9 am to 8 pm, all USA east coast standard time.
In the late 1970s and early 80s young men started dying from a mysterious disease. All were gay. Clinical exams showed all died because of acquired immunodeficiency due to a loss of CD4 + lymphocytes, a WBC that protects us from simple infections like colds. And, since the disease was acquired and no direct cause, it was named Acquired Immunodeficiency Syndrome (a Syndrome is a group of signs & symptoms the cause undiscovered) and the name became AIDS. But the cause was soon found to be a retrovirus that infects apes like Chimpanzees but only gives them a mild illness. Somehow it had crossed the species to humans in southern Africa in the 1950s and gradually spread so that by 1976 the first cluster of cases appeared in NYC. It was named Human Immunodeficiency Virus and we know it as HIV and the disease is usually writ AIDS/HIV (but may be referred to simply as “AIDS” or “HIV”.
At first it was one virus but soon its twin was found, so we had HIV-1 and HIV-2, both causing AIDS and both giving the same response on the diagnostic blood test (The conventional test uses blood and takes 3 to 10 days and is 99.9 percent sensitive and specific; in 2012 the rapid self help test OraQuick became available; it uses an oral swab and takes 20 minutes and can be got OTC, it is one of two home tests now available OTC).
Initiation of Infection and Clinical Course
HIV is present in blood, semen, cervical & vaginal secretions, and, to a lesser extent, in saliva, tears, breast milk, and the spinal fluid of the infected. It is most often transmitted thru penis/vagina sexual intercourse or the transfer of infected blood as in shared needles. A less frequent but important transmission is through pregnancy and breast milk to the newborn. Once in the body of the newly infected, the virus targets CD4+ lymphocytes and after binding to the lympho the HIV injects its RNA which is copied and incorporated into the genes of the lympho and converts the lympho into a factory for newly produced HIV. The infected person’s body mounts an immune defense that is partly successful but eventually (C. 8 to 11years) the CD4 lymphos numbers fall to low levels and clinical AIDS begins. The initial stage of infection has two possible fates. In most cases the HIV is enough in number and pathogenicity and the Host’s WBC killer cell defense not effective enough to eradicate all the HIV. So an HIV infection is established. But if the infective HIV are too few (A needle accident) the killer cells of the host (The body fluid’s initial defense against infection; not the immune response which comes later) eradicate every HIV and no infection occurs. We do not know how often this latter event but it explains the rare case where a previously HIV neg person has sex with an HIV + and does not catch AIDS. But it must be very rare and best to consider HIV totally pathogenic from one connection.
Let’s take the usual case, maybe me, an HIV neg guy contacting HIV+ blood (by sex or an accidental needle stick, as happens with doctors drawing blood from patients). The infecting HIV overwhelm my killer cell early defense barrier and a new HIV infection may be started. It is important to mention here that if I knew or suspected immediately that I had just got connected with HIV and quickly took an appropriate dose of anti-HIV medication (Non-occupational PEP —- post exposure prophylaxis —- in USA the hotline is 1 888 448 4911, from 9am to 8 pm M — F, ET, and 11 to 8 on W/ends and holidays), I might well prevent contracting AIDS/HIV.
And thus HIV infection is initiated and must almost always end in the death of the newly infected from AIDS.
After infection is initiated the body mounts an immune response against HIV and this is the basis of the HIV blood test. Also it is partly effective in eradicating the HIV infection, explaining the often long hiatus between initiation of HIV infection and clinical signs and symptoms of AIDS. Those who test positive have HIV in their bodies with the potential to transmit it; but they may feel and look normal. But a negative test could still occur within 1 year from initiation of infection so one negative test within 1 year of the initial contact cannot be used for reassurance. In the usual case, so called “seroconversion” (from HIV neg to HIV+) occurs 6 to 12 weeks after initiation of infection.
Clinical studies show the virus causes a barely observable, brief flu-like illness after the first few weeks in 30 percent and then years pass without symptoms. But inside the body a war is going on between the newly infective HIV and the infectee’s CD4 WBC (white blood cells). And, as years pass, the HIV is winning the war by reproducing billions of new HIV and killing off the CD4. And, as the CD4 numbers drop below normal, AIDS commences. There are many sub-syndromes, ranging from reactivating of herpes zoster, to serious brain infections, to death-dealing pneumonia’s, to just wasting away, mentioning only a few of the terrible consequences. And before the advent of good anti-HIV treatment every infected persons was dead from the AIDS by 15 years after initial contact.
But today in 2021, relatively effective anti-HIV treatment has changed things: AIDS/HIV can now be analogized to diabetes mellitus: a chronic lifelong potentially good quality life (if one takes medication).
About anti-HIV medication: a growing list of agents that act at different points to limit HIV replication has raised the hope that HIV might be eradicated from the body and although this has not yet been achieved, the success to date has, as just mentioned, changed AIDS/HIV from an invariably deadly infection to a lifetime disease one can live productively and happily with. Presently the anti HIV medications are 5 types and in most advanced centers one type of each class of medication is combined with the others so that the AIDS/HIV patient may now take a single dose a day (for life). This is referred to as “highly active antiretroviral therapy (HAART). There are side effects and fine points that the reader may learn about from www.nccc.ucsf.edu or by telephoning AIDS information hotline daytimes at 1 800 448 0440 or the night line 1 800 628 9240. Also AIDS/HIV management phone consultation: 1 800 933 3413, M-Fri, 9 am to 8 pm, all USA east coast standard time.
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