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Before today is over, more than 14,000 people will have been infected with the Human Immunodeficiency Virus (HIV), the virus that causes AIDS. Around 8,500 people already infected with the virus will also die today because of AIDS. That is how far the HIV/AIDS pandemic has spread around the world.
However, many people do not understand how this small virus works and how it can wreck the body's immune system.
HIV is a small virus belonging to the family Retroviridae, thus it belongs to a group called retroviruses. They take their name from the fact that they use a reverse transcription process to replicate inside a host cell. HIV is the most dangerous human retrovirus discovered so far.
Modes of Transfer
HIV is transmitted through body fluids. In people carrying the virus, it can be found in high concentrations in blood or in sexual secretions. Therefore, it may be transmitted through sexual contact, through blood transfusion, through sharing of needles, or from a mother to her baby either during birth or during lactation.The virus, however, cannot be transferred through saliva, tears, or urine, since it is at a negligible concentration in these fluids.
Once HIV enters the body, it quickly seeks out certain immune cells called CD4 cells. The virus uses these cells as hosts for replication. The virus also starts to actively destroy CD4 cells through various methods. This leads to a decrease in the CD4 cell count inside the body, which is a sign of decreased immunity. This is accompanied by an increase in the amount of virus in the blood, known as the viral load.
Normally, the CD4 cell count in an uninfected human is over 1,000 cells per cubic millimeter of blood. If the CD4 cell count of a person drops to below 250, then this person is diagnosed with Acquired Immunodeficiency Syndrome (AIDS).
Developing AIDS
Progression from HIV infection to AIDS usually takes 5–10 years, but there are exceptions. If untreated, a person with AIDS might die within less than a year.
HIV itself does not kill, but it leads to a serious decrease in the immunity of the infected person. This reduced immunity means that any opportunistic infection can easily overcome the body's defenses. Thus, people with AIDS die by parasites or bacteria that are otherwise usually repelled by the immune system. People living with AIDS also tend to develop cancers at a higher rate. In severe cases of AIDS, a simple cold could become a life-threatening condition.
One of the most dangerous aspects of HIV/AIDS is that it is a silent disease. There are no obvious symptoms associated with the virus. People can carry the virus for many years and live their lives normally; unaware they may be infecting others. In fact, according to BroadReach HealthCare, a leading company in healthcare delivery, distribution, and financing, 75–90 percent of people who are infected with the virus are unaware of it.
Impact
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| Over 15 million children have become orphans due to AIDS. |
According to the UNAIDS 2006 Report on the Global AIDS Epidemic, 2.9 million people worldwide died of AIDS in 2006. One-third of the deaths occurred in sub-Saharan Africa, which is the most severely AIDS-hit area of the world. It is home to around 65 percent of people living with AIDS.
AIDS has had a severe impact on sub-Saharan Africa's society and economy. With a prevalence of up to 33 percent in countries such as Swaziland, AIDS has brought life expectancy to as low as 30 years in some places (according to UNAIDS). This has hindered development and, in many places, brought the economic growth to a grinding halt.
The disease has also claimed the lives of millions of adults, leaving over 15 million "AIDS orphans." Many of those grow into crime or prostitution to make ends meet. In severely hit places in sub-Saharan Africa, it is not uncommon to see 12-year-olds raising a household with half a dozen younger siblings.
To make matters more dire, BroadReach HealthCare expects the number of AIDS orphans to grow to 43 million by 2010.
Dealing With AIDS
For years, experts have debated on how to control and slow down the ever-growing pandemic. The latest trends are a combination of prevention and treatment. To prevent new infections, people who are HIV-negative (i.e. do not have the virus in their bodies) should stay negative, and people who are HIV-positive should not infect others.
This can be achieved by some behavioral and cultural changes, such as promoting sexual abstinence and regular testing for HIV. Prevention can also be maintained through the use of barriers during sexual intercourse, such as condoms.
But applying these options can be tricky because of stigmas and cultural norms present in many places. For example, it is hard to convince some people to be sexually abstinent or to have fidelity. Many people also refuse the use of condoms during sexual intercourse even when they know they are HIV-positive.
Treatment is another complicated issue. So far, no cure exists for HIV/AIDS. However, antiretroviral (ARV) drugs have been used successfully to prolong the life of HIV-positive patients. ARV drugs disrupt the replication cycle of HIV inside the CD4 cells. They also suppress the amount of viral cells inside the body. But at present, these drug combinations do not completely eliminate the virus. That is why ARV drugs do not cure AIDS but allow it to be managed chronically, just as relevant medications help manage diabetes for example.
Because HIV is a fast-mutating virus, it develops resistances to therapeutic agents quickly. That is why scientists and researchers must come up with new ARV drugs all the time to stay effective against HIV. Treatment by ARV drugs is given as a combination of three different drugs. This complex treatment is called Highly Active Anti-Retroviral Therapy (HAART) and is often known as "drug cocktails." If patients start taking ARV drugs, they must be closely monitored and must take their doses on time and not miss any. Missing doses or taking the medication irregularly may result in more resistant viral strains of HIV. This will require new and more expensive drugs to be formulated.
Challenges
The most powerful aspect of HIV is not the abilities of the virus itself, but the stigma that surrounds it. Most people are unwilling to take the HIV test for fear of being found HIV-positive and of facing the harsh stigma from their communities. But as long as infected people are unaware they carry the virus, they will not be treated. Furthermore, they could be infecting other people, leading to further propagation of the virus.
That is why the biggest challenge in controlling the HIV pandemic is getting people to test for HIV. The only way to avert the crisis of 43 million AIDS orphans by 2010 is by treating their parents. For that to take place, they must be tested and put on a treatment regimen.
The second biggest challenge is the availability of ARV drugs. While ARV drugs' prices have gone down to less than five percent of the original, they still reach only a very small percentage of people in need.
Need to Act
The problem is that no matter what efforts are exerted, year after year the pandemic shows no sign of receding or even slowing down. According to BroadReach HealthCare, there have been massive efforts since 2003 to stop the virus but, while they have been successful, much more needs to be done.
If efforts to halt the pandemic do not bear fruit soon, then the 25 million who already died from HIV/AIDS will be dwarfed by the deaths in the following years.
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