Spectrum of Disease following HIV Infection

Spectrum of Disease following HIV Infection

AIDS is the late stage of HIV infection. AIDS is characterised by a severely weakened immune system that can no longer ward off life-threatening infections and cancers. The risk for AIDS is related to the length of HIV infection. Without antiretroviral therapy, the vast majority of HIV-infected individuals will eventually develop AIDS.

• 
  Prior to antiretroviral therapy (ART; that is, drugs used to fight infection by retroviruses), the average time from HIV infection to onset of clinical AIDS in North American patients was 10 years.
  

• 
  The advent of effective ART has considerably reduced the rate of progression to AIDS in areas where these drugs are accessible. It has also been associated with changes in the types of opportunistic infections that appear with AIDS. Overall, in the Caribbean, fewer than one in four (23%) of the people in need of antiretroviral therapy were receiving treatment in 2005.
  

Preventing Transmission of HIV/AIDS

Prevent sexual

transmission

The best long-term solution for controlling the HIV/AIDS epidemic is a low-cost, highly effective vaccine, but one will not be available in the near future. Therefore, the best options remain changes in behaviour and a handful of prevention technologies.

• 
  decreasing the risk of being exposed by avoiding sexual intercourse with an infected person
  
• 
  decreasing the risk of transmission, if exposed.
  

approach

• 
  delay age of sexual debut
  
• 
  decrease the numbers of sexual partners
  
• 
  consistently use male and female condoms
  
• 
  undergo voluntary testing and counselling to know your HIV status
  
• 
  identify and appropriately treat STIs
  
• 
  avoid blood-borne transmission.
  

Table 2.3. Avoiding blood-borne transmission of HIV.

In some parts of the world, the principal means of parenteral transmission has been the sharing of needles and syringes by illegal drug users.

Discussing

the table

Look at Table 2.3 to answer these questions:

1. 
   List three ways that healthcare workers can protect themselves from infection.
   

2. 
   Is illegal drug injection a problem in your country?
   

Prevent

transmission

A short-course antiretroviral regimen given to the mother and the newborn baby substantially reduces the risk of transmission. Cuba’s prevention of mother-to-child transmission of HIV programme is among the most effective in the world and has kept the total number of babies born with HIV to date below 100.

• 
  malnutrition
  
• 
  exposure to other infections.
  

WHO/UNICEF/UNAIDS have developed several documents that address HIV and breastfeeding. A summary of their recommendations follows:

• 
  When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended. Otherwise, exclusive breastfeeding is recommended during the first months of life.
  

• 
  All HIV-infected mothers should receive counselling about the risks and benefits of various infant-feeding options. Whatever a mother decides, she should be supported in her choice.
  

• 
  When HIV-infected mothers choose not to breastfeed from birth or stop breastfeeding later, they should be provided with specific guidance and support for at least the first two years of the child’s life to ensure adequate replacement feeding.
  

• 
  Breastfeeding should be discontinued as soon as feasible. This is known as “early weaning,” and it should take into account local circumstances, nutritional considerations, the individual woman’s situation and the risks associated with replacement feeding.