DIFFERENCE BETWEEN HIV AND AIDS

HIV is the virus, which attacks the T-cells (CD-4 cells) in the immune system OF HUMAN BODY and alters the immune system to make people much more vulnerable to various OPPORTUNISTIC infections caused to diseases. The susceptibility of such infections worsens as the syndrome progresses.

AIDS (Acquired Immuno Deficiency Syndrome) is a medical condition or syndrome caused by HIV virus (Human Immunodeficiency Virus). it is possible to be infected with HIV without developing AIDS. Without treatment, the HIV infection can progress and, eventually, it will develop into AIDS in the vast majority of cases

How is HIV transmitted?
Sexual transmission – it can happen when there is contact with infected sexual fluids (rectal, genital, or oral mucous membranes). This can happen while having unprotected sex, including vaginal, oral, and anal sex, or sharing sex toys with someone infected with HIV.

Perinatal transmission – a mother can pass the infection on to her child during childbirth, pregnancy, and also through breastfeeding.

Blood transmission – the risk of transmitting HIV through blood transfusion is nowadays extremely low in developed countries, thanks to meticulous screening and precautions. However, among injection or IV drug users, sharing and reusing syringes contaminated with HIV-infected blood is extremely hazardous.

HIV and AIDS myths and facts
There are many misconceptions AND TABOOS RLEATED TO HIV and AIDS.
The virus CANNOT be transmitted from:
• sharing cutlery
• using the same toilet
• sharing towels
• touching unbroken skin
• casual kissing
• mouth-to-mouth resuscitation
• sneezing
• shaking hands
• hugging
• or other forms of “casual contact”

HIV symptoms
DUE TO LACK OF IMMUNITY HIV infected persons are easily INFECTED BY by VARIOUS KIND OF bacteria, viruses, fungi, and/or parasites
Symptoms of early HIV infection
Many people with HIV have no symptoms for several months to even years after becoming infected. THEY may develop symptoms similar to flu, usually 2-6 weeks after catching the virus.
The symptoms of early HIV infection may include:
• unintentional weight loss
• sweats (particularly at night)
• joint pain
• tiredness
• muscle aches
• sore throat
• fever
• chills
• enlarged glands
• a red rash
• weakness

SYMPTOMS OF Asymptomatic HIV
In many cases, after the initial symptoms disappear, there will not be any further symptoms for many years.
During this time, the virus CONTINEOUSLY REPICATE IN THE BODY and START damaging the immune system and organs. Without being on medications to stop HIV’s replication, this process can take up to 10 years on average. THOUGH The infected person often experiences no symptoms, feels well, and appears healthy.
Late-stage HIV infection
If left untreated, HIV weakens the IMMUNE SYSTEM IN SUCH A LEVEL THAT IT COULD NOT ABLE to fight WITH THE INFECTION. The INFECTED person becomes vulnerable to LIFE THREATENING illnesses. This stage of infection is known as AIDS.

Symptoms of late-stage HIV infection may include:
• white spots on the tongue or mouth
• night sweats
• fever of above 100 °F (37 °C) lasting for weeks
• permanent tiredness
• shortness of breath (dyspnea)
• dry cough
• diarrhea, which is usually persistent or chronic
• swollen glands lasting for weeks
• blurred vision
• unintentional weight loss

Diagnosis of HIV and AIDS
Diagnosis is made through a blood test that screens specifically for the virus. If the HIV virus has been found then the test result read as “positive.” The blood should be re-tested several times before a positive result is given to the patient.

If a person has been exposed to the virus, it is mandatoryl that they should be get tested as soon as possible. The earlier the HIV will be detected, the chances of a successful treatment can be expected. A home testing kit can be used as well.

After the exposure with HIV, it may take 3 weeks to 6 months to show up the presence of antibody in the specimen of the test like blood . Hence Re-testing is always mandatory.

Tests for HIV and AIDS
The primary tests for diagnosing HIV and AIDs include:

• ELISA Test — ELISA, which stands for enzyme-linked immunosorbent assay, is used to detect HIV infection. If an ELISA test is positive, the Western blot test is usually administered to confirm the diagnosis. If an ELISA test is negative, but you think you may have HIV, you should be tested again in one to three months.
• Western Blot — This is a very sensitive blood test used to confirm a positive ELISA test result

ELISA is quite sensitive in chronic HIV infection, but because antibodies aren’t produced immediately upon infection, you may test negative during a window of a few weeks to a few months after being infected. Even though your test result may be negative during this window, you may have a high level of the virus and be at risk of transmitting infection.

• Saliva Tests — A cotton pad is used to obtain saliva from the inside of your cheek. The pad is placed in a vial and submitted to a laboratory for testing. Results are available in three days. Positive results should be confirmed with a blood test.

• Viral Load Test — This test measures the amount of HIV in your blood. Generally, it’s used to monitor treatment progress or detect early HIV infection. Three technologies measure HIV viral load in the blood: reverse transcription polymerase chain reaction (RT-PCR), branched DNA (bDNA) and nucleic acid sequence-based amplification assay (NASBA). The basic principles of these tests are similar. HIV is detected using DNA sequences that bind specifically to those in the virus. It is important to note that results may vary between tests.

AIDS treatments
CURENTLY there is no vaccine or cure for HIV or AIDS. Treatments can slow down the progress of the disease and assist most of the infected persons to live long and relatively healthy life.

Starting of Antiretroviral treatment after detecting the antibody of HIV is the mandatory to improve quality of life by extending life expectancy and simultaneously reduces the risk of transmission
Emergency HIV pills (post-exposure prophylaxis)
After exposure of HIV virus by any means then the PEP (post-exposure prophylaxis) should start within 72 hours (3 days) of exposure which may arrest infection to spread. 4 weeks of treatment with PEP is very promising to stop the infection to spread.but person could experience some unpleasant side effects like diarrhoea, nausea, and headache.

A person with HIV positive should undergo regular blood tests to monitor viral load in the blood and disease progress before starting treatment. The Antiretroviral therapy is designed to reduce the viral load of HIV antibody in the blood. Generally, patients take a combination of medications called HAART (highly active antiretroviral therapy) or cART (combination antiretroviral therapy).

The combination of drugs is adapted to each individual. HIV treatment is usually permanent and lifelong. HIV treatment is based on routine dosage. Pills must be taken on a regular schedule, every time. Each class of ARVs has different side effects, but some possible common side effects may include nausea, fatigue, diarrhea, headache, skin rashes, or mood swing.

Second-line treatment:
In December 2010, the Supreme Court of India directed Indian government to provide second-line Antiretroviral Therapy (ART) to all AIDS patients in the country, by warning the government against abdicating its constitutional duty of providing treatment to HIV positive patients on grounds of financial constraint, as it was issue of the right to life guaranteed under Article 21 of the Indian Constitution. Previously in an affidavit before the Supreme Court, NACO had said second-line ART treatment for HIV patients, costing Rs28,500 each, could not be extended to those who had received “irrational treatment” by private medical practitioners for the first round, which costs around Rs6,500. The court rejected both the arguments of financial constraints .
The National AIDS Control Organisation (NACO) has increased the number of centres providing free Anti Retroviral Treatment (ART) from 54 to 91 centres. At these 91 centres medicines for treating 8,5000 patients have been made available. All the 91 centres have specially appointed and trained doctors, counsellors and laboratory technicians to help initiate patients on ART and follow them up regularly. The ART is a combination of three potent drugs, which is being given to the persons with advanced stage of AIDS. Although these drugs do not cure HIV infection, they suppress multiplication of the virus and reduce the number of opportunistic infections thereby improving the quality of life and prolonging the life span. Apart from providing free treatment, all the ART centres are providing counselling to the infected persons so that they maintain regularity of their medication. Continuity is the most important factor for the long term effectiveness of the ART drugs as disruption can lead to drug resistance

HIV prevention
Unprotected sex –
Having unprotected sex (vaginal, oral, and/or anal sex) with sex workers or people of LGBT community or other infected person x) without a condom can put a person at risk of being infected with HIV and other sexually transmitted infections (STIs) or STDs. It can also be caught from sharing sex toys with someone infected with HIV. Hence Condoms should be used with every sexual act.

Drug abuse and needle sharing –
Intravenous drug ause is an important mode of HIV transmission in developed countries. Sharing needles can expose users to HIV and other viruses, such as hepatitis C. Strategies such as needle-exchange programs are used to reduce the infections caused by drug abuse. If someone needs to use a needle, it must be a clean, unused, unshared needle.

Body fluid exposure –
Exposure to HIV can be controlled by employing precautions to reduce the risk of exposure to contaminated blood,semen,sputum At all times, healthcare workers should use barriers (gloves, masks, protective eyewear, shields, and gowns). Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection.

Pregnancy – some ARVs can harm the unborn child. But an effective treatment plan can prevent HIV transmission from mother to baby. Precautions have to be taken to protect the baby’s health. Delivery through caesarean section may be necessary. HIV-infected mothers should not breastfeed.
Education – health education is an important factor in reducing risky sexual behavior and exposure .

Managing HIV
General Health –
it is crucial for patients to take medication correctly and take steps to avoid illness. Patients should seek to improve their general health and reduce the risk of falling ill by practicing regular exercise, healthy eating, and not smoking.

Psychological – common misconceptions about AIDS and HIV are diminishing. However, the stigma of the condition persists in many parts of the world. People infected with the virus may feel excluded, rejected, discriminated, and isolated.Being diagnosed with HIV can be very distressing, and feelings of anxiety or depression are common. If you feel anxious or have symptoms of depression, seek medical help immediately

Compliance –
HIV treatment is effective if the patient is committed and constant in taking the medication on time. Missing even a few doses may jeopardize the treatment. A daily, methodical routine should be programmed to fit the treatment plan around the patient’s lifestyle and schedule. A treatment plan for one person may not be the same treatment plan for another. “Adherence” is sometimes known as.

Long-term condition –
HIV is a lasting condition, and therefore patients have to be in regular contact with their healthcare team. Treatment plan is reviewed regularly

Additional precautions –
HIV-infected people should be extra cautious to prevent exposure to infection. They should be careful around animals, avoid coming into contact with cat litter, and animal feces, and often birds too. Meticulous and regular washing of hands is recommended.

INDIAN SCENERIO OF HIV/AIDS
According to National AIDS Control Organization of India; the prevalence of AIDS in India in 2013 was 0.27, which is down from 0.41 in 2002. While the National AIDS Control Organisation estimated that 2.39 million people live with HIV/AIDS in India in 2008–09

In last decade a 50% decline had been observed in the number of new HIV infections. According to more recent National AIDS Control Organisation data, India has demonstrated an overall reduction of 57 percent in estimated annual new HIV infections (among adult population) from 0.274 million in 2000 to 0.116 million in 2011, and the estimated number of people living with HIV was 2.08 million in 2011.In 2014, India’s AIDS prevalence rate stood at approximately 0.26% — the 90th highest in the world. The spread of HIV in India is primarily restricted to the southern and north-eastern regions of the country and India has also been praised for its extensive anti-AIDS campaign.

HISTORY OF HIV /AIDS IN INDIA:
In 1986, the first known case of HIV was diagnosed by Dr. Suniti Solomon and her student Dr. Sellappan Nirmala amongst female sex workers in Chennai, Tamil Nadu .By 1987, about 135 more cases came to light. Among these 14 had already progressed to AIDS.

To control the spread of the virus, the govt of India set up the National AIDS Control Programme in 1987 to co-ordinate national responses such as blood screening and health education
In 1992-1999; the government set up the National AIDS Control Organisation (NACO) to oversee policies and prevention and control programmes relating to HIV and AIDS and the National AIDS Control Programme (NACP) for HIV prevention.

In 1999-2006, the second phase of the National AIDS Control Programme (NACP II) was introduced to decrease the reach of HIV by promoting behaviour change. The prevention of mother-to-child transmission programme (PMTCT) and the provision of antiretroviral treatment were materialized.

In 2007, the third phase of the National AIDS Control Programme (NACP III) targeted the high-risk groups, conducted outreach programmes, amongst others. It also decentralised the effort to local levels and non-governmental organisations (NGOs) to provide welfare services to the affected.

In 2009 India established a “National HIV and AIDS Policy and the World of Work”, which sough to end discrimination against workers on the basis of their real or perceived HIV status. Under this policy all enterprises in the public, private, formal and informal sectors are encouraged to establish workplace policies and programmes based on the principles of non-discrimination, gender equity, health work environment, non-screening for the purpose of employment, confidentiality, prevention and care and support

World SCENERIO of HIV/AIDS
• there were approximately 36.7 million people worldwide living with HIV/AIDS at the end of 2016. Of these, 2.1 million were children (<15 years old).
• An estimated 1.8 million individuals worldwide became newly infected with HIV in 2016 – about 5,000 new infections per day. This includes 160,000 children (<15 years). Most of these children live in sub-Saharan Africa and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding.
• Currently only 60% of people with HIV know their status. The remaining 40% (over 14 million people) still need to access HIV testing services.
• As of July 2017, 20.9 million people living with HIV were accessing antiretroviral therapy (ART) globally, up from 15.8 million in June 2015, 7.5 million in 2010, and less than one million in 2000.
• 1 million people died from AIDS-related illnesses in 2016, bringing the total number of people who have died from AIDS-related illnesses since the start of the epidemic to 35.0 million.