Acquired Immune Deficiency Syndrome

Excerpt

Human immunodeficiency virus (HIV) is transmitted sexually, via blood transfusions, sharing intravenous needles, and from the mother to a child during the birth process and breastfeeding. HIV disease has distinct phases: viral transmission, acute seroconversion, acute retroviral syndrome, recovery and seroconversion, asymptomatic chronic infection, and symptomatic HIV infection or acquired immunodeficiency syndrome (AIDS.) This discussion will focus specifically on the sequelae of chronic HIV infection and the AIDS phase.

HIV is a retrovirus that attacks CD4 T lymphocytes, eventually leading to the death of these cells and severe immunodeficiency of the individual who has acquired the infection. Once the CD4 count becomes too low, host immune defenses cannot fend off opportunistic infections and malignancies. The presence of a CD4 count of less than 200 or an AIDS-defining illness in a patient with HIV is the criteria for a diagnosis of AIDS. Treatment of AIDS is focused on the opportunistic illness or condition and decreasing the HIV viral load, and monitoring for an increase in CD4 cells through antiretroviral therapy (ART.)

Most patients diagnosed with HIV will develop AIDS within ten years if left untreated. With the initiation of antiretroviral therapy after AIDS diagnosis, the patient may live for greater than ten years and even have a normal life span. Once a patient has been diagnosed with AIDS and they do not receive ART, they will probably die within two years.