Human Immunodeficiency Virus (hiv) Research Paper

Chase Dieleman

01/08/2017

Comp II: Concept Paper

Human Immunodeficiency Virus

The definition of human immunodeficiency virus (HIV) is that it is a viral infection that can cause a chronic and potentially life-threatening condition called acquired immunodeficiency syndrome (AIDS) by damaging one’s immune system and interfering with the body’s ability to fight off organisms that can cause diseases (Mayo Clinic, n.d.). The symptoms of HIV or AIDS depend on the stage of which the infection is in. During the initial or acute phase of an HIV infection, one might expect to experience some flu-like symptoms within a few months post infection, like: fever, headache, muscle or joint pain, rash, sore throat, and swollen lymph glands (Mayo Clinic, n.d.). These symptoms can last for a few weeks. This is the largest signifier of an HIV infection, for this period of symptoms is the most recognizable phase of the initial infection.

Even though the symptoms may not seem significant and can easily go unnoticed during this phase, the viral load within the blood can be quite high at this time (Mayo Clinic, n.d.). During the more latent or chronic phase of an HIV infection the only sign or symptom is a persistent swelling of the lymph glands (Mayo Clinic, n.d.). As the virus progresses, one might continue to experience these signs and symptoms: as well as, diarrhea, weight loss, oral yeast infections, and shingles (Mayo Clinic, n.d.).

        HIV is acquired through contact of blood, semen, vaginal secretions, or breast milk. The virus must have a very direct pathway from the infected host to a susceptible host. However, one cannot acquire the infection through regular contact, such as hugging or kissing. These types of interactions are indirect, and don’t provide the direct pathway the virus requires. Those that are at an increased risk of infection are those partaking in unprotected sex, receiving contaminated blood transfusions, sharing needles intravenously (specifically for recreational drug use), possessing another sexually transmitted infection, uncircumcised males, and babies being delivered or breastfeeding from an infected mother (Mayo Clinic, n.d.). However, it is most commonly seen in men who have had unsafe sex with other men. Some common HIV prevention methods include; practicing safe sex with the use of condoms, drug treatment with Truvada, using clean needles, seeking out medical attention if you are pregnant, and male circumcision (Mayo Clinic, n.d.). Truvada is commonly known pre-exposure prophylaxis, or PrEP, and is a promising way to prevent HIV infection in high-risk populations like homosexuals (Montgomery, Oldenburg, Nunn, Mena, Anderson, Liegler, Mayer, Patel, Almonte, & Chan, 2016).

        HIV, once infected into the body, injects it’s own RNA into T-lymphocytes or CD4 cells. This is done by attaching to receptors on the lymphocyte that allows it to fuse with the T-cell (Egaña-Gorroño, Guardo, Bargalló, Planet, Vilaplana, Escribà, Pérez, Gatell, García, Arnedo, Plana, 2016). Once the virus is inside, it starts a process of integrating it’s own DNA into the host cell, which then begins production of HIV cells (Egaña-Gorroño et al. 2016). This, in turn, kills the T-lymphocyte and releases the produced HIV cells back into the blood to start the process over (Egaña-Gorroño et al. 2016). That is how HIV replicates and spreads through the body, and depletes the immune system at the same time.

To properly diagnose HIV, saliva or blood must be collected and tested for the development of antibodies to the virus. Once diagnosed with HIV or AIDS, there are several tests the doctor can perform to determine the stage of the disease. One test might be a CD4 count to see how many CD4 cells are within the body, because HIV targets this type of white blood cell and destroys it (Mayo Clinic, n.d.). Another test might be a viral load to see how much of the virus is found within the blood (Mayo Clinic, n.d.). The final test that can be performed is drug resistance to determine whether or not the form of HIV infection is resistant to any specific anti-HIV drugs (Mayo Clinic, n.d.). Each test is crucial in determining the approach a doctor takes in choosing the proper treatment plan for the patient. They all play an important role in discovering where the patient is coming from, and figuring out how far into the infection they are.

        Though there is no cure for HIV or AIDS, a number of drugs exist that can be used in combination to manage the virus. There are five different types of antiretroviral drugs for treating HIV that can be used to block the virus in various ways. It’s common practice to use at least three drugs from two separate types of medications to prevent the creation of virus that are immune to drugs. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are a class of anti-HIV drugs that disable the protein that’s needed by HIV to replicate itself (Mayo Clinic, n.d.). Nucleotide reverse transcriptase inhibitors (NRTIs) are another class that contains faulty versions of the building blocks that HIV require to replicate itself, and therefore copies itself incorrectly (Mayo Clinic, n.d.). Protease inhibitors (Pls) are a separate class of drugs that disable another protein that HIV requires to replicate, called protease (Mayo Clinic, n.d.). Entry or fusion inhibitors prevent HIV from entering CD4 by blocking the entry points (Mayo Clinic, n.d.). Integrase inhibitors disable integrase, which is used by HIV to insert it’s own genetic material into a CD4 cell (Mayo Clinic, n.d.). These drugs are important for helping the patient achieve an undetectable status, which means that the HIV positive patient has achieved such a low viral load in their system that it is no longer detectable.

Immunizations are also crucial for these patients, in an effort to prevent infections like pneumonia and flu from severely impacting the patient (Mayo Clinic, n.d.). However, these vaccines shouldn’t contain any live viruses, because immunosuppressed individuals are not capable of properly fighting off live infections. The infection weakens the immune system, which makes HIV positive individuals highly susceptible to infections and certain cancers. Therefore, tests for tuberculosis, hepatitis, pneumonia, and specific cancers may also be performed (Mayo Clinic, n.d.).

As for when treatment should be started, it’s suggested that any patient with HIV infection should be started on antiretroviral medications immediately. However, it is absolutely imperative to start therapy when sever symptoms or infection are observed, the CD4 count is below 350, patient is pregnant, kidney disease arises from HIV, or when being treated for hepatitis B or C (Mayo Clinic, n.d.). It’s also important to realize that the treatment plan for HIV often includes taking multiple pills at a specific time every single day for the remaining time period of life. This can make the treatment quite difficult, and can also have a taxing affect on the body. Some side effects of this rigorous treatment plan include; nausea, vomiting, diarrhea, heart disease, bone loss, deterioration of muscle tissue, abnormal cholesterol, and increased glucose levels (Mayo Clinic, n.d.). The physician overseeing the treatment of an HIV patient should monitor the patient on a regular basis, to ensure that the regime is remaining effective for the patient.