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Date Posted: 20:41:22 10/22/12 Mon
Author: d
Subject: hiv

An Essay of mine.
Posted By: Offline

* kimsnursing
o kimsnursing
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Thu Nov 8, 2007 6:28 pm |


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I hope this is of some help to others.

Human Immunodeficiency Virus - A Nurses Guide

Human Immunodeficiency Virus (HIV) is an RNA virus which converts RNA
to DNA, which makes it a retrovirus. Retroviruses use single stranded
RNA as a template to make double stranded DNA using a viral enzyme. A
person who becomes infected with HIV results in a complex clinical
disease known as acquired immune deficiency syndrome(AIDS), which may
take ten years or more to develop.

HIV contains a protein that is called "reverse transcriptase" which is
crucial for viral replication inside of T-cells. This eventually
causes the immune system to shut down causing an extremely low
tolerance to infectious diseases and eventually death.

HIV is passed on when the virus from an infected person gets into the
blood stream of someone else, this can occur during unprotected sex
between same sex and or heterosexual couples, there is a small chance
of infection through unprotected oral sex, although the exact size of
this risk is unclear. There is no method of barrier protection that
completely eliminates the risk; however the use of condoms is
considered the safest form of protection.

HIV can also be passed on when people use dirty needles for injections
or tattoos; this can be avoided by using single use or sterilized
needles. People who inject drugs can avoid infection by never sharing
injection needles; it can also be transmitted, in rare cases, through
being stuck with a needle that has been used by an infected person.
Additionally, a baby can contract the disease by being born to an
infected mother or by breastfeeding from an infected woman.

Because the early symptoms of HIV are not always obvious, a person may
be able to pass on the virus before they realize that they are
infected. HIV cannot be passed on through normal day to day contact,
such as sitting on toilet seats or by shaking hands.

Like all viruses, HIV is comprised of only genetic material, a few
proteins and a protective envelope, its genetic material, carried by
single stranded RNA molecules, contains all the information needed to
make more viruses. HIV can not reproduce itself outside of a cell, but
when HIV invades a living cell, it turns the cell into a factory for
making more HIV.

The development of HIV occurs when the virus infects CD4
T-lymphocytes; a type of white blood cell, HIV weakens the immune
system and leaves the infected individual open to deadly infections.
The viruses gain access to a T-lymphocyte by attaching to CD4 proteins
on the outer surface of the cell membrane. HIV infects certain human
cells by binding its envelope glycoprotein's gp120 and gp41 to
specific molecules on the surface of the cells. Only cells which carry
the appropriate molecules are susceptible to infection by HIV.

In the 1980s, scientists quickly recognised that a molecule called
CD4, which is found particularly on certain T-lymphocytes (a type of
white blood cell), was the primary binding site, but it was only in
1996 that other co-receptors that are also required for infection were
identified. Fusion of the virus with the cell membrane permits the
viral nucleotide to enter the cell.

As HIV disease progresses, HIV variants called synctium-inducing (SI)
strains evolve within the individual's body. SI variants can use an
additional co-receptor on human cells, called CXCR4. This may allow
HIV to infect a wider range of cells. Once fusion has taken place,
reverse transcription then occurs to convert the viral genomic RNA
into double-stranded DNA. The viral DNA is transported to the cell
nucleus and is integrated, or inserted, into the normal cellular
chromosomal DNA.

When the right activation signals are present, the process of making
new virions begins. Using the replication machinery of the host cell,
the integrated viral DNA is transcribed to make messenger RNA (mRNA)
and new strands of viral genomic RNA. The viral mRNA is then
translated into a protein string that is cleaved into specific viral
proteins.

Assembly of new virions then takes place within the cell, and the new
HIV particles are released by budding from the cell surface, taking a
piece of the cell membrane as their envelope.

HIV replication can directly kill CD4 + T-lymphocytes. The loss of
these cells paralyses the immune system and is one mechanism by which
HIV infection causes AIDS.

People who have HIV may look and feel completely well, but their
immune systems may nevertheless be damaged. There are no set symptoms
for HIV or AIDS, usually if a person becomes infected with HIV they do
not notice they have been infected, some may however suffer from a flu
like illness shortly after infection. It is important to note that
once someone is infected they can pass HIV on, even if they feel well.

The more time passes, the more likely damage is to have occurred to
the immune system. Once the immune system is compromised, the person
may be susceptible to `opportunistic infections', these are infections
that are around us all the time and can normally be fought off by a
healthy immune system. Also, some tumours or cancers can occur as a
result of a damaged immune system and can cause damage to the brain
and nervous system. These `symptoms' are not caused by HIV, but by the
opportunistic infections, so until the immune system is so damaged
that other infections begin to cause health problems which become
increasingly difficult to treat.

The only way to know if a person is infected is for them to have and
HIV Antibody Test. HIV and AIDS is such a world wide epidemic it is
vitally important that people are educated in the disease.

Zidovudine (brand name retrovir), formerly known as AZT from its
synthetic chemical name, azidothymidine, is the drug most commonly
used in the treatment of HIV infection. The drug inhibits the
replication of HIV by interfering with the process of reverse
transcription, which is necessary for the production of new virus
particles.

Zidovudine was shown by clinical trials in 1986 to be effective at
improving survival in patients with AIDS, and has since then been
licensed as the first choice treatment for HIV infection in Europe,
North America and Australia. The drug appears temporarily to delay the
progression of disease and death in people who have HIV infection
symptoms, but does not significantly delay the development of AIDS in
HIV-positive people without symptoms.

Zidovudine is increasingly prescribed as part of a combination of
antiviral drugs, and a recent international study conducted in Britain
and the United States showed that this approach results in greatly
enhanced survival when compared with Zidovudine treatment alone.

It appears to have a significant protective effect against HIV related
brain disease and dementia. This is due to the ease with which the
drug crosses the blood brain barrier, a quality not shared by other
anti HIV drugs that have come into use subsequently. Because of the
lack of effective treatment for HIV, more importance is put on
preventive strategies. All blood donors are screened for HIV, greatly
reducing any chances of contracting HIV through a blood transfusion,
or through factor VIII for haemophiliacs.

A key preventive strategy has been to change behaviour through
education and promotion of safe sex. This has been promoted through
advertising and education, with television taking the lead in
promoting the use of condoms, especially to young people.

The transmission of HIV through intravenous drug users is also reduced
by education, and there is also a Government sponsored needle exchange
programme, where clean needles can be collected free of charge, thus
stopping the infection being passed on by the sharing of dirty needles.

http://kimsnursing.info

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