INTRODUCTION:

HIV standsfor Human (mortal) immunodeficiency contagion.

AIDS stands for acquired immune insufficiency (deficiency) syndrome.

● HIV

H-it infects only mortal beings and also transmitted between humans not from creatures. It isn't transmitted from mouthfulsof mosquitoes, batons or any other species.

I- The body has vulnerable system whose function is to cover our body from origins, infections etc. But a person suffering from HIV has incapability to fight against conditions. still, vulnerable system become deficient

V- Contagion is a small, simplest thing which is in inactive form outside the body and becomes active when it goes inside mortal body.

● AIDS–

A-It isn't inherited means it can not be transmit from one generation to another. It's transmitted to healthy person by infected person.

I- It weakens the vulnerable system.

D- Creates a insufficiency of CD4cells in the vulnerable system.

S- It's a collection of conditions.¹

HIV (Human Immunodeficiency contagion) is the causative agent for AIDS (Acquired immuno insufficiency pattern). This contagion interferes with body’s vulnerable system. The vulnerable system helps body to fight off infections. But this contagion if left undressed, infects and kills the CD4 cells, which are a type of vulnerable cell called T cells. Due to weakened vulnerable system the other bacteria and contagions take advantage and worsen the situation. As a result of this body is more likely prone to other infections and cancer which further prove fatal.²

There's no cure of AIDS but there are certain drugs which are use to decelerate down the conditions so you stay healthier for long time. There's no drug to get relieve of conditions.¹

● Origin of Disease -

Scientists believe that the HIV infection was transmitted from a type of chimpanzee in West Africa to humans. SIV (Simian immunodeficiency contagion) is the chimpanzee interpretation of immunodeficiency contagion. It’s believed that this contagion was transferred and shifted to HIV in humans when they hunted SIV infected chimpanzee foe meat and came in contact with its blood.

SIV strains were set up in hoods as well. The strain set up in hoods is known as SIVgor and it's distinct from the strain set up in chimpanzees. AIDS is considered a zoonosis, an infection participated by humans and other invertebrates.³

● Subtypes of Virus:

HIV- 1 and HIV- 2 are two main types of the HIV contagion. HIV- 1 is most generally set up in affected people. About 95 percent people infected with HIV have HIV- 1 infections. It (HIV- 1) is fluently transmitted as compared to the ultimate one (HIV- 2). Though HIV- 1 and HIV- 2 are both retroviruses that also affect body’s vulnerable system, they vary in their inheritable composition.³

● Structure of HIV virus –

HIV is one of a group of atypical contagions called retroviruses that maintain their inheritable information in the form of ribonucleic acid (RNA). Through the use of an enzyme known as reverse transcriptase, HIV and other retroviruses are able of producing deoxyribonucleic acid (DNA) from RNA.⁵

Each virion expresses 72 glycoprotein protrusions composed of gp12O and gp41.

· Gp41 is a transmembrane patch that crosses the lipid bilayer of the envelope.

· Gp120 is noncovalently associated with gp41 and serves as the viral receptor for CD4 on host cells. The viral envelope also contains some host- cell membrane proteins similar as class I and class II MHC motes.

· Within the envelope is the viral core, or nucleocapsid, which includes a subcaste of a protein called p17 and an inner subcaste protein called p24.

The HIV genome consists of two clones of ssRNA, which are associated with two motes of reverse transcriptase p64 and nucleoid proteins p10, a protease, and p32, an integrase.[6]

Transmission:

HIV can transmit when body fluids containing the contagion come into contact with a passable hedge in the body or small breaks in wettishapkins of areas, similar as the genitals. Specifically, HIV can transmit via

Blood: semen pre-seminal fluid vaginal fluids rectal fluids breast milk

The contagion can not transmit through slaver, so a person can not contract HIV through open- mouthed kissing, for illustration.

1. One of the main causes of HIV transmission in the U.S. is anal or vaginal intercourse. Transmission of HIV occurs when individualities don't use hedge protection, similar as a condom, during intercourse or aren't takingpre-exposure prophylaxis (PrEP), a treatment that aims to help HIV transmission among people with known threat factors.

2. Participating outfit for edging in medicines is another main cause of HIV transmission in theU.S.

3. Lower generally, HIV transmits to babies during gestation, parturition, or breastfeeding or chestfeeding.

4. There's also a chance of transmission through blood transfusions, though the threat is extremely low when blood donations suffer effective webbing.⁷

Conditioning That Allow HIV Transmission:

● vulnerable sexual contact

● Direct blood contact, including injection medicine needles, blood transfusions, accidents in health care settings or certain health care products.

● mama to baby (before or during birth)⁸

The threat of HIV transmission is dependent on-

· The attention of HIV in the infected fluid.

· The volume of fluid introduced into the body.

· The ACCESS of the infected fluid to the t4 cells.[9]

Progression to AIDS:

The chances of HIV progressing to AIDS vary extensively from person to person and depend on numerous factors, including

· The person’s age

· The body’s capability to defend against HIV

· Availability of quality healthcare the presence of other infections a person’s inheritable resistance to certain strains of HIV

· The strain of HIV, as some are medicine- resistant.⁷

HIV life cycle:

The seven stages of HIV life cycle are –

1. Attachment

2. Fusion

3. Reverse transcription

4. Integration

5. Repilcation

6. Assembly

7. Budding

Symptoms:

Acquired immunodeficiency pattern (AIDS) is a habitual, potentially life- hanging condition caused by the mortal immunodeficiency contagion (HIV).

symptoms of HIV and AIDS vary, depending on the phase of infection.

Primary infection (Acute HIV):

Some people infected by HIV develop a flu- suchlike illness within 2 to 4 weeks after the contagion enters the body. This illness, known as primary (acute) HIV infection, may last for a many weeks.

Possible signs and symptoms include -

I. Fever

II. Headache

III. Muscle pangs and common pain

IV. Rash Sore throat and painful mouth blisters

V. Swollen lymph glands, substantially on the neck

VI. Diarrhoea

VII. Weight loss

VIII. Cough

IX. Night sweats

Clinical latent infection (habitual HIV)

In this stage of infection, HIV is still present in the body and in white blood cells. still, numerous people may not have any symptoms or infections during this time.

Untreated , HIV typically turns into AIDS in about 8 to 10 years. when AIDS occur, your immune system has been severely damaged.¹¹

● Symptoms -loss of memory

Seizure and lack of coordination

Vision loss¹²

Diagnosis:

Blood and slaver testing are done to diagnose the HIV infections. The tests carried out are

Antigen/Antibody testing:

Antigen can show positive test within many days of infection but vulnerable system requires time to produce antibodies to infection and hence my bear time( 2- 6 weeks) to be positive. Hence a combination of Antigen/ Antibody test may take 2- 6 weeks to show positive results after exposure to contagion.

ELISA Test:

ELISA (enzyme- linked immunosorbent assay) is used to descry the presence of HIV infection. After getting positive result of ELISA test, generally western spot test is administered to confirm the infection. Though ELISA test may show negative result, but if patient thinks that there may be HIV infection present, he she should again get tested after one or three months. ELISA is a veritably sensitive to HIV infection, but antibodies aren’t produced incontinently after infection so one may test negative within many weeks after being infected. Although, you may get negative test results, the position of contagion present is high and you’ll be at threat of transmitting infection.

Home Tests:

The home access expert test is approved by US FDA and is vended in apothecaries. It’s the only approved home test tackle.

Slaver Tests:

By using a cotton pad, slaver is attained from the inside of case’s impertinence. It’s placed in vial and submitted for testing. Results are generally available within 3 days and positive results are verified with blood tests.

Viralcargo Test:

The quantum of HIV in blood is measured using viral cargo test. This test is generally used to cover treatment progress and also is helpful in detecting early HIV infections. The three technologies which measure HIV viral cargo with same introductory principle are 1. Fanned DNA( bDNA) 2. NA( nucleic acid) sequence grounded modification assay 3. Rear recap PCR DNA sequences that bind specifically to HIV contagion are detected, although results may vary between tests.

Westernblot:

The most sensitive test used to confirm ELISA test results is western blot test.¹³

Treatment:

Antiretroviral Remedy:

In a standard antiretroviral remedy generally called as ART is combination of at least 3 antiretroviral (ARV) medicines which is intended for minimal repression of HIV contagion in the body. It’s also used to stop progression of HIV infection. This remedy has proven to be salutary in reduction of large quantum of death rates and mournings when used effectively in early stages stage of infection. Besides, threat of HIV transmission at population position is also reduced which save families. According to check by WHO and UNAIDS, 34 million people were living with HIV in 2011 and about 15 million people were in need pf ART. By the end of 2012, ART was accessible to9.7 million people in developing and under developed countries. Guidance, tools and support is handed by WHO which supports delivery and increased assay of ART within public. Treatment2.0 strategy was launched by WHO and UNAIDS in the time 2010, that promoted radical simplification of ART. Along with this, acceleration of treatment scale- up and integrity of forestallment was done to make it widely accessible. Likewise, WHO launched new guidelines with recommendations of ART in July 2013 for grown-ups and adolescents.

Medicines Used in Art Nucleoside/ Nucleotide Reverse Transcriptase Impediments (NRTIs):

HIV contagion is forced to use defective performances of erecting blocks by NRTIs so that further HIV aren’t made by infected cells.

a. Abacavir or Ziagen *

b. Zidovudine or Retrovir *

c. Stavudine or Zerit *

d. Didanosine or Videx *

e. Emtricitabine or Emtriva *

f. Lamivudine or Epivir *

g. Tenofoviralafenamide or Vemlidy *

h. Tenofovirdisoproxil fumarate or Viread *

Non-nucleoside Reverse Transcriptase Impediments (NNRTIs) –

NNRTIs function by binding to specific protein, making HIV unfit to make further clones of itself and are also called as “non-nukes ”

a. Delavirdine or Rescripor *

b. Rilpivirine or Edurant *

c. Etravirine or Intelence *

d. Doravirine or Pifeltro *

e. Efavirinz or Sustiva *

f. Nevirapine or Viramune *

ProteaseImpediments (PIs) –

Infected cells need to put together a protein to form a new HIV contagion flyspeck. These medicines serve by blocking those proteins.

a. Atazanavir or Reyataz *

b. Darunavir or Prezista *

c. Tipranavir or Aptivus *

d. Ritonavir or Norvir *

e. Lopinavir ritonavir or Kaletra *

f. Fosamprenavir or Lexiva *

g. Indinavir or Crixivan *

h. Nelfinavir or Viracept *

i. Saquinavir or Invirase *,

j. Fortovase *

Integrase beachfront transfer impediments (INSTIs). Integrase impediments act by blocking a crucial protein and inhibit HIV from making clones of itself. Crucial protein allows the contagion to put its DNA into healthy cell’s DNA. Bictegravir or combined with other medicines as

a. Biktarvy *

b. Dolutegravir o Tivicay *

c. Elvitegravir or Vitekta *

d. Raltegravir or Isentress *

FusionImpediments:

At the veritably first place, HIV is blocked from getting into healthy cells. The function of FIs is completely different from NRTIs, NNRTIs, PIs, and INSTIs- as these work on infected cells.

● Enfuvirtide or Fuzeon *

CCR5Antagonist:

It also stops HIV from getting into healthy cells but by blocking a specific kind of “ hook ” on certain cells. Eventually, contagion isn’t suitable to plug on cell.

● Maraviroc or Selzentry *¹⁴

* Indicates brand name of the drug

Prevention

Threat factors:

Anyone of any age, race, coitus or sexual exposure can be infected with HIV, but you are at topmost threat of HIV/ AIDS if you

· Have vulnerable coitus with multiple mates. vulnerable coitus means having coitus without using a new latex or polyurethane condom every time.

· Have vulnerable Sexual relationship with someone who's HIV-positive.

· Have another sexually transmitted complaint, similar as syphilis, herpes, Chlamydia, gonorrhoea or bacterial vaginosis.

· Share needles during intravenous medicine use.

· Entered a blood transfusion or blood products before 1985.[15]

· Babe or nursing babies whose mommies tested positive for HIV but didn't admit treatment also are at high threat.

· Fastest growing system of HIV transmission heterosexual contact.

· Heterosexual transmission is easier from men to women than from women to men.

· Threat of acquiring for men is lesser if contact occurs during period (menstruation).

· Uncircumcised men are more likely to be seropositive and contract HIV during coitus.[16]

REFERENCES:

1. Coffin, J. M. Molecular biology of HIV. In The Evolution of HIV, ed. K. A. Crandall, 1999; 3-40.

2. https://aidsinfo.nih.gov/understanding- hiv-aids/factsheets/19/45/hiv-aids--the- basics

3. https://www.britannica.com/science/AIDS/Theorigin-of-HIV

4. https://www.alamy.com/stock-photo/immunodeficiency.html?sortBy=relevant

5. https://micro.magnet.fsu.edu/cells/virus/hivvirus.html

6. https://biosci.mcdb.ucsb.edu/immunology/Immunodeficiencies/HIV-structure.htm

7. https://www.medicalnewstoday.com/articles/17131#causes

8. Friedland, G. and Klein R. Transmission of HIV. Nejm1987; 317:18: 1125-1135.

9. Downs, A.M. and De I. Vincenzi. Probability of Heterosexual transmission of HIV: relationship to the Number of unprotected sexual contacts. Europeon study Group in heterosexual transmission of HIV. J. A cquir Immune DeficSyndr Hum Retroviral 1996; 11(4): 388 95.

10. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-life-cycle

11. https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524

12. Amborzia, J. and Levy J. A. Epidemiology, natural history and Pathogenesis of HIV Infection. In Sexually Transmitted Diseases, 3d ed, ed. K.K. Holmes, P.F. Sparling, P.A. Mardh, S.M. Lemon, W.E. Stamm, P Piot, and J.N. Wasserheit, 1998; 251–58.

13. /diagnosis#:~:text=The%20primary%20teSts%20for%20diagnosing,administered%20to%20confirm% 20the%20diagnosis.

14. https://www.who.int/hiv/topics/treatment/Art/en/#:~:text=HIV-Antiretroviral%20therapy,the%20progression%20of%20HIV%20disease.

15. https://images.app.goo.gl/Y7czcRxPUAkNAZr19

16. https://images.app.goo.gl/7Jm4hPC3CuUww8KY6

Received on 29.08.2023 Modified on 18.11.2023

Research J. Science and Tech. 2024; 16(1):68-74.

DOI: 10.52711/2349-2988.2024.00011