Anatomy and Physiology of AIDS Paper Example

Introduction

In the 1970s some homosexual men were suffering from a unique kind of cancer and pneumonia which was as a result of benign microorganism. This condition affected the immune system and became what is currently known as acquired immunodeficiency syndrome (AIDS) (In Cohen, In Trussell & NRCS, 2004). Even though the instrumental virus (HIV) was identified in 1983, the cure for AIDS is still a mirage. In years that followed, the disease killed many men, women, and children from all social and economic classes, races and across all nations. To date, HIV remains a major issue for numerous reasons. First, the virus has a very high mutation rate to the point that the affected person often harbors numerous variations. Due to the high rate of mutation, the virus easily evolves resistance to different drug options used to treat it. Furthermore, the white blood cells essential to a strong immune system may be suppressed for a long time (Simon, Ho, & Karim, 2006). The treatment for AIDS depends on knowledge of the dynamic life cycle of the virus and understanding of the immune system. This means that controlling AIDS calls for more than the advancements in the medical field and vaccines but also attending to the politics revolving around the disease.

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Etiology of AIDS

The etiologic agent for AIDS is HTLV-III virus which shares numerous biological and physicochemical attributes of this virus correlates with the family of retroviruses known as human T-cell leukemia virus (HTLV). Due to the similarities, and the similar nomenclature for HTLV, the virus linked to the cause of AIDS was named HTLV-III. The virus is transmitted from body fluids in non-occupational setup across cell membranes or primarily through different modes of transmission; unprotected sexual intercourse, injection drug use, unsafe blood transmission or mother-child transmission during pregnancy, during birth or lactation (Hall, Hall & Cockerell, 2011). The risk of spread of infection depends on the stage of HIV disease, circumcision status and the presence of ulcer disease around genitals.

The causative agent (HIV) has a life cycle just as other viruses. A person is infected when the virus attaches itself to the host cell. CCR5 and CXCR4 are used as receptors which dominate during the first stages of the infection and stays dormant. Virus entry into the host cell is triggered by other viral proteins which facilitate the surrounding of the cell with the host cell membrane. Once the virus enters the host cell, its capsid proteins are shed off through uncoating as the viral nuclear begins to mutate and enters the host cell polymerases. This is followed by the replication and copying of DNA or RNA into mRNA. HTLV-III is an RNA retrovirus, and this means that after uncoating, reverse transcription begins (Hall, Hall & Cockerell, 2011). The resulting synthesized mRNA is then transferred to the ribosomes of the host cells. This is followed by continuous mutation to other cells and weakening of the immunity system.

History of AIDS

Health care practitioners do not know the exact origin of HIV, but it is believed that it developed from a virus type which was found in West Africa, in a chimpanzee. There were hunters who feasted on the animal and as a result came into contact with the virus. Scientists believe that the virus mutated into the human virus known as HIV. The first sample of the virus was collected in 1959 in Congo. The generic analysis of the virus revealed that it might have developed between 1910 to 1930. Before 1980, some people developed unique forms of opportunistic infections which are prone to people with the weak immune system (In Cohen, In Trussell & NRCS, 2004). During this time, doctors were unable to comprehend the prevailing reasons behind these infections. Between 1980 to 1990, there was misunderstanding across the globe on the virus and its mode of transmission. Researchers noticed similar symptoms among homosexuals and the disease was called gay-related immune deficiency (GRID). Similar symptoms were evident among intravenous drug addicts. As a result, it was called acquired immunodeficiency syndrome (AIDS). After intensive research, the virus that causes AIDS was identified as HTLV-III/LAV in 1983. The name was later changed to human immunodeficiency virus (HIV) (Simon, Ho, & Karim, 2006). By 2000, AIDS-related diseases were among the leading cause of death in Africa.

Epidemiology

The disease has shifted over the last three decades from the first case in the 1980s to almost 3.7 million infections registered in 1997, to another decline in AID-related in 2000s. Around 2014, more than 9.7 million people in the low-and-middle income nations were on antiviral drugs (ART). The expansion of ART use has significantly increased the survival rate among people living with the virus. Due to the increased use of ART across the globe, AIDS-related mortalities reduced by 30 percent between 2006 to 2012. Subsequently, new infections have reduced which is credited to the new advancements made in ARTs, programs for prevention of mother-child transmission and safe sex interventions. According to the World Health Organization (WHO), the key population includes areas that are prone to HIV. The most at risk population are homosexuals, transgender and sex workers. This population is affected in most cases in epidemic situations (Hall, Hall & Cockerell, 2011). The vulnerable population is marked by highlighting the social and demographic characteristics of the region, and this may differ depending on different situations and contexts. Concentrated epidemic area has a prevalence of more than 5 percent but not well established in the entire population.

In Sub-Saharan African, AIDS is mainly transmitted through unprotected intercourse. The prevalence increases with multiple sex partners and other sexual infections such as herpes. A significant proportion of new infections are linked to long-term sexual relationships. Another risk factor is the mother-child transmission which occurs during pregnancy, at birth or when breastfeeding. Although ART reduces mother-child transmission rate to less than 1 percent, there is a need for other interventions like HIV testing and easy access to ART to achieve an HIV free generation. Asia comes second in relation to HIV infections after Africa. Mortalities caused by AIDS-related sicknesses has significantly reduced in Asia. This is attributed to improvements in ART and mother-child transmission prevention initiatives (Hall, Hall & Cockerell, 2011). With more than 85 percent of mothers with the virus using ART, the overall new infections have reduced. The dominant mode of transmission in Asia includes paid sex and drug use, with variations across different nations.

Pathology

AIDS is caused by human immunodeficiency virus (HIV) which targets the CD4 cells and ultimately the immune system. As a result, numerous opportunistic infections and tumors develop in the body. At the same time, there are body organs that are damaged. The occurrence and pattern of the opportunistic infections among people affected with HIV vary across different regions relative to the prevalence rate and survival rate of HIV patients. This means that opportunistic infections changes as people migrate or travel to different parts of the world. The introduction of ART and the application of mathematical models to calculate HIV clearance rate has played a critical part in understanding and managing the condition. Research on lymphoid tissue has facilitated the assessment of viral dynamism and assess the correlation of virus mutation in lymphocytes and the blood (Celentano & Beyrer, 2008). The virus has been studied not only in quasi-state of infection but also during the early stages of infection. Recent improvements in ART has helped curb numerous opportunistic infections and studies continues with the aim of finding vaccines and ultimately cure. This means that AIDS pathology is not static; new inventions are made occasionally.

Clinical Manifestations

An understanding of the causes of AIDS has helped in the management of the disease and revolutionization of treatment, referred to as Highly Active Antiretroviral Therapy (HAART). Networks of statisticians, clinicians, virologists, and medical researchers have been studied the history of AIDS to list the Clinical Manifestations. The clinical manifestations related to acute HIV has been termed as primary HIV syndrome and acute retroviral syndrome (ARVS). The first case was registered in Australian researchers where the patient had fever, headache, diarrhea, and rashes. This has been expanded to other symptoms:

• Neurological Meningitis, headache
• Systemic Fever, fatigue, weight loss, dehydration, night sweat, rigors
• Respiratory Cough, bronchitis
• Psychological Depression, anxiety, mood change
• Gastrointestinal Vomiting, abdominal pains
• Dermatological Herpes zoster, rashes, Erythema
• Oral Herpes, stomatitis

Due to the high number of patients living with HIV, infections other than those listed as diagnostic with AIDS can occur. This makes it difficult to validate the direct association between medical issues and HIV- stimulated infection. This is evident with diseases that dominant among members of AIDS vulnerable groups before the introduction of HIV (Celentano & Beyrer, 2008). For instance, the drug users are prone to hepatitis B virus and endocarditis. This is similar to bisexual and homosexuals who are frequently affected by other infections other than those related to HIV. Homosexual and bisexuals have a high probability of sexually transmitted diseases such as herpes, genital warts, and gonorrhea among other infections. Even though lifestyle changes among homosexuals have changed in response to the AIDS epidemic, the sexually transmitted infections remain dominant. When a patient has been exposed to HIV, treatment often starts between 10 days to 6 weeks.

Evaluation

Hematology and laboratory test are the first steps for evaluating AIDS. The tests can include neutropenia, mild anemia, and aspartate aminotransferase. At the same time, lymphocytes can be noted on the blood sample of the patient. During the initial stages of infection, there may be lymphopenia and lymphocytosis (which includes CD8 cells and T cells). This will lead to a reversed T cell in CD4: CD8 form. As time progresses, the CD8 lymphocytosis reduces in number, but the actual number of CD8 and T cells remain more than the CD4 cells.

An assessment of the antibodies follows to validate acute infection with HIV. At this point, the enzyme-linked immunosorbent assay (ELISA) can be negative while viral replication is taking place. Viral replication can be denoted by either HIV p24 antigen or mRNA. Similarly, the Western blot essay can be negative if performed during the early stages of infection.

Treatment

There is no absolute cure for AIDS, but a combination of different ART drugs helps control the virus. Every type of drug helps control the virus in different ways. This is administered based on the available CD4 T cells. The classes include:

• Non-nucleoside reverse transcriptase inhibitors (NNRTIs): suppresses the proteins used for mutation.
• Nucleotide reverse transcriptase inhibitors (NRTIs): produces a fake version of building blocks used by the virus to replicate
• Protease inhibitors (PIs): Deactivate protease, a protein used for replication
• Fusion inhibitors: prevents the entry of the virus into CD4 T cells.
• Integrase inhibitors: deactivates integrase, a protein used by the virus to move its genetic components into CD4 T cells.

Socio-politico-economic

Many countries across the globe bear the burden of the AIDS epidemic triggered by the political, social and economic complexities. Managing the disease requires a signi...