AIDS: history of origin, spread, symptoms. Reference

1. HIV infection
2. Causes of AIDS
3. How is AIDS not transmitted?
4. Pathogenesis
5. Symptoms of AIDS
6. Forms of flow
7. Pulmonary
8. Gastrointestinal
9. Cerebral
10. Disseminated
11. Undifferentiated
12. Complications of AIDS
13. Diagnostics
14. AIDS treatment
15. Prognosis and prevention

Acquired immunodeficiency syndrome - AIDS, the “plague of the 20th century” - was first identified in the 1980s in the United States. Then cases of death of young men due to pneumonia were recorded. More than 35 million people with AIDS are registered in the world.

HIV infection

AIDS - acquired immunodeficiency syndrome - is a consequence of the development of HIV infection, one of its main markers and is manifested by complete suppression of the immune system. The condition occurs approximately 5 years after infection. Any disease that occurs against the background of HIV can be fatal. Diagnostics is aimed at identifying HIV infection, checking the number of immunocompetent cells and antibodies to the virus. The goal of therapy is to suppress the pathogen through the use of antiviral drugs. It is mandatory to eliminate bacteria, fungi, and viruses that provoke the development of secondary pathologies.

Causes of AIDS

Human immunodeficiency virus (HIV) is a type of retrovirus. It is found in blood, sweat, vaginal secretions, semen, breast milk, and tears. The infection is transmitted intravenously, from mother to fetus, or sexually. You can become infected with HIV from medical instruments (syringes, etc.) that are used multiple times, during blood transfusions, or when applying tattoos and piercings.

The risk group includes people who have been infected with HIV for more than 5 years, who do not receive proper treatment, injection drug users, pregnant women, people living in unfavorable conditions, people

Similar names do not always have the same meaning

HIV is the human immunodeficiency virus. It can be asymptomatic for a long time, but during periods of exacerbation the manifestations are quite powerful. The difference between HIV and AIDS is that with the former you can live an almost full life, but with its final stage, immunodeficiency syndrome, this becomes impossible. Any infection can cause quick death.

Modern medicine can prolong the life of a person who has been diagnosed with an immunodeficiency virus, provided that they consult a doctor in a timely manner. But the danger is that the patient may not know for a long time that there are damaging cells in his blood, which means he does not get tested for this virus, and therefore will not receive help on time.

Pathogenesis

AIDS provokes a gradual decrease in the population of T-lymphocytes (they recognize cells with foreign antigens and play an important role in the acquired immune response), which is caused by a direct cytolytic effect and activation of apoptosis (the process of cell death) in T-helper cells. Leads to deactivation and depletion of the immune pool. HIV infection provokes the destruction of nerve cells and has a toxic effect on neurons. Against the background of decreased immunity, persistent (constantly present) infections are activated. Due to the lack of the necessary response of immunocompetent cells, active reproduction and generalization of the infection occurs.

Symptoms of AIDS

From the moment of HIV infection to the first manifestations of acquired immunodeficiency syndrome, years and sometimes decades pass. The patient's condition begins to deteriorate due to the development of other diseases. One of the manifestations is a persistently elevated body temperature, which is accompanied by night chills, flashes of sweat (mainly at night), and a state of delirium. Blue-red nodes, characterized by pain, appear on the lower extremities, oral mucosa, and face (Kaposi's sarcoma).

White cheesy deposits of candida nature may appear on the surface of the mucous membrane and on the skin. There may be difficulty swallowing, a burning sensation in the mouth and a “lump” in the throat, pain in the chest area. There are traces in the form of herpes zoster, vesicles, the condition is accompanied by severe pain, rashes in the form of blisters. The patient complains of lack of appetite, diarrhea, and weight loss is observed - up to 10% of weight in a short period of time.

If the lung tissue is damaged, there is a strong dry cough and shortness of breath. Sometimes among the first symptoms of AIDS are manifestations of damage to the central nervous system: forgetfulness, dementia, severe headaches, decreased concentration, paralysis. Forms of flow

With acquired immunodeficiency syndrome, the patient is easily infected with other infectious diseases. Against the background of reduced immunity, fungi and bacteria spread. Tumors of the skin and internal organs may develop. The manifestation of AIDS differs depending on the clinical form.

Forms of flow

Pulmonary

The most common form of AIDS, present in 50%-80% of adult patients and children. Accompanied by various forms of pneumonia, fever, severe cough, shortness of breath, chest pain. The condition causes oxygen starvation. X-ray shows scattered pulmonary infiltrates. Sometimes pneumonia is accompanied by respiratory failure, intoxication, and tuberculosis may occur. Treatment is carried out according to a complex scheme, which is built in accordance with the patient’s condition.

Gastrointestinal

The second most common form, which affects the intestines. The patient complains of prolonged diarrhea or obstruction, painful swallowing, and chest pain. The gastrointestinal tract is affected not only by associated infections, but also by the HIV pathogen itself. Changes occur not only in housing and communal services, but also in the liver and kidneys. Manifested by stomatitis, colitis, isosporosis, salmonellosis. The main risk is critical weight loss.

Cerebral

A form of HIV infection occurs in 15-20% of patients. NeuroAIDS is characterized by secondary damage to the central nervous system. Brain abscess, meningitis, encephalitis, and multifocal leukoencephalopathy develop. Damage to the central nervous system causes changes in cognitive abilities, behavior, and memory. There is a change in coordination of movements, lethargy, the presence of anxiety, irritation to bright light and loud music. In severe forms, dementia and schizoid manifestations may develop, and in some cases, HIV contributes to the formation of a brain tumor.

Disseminated

Develops in approximately 30% of AIDS cases. It manifests itself as tumors of the skin and mucous membrane, most of the formations are related to Kaposi's sarcoma. A small percentage of HIV-infected people are faced with a malignant tumor - B-cell lymphoma.

Undifferentiated

Clinical form, the etiology of which remains unclear. It manifests itself as prolonged diarrhea, asthenia, lymphadenopathy, purulent foci, and elevated temperature for months. A complex of AIDS-associated symptoms is observed.

What is HIV and how does it manifest itself?

People first started talking about HIV infection in the 80s of the twentieth century, but earlier cases of similar diseases can be found in historical documents.

The virus is believed to have come from central Africa during an intense migration.

The virus belongs to the family of so-called “slow” viruses. The fact is that many years can pass from the moment of infection to the appearance of the first symptoms (about 50% of infected people do not know that they are infected for about 10 years). The mechanism of infection begins from the moment the virus enters the blood. Having found the cells responsible for immunity, the virus adheres to them. The immune system is unable to effectively fight back against foreign substances, sometimes due to the variability of the virus, when cells simply cannot recognize it. The disease begins to progress, affecting more and more lymphocytes, and eventually there are so few of them left that HIV turns into AIDS. A condition in which the number of lymphocytes is less than 200 per 1 ml of blood is considered the beginning of the last stage of immunodeficiency; the body can no longer produce the required number of immune cells and becomes vulnerable to any infection.

There are several stages of the immunodeficiency virus disease:

• Incubation period. This is the time when the virus has just entered the body. It can occur without any symptoms or with flu-like symptoms. The duration of this period can be short, or it can last up to six months;
• Acute manifestations of infection. The patient may begin to get sick with encephalitis and fever. However, this is not observed in everyone; there may be no symptoms at this stage;
• The next stage is called latent. At the same time, not a single symptom will indicate the presence of the virus; only an HIV test can show its presence;
• The last stage when HIV turns into AIDS. At this time, the body is no longer able to resist any diseases. Infection with fungal and viral infections, as well as oncology, leads to the death of the patient.

Complications of AIDS

People with acquired immunodeficiency syndrome are at risk of developing tuberculosis. Most of these patients have a generalized form of tuberculosis, which can lead to death and disability. Up to 90% of AIDS patients suffer from Pneumocystis pneumonia, and 10% have damage to the central nervous system. Up to 23% of cases of tuberculous meningoencephalitis are registered.

All HIV-infected people are at risk of developing candidal pharyngitis, regardless of the stage of the disease. A tenth of patients have a fungal infection of the esophagus; the patient’s condition worsens due to a decrease in T-helper cells.

Diagnostics

The diagnosis of AIDS is made after consultation with an infectious disease specialist. If there are concomitant diseases, other medical specialists are involved. Patients with HIV infection are mostly advised by phthisiatricians. The following methods are used to diagnose the disease:

1. Physical. A medical examination is aimed at identifying signs of the disease, in particular, the growth of lymph nodes, changes in behavior, rashes on the mucous membranes and skin. Rhythm disturbances and noises may be heard in the heart, and snoring in the lungs. White plaque may be present in the oral cavity.
2. Ophthalmological. Signs of the disease are retinal necrosis, precipitates in the anterior chamber, and nerve atrophy. The patient complains of decreased sharpness and the formation of spots before the eyes.
3. Laboratory. Shows the main manifestations of immunodeficiency: thrombocytopenia, anemia, leukopenia, lymphopenia. Clinical urine analysis shows proteinuria, lipiduria. The screening method allows you to determine the immune blot. PCR testing is used to identify antigens.
4. Instrumental. Includes chest x-ray, MSCT, MRI of the brain and mediastinal tomography. For all patients with HIV, ultrasound of the kidneys, abdomen, and pelvis is recommended.
5. Differential diagnosis. It is carried out in the presence of clinical symptoms. Skin manifestations are similar to those of allergic dermatitis, syphilis, and herpes zoster. Enlarged lymph nodes are detected with tuberculosis and brucellosis.

The first signs of AIDS in men and women

An absolutely asymptomatic onset of HIV infection is typical for most cases. How long HIV takes to develop in the body can depend on a variety of factors, such as the general health of the infected person. Many people experience no symptoms after infection, and some people experience flu-like symptoms after a few days or weeks. This may be enlarged lymph nodes in the neck, excessive fatigue, or fever.

These symptoms often go away on their own after a few weeks. It may take a long time (even several years) before the patient notices any changes in his health, but during this period he is able to infect his partner. When the immune system weakens, an infected person may experience certain symptoms:

1. Frequent sweating and fever.
2. Weight loss.
3. Loss of energy.
4. Short-term memory loss.
5. Peeling skin and persistent skin rash.
6. Herpetic rashes in the anus, genitals or mouth.
7. Chronic fungal infections.

Common symptoms of AIDS include:

1. Lack of coordination and convulsions.
2. Persistent diarrhea.
3. Painful or difficult swallowing.
4. Shortness of breath and cough.
5. Mental symptoms such as forgetfulness and confusion.
6. Vomiting, stomach cramps, nausea.
7. Severe headaches.
8. Heat.
9. Extreme fatigue and weight loss.
10. Loss of vision.

AIDS treatment

The advisability of treatment in a hospital will be determined by the patient’s condition. Hospitalization in highly specialized medical institutions is possible: oncology and tuberculosis dispensaries. In some cases, hospitalization in intensive care is necessary. For concomitant diseases, such as hepatitis, diabetes, a patient with symptoms of AIDS is prescribed a diet. Bed rest is necessary for prolonged fever.

Etiotropic antiretroviral drugs prevent the progression of HIV infection. The action is aimed at reducing the amount of virus in the blood. Antiviral, antifungal and antibacterial agents are used to treat concomitant infections. If indicated, radiation and chemotherapy are performed; surgery may be required. To relieve symptoms, medications are taken to reduce fever, detoxification, and vasoprotective agents.

How is AIDS not transmitted?

Despite the fact that the biological fluids of a sick person contain viral particles, infection does not occur through the following routes:

1. When using a swimming pool or public toilet.
2. When kissing, shaking hands or hugging (naturally, if people do not have open bleeding wounds at the point of contact when shaking hands and kissing, but it is quite difficult to imagine this).
3. Airborne droplets.
4. When using household items.
5. Through food.
6. When bitten by various blood-sucking insects (for example, mosquitoes).
7. When touching the doorknob.
8. In contact with pets.

Numerous studies have been conducted that have established that AIDS is not transmitted through saliva. For infection to occur, at least 2 liters of salivary fluid must enter the bloodstream or damaged mucous membranes of a healthy person. In real life this is impossible. Therefore, you cannot become infected with AIDS during a kiss.

There is no risk of infection when using shared utensils.

This is due to factors such as:

Two liters of saliva cannot be on any dish or utensil.

• If so much saliva has accumulated somewhere, it cannot enter the human body.
• Even if the dish contains saliva with blood (when the patient has periodontal disease or stomatitis) and it is swallowed by a healthy person, he will still not become infected. In air, the virus dies very quickly.

If the liquid containing the virus has dried, then it does not pose a danger in terms of infection. In the air, the viruses that cause AIDS die very quickly.

Since the pathogens of AIDS are not able to exist in the external environment, infection does not occur either through conversation, or through the common consumption of food, or through the use of towels. Infection does not occur when using public toilets, showers or other household items.

Infection does not occur with a handshake. The skin protects a person well from viruses. The infection can only be transmitted if people have bleeding wounds on their hands that are in contact with each other.

Mosquitoes and other blood-sucking insects do not spread AIDS. The organs with which they feed are designed in such a way that the blood of the previous owner is not able to be transferred to the next victim. Science does not know of a single case of AIDS transmission by insects.

It is impossible to get AIDS from contact with domestic and wild animals. The virus cannot exist in their body.

You can safely visit swimming pools, saunas and steam baths. AIDS does not spread through water.

Prognosis and prevention

The prognosis will depend on the timeliness of detection of HIV and opportunistic pathologies. With the help of antiretroviral drugs it will be possible to prevent the appearance of systemic forms. With HIV infection, tuberculosis leads to death in 50% of cases, toxoplasmosis and pneumystosis - in 17%, CMV infection (cytomegalovirus infection) - in 15%. Other conditions are less likely to cause mortality. If an opportunistic pathology (except tuberculosis) is detected, patients are prescribed two-week antiretroviral therapy.

Work is underway to create a vaccine that prevents HIV infection, but the main difficulty lies in the constant mutation of the virus. As nonspecific preventive measures, it is recommended to abstain from unprotected sexual intercourse (sexual intercourse without a condom) and drug use. At the state level, it is required to introduce educational programs related to HIV infection, disseminate information through the media and social events.

WHO activities

The World Health Assembly, at its sixty-ninth session, endorsed the new Global Health Sector Strategy on HIV 2016–2021. The Strategy includes five strategic directions to guide countries and WHO in their priority actions over the next six years.

These are the following strategic directions:

• information for targeted actions (understanding the scale of the epidemic and combating it);
• interventions to achieve impact (covering the full range of services needed);
• providing services in an equitable manner (reaching groups in need of services);
• financing for sustainability (financing the costs of providing services);
• innovation for acceleration (future-oriented).

WHO is one of the sponsors of the Joint United Nations Program on AIDS (UNAIDS). Within UNAIDS, WHO leads work on HIV treatment and care and co-infection with HIV and tuberculosis, and coordinates with UNICEF efforts to eliminate mother-to-child transmission of HIV.