HIV infection
Description:
HIV infection - a disease of infectious character which result is a long-term persistirovaniye in lymphocytes, in macrophages and the HIV nervous tissue that differs in slowly amplifying defect of immune system that in the investigation leads to death of the patient from the secondary defeats described as acquired immunodeficiency syndrome (AIDS), or from subacute encephalitis. Also HIV infection - an antroponozny viral disease in which the progressing immunodeficiency is the cornerstone of a pathogeny in which investigation consecutive opportunistic infections and tumoral processes develop.
HIV infection symptoms:
It is considered that HIV infection "is very artful". It is connected with the fact that implementation in a human body of a virus of an immunodeficiency and its reproduction, most often, does not cause any symptoms of HIV of infection. Passing of the test for HIV - the only reliable way to define the HIV status of the person.
After infection, only in certain cases there are HIV symptoms, namely in the period of an acute phase of HIV infection.
First symptoms of HIV infection hidden. For example, at the person temperature to 37,5 — 38 in several weeks after HIV infection can increase, sometimes there is an unpleasant feeling in an oral cavity, pain when swallowing, causeless loss of weight (10 and more than a kg), quite often happens a diarrhea, red spots on skin appear.
Skin manifestations:
* Spots, bubbles, a whitish plaque which easily is removed a cotton plug - it is caused by the milkwoman or candidiasis;
* Seborrheal dermatitis - a skin inflammation when its surface is covered with the died-off scales;
* A chromophytosis - small spots of brownish color which cover all surface of skin;
* The chronic vegetatiruyushchy pyoderma - an inflammation of skin of a stafilokkokovy origin - on skin is observed many spots and pustules;
* Kaposha's sarcoma;
* Surrounding deprive, at young people.
Patients often do not pay attention to manifestation of similar symptoms of HIV infection, taking them for symptoms of insignificant poisoning or cold. It is difficult to distinguish them from symptoms of flu or usual cold. Especially as these primary symptoms of HIV infection quickly enough disappear and happen not at all caught. However, in that case if symptoms were really caused by HIV infection, their disappearance can mean only that the infection develops further.
Absolutely imperceptible presence of HIV infection at an organism can be within 10 — 12 years: such time, as a rule, in the absence of treatment brings from the HIV infection moment before development of AIDS.
Sometimes HIV infection has an effect such almost imperceptible signs as a hyperadenosis: over a clavicle, in axillary hollows, in a groin, on back side of a neck, sometimes on front side of a neck. It is necessary to be checked, in that case, not only for diseases which are followed by increase in lymph nodes, but also to be checked for HIV infection.
HIV infection reasons:
HIV carry to family of retroviruses (Retroviridae), a sort of lentiviruses (Lentivirus). From the Latin word lente — slow there is a name Lentivirus. Such name reflects one of features of this group of viruses, namely — the slow and unequal speed of development of infectious process in a macroorganism. The long incubation interval is also characteristic of lentiviruses.
First of all, the human immunodeficiency virus infects cells of immune system (Tlimfotsita's CD4+, macrophages and dendritic cells) and some other types of cells. HIV the T lymphocytes infected with CD4+ gradually perish.
Mainly their death is caused by three factors:
* direct destruction of cells virus;
* the programmed cellular death;
* murder of the infected CD8+ cells T lymphocytes. Gradually subpopulation of CD4+ of T lymphocytes decreases therefore cellular immunity decreases, and at achievement of crisis level of quantity of CD4+ of T lymphocytes the organism becomes very susceptible to opportunistic infections.
In any stage of infectious process - the person is a contagium source. In significant amounts the virus is found in breast milk, blood, a vulval secret, semen that defines ways of its transfer.
Treatment of HIV infection:
Systematic control of the state of health of the patient, the prevention and treatment of opportunistic infections, associated diseases, consultation, the psychological and social assistance, the organization of access to programs of reduction of harm, replacement maintenance therapy, the narcological help, rehabilitation programs can be effective preparation for anti-retrovirus therapy (ART) and a basis of high level of commitment during performing anti-retrovirus therapy.
Art of purpose of anti-retrovirus therapy is specialized discipline which quickly develops. It is considered that each two years there are 100% updating of knowledge. Appointment and performing anti-retrovirus therapy always demands individual approach.
The problem of anti-retrovirus therapy consists in oppression of virus loading to the level which is not defined by a research on the longest time (years) and increase in quantity of lymphocytes of CD4. In Ukraine it is recommended to appoint anti-retrovirus therapy, proceeding from clinical and immunological criteria which meet standards of WHO.
In world practice apply combinations of antiviral drugs of the following groups to suppression of a reproduction of a virus:
* nukleozidny inhibitors of the HIV return transcriptase (NIOT):
thymidine analogs (ретровир, zerit);
cytidine analogs (хивид, эпивир);
adenine analogs (Videxum);
analogs of guanine (зиаген)
* NIOT combinations: комбивир, тризивир
* nucleotide inhibitors of the HIV return transcriptase (НтИОТ):
виреад, truvada
* nenukleozidny inhibitors of the HIV return transcriptase (NNIOT): вирамун, hundred-crinins, интеленс (этраверин);
* protease inhibitors (PI): prezist (дарунавир), inviraza, норвир, вирасепт, ритонавир, индинавир, нельфинавир, etc.
* fusion inhibitors: фузеон
It agrees with soveremenny recommendations, after an initiation of treatment patients need to apply anti-retrovirus therapy a long time, practically throughout all life. Achievement of the best results of treatment is possible only on condition of the high level of commitment to therapy.
The commitment to therapy means that the patient:
* in time takes medicine;
* accepts them in the necessary, appointed by the doctor dose
* adheres to recommendations about a diet
* adheres to the appointed treatment mode (a continuity for the ART, frequency rate of reception, etc.)
Besides, carry out intensive treatment of the opportunistic infections which are available for the patient that demands use of various etiotropic means: an orungala, a diflukana (the disseminated candidiasis), Biseptolum (pneumocystic pneumonia), an acyclovir, a gantsiklovir (herpes infections), etc. Purpose of tsitostatik at tumors aggravates an immunodeficiency.
The immunostimulating therapy is not shown as promotes more bystry progressing of a disease.
Information on infection causes HIV, irreversibility and the fatal forecast at infected heavy emotional reactions, up to a suicide. Therefore creation of the guarding mode is the major therapeutic measure. Consultation and psychological support of HIV-positive people as well as purpose of medicinal therapy, is carried out from their voluntary consent.
