HIV Preventative Measures Health Article

Diagnosis

Blood tests are used to detect the presence of HIV antibodies in the blood. Antibodies are developed two weeks to three months after infection. Other bodily secretions may also provide evidence of HIV infection. Even before the antibody test is positive, a person can pass the virus to others.

AIDS is the final stage of the HIV infection. The diagnosis is supported by the presence of a variety of conditions and opportunistic infections (i.e., conditions caused by a microorganism that does not ordinarily cause disease, but which becomes pathogenic under certain circumstances) related to HIV. During the disease process, the AIDS virus attacks certain white blood cells (T-lymphocytes). AIDS destroys the body's immune (defense) system and allows otherwise controllable infections to invade the body and cause additional diseases. These opportunistic diseases gain strength in the body and may eventually cause death.

The AIDS virus may also attack the nervous system and cause brain damage. It may take years for symptoms of brain damage to occur, manifesting as memory loss, loss of coordination, partial paralysis, or mental disorder. These symptoms may occur alone or in combination with any of the other symptoms associated with the disease.

HIV/AIDS can only be diagnosed by physicians or qualified health professionals. While AIDS patients are treated by physicians using established protocols for care, patients are often referred to medical specialists, known as epidemiologists, for consultation and monitoring the course of their disease. These specialists study the factors that influence the frequency and distribution of infectious diseases among populations of human beings. The physician specializing in epidemiology concentrates on research and management of infectious diseases.

Medical specialists utilize the support of pathologists in the diagnosis, management, and treatment of patients with the AIDS virus. The scientific study of bodily changes produced by AIDS, pathology is concerned with conducting research. This research is accomplished using comparative analyses of disease processes. Other research may include the practice of experimental pathology, whereby pathologic processes are artificially induced in the laboratory setting. Both methods, however, provide pathologists with the opportunity to learn about the fatal impact of AIDS.

Treatment

As of mid-2001, there is no known cure for, or vaccine against, HIV/AIDS. However, using new drug combination therapy can allow infected persons to remain symptom-free for longer periods, provided the disease is detected early. When HIV is detected early in pregnancy, its treatment with antiretroviral drugs might reduce the risk of transmitting the virus to the child. However, the an HIV-positive, pregnant woman's doctor will frequently advise delivery by cesarean section (cs) to eliminate the chance of transmitting the virus during childbirth.

Success with new, highly active antiretroviral therapy (i.e., HAART, also known as a drug "cocktail") and the decline in the number AIDS cases newly reported, as well as the number of deaths, are good news. A number of HIV-infected people who are still alive due to HAART, and that number is growing.

Drug therapies include TMP-SMX (trimethoprimsulfamethoxazole [tri-METH-o-prim-sul-fa-meth-OX-uh-zole]). Brand names for these drugs are Bactrim, Septra, and Cotrim. The long-term effectiveness of HAART is unknown; HIV may develop resistance to these drugs. Further, this combination drug therapy is very expensive, and a vast number of HIV-infected persons do not have health insurance or the financial means to purchase medication.

Patients also have difficulty maintaining a complicated drug treatment schedule that involves taking a large numbers of pills. Many of these drugs have unpleasant or intolerable side effects, interact with other medications, and cause serious medical problems. Patients might even forget to take all of their medications, or skip doses.

Patients who feel healthy have been known to take "drug holidays," by not taking their medications for days or weeks. Treatment regimes are less effective in the overall population when there is an increased possibility of developing a drug-resistant strain of HIV. If drug resistance is developed by the evolving virus and is coupled with a relaxation in treatment regimens, resistant strains may be transmitted to others, and thus spread widely. Prevention remains the best and most cost-effective approach to controlling the HIV/AIDS epidemic and saving lives.

Prognosis

HIV infections and many AIDS-related conditions, such as pneumonias, cancers, and a variety of infections that take advantage of weakened immune systems, can be managed to some extent with different treatments. Improved treatment options are continually being developed by scientists and pharmaceutical companies. However, no one has ever recovered from full-blown AIDS. As of 2001, the disease is still considered fatal.

Assessment

Nurses and allied health professionals are likely to be the first medical contact for HIV-infected patients. Information obtained about the patient's signs and symptoms, lifestyle, and social behavior must be documented by the medical staff.