Practice of diagnosis and treatment for HIV and AIDS

2021-03-25 12:00 AM

This is followed by the full-blown AIDS phase, characterized by an abnormally high risk of infection as the number of CD4 cells in the blood continues to decline.

HIV is the abbreviation for a Human immune deficiency virus that causes Acquired immune deficiency syndrome (AIDS). Thus, HIV infection is the prerequisite to AIDS, but from HIV infection to development of AIDS, it takes a certain time different for each person, from a few months to 15 years. Doctors often use the term AIDS to refer to HIV cases that have developed and cause immunodeficiency in patients.

First discovered in 1981, by the late 1980s, about 100,000 people had been diagnosed with AIDS, and about half of them died. By 2003, the World Health Organization (WHO) said that about 40 million people worldwide are currently living with HIV or have progressed to AIDS, of which about 2.5 million. children under 15 years old. It also estimated that between 1981 and the end of 2002, about 20 million people died of AIDS, of which about 4.5 million children were under 15 years old. In 2003 alone, up to 3 million people died of AIDS and an additional 5 million people became infected with HIV. HIV / AIDS has truly become a terrible disaster for all of humanity.

Reason

The AIDS virus belongs to the group of lentiviruses, belonging to the strain Retroviridae, also known as retrovirus. It is known that there are 2 strains of HIV. HIV – 1 is the main virus that causes AIDS around the world, while HIV – 2 is found primarily in West Africa.

HIV can be found in the blood, semen, saliva, tears, nerve tissue, milk glands, and genital secretions of HIV-infected people. However, the disease is only transmitted mainly through semen and blood, so direct contact with the sick person such as shaking hands, embracing, talking ... usually does not cause infection. The main forms of HIV infection are:

Having sexual activity with an HIV-infected person.

Sharing injection equipment with an HIV-infected person.

An HIV-infected mother is passed on to her baby during pregnancy, childbirth, and while breastfeeding.

The limits in HIV transmission are partly explained by the weakness of the bacteria when exposed to the environment. When pushed into the environment, HIV is quickly destroyed. It can only live with the right conditions in the body, in the blood. HIV is not contagious at all in the ways that are common with other infectious diseases, such as through an insect bite or by inhaling a virus released into the air by an infected person. Therefore, the cause of HIV infection up to now is still believed to be limited to the three main forms of infection mentioned above.

HIV that enters the body begins to attack a type of cell in the blood called CD4 cells (or T4 lymphocytes). HIV-infected CD4 cells may be disrupted by the entry of HIV and duplicated inside the cell, or HIV can enter a state temporarily inactive. When the CD4 cells are heavily damaged, the body's immune system weakens, as the function of this cell is to help other immune cells respond to bacterial invasion, so that muscle masses are more likely to develop. can be more easily attacked by pathogens from the environment. The normal human body has about 1000 CD4 cells in one microliter (one millionth of a liter). When these cells are destroyed to less than 200 cells per microliter, the body's immune system weakens and is no longer able to respond to most environmental pathogens.

Not all people infected with HIV will develop the disease. About 1% of people with HIV are known to be fully cured afterwards, with tests showing that both HIV and antibodies to HIV are no longer in the patient's blood. It is possible that the bodies of these people have some resistance to this virus. Others carry the virus inactivated for a long time, possibly up to 10-15 years. But once AIDS is diagnosed, most patients have a bad prognosis, because there are currently no drugs or treatment for this disease.

Diagnose

The first stage after HIV infection usually has only mild symptoms and is not clear, it is easy to confuse with other medical cases. If completely without the intervention of drugs, the disease usually progresses in sequence as follows:

1-3 weeks after HIV infection develops flu-like symptoms, such as fever, sore throat, headache, itchy skin, sensitivity in the lymph nodes, and a cold Feeling slightly uncomfortable for unknown reasons. Symptoms usually last for 1 - 4 weeks. During this period, HIV proliferates rapidly in the blood of the patient, follows the blood throughout the body, and especially focuses on the organs of the lymphatic system.

The body's immune system then initiates resistance to HIV, reducing the viral proliferation but not being able to completely eliminate it. People with HIV go into an asymptomatic stage that can last up to 10 years or more. During this period, although the health seems normal, but HIV in the body is constantly proliferating and continuously damaging the body's immune system. Most people infected with HIV during this stage are still completely unaware that they are carrying HIV, so they can unknowingly pass HIV on to others, especially those who have sex with them.

When the CD4 cell count in a millionth of a liter of blood falls below 200, early AIDS symptoms begin to appear, and can last from months to years. Symptoms may not be life-threatening during this stage, but often greatly impair the patient. In women, the early symptom of AIDS can be a frequent recurring vaginal yeast infection. Differential symptoms include rapid weight loss and fatigue, weakness, high cyclical fever, frequent recurring diarrhea, itchy areas of the skin, or a yeast infection in the mouth. While there is no risk of dying from the symptoms during this stage, the severity is usually sufficient for the patient to seek hospital treatment. And that is why the majority of people infected with HIV are usually detected at this stage.

This is followed by the full-blown AIDS phase, characterized by an abnormally high risk of infection as the number of CD4 cells in the blood continues to decline. The earliest common risk of infection is Pneumocystis carinii pneumonia. The reason is that this fungus often enters the body of most of us from an early age and lives in the lungs but does not cause disease, due to the control of the body's immune system. When AIDS weakens the immune system, the fungus Pneumocystis immediately has a chance to cause illness by blocking the supply of oxygen to the blood. Due to lack of oxygen, patients often have shortness of breath, very short breathing and are accompanied by fever and dry cough. In addition to this pneumonia, people with AIDS also often develop a number of other fungal infections. About 23% of AIDS sufferers are infected with Cryptococcus, which causes meningitis. Approximately 10% of AIDS patients are infected with the fungus Histoplasma capsulatum, which causes symptoms of rapid weight loss with fever and respiratory complications. Tuberculosis caused by Mycobacterium tuberculosis infection also develops more seriously in people with AIDS. Mycobacterium avium infection can cause symptoms such as fever, anemia and diarrhea. In addition to fungi and bacteria, AIDS patients also increase the risk of infection with viruses, especially the herpesvirus group. In this group, the most common are cytomegalovirus (CMV) that cause retinal diseases that can blind the eyes, Epstein-Barr virus (EBV) that causes blood cancer, Herpes simplex virus (HSV) causes pain in the mouth and muscles. genitals or anus. Tuberculosis caused by Mycobacterium tuberculosis infection also develops more seriously in people with AIDS. Mycobacterium avium infection can cause symptoms such as fever, anemia and diarrhea. In addition to fungi and bacteria, AIDS patients also increase the risk of infection with viruses, especially the herpesvirus group. In this group, the most common are cytomegalovirus (CMV) that cause retinal diseases that can blind the eyes, Epstein-Barr virus (EBV) that causes blood cancer, Herpes simplex virus (HSV) causes pain in the mouth and muscles. genitals or anus. Tuberculosis caused by Mycobacterium tuberculosis infection also develops more seriously in people with AIDS. Mycobacterium avium infection can cause symptoms such as fever, anemia and diarrhoea. In addition to fungi and bacteria, AIDS patients also increase the risk of infection with viruses, especially the herpesvirus group. In this group, the most common are cytomegalovirus (CMV) that cause retinal diseases that can blind the eyes, Epstein-Barr virus (EBV) that causes blood cancer, Herpes simplex virus (HSV) causes pain in the mouth and muscles. genitals or anus.

During the next stage of development, many neurological disorders can arise when HIV enters the brain, collectively known as AIDS dementia.

For children, symptoms are often severe in the first place. More than half of all new-borns infected with HIV die before they are 2 years old.

Examination may reveal unusual signs, such as enlarged lymph nodes.

Patients often lose weight rapidly for unknown reasons.

However, the definitive diagnosis must be through blood test to find antibodies to HIV. Positive results confirm HIV infection, but AIDS cannot be concluded. Some people who are infected with HIV do not progress but belong to the "virus carriers" type. In some cases, when the patient is newly infected with HIV, the test result may be negative. If there are other suspect factors, the blood test should be repeated after 6 months.

A diagnosis of AIDS is usually based on two factors: a positive HIV test result and an abnormal infection or tumour. Under permissible conditions a blood CD4 count test should be performed. The patient has a definitive diagnosis when the CD4 cell count falls below 200 per microliter.

Treatment

Up to now, there is no real cure or cure for AIDS. Current medical interventions are only effective at preventing disease progression and responding promptly to symptoms caused by the disease.

In addition to the scientific research that is still being continued to aim at the possibility of treating AIDS, the current response to the disease has two purposes: to ensure the best life for those infected with HIV or developing AIDS, and minimize the development and spread of HIV in the community. To achieve these two purposes, everyone in society needs to agree on some correct perceptions about this disease:

Understand the main forms of HIV transmission, namely through sexual activity, needle sharing, and mother-to-child transmission. Since then, actively apply effective preventive measures in sexual activity, injection as well as carefully consider before deciding to give birth after being diagnosed with HIV positive.

People with HIV infection should not be discriminated against and segregated, because the risk of infection is not part of normal communication with HIV carriers.

Actively detect HIV cases early to avoid unintentional spreading of HIV in the community. Advocacy and general education on HIV / AIDS in the community can help promote the early detection of HIV-infected people through voluntary diagnostic tests for high-risk populations. At the same time, HIV also helps people already infected with HIV to have a full awareness of the responsibility to limit transmission in the community.

Comfort and encouragement for those already infected with HIV so that they can continue a normal life in society, as the time from HIV infection to AIDS outbreak can last up to 10 years or longer. The patient does not need to grieve during this time, but can have a better life if she accepts the truth. Moreover, the positive progress in scientific research is now able to help patients prolong a healthy life, and in the future, there is still hope for complete success in pushing AIDS recession.