HIV

HIV

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HIV

Many eyebrows raised late in 1979, when the then unkown HIV virus raised its ugly head. The first two cases of the rare cancer, Karposis Sarcoma was diagnosed in two homosexual men in N>Y>C. About the same time in Los Angeles, several cases of the rare infection, Pneumocytis cariini pneumonia were being treated. Incidences of these strange diseases and infections were sky-rocketting around the country. The disease was effecting mostly young gay men in their 30's. There was no official name for the syndrome, but it was referred to by various names, GRID (gay related inmmune disease), Gay Cancer, and, "Community Acquired Syndrome". In 1982 public health officials began to use the term, Acquired Immunodeficiency Disease (AIDS) to describe the incidences of oppotunistic infections that caused AIDS. Scientists discovered the virus that caused AIDS in 1983 (HorowitzXV). According to Brennnan Durack, this was the dawning of AIDS epidemic, or the beginnning of the public's awareness of AIDS (Durack 385-386).

After becomin g infected with the HiV virus either by sexual activity, blood and blood products, needle sharing, mother to fetus, stage one begins. For the 4 to 8 weeks after being infected, the person may experience general flu-like symptoms. At this time blood levels of the virus are high in the blood and low in the lymph nodes. then the virus llies dormant. Stage two begins when the infected Helper T cell icalled on for an immune response, at this time the virus begins to replicate destroying the Helper T cells. B cells and T celss attempt to destroy the virus, but are unable to without the help of the Helper T cell, the very cell that is needed to help kill the virus. Stage three begins when the person begins to experience opportunistic infections, and THCD4 levels fall below 500 cells mm3. Full blown AIDS begins when the levels fall below 200 cells mm3, and patient has one or more opportunistic infections (Lintown Maebus 549).

HIV antibodies can be detected by a simple blood test, knowns Elisa (Enzyme Linked immunosorbent assay); they are considered to be 99% accurate, although some false positives do occus. Therefore, a second test, the Western Blot test is done to confirm the diagnosis of HIV The only infected patients who are not confirmed are those who are tested within the first few weeks of infection (Mirken 45).

Pneumocytis carinii pneumonia was the first opportunistic infection that Nancy, the character in It Happened to Nancy experienced (Sparks107), Normally, this disease infection is rare, but is quite common in the AIDS patient.

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Nancy also developed Cytomegalovirus retinitis, a devastating disease that if left untreated will result in certain blindness (Sparks 124). Takin the antiretroviral drug AZt, a drug that prolongs life together with foscarnet or ganciclovir causes anemia. Nancy had to choose between foscarnet or ganciclovir; she decided on ganciclovir throught the intravitreal route aboiding a systemic effect. The drugs mentioned above are antivirals or antiretrovirals, the difference between the two are simply, the point at which the drug interferes with viral replication. In our drug book there are several different generic drugs listed un the class of antivirals and antivirals, each of them are made by different drug companies. Nancy also experienced several kidney infections that causes urinary incontinence (Sparks 142), rectal ulcers, Oral Hairy Leukopenia, Nancy describes "the yck on my forehead like Mount Vesuvius (Sparks 139), and "the black things starting on my face and neck". Signs and symptoms of Karposis Sarcoma are, "lesions that appear on the body that enlarge to form large plaques that may drain" (Linton Maebus 1039). Karposis Sarcoma is the diseas that ultimately killed Nancy (Mosby 947).

Unfortlunately, Nancy's disease progression was rapid. She died prior to the introduction of Protease Inhibition Therapy, also known as Haart. PI therapy is a suggested regimen that consists of a combination of eithere a PI or a Nonnucleoside Reverse Transcriptase Inhlibitor (NNRTI) with two Nucleoside Reverse Transcriptase Inhibitors (NRTI). This regimen is known to lowere the viral load and boost the body's defense, proventing opportunistic infections, therefore prolonging the life of the HIV Patients. The adverse effects of these therapies are Lipodystrophy and hight cholesterol (Stuart 22)

Besides drug thereapy, nutrition is equally important in AIDS management. Maintaining a healthy diet with AIDS is a major concern, because the patient often has diarrhea, vommiting, due to the disease or the effects of the drugs. AIDS also effects the GI tract, making it hard for the body to absorb essential nutrients. General guidelines for HI V nutrition is similar to the food pyramid, although more protein is suggested foir muscle wasting, low fat is suggested as well, along with a good multivitamin. Safe handling is vital for the health of the infected person. Salmonella enteritidis is a risk for the HIV patient, to aboid this infection eggs should be boiled for at least seven minultes until hard, in addition, meats should be cooked until well done, all reaw foods hould be avoided, raw vegetables should be washed thouroughly. If a person is unable to attain their nutrients orally, enteral tube feeding may be necessary (Gianaro).

Today the HIV infected population are living longer than ever. Some people consider this disease chronic rather than a prescription for death. This is due in part to the rieless reseach that has gone into combatting this disease, and the new drug therapies that are abailable today for the HIV patient. Recently, in an article in the Post Star, a local women wa interviewed. She has had the virus for 23 yeasrs. According to the Center for Disease Control, Sue is one of a few hundred that have survived HIV for more than twent years. Sue states, "half of the new cases of HIV reported last year were teens between 13 and 19 years. Sue has giver her testimony to High Schoos around the region. Sue warn them of the risks of unprotected sex. When she hears teenagers say "they don't care because drugs take care of everything if they get infected", she gets upset. She adds that AIDS is deadly, and touches every part of you life (Randal 1&5).
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