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HIV and AIDS

Demystifying HIV

05/23/2006

Question:

I am a student who is still studying and would like to ask questions regarding to AIDS, as I need some information that will help me in my assignment. I hope you can answer all of my questions, but if you can`t then just omit the question.

1. What are the strategies taken to increase the level of AIDS awareness among people?

2. Do you think cocktail drugs or antiretroviral drugs are effective to prolong the lives of AIDS patients? If possible, please give some example of cases to support your view.

3. Can you please explain how AIDS prevention is able to reduce the number of new AIDS cases among homosexual and heterosexual?

4. What are the efforts taken to educate AIDS patients to prevent spreading HIV to others?

5. How may people’s denial and complacency affect AIDS prevention and awareness campaign?

I hope you can give me some feedback since there are lots of book and articles that I have read giving different answers for the above questions that makes me wondering which one is true and accurate. Please kindly state your name, position and qualification so that I can refer your name in my reference list. Thank you and hope you will reply me soon.

Answer:

Answers to questions #1, #3, #4. The HIV Prevention Trials Network (HPTN) is a worldwide collaborative clinical trials network established by the National Institutes of Health (NIH) to evaluate the safety and efficacy of non-vaccine prevention interventions, alone or in combination, using HIV incidence as the primary endpoint. The HPTN will conduct Phase I, II, and III trials at 9 U.S. and 16 international sites, and is a successor to the HIVNET research network. For example, SEXUAL TRANSMISSION Prevention efforts Viral Load and Heterosexual Transmission of HIV-1. The risk of heterosexual transmission within couples in Uganda, in which one partner was HIV- infected and the other was not, increased with higher viral load. HIV transmission was rare among the couples where the HIV-infected partner had a viral load of less than 1500 copies of HIV-1 RNA per mL. Reductions in STDs Not Associated with Reduced HIV Incidence. A large study in rural Uganda found that community interventions to control sexually transmitted disease (STDs) were effective in reducing STDs, but did not impact the incidence of HIV. Intense HIV exposure in these communities and low population attributable risk may have overwhelmed the potential effects of the community intervention.

MOTHER-TO-INFANT TRANSMISSION Simple and Low Cost Nevirapine Regimen Reduces Transmission From Mother to Infant by 50%. A study conducted in Uganda found that a single oral dose of nevirapine given to an HIV-infected woman in labor and another to her baby within three days of birth reduced the transmission rate by half compared to a similar short course of AZT. Because the regimen is simpler to administer and much cheaper than the short course regimen of AZT, it may have useful in preventing mother to infant transmission globally. AZT Shown to Significantly Reduce Mother to Infant Transmission of HIV. In 1994, a landmark study conducted by the Pediatric AIDS Clinical Trials Group (ACTG) demonstrated that AZT, given to HIV-infected women who had very little or no prior antiretroviral therapy and CD4+ T cell counts above 200/mm3, reduced the risk of mother to infant transmission from 25% to 8%. This study formed the basis for the treatment of HIV-infected pregnant women in the U.S. and has resulted in the dramatic decrease in the number of pediatric AIDS cases in the U.S.

HIV Transmission through Breastfeeding. In urban Malawi, Africa, researchers measured the frequency, timing and risk factors for breastfeeding transmission of HIV. The results show that the risk of HIV transmission to an infant is highest in the early months of breastfeeding but is present for as long as an HIV-infected mother breastfeeds her child. Level of Maternal HIV RNA Strong Predictor For Risk of Perinatal Transmission. A study of HIV-infected pregnant women found that the infants born to women with the high levels of HIV in their blood had the highest rates of infection, while infants born to women with undetectable levels of HIV avoided infection.

SECONDARY PREVENTION Prevention of Recurrent Tuberculosis in HIV-infected Individuals. The rate of recurrence of Tuberculosis (TB) was found to be higher in HIV-infected individuals and strongly associated with a history of symptomatic HIV disease before initial diagnosis of TB. Post-treatment isoniazid prophylaxis was effective in decreasing the risk of recurrence in HIV-infected individuals and should, therefore, be considered for HIV-infected patients with a history of HIV-related symptoms at the time of TB diagnosis.

Answer to question #2. In the early 1980s when the epidemic began, AIDS (acquired immunodeficiency disease) patients were not likely to live longer than a few years. With the development of safe and effective drugs, however, people infected with HIV (human immunodeficiency virus) now have longer and healthier lives. 

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Response by:

Pamposh   Kaul, MD Pamposh Kaul, MD
Assistant Professor
College of Medicine
University of Cincinnati