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In the United States, AIDS is the fifth leading cause of death among persons between ages 25 and 44. The Center of Disease Control has estimated that about 2.2 million Americans were infected with HIV virus as of January 1998 and that just about 30.6 million people worldwide were infected with HIV. Approximately 41 percent of the 30.6 million adults living with HIV were women and the numbers are growing everyday. Human Immunodeficiency virus (HIV) causes AIDS. AIDS is the final and most serious stage of the HIV disease. It is scientifically proven that HIV is spread by sexual contact with an infected person, by sharing needles or less commonly, through transfusions of infected products. Babies born to HIV infected women may become infected before, during birth or through breast milk. There was one instance of patients being infected by a healthcare worker in the United States; this involved HIV transmission from one infected dentist to six patients. Some fear that HIV might be transmitted in other ways. However, no scientific evidence has been found to support any of these fears. Some people think that they can catch HIV from casual contact. Yet, 90% - 99% of HIV virus weakens in just several hours; it does not survive the environment. If you live with an infected person transmission is very rare and for the work place there are no risk factors for transmission to co-workers, clients or consumers from food service establishments. Closed mouth kissing also has no risk factors. Although in 1997, the CDC found some evidence of transmission from human bites. HIV has been found in saliva and tears in very low quantities from AIDS patients, but this does not necessarily mean it is transmitted by those body fluids. Insect bites have shown no evidence either. On the other hand, it has been proven that HIV is transmitted when body fluid of infected person enters the bloodstream of a person without HIV and is found in semen, blood, vaginal secretions, and human breast milk. There are five good ways to prevent infection of this very deadly disease: 1. Do not have sex with infected person, multiple partners or drug users. 2. Do not use intravenous drugs or share needles. 3. If infected do not exchange body fluids or donate blood, plasma, semen or body organs. 4. HIV women should be counseled before becoming pregnant. 5. HIV women should not breast feed their infants. HIV was first identified in the United States in 1981, after the New York Times reported an outbreak of a rare form of cancer in young gay men in New York and California, first referred to as "gay cancer" but medically known as Kaposi Sacoma. About a year later, the CDC linked the illness to blood and coins the term AIDS (Acquired Immune Deficiency Syndrome). As the number of deaths increased, medical experts scrambled to find a cause and more importantly a cure. In 1984, Institut Pasteur of France discovered what they called the HIV virus, but it wasn't until a year later that a US scientist, Dr. Robert Gallo, confirmed that HIV was the cause of AIDS. Population based surveillance has been used to track the progression of the HIV epidemic from the initial case report of opportunistic illnesses caused by a then unknown agent to a few large cities to the reporting of 711,344 AIDS cases nationwide through June 30, 1999. Since 1985, many states have implemented HIV case reporting as part of their comprehensive HIV/AIDS surveillance programs. As of November 1, 1999, a total of 34 states and the Virgin Islands conduct surveillance for adults, adolescents, and children. They have reported 42% of cumulative US AIDS cases. In 1996, national AIDS incidences and AIDS deaths declined for the first time during the HIV epidemic. These declines have been primarily due to the early use of combination antiretroviral therapy, which delays progression to AIDS and death for persons with HIV infection. Symptoms of AIDS are primarily the result of an infection that does not normally develop in a person with a healthy immune system. These infections are called opportunistic infections. AIDS destroys the immune system and makes the infected person more susceptible to such infections. General symptoms include fevers, sweats, chills, weakness, and weight loss. For people with HIV to have AIDS, their immune system must become severely damaged. The severity of damage is measured by an absolute CD4 lymphocyte count. The CD4 lymphocyte is an important cell in the bloodstream that helps protect from several infections and cancers. If a person with HIV has a CD4 count less than 200 they are said to have AIDS. The following is a list of diseases that people with AIDS acquires when the CD4 decreases. CD4 count below 350/ml: Herpes Simple Virus, Tuberculosis, Oral and/or vaginal thrush, Herpes zoster, Non-Hodgkins Lymphoma. CD4 count below 200/ml: Pneumocystis carinii pneumonia, Candida esophagitis. CD4 below 100/ml: Crytococcal meningitis, AIDS Dementia, Wasting Syndrome. CD4 count below 50/ml: Mycobacterium, Cytomegalovirus infection. There are a few new tests for the AIDS virus; one is the Western Blot Test. When the body is infected with a virus, the immune system responds by producing antibody-proteins that circulate in the blood and attempt to destroy the virus. Exposing a blood sample to a special paper impregnated with selected virus fragments will cause any antibodies present to bind to the virus and produce a characteristic pattern. A test performed too soon after exposure may fail to detect the infection because antibodies have not yet developed. The first HIV test was approved in 1985. Today the United States National Institute of Health formed the HIV Vaccines Trials Network to develop and test preventive HIV vaccines. Composed of core operations, data, and laboratory centers, as well as clinical research centers located worldwide. HIV LIFE CYCLE begins when the virus binds to the cell surface, fuses with the cell membrane and empties its contents into the cell. Next, the HIV enzyme reverse transcriptase copies the viral genetic material from RNA into double-strand DNA, which another HIV enzyme-integras-splices into the cellular DNA. Using the integrated DNA, or provirus, as a blueprint, the cell makes viral proteins and RNA. A third enzyme, HIV protease, slices the new proteins, enabling them to join the RNA in new viral particles that bud from the cell and infect others. Current HIV drugs aim to stop viral replication by inhibiting reverse transcriptase or protease. Other kinds of drugs are under investigation. Many people do not develop symptoms when they first become infected with HIV. Some people, however, have flu-like illness within a month or two after exposure to the virus. These symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During the period, people are very infectious, and HIV is present in large quantities in genital fluids. More severe symptoms may not surface for a decade or more after HIV first enters the body in adults, or within two years in children born with HIV infection. During the asymptomatic period, however, the virus is actively multiplying, infecting, and killing cells of the immune system. As the immune system deteriorates, a variety of complications start to take over. The term AIDS applies to the most advanced stages of HIV infection. In addition, the definition includes 26 clinical conditions that affect people with advanced HIV disease. Most of the conditions are opportunistic infections, which rarely cause harm in healthy people. These infections are fatal in people with AIDS. Many people cannot hold steady employment or do household chores because of these symptoms of AIDS. Others may experience phases of intense life-threatening illness followed by phases in which they function normally. Scientists are trying to determine what factors may account for their lack of progression to AIDS, such as particular characteristics of their immune systems or whether they were infected with less aggressive strain of the virus, or if their genes may protect them from the effects of HIV. Scientists hope that understanding the body's natural method of control may lead to ideas for protective HIV vaccines and use of vaccines to prevent the disease from progressing. There is still no cure for AIDS or HIV. There are several different types of drug treatments to help cope with the difficult symptoms of the virus. Scientists are coming up with new treatments daily. Hopefully, soon we will have a cure or way to prevent the virus altogether. Crime scene professionals should protect themselves from all blood born diseases. Follow all the necessary protocols and procedures. Bibliography: 1. National Institute of Allergy and Infectious Diseases National Institute of Health Bethesda, MD 20892 2. CDC. Update: trends in AIDS incidence-United States, 1996. MMWR 1997; 46; 861-7 3. CDC. HIV/AIDS surveillance report, 1999; 11(no.1) 4. www.webmd.com 5. www.about.com 6. www.planetrx.com 7. www.thebody.com 8. www.sciam.com Word Count: 1554
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