hiv Library

HIV, Human Immunodeficiency Virus

HIV (Human immunodeficiency virus) is a retrovirus that can lead to AIDS (Acquired Immunodeficiency Syndrome). AIDS is a condition effecting humans in which the immune system begins to fail. This eventually leads to a life threatening condition via other opportunistic infections.

Previous names for the virus include human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV), or AIDS-associated retrovirus (ARV).

Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, the HIV retro-virus is present both as free virus particles and virus within infected immune cells contained in the fluid.

The four major routes of transmission are unprotected sexual intercourse, contaminated needles, and transmission from an infected mother to her baby at birth, or through breast milk. Screening of blood products for HIV in the developed world has largely eliminated transmission through blood transfusions or infected blood products.

There is currently no cure for HIV or AIDS however, an antiretroviral treatment, known as post-exposure prophylaxis has shown to reduce the risk of infection if begun directly after exposure the the HIV virus.

Current treatment for HIV infection consists of a process called HAART this stands for Highly Active Antiretroviral Therapy. This has been highly beneficial to many people who suffer HIV and was introduced in 1996. Current HAART options are comprised of a cocktail of drugs consisting of at least three drugs. These drugs belong to at least two types of anti-retroviral agents (typically these are two Nucleoside Analogue Reverse Transcriptase Inhibitors - NARTIs or NRTIs, plus either a protease inhibitor or a Non-NRTI.

AIDS progression in children is more rapid and less predictable than in adults (particularly in babies) so more aggressive treatment is usually carried out on children than adults.

HIV primarily infects vital cells in the human immune system such as helper T cells, macrophages and dendritic cells. The HIV infection leads to low levels of T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells (the rate at which the cells normally die increases); and thirdly, killing of infected T cells by white blood cells (CD8 cytotoxic lymphocytes) that recognize infected cells and destroy them.

When T cell numbers decline below a critical level, immunity at this fundamental level is lost, and the body becomes progressively more susceptible to infections and if untreated, eventually leads to development of AIDS (Acquired Immunodeficiency Syndrome) and death

However about one in ten sufferers remain healthy for many years, with no noticeable symptoms. Treatment with anti-retrovirals, where available, increases the life expectancy of people infected with HIV. It is hoped that current and future treatments may allow HIV-infected individuals to achieve a life expectancy approaching that of un-infected people.

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