Human Immunodeficiency Virus

April 6, 2010 | Posted by Muhammad Zamir

What is HIV?

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immunodeficiency syndrome). By killing or damaging cells of your body’s immune system, HIV progressively destroys your body’s ability to fight infections and certain cancers. People diagnosed with AIDS may get life-threatening diseases called opportunistic infections, which are caused by microbes such as viruses, bacteria, or fungi. These infections do not usually make healthy people sick. Those with HIV/AIDS are also at an increased risk of developing certain cancers, neurological disorders, and a variety of other conditions.

In the United States, more than 980,000 diagnosed cases of AIDS were reported to the Centers for Disease Control and Prevention (CDC) between 1981 (when the first case was reported) and 2006. The CDC estimates that more than one million people in America may be infected with HIV and that as many as 250,000 of these may not know that they are infected and can pass on the virus to others.

Signs and Symptoms

HIV initially causes an acute illness with nonspecific or flu-like symptoms such as fatigue, headache, fever, and enlarged lymph nodes. Some people will not experience any noticeable symptoms. During this time period, the virus is present in large numbers and is carried throughout the body. HIV infects immune cells called CD4 T-cells (also called helper T cells) and slowly begins to decrease their numbers. The virus sets up house in places such as the brain and lymph nodes, where it will linger even during future drug treatment.

The patient’s immune system responds to the acute HIV infection by producing antibodies against the virus. In most people, the initial symptoms go away after a short time period. The patient may be apparently healthy for a decade or more but behind the scenes HIV is still replicating and destroying CD4 T-cells. Eventually, the affected person’s immune system is compromised to the extent that they begin having symptoms such as persistently enlarged lymph nodes, weight loss, sweating, recurrent yeast infections, fever, herpes infections, rashes, and memory loss or difficulty concentrating.

In children who are infected with HIV at or before birth, symptoms may emerge within a couple of years. They may have delayed development and be frequently ill.

When does AIDS develop?

The term AIDS applies to the most advanced stages of HIV infection. According to the CDC, AIDS is diagnosed when your CD4 T-cell count drops below 200 or when you have HIV and an AIDS-related illness such as tuberculosis or pneumonia caused by the microorganism Pneumocystis jirovecii (carinii). In people with AIDS, opportunistic infections are often severe and sometimes fatal because the immune system is so damaged by HIV that the body cannot fight off certain bacteria, viruses, fungi, and parasites.

Opportunistic infections common in people with AIDS cause symptoms such as:

• coughing and shortness of breath
• seizures and lack of coordination
• difficult or painful swallowing
• mental symptoms such as confusion and forgetfulness
• severe and persistent diarrhea
• fever
• vision loss
• nausea, abdominal cramps, and vomiting
• weight loss and extreme fatigue
• severe headaches
• coma.

How is HIV transmitted?

HIV is spread most commonly in these ways:

• By having sex with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth during sex.
• Through contact with infected blood. Before blood was screened for evidence of HIV infection and before heat-treating techniques were introduced to destroy HIV in blood products, such as factor 8 and albumin, HIV was transmitted through transfusions of contaminated blood or blood components. Today, because of blood screening and heat treatment of blood derivatives, the risk of getting HIV from such transfusions is extremely small.
• By sharing needles or syringes (such as with intravenous injection drug abuse), which can be contaminated with very small quantities of blood from someone infected with the virus. It is rare, however, for a patient to give HIV to a health care worker or vice-versa by accidental sticks with contaminated needles or other medical instruments.
• During pregnancy or birth. Approximately one-quarter to one-third of all untreated pregnant women infected with HIV will pass the infection to their babies. HIV also can be spread to babies through the breast milk of mothers infected with the virus. If the mother takes the drug AZT during pregnancy, she can significantly reduce the chances that her baby will be infected with HIV. If doctors treat mothers with AZT and deliver their babies by cesarean section, the chances of the baby being infected can be reduced to a rate of one percent.
• Having a sexually transmitted disease such as syphilis, genital herpes, chlamydia, gonorrhea, or bacterial vaginosis, which appears to make people more susceptible to and at higher risk for acquiring HIV infection during sex with infected partners.

Categories: Hiv/Aids | Tags: dental health, department of health, environmental health, Health, health articles, health benefits, health concerns, health department, health dept, health diet, health education, health insurance, health nutrition, health plans, health policy, health products, health promotion, health risk assessment, health supplements, hiv, human health, Human Immunodeficiency Virus, insurance health, natural health, public health, skin health, Women's Health | No Comments »

Skin Allergies

December 13, 2009 | Posted by Muhammad Zamir

Allergies of the skin is one of the most common problems seen by the allergist, and one of the most debilitating problems experienced by patients. From hives to swelling, and eczema to drug and medication rashes, skin allergies are explained in these easy to understand articles.

Sun Allergy

There are many forms of sun allergy. Find out what form of sun allergy that you may have, as well as how these diseases are diagnosed and treated.

Skin Allergies — Treatment of Skin Allergies

Learn from other readers’ experiences regarding how they found relief from their skin allergies.

Pictures of Itchy Skin Rashes

Learn what the most common forms of itchy skin rashes look like.

Skin Allergies

Have an itchy rash? Think it might be due to skin allergies? Start here to learn the basics of allergic skin rashes and which type you may have.

Itching (Pruritus)

Feeling itchy can have a huge impact on a person’s quality of life, disrupting daily activities and sleep. Itchy skin, also called pruritus, can be localized to one area of occur all over the body.

Topical Steroids

Find out about the different types of topical steroids used to treat various allergic skin diseases, the types of topical steroids that are available, and the side effects they may cause.

Reactions to Medications

A basic overview of allergic and non-allergic reactions to medications. Specific medications are covered, along with information on symptoms, avoidance, and possible testing for allergies to certain medications.

Dyshidrotic Eczema (Pompholyx)

Dyshidrotic eczema, or pompholyx, is a chronic recurring dermatitis of the hands and/or feet, with characteristic itchy blisters and vesicles forming along the sides of fingers. This article discusses the causes and treatment measures for this common disease.

Pityriasis Alba

Light colored spots related to decreased skin pigmentation, usually seen on the face, is called pityriasis alba. It is frequently seen in children with atopic dermatitis, doesn’t cause symptoms, but can be confused with certain fungal infections.

Lichen Simplex Chronicus

An area of itchy skin that is rubbed or scratched for long periods of time may develop a thickened, reddish appearance. This rash is called lichen simplex chronicus (LSC), and is related to “itch-scratch-itch” rather than a disease process. Find out more about the causes and treatments for LSC.

Reactions to Bedbugs

Bedbugs bites can appear as itchy, red bumps and are frequently confused with allergic rashes. Learn more about bedbugs, how to tell if you’ve been bitten, and what to do as a result.

Categories: Allergies | Tags: Allergies, board of health, clinics health, current health, dept of health, doh health, google health, gov health, health articles, health center, health county, health coverage, health departments, health effects, health forum, health regulations, health services, health state, health websites, nutrients health, nutrition and health, nutritional health, penis health, skin care, total health, Women's Health | 1 Comment »

Drug Allergy(Medication Allergies)

December 13, 2009 | Posted by Muhammad Zamir

Allergic Reactions to Medications – A Common Problem

Reactions to medication are extremely common. In fact, 15-30% of all hospitalized patients will experience an unintended reaction as a result of medications. However, true allergic reactions to medications only occur in about 1 of 10 of all adverse drug reactions.

Classification of Reactions to Medications

Before we can discuss the huge topical of medication allergy, we need to group reactions to drugs into one of 2 categories:

• Reactions which are common and predictable in any person. This would include expected side effects from medications, interactions between 2 medications that the person is taking, and reactions from using too much of the medication (overdose). This group represents the majority of all reactions to medications.
• Reactions which are unpredictable, and only occur in certain people. These reactions can include an unexpected side effect, medication intolerance, allergic reactions and other non-allergic immunologic reactions.

Allergic Reactions to Medications

True allergic reactions to medications typically follow certain features:

• The first time the medication was taken there was no reaction.
• The medication is either taken for a period of time (usually at least 1 week) without problems or there is at least a week before the medication is taken again.
• The reaction that occurs from the medication is different from expected side effects.

• The reaction is suggestive of allergy or anaphylaxis.
• The symptoms of the reaction disappear within a few days of the medication being stopped.

Symptoms of Allergic and Immunologic Reactions

Skin rashes are the most common symptoms occurring from adverse drug reactions. Urticaria and angioedema suggest an allergic cause, while blistering, peeling and sun-burn like reactions suggest a non-allergic immunologic causes. When a rash blisters and peels, is painful or involves sores in the mouth and mucous membranes, Stevens-Johnson Syndrome or toxic epidermal necrolysis is the likely diagnosis, which can be life-threatening.

Other non-allergic immunologic symptoms can include fever, kidney failure, hepatitis and blood problems (such as anemia).

Allergy to Common Medications

People can experience allergic reactions to just about any medication, although some are more common than others. Here is a list of the most common medication allergies (or non-allergies, in some cases):

1. Penicillin (and all related antibiotics). About 1 in every 10 people reports a history of an “allergic reaction” to penicillin. It turns out that much less than 10% of those who think they are allergic to penicillin actually are. However, people with a true allergy to penicillin could have life-threatening anaphylaxis as a result, it is important to tell your doctor about your past reaction to the medication. Skin testing to penicillin can help determine if the past reaction was a true allergy or some other side effect.

2. Cephalosporins (and all related antibiotics). Severe reactions to cephalosporins are much less common than with penicillins. However, there is a small chance that someone with a true penicillin allergy could also react to cephalosporins, since the drugs are related. An allergist may be able to help determine if these antibiotics are safe for you.

3. Sulfonamides (including antibiotics, oral diabetes medications and some water pill diuretics). It is unclear whether these reactions are truly allergic or due to another immunologic process. There is no reliable test available to determine is a person is allergic to this class of medications.

Categories: Allergies | Tags: Allergic Reactions, benefit health, benefits health, Drug Allergy, first health, health benifits, health blog, health class, health clinic, health community, health info, health it, health link, health media, health one, health options, health point, health source, health supplement, health website, ideal health, internet health, select health, vitamins health, west health | No Comments »

Tips to Make Hair Grow Faster

October 17, 2009 | Posted by Muhammad Zamir

Your hair and how you wear it, happen to be one of the many factors which contribute significantly towards your look, appearance and style. Different people have different preferences and comfort zones when it comes to growing their hair. Some like their hair short, others like it curly, and quite a few like to wear their hair long. Well, this article will cater to the requirements of those belonging to the third category. Listed below are a few hair care tips to make hair grow faster.

Easy Tips to Make Hair Grow Faster
If you are wondering how to make your hair grow faster naturally, then let me make one thing clear. First and foremost, hair growth is a process that takes its own time. The time required differs from person to person. There is no magic potion or wonder lotion which will result in your hair growing six inches overnight. You need to realize that there are multiple factors that are involved in the process of hair growth, some of which happen to be your overall health, diet, scalp health, hair care activities, etc. All these factors have a cumulative impact on the health and growth rate of your hair. Now that I have clarified that point, let us have a look at a few tips to make hair grow quicker.

Regular Washing
You’re wondering how to make your hair grow quicker, right? Well, the first thing to do is to get the basics right. Regularly washing your hair with a good shampoo will help in cleaning your hair as well as the scalp. Shampooing helps in removing all traces of dirt, dandruff, dry flakes and other hair care product residue that may otherwise accumulate on the scalp. Depending on your lifestyle and your hair type, you can choose between strong, mild, gentle or everyday use shampoos and hair conditioners. Clean hair is healthy hair, and the more healthy your hair, the better it will grow.

Protein Intake
Most of you would know that your hair is actually made out of protein. And for those of you who didn’t know, well, now you do! It is true that your hair is a reflection of your overall health and diet. A person with a balanced diet will have strong and healthy hair as opposed to a person whose diet is lacking in vital, essential nutrients. Improving the protein intake in your diet can help in making your hair strong and healthy and promoting better hair growth. For that purpose, you could consider eating protein-rich food such as eggs, fish, chicken, sprouts, pulses, etc.

Hair Oil
Oiling your hair a few times a week does work wonders for both the health and the growth of your hair. Almond oil, coconut oil and olive oil are good options when it comes to hair oils. At the same time, using a few essential oils such as jojoba oil, rosemary oil, tea tree oil, etc. in combination with one of the aforementioned hair oils, offers many benefits with respect to hair care and hair growth. You can read more on essential oils for hair growth.

Head Massages
Head massages in this context, refers to both massaging your head as well as focusing on your scalp. Regularly massaging your scalp using the tips of your fingers is said to be immensely beneficial for overall hair care. This is because it improves the blood circulation in the scalp which results in more blood being supplied to the underlying cells. As a result, the cells get stimulated, the hair follicles become stronger and your hair gets a new shine and added strength. Scalp massaging can be done anytime during the day using hair oil or otherwise, although it is believed that massaging your scalp using hair oil at night, before retiring to bed, really works wonders.

Regular Trimming
Considering the fact that the topic being discussed in this article is ‘tips to make hair grow faster’, this may seem a contradictory point. However, it is true that regular trimming helps hair growth to a certain extent. It doesn’t mean that you should chop off long lengths of your hair. Just trimming the dead ends or cutting a couple of centimeters at the tip is sufficient.

Yoga
Certain yoga exercises, asanas and postures are known for their role in boosting hair growth and improving hair health. Yoga poses such as the headstand, camel pose, cobra pose and cow pose help in improving blood circulation to the scalp, thereby strengthening your hair and boosting hair growth.

Categories: Hair Loss | Tags: eating health, education health, environment health, Hair Grow, Hair Grow Faster, Hair Loss, Hair Tips, health exposure, health hazards, health natural, health plan, health plus, health programs, health risk, health risks, health strategies, health vitamin, health works, herbal health, herbs health, hospital health, hospitals health, memorial health, optimal health, optimum health, promoting health, promotion health, sun health | 3 Comments »

Asymptomatic HIV infection

September 26, 2009 | Posted by Muhammad Zamir

Definition

Asymptomatic HIV infection is a phase of chronic infection with human immunodeficiency virus (HIV) during which there are no symptoms of HIV infection.

Alternative Names

HIV infection – asymptomatic

Causes

Asymptomatic HIV infection is a period of varying length in which the immune system slowly deteriorates without symptoms.

The length of this phase varies from person to person. It depends on how quickly the HIV virus is copying itself and the genetic differences that affect the way the immune system handles the virus.

Some people can go 10 years or longer without symptoms, while others may have symptoms and worsening immune function within a few years after the original infection.

Symptoms

Asymptomatic HIV infection, by definition, does not have symptoms associated with HIV, such as:

• Fever
• Opportunistic infections (such as Pneumocystis carinii pneumonia, cytomegalovirus, and Mycobacterium avium )
• Oral thrush
• Weight loss

Exams and Tests

The diagnosis of HIV infection is based on standard blood tests such as the HIV antibody test (ELISA). A Western blot confirms the diagnosis.

Treatment

When a person without symptoms should receive therapy is controversial. People who are asymptomatic but who have CD4 lymphocyte counts of less than 200 should be on therapy.

Some doctors would also treat individuals with CD4 counts between 200 and 350, but the toxic side effects of the antiretroviral medications has made this less common.

Doctors must consider other factors, such as patient readiness and ability to stick to therapy, before starting antiretroviral therapy.

Outlook (Prognosis)

HIV is a chronic medical condition that can be treated, but not cured. Combinations of antiretroviral drugs have significantly delayed the progression to AIDS and decreased the incidence of AIDS-related opportunistic infections.

Possible Complications

People with asymptomatic infection can progress to symptomatic HIV infection and develop opportunistic infections associated with HIV. In addition, pregnant women with asymptomatic HIV infection can still transmit HIV to their fetus.

When to Contact a Medical Professional

Call your health care provider if you have HIV and you develop fevers, weight loss, swollen glands, or night sweats. You will need to be checked, and your doctor might need to consider giving you antiretroviral therapy.

Categories: Hiv/Aids | Tags: aids, Asymptomatic, Asymptomatic HIV infection, benefit, benefits, benifits, center, centers, concerns, department, departments, eating, garlic, green tea, hazards, helath, HIV infection, Hiv/Aids, honey, hospital, hospitals, individual, liquid, medical center, memorial, memorial hospital, nutrients, nutritional, physical activity, promoting, regional, risks, vital statistics | 1 Comment »

AIDS

September 26, 2009 | Posted by Muhammad Zamir

Definition

AIDS (acquired immune deficiency syndrome) is the final and most serious stage of HIV disease, which causes severe damage to the immune system.

Alternative Names

Acquired immune deficiency syndrome

Causes

AIDS is the fifth leading cause of death among people aged 25 – 44 in the United States, down from number one in 1995. About 25 million people worldwide have died from this infection since the start of the epidemic, and in 2006, there were approximately 40 million people around the world living with HIV/AIDS.

Human immunodeficiency virus (HIV) causes AIDS. The virus attacks the immune system and leaves the body vulnerable to a variety of life-threatening infections and cancers.

Common bacteria, yeast, parasites, and viruses that ordinarily do not cause serious disease in people with healthy immune systems can cause fatal illnesses in people with AIDS.

HIV has been found in saliva, tears, nervous system tissue and spinal fluid, blood, semen (including pre-seminal fluid, which is the liquid that comes out prior to ejaculation), vaginal fluid, and breast milk. However, only blood, semen, vaginal secretions, and breast milk generally transmit infection to others.

The virus can be transmitted:

• Through sexual contact — including oral, vaginal, and anal sex
• Through blood — via blood transfusions (now extremely rare in the US) or needle sharing
• From mother to child — a pregnant woman can transmit the virus to her fetus through their shared blood circulation, or a nursing mother can transmit it to her baby in her breast milk

Other transmission methods are rare and include accidental needle injury, artificial insemination with infected donated semen, and organ transplantation with infected organs.

HIV infection is not spread by casual contact such as hugging, by touching items previously touched by a person infected with the virus, during participation in sports, or by mosquitoes.

It is NOT transmitted to a person who DONATES blood or organs. Those who donate organs are never in direct contact with those who receive them. Likewise, a person who donates blood is not in contact with the person receiving it. In all these procedures, sterile needles and instruments are used.

However, HIV can be transmitted to a person RECEIVING blood or organs from an infected donor. To reduce this risk, blood banks and organ donor programs screen donors, blood, and tissues thoroughly.

People at highest risk for getting HIV include:

• Injection drug users who share needles
• Infants born to mothers with HIV who didn’t receive HIV therapy during pregnancy
• People engaging in unprotected sex
• People who received blood transfusions or clotting products between 1977 and 1985 (prior to when screening for the virus became standard practice)
• Sexual partners of those who participate in high-risk activities (such as injuection drug use or anal sex)

AIDS begins with HIV infection. People infected with HIV may have no symptoms for 10 years or longer, but they can still transmit the infection to others during this symptom-free period. Meanwhile, if the infection is not detected and treated, the immune system gradually weakens, and AIDS develops.

Acute HIV infection progresses over time (usually a few weeks to months) to asymptomatic HIV infection (no symptoms) and then to early symptomatic HIV infection. Later, it progresses to AIDS (advanced HIV infection with CD4 T-cell count below 200 cells/mm³ ).

Almost all people infected with HIV, if not treated, will develop AIDS. There is a small group of patients who develop AIDS very slowly, or never at all. These patients are called nonprogressors, and many seem to have a genetic difference that prevents the virus from damaging their immune system.

Symptoms

The symptoms of AIDS are primarily the result of infections that do not normally develop in individuals with healthy immune systems. These are called opportunistic infections.

People with AIDS have had their immune system depleted by HIV and are very susceptible to these opportunistic infections. Common symptoms are fevers, sweats (particularly at night), swollen lymph glands, chills, weakness, and weight loss.

See the signs and tests section below for a list of common opportunistic infections and major symptoms associated with them.

Note: Initial infection with HIV may produce no symptoms. Some people, however, do experience flu-like symptoms with fever, rash, sore throat, and swollen lymph nodes, usually 2 weeks after contracting the virus. Some people with HIV infection remain without symptoms for years between the time they are exposed to the virus and when they develop AIDS.

Exams and Tests

The following is a list of AIDS-related infections and cancers that people with AIDS may get as their CD4 count decreases. In the past, having AIDS was defined as having HIV infection and getting one of these additional diseases. Today, according to the Centers for Disease Control and Prevention, a person may also be diagnosed as having AIDS if they have a CD4 cell count below 200, even if they don’t have an opportunistic infection.

AIDS may also be diagnosed if a person develops one of the opportunistic infections and cancers that occur more commonly in people with HIV infection. These infections are unusual in people with a healthy immune system.

CD4 cells are a type of immune cell. They are also called “T cells” or “helper cells.”

Many other illnesses and corresponding symptoms may develop in addition to those listed here.

Common with CD4 count below 350 cells/mcl:

• Herpes simplex virus — causes ulcers/small blisters in the mouth or genitals, happens more frequently and usually much more severely in an HIV-infected person than in someone without HIV infection
• Tuberculosis — infection by the tuberculosis bacteria that mostly affects the lungs, but can affect other organs such as the bowel, lining of the heart or lungs, brain, or lining of the central nervous system (brain and spinal cord)
• Oral or vaginal thrush — yeast infection of the mouth or vagina
• Herpes zoster (shingles) — ulcers/small blisters over a patch of skin, caused by reactivation of the varicella zoster virus
• Non-Hodgkin’s lymphoma — cancer of the lymph nodes
• Kaposi’s sarcoma — cancer of the skin, lungs, and bowel, associated with a herpes virus (HHV-8). Can happen at any CD4 count, but is more likely to happen at lower CD4 counts, and is more common in men than in women

Common with CD4 count below 200 cells/mcl:

• Pneumocystis carinii pneumonia, “PCP pneumonia,” now called Pneumocystis jiroveci pneumonia
• Candida esophagitis — painful yeast infection of the esophagus
• Bacillary angiomatosis — skin lesions caused by a bacteria called Bartonella, which may be acquired from cat scratches

Common with CD4 count below 100 cells/mcl:

• Cryptococcal meningitis — fungal infection of the lining of the brain
• AIDS dementia — worsening and slowing of mental function, caused by HIV itself
• Toxoplasma encephalitis — infection of the brain by a parasite, called Toxoplasma gondi, which is frequently found in cat feces; causes lesions (sores) in the brain
• Progressive multifocal leukoencephalopathy — a viral disease of the brain caused by a virus (called the JC virus) that results in a severe decline in mental and physical functions
• Wasting syndrome — extreme weight loss and loss of appetite, caused by HIV itself
• Cryptosporidium diarrhea — Extreme diarrhea caused by one of the parasites that affect the gastrointestinal tract

Common with CD4 count below 50/mcl:

• Mycobacterium avium — a blood infection by a bacterium related to tuberculosis
• Cytomegalovirus infection — a viral infection that can affect almost any organ system, especially the large bowel and the eyes

In addition to the CD4 count, a test called HIV RNA level (or viral load) may be used to monitor patients. Basic screening lab tests and regular cervical Pap smears are important to monitor in HIV infection, due to the increased risk of cervical cancer in immunocompromised women. Anal Pap smears to detect potential cancers may also be important in both HIV infected men and women.

Treatment

There is no cure for AIDS at this time. However, a variety of treatments are available that can help keep symptoms at bay and improve the quality of life of those who have already developed symptoms.

Antiretroviral therapy suppresses the replication of the HIV virus in the body. A combination of several antiretroviral agents, termed highly active antiretroviral therapy (HAART), has been highly effective in reducing the number of HIV particles in the blood stream, as measured by the viral load (how much virus is found in the blood). Preventing the virus from replicating can help the immune system recover from the HIV infection and improve T-cell counts.

HAART is not a cure for HIV, and people on HAART with suppressed levels of HIV can still transmit the virus to others through sex or sharing of needles. But HAART has been enormously effective for the past 10 years. There is good evidence that if the levels of HIV remain suppressed and the CD4 count remains high (above 200 cells/mcl), life can be significantly prolonged and improved.

However, HIV may become resistant to HAART in patients who do not take their medications on schedule every day. Genetic tests are now available to determine whether a particular HIV strain is resistant to a particular drug. This information may be useful in determining the best drug combination for each individual, and adjusting the drug regimen if it starts to fail. These tests should be performed any time a treatment strategy begins to fail, and prior to starting therapy.

When HIV becomes resistant to HAART, other drug combinations must be used to try to suppress the resistant strain of HIV. There are a variety of new drugs on the market for the treatment of drug-resistant HIV.

Treatment with HAART has complications. HAART is a collection of different medications, each with its own side effects. Some common side effects are nausea, headache, weakness, malaise (a general sick feeling), and fat accumulation on the back (“buffalo hump”) and abdomen. When used for a long time, these medications increase the risk of heart attack, perhaps by increasing the levels of fat and glucose in the blood.

Any doctor prescribing HAART should carefully watch the patient for possible side effects associated with the combination of medications the patient takes. In addition, routine blood tests measuring CD4 counts and HIV viral load (a blood test that measures how much virus is in the blood) should be taken every 3 – 6 months. The goal is to get the CD4 count as close to normal as possible, and to suppress the HIV amount of virus in the blood to an undetectable level.

Other antiviral medications are being investigated. In addition, growth factors that stimulate cell growth, such as erthythropoetin (Epogen) and filgrastim (G-CSF or Neupogen) are sometimes used to treat anemia and low white blood cell counts associated with AIDS.

Medications are also used to prevent opportunistic infections (such as Pneumocystis jiroveci pneumonia) if the CD4 count is low enough. This keeps AIDS patients healthier for longer periods of time. Opportunistic infections are treated when they happen.

Support Groups

Joining support groups where members share common experiences and problems can often help the emotional stress of devastating illnesses. See AIDS – support group.

Outlook (Prognosis)

Right now, there is no cure for AIDS. It is always fatal if no treatment is provided. In the US, most patients survive many years after diagnosis because of the availability of HAART. HAART has dramatically increased the amount of time people with HIV remain alive.

Research continues in the areas of drug treatments and vaccine development. Unfortunately, HIV medications are not always available in the developing world, where the bulk of the epidemic is raging.

Possible Complications

When a person is infected with HIV, the virus slowly begins to destroy that person’s immune system. How fast this occurs differs in each individual. Treatment with HAART can help slow or halt the destruction of the immune system.

Once the immune system is severely damaged, that person has AIDS, and is now susceptible to infections and cancers that most healthy adults would not get. However, antiretroviral treatment can still be very effective, even at that stage of illness.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have any of the risk factors for HIV infection, or if you develop symptoms of AIDS. By law, AIDS testing must be kept confidential. Your health care provider will review results of your testing with you.

Prevention

1. See the article on safe sex to learn how to reduce the chance of acquiring or spreading HIV, and other sexually transmitted diseases.
2. Do not use injected drugs. If IV drugs are used, do not share needles or syringes. Many communities now have needle exchange programs, where you can get rid of used syringes and get new, sterile ones for free. These programs can also provide referrals to addiction treatment.
3. Avoid contact with another person’s blood. Protective clothing, masks, and goggles may be appropriate when caring for people who are injured.
4. HIV-positive women who wish to become pregnant should seek counseling about the risk to unborn children, and medical advances that may help prevent the fetus from becoming infected. Use of certain medications can dramatically reduce the chances that the baby will become infected during pregnancy.
5. Mothers who are HIV-positive should not breast feed their babies.

HIV-positive patients who are taking anti-retroviral medications are less likely to transmit the virus. For example, pregnant women who are on effective treatment at the time of delivery, and who have undetectable viral loads, give HIV to the infant less than 1% of the time, compared with about 20% of the time if medications are not used.

The US blood supply is among the safest in the world. Nearly all people infected with HIV through blood transfusions received those transfusions before 1985, the year HIV testing began for all donated blood. In 2000, according to the American Red Cross, the risk of infection with HIV through a blood transfusion or blood products was 1 in 2,135,000 in the United States.

If you believe you have been exposed to HIV, seek medical attention IMMEDIATELY. There is some evidence that an immediate course of antiviral drugs can reduce the chances that you will be infected. This is called post-exposure prophylaxis (PEP), and has been used to treat health care workers injured by needlesticks, to prevent transmission.

There is less information available about how effective PEP is for people exposed to HIV through sexual activity or IV drug use. However, if you believe you have been exposed, you should discuss the possibility with a knowledgeable specialist (check local AIDS organizations for the latest information) as soon as possible. Anyone who has been raped should be offered PEP and should consider its potential risks and benefits.

Categories: Hiv/Aids | Tags: aetna, aids, aids treatment, clinic, clinics, community, coverage, dental, doctor, doctors, family practice, flu shots, free clinic, healthcare, healthcare insurance, hiv, Hiv/Aids, hmo insurance, hospital center, insurance, internal medicine, medicaid, medicare supplement, physician, physicians, products, small business, vital records, walk clinic | 1 Comment »

ELISA/Western blot tests for HIV

September 26, 2009 | Posted by Muhammad Zamir

Definition

HIV ELISA/Western blot is a set of blood tests used to diagnose chronic infection with human immunodeficiency virus (HIV).

Alternative Names

HIV testing

How the Test is Performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

How to Prepare for the Test

No preparation is necessary.

How the Test Will Feel

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the Test is Performed

Testing for HIV infection is done for many reasons, including:

• Screening people who want to be tested
• Screening people in high-risk groups (men who have sex with men, injection drug users and their sexual partners, and commercial sex workers)
• Screening people with certain conditions and infections (such as Kaposi’s sarcoma, Pneumocystis pneumonia )
• Screening pregnant women to help prevent them from passing the virus to the baby
• When a patient has an unusual infection

Normal Results

A negative test result is normal.However, early HIV infection (termed acute HIV infection or primary HIV infection) often results in a negative test.

What Abnormal Results Mean

A positive result on the ELISA screening test does not necessarily mean that the person has HIV infection. There are certain conditions that may lead to a false positive result, such as Lyme disease, syphilis, and lupus.

A positive ELISA test is always followed by a Western blot test. A positive Western blot confirms an HIV infection. A negative Western blot test means the ELISA test was a false positive test. The Western blot test can also be indeterminate, in which case additional testing is done to clarify the situation.

Negative tests do not rule out HIV infection. There is a period of time (called the “window period”) between HIV infection and the appearance of anti-HIV antibodies that can be measured.

If a person might have acute or primary HIV infection, and is in the “window period,” a negative HIV ELISA and Western blot will not rule out HIV infection. More tests for HIV will need to be done.

Risks

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Considerations

People who are at high risk (men who have sex with men, injection drug users and their sexual partners, commercial sex workers) should be regularly tested for HIV.

If the health care provider suspects early (acute or primary) HIV infection, other tests (such as HIV viral load) will be needed to confirm this diagnosis, because the HIV ELISA/Western blot test will often be negative during this window period.

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Chronic

September 26, 2009 | Posted by Muhammad Zamir

Definition

Chronic refers to something that continues or persists over an extended period of time. A chronic condition is usually long-lasting and does not easily or quickly go away.

Chronic is the opposite of acute.

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Acute HIV infection

September 26, 2009 | Posted by Muhammad Zamir

Definition

Acute HIV infection is caused by the human immunodeficiency virus (HIV), a virus that gradually destroys the immune system.

Alternative Names

Primary HIV infection; HIV seroconversion syndrome; Acute retroviral syndrome

Causes

Primary or acute HIV infection is a condition that occurs 2 – 4 weeks after infection with the human immunodeficiency virus (HIV). The virus is spread by:

• Breastfeeding (rarely)
• Contaminated blood transfusions and blood products
• Intravenous (IV) drug use with contaminated needles and syringes
• Passing through the placenta from the mother to the fetus
• Sexual contact

After someone is infected with HIV, tests can detect antibodies to the virus in the blood. This is called HIV seroconversion (converting from HIV negative to HIV positive), and usually occurs within 3 months of exposure, but on rare occasions can occur up to a year after exposure.

Following the acute infection, there may be no further evidence of illness for the next 10 years.

Acute HIV infection can, but does not always, progress to early symptomatic HIV infection and to advanced HIV disease (AIDS).

Not all people infected with HIV will necessarily progress to AIDS, but time has shown that the vast majority do. To date there are a small number of people who have tested positive for HIV, but later no longer test positive and have no signs of disease. Although this is relatively rare, it provides evidence that the human body may be capable of removing the disease. These people are being carefully watched and studied.

HIV has spread throughout the United States and other countries. Higher numbers of people with the disease are found in large metropolitan centers, inner cities, and among certain populations with high-risk behaviors.

Symptoms

Note: At the time of diagnosis with HIV, many people have not experienced any symptoms.

Acute HIV infection can appear like infectious mononucleosis, flu, or other viral illnesses.

Any of the following symptoms can occur:

• Decreased appetite
• Fatigue
• Fever
• Headache
• Malaise
• Swollen lymph glands
• Muscle stiffness or aching
• Rash
• Sore throat
• Ulcers of the mouth and esophagus

These symptoms can last from a few days to 4 weeks, and then subside.

Exams and Tests

• Blood differential may show abnormalities.
• HIV ELISA/Western blot is usually negative or undetermined during the acute infection and will become positive over the next 3 months.
• HIV RNA viral load is positive in patients with acute HIV infection.
• Lower than normal CD4 count may indicate suppression of the immune system. The CD4 count usually improves 1 – 2 months after acute infection.
• P24 antigen blood test is often positive.

Treatment

People with HIV infection need to be educated about the disease and its treatment so they can be active partners in making decisions with their health care provider.

There is still controversy about whether aggressive early treatment of HIV infection with HIV medications will slow the progression of disease. You should discuss this option with your health care provider.

Follow these healthy practices in the early stages of HIV infection:

• Avoid exposure to people with acute infectious illnesses.
• Avoid settings and situations that could lead to depression. Maintain positive social contacts, hobbies, interests, and pets.
• Eat a nutritious diet with enough calories.
• Get enough exercise, but don’t wear yourself out.
• Keep stress to a minimum.
• Practice safer sex. The disease is highly transmissible, especially in the first months after infection.

Support Groups

You can often reduce the stress of illness by joining a support group where members share common experiences and problems. See AIDS – support group.

Outlook (Prognosis)

HIV is a long-term medical condition that can be treated but not yet cured. There are effective means of preventing complications and delaying (but not preventing) progression to AIDS. At the present time, not all cases of HIV have progressed to AIDS, but time has shown that the vast majority do.

Possible Complications

• AIDS (acquired immune deficiency syndrome)
• Autoimmune diseases
• Cancers, typically Kaposi’s sarcoma and lymphomas
• Opportunistic infections (unlikely to occur in early stages of HIV disease)
  • Bacillary angiomatosis
  • Candidiasis
  • Cryptosporidium or other protozoal enterocolitis
  • Cytomegalovirus infection
  • Pneumocystis carinii pneumonia
  • Mycobacterium avium complex (MAC)
  • Progressive multifocal leukoencephalopathy
  • Salmonella infection of the bloodstream
  • Toxoplasmosis
  • Tuberculosis

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have had a possible or actual exposure to AIDS or HIV infection, or if you are at risk and have had symptoms like those of acute HIV infection.

Prevention

For a comprehensive discussion, see the prevention section in AIDS.

Safer sex behaviors may reduce the risk of getting the infection. There is still a risk of getting infected with HIV, even if you practice “safe sex,” because condoms can break. Abstinence is the only sure way to prevent sexual transmission of the HIV virus.

General guidelines:

• Do not have unprotected sexual intercourse with numerous partners, any person who has multiple partners, people who use IV drugs, or people you know or suspect are infected with AIDS.
• Avoid intravenous drugs. If you do use IV drugs, do not share needles or syringes.
• People with AIDS or who have had positive HIV antibody tests can pass the disease on to others and should not donate blood, plasma, body organs, or sperm. Do not exchange body fluids during sexual activity.

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Penicillin, Amoxicillin and Cephalosporin Allergy

September 26, 2009 | Posted by Muhammad Zamir

What is a Penicillin Allergy?

Penicillin is perhaps the most well-known member of a group of antibiotics called beta lactams, which refers to a particular structure in their chemical makeup. The structure is also shared by semi-synthetic penicillin (amoxicillin), cephalosporins, and other antibiotics (such as imipenem). Penicillins and cephalosporins are the most commonly used antibiotics to treat common infections.

Penicillins and cephalosporins are also the most common causes of drug allergy. About 10% of Americans report an allergy to penicillin or a related antibiotic. While penicillin allergy most commonly occurs in young adults, reactions can occur at any age. Women appear to be at higher risk than men. Approximately 300 deaths can be attributed to penicillin allergy each year in the United States. Symptoms of an allergic reaction to penicillin may include anaphylaxis, hives, below-the-skin swelling, asthma symptoms, as well as non-allergic symptoms such as serum sickness, certain forms of anemia, and other drug rashes.

How is Penicillin Allergy Diagnosed?

While many people report having an allergy to penicillin, less than 10% of these actual have a true allergy to the drug. Skin testing is the best method for diagnosing a penicillin allergy. However, the commercially available extract for penicillin testing has not been available since 2004; there are plans for this extract to become commercially available again at some point in the future. In the meantime, a RAST for penicillin is available. Unfortunately, a negative RAST result does not exclude the possibility of penicillin allergy.

How is Penicillin Allergy Treated?

Other than the immediate treatment of drug allergy symptoms, the main treatment for penicillin allergy is avoidance of future use of penicillin and related antibiotics.

Cephalosporins can cause allergic reactions in people with penicillin allergy. The overall rate of allergy to cephalosporins in people with penicillin allergy is approximately 5 to 10%, although rates may be higher for certain people. Allergic reactions to cephalosporins can be severe and even life-threatening; it is generally recommended that those allergic to penicillin avoid cephalosporins all together.

There may be certain cases, however, when a person with a history of penicillin allergy absolutely needs penicillin or cephalosporin. In these situations, an allergist can perform skin testing and, if negative, give the patient a small amount of the drug under close monitoring to determine how much–if any–he can tolerate (known as an oral challenge.) If a person who is truly allergic to penicillin has an infection that requires treatment with penicillin, a desensitization process can be performed in a hospital. This entails giving initially small amounts of the drug and gradually increasing doses over a number of hours, until the person can tolerate a full therapeutic dose.

What Other Medications Should a Person with Penicillin Allergy Avoid?

The family of penicillin antibiotics includes:

• Penicillin VK
• Penicillin G
• Dicloxacillin
• Oxacillin
• Nafcillin
• Amoxicillin
• Ampicillin
• Augmentin (amoxicillin/clavulanate)
• Unasyn (ampicillin/sulbactam)
• Zosyn (pipercillin/tazobactam)

The family of cephalosporins includes:

• Keflex (cephalexin)
• Ancef (cefazolin)
• Ceftin (cefuroxime)
• Cefzil (cefprozil)
• Omnicef (cefdinir)
• Vantin (cefpodoxime)
• Many other antibiotics beginning with “cef-“ or “ceph-“

Imipenem may also cause allergic reactions in people with penicillin allergy and should be avoided.

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