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Fact sheet: HIV/AIDS
Aids2006.org
August 2006

http://www.aids2006.org/subpage.aspx?pageId=474

HIV/AIDS is the most devastating disease humankind has ever faced. Since the beginning of the pandemic 25 years ago nearly 65 million people have been infected with HIV and AIDS has killed more than 25 million people. AIDS 2006 aims to link community and science to galvanise the world’s response to this pandemic through increased commitment, leadership and accountability.

HIV stands for Human Immunodeficiency Virus, and is the virus that causes AIDS. HIV destroys certain blood cells that are crucial to the normal function of the immune system, which defends the body against illness.

AIDS stands for Acquired Immunodeficiency Syndrome. It occurs when the immune system is weakened by HIV to the point where a person develops any number of diseases or cancers.

HIV Detection
HIV infection is most commonly detected through the test of a sample of blood or oral fluid (oral mucosa). If the blood or oral fluid sample contains HIV antibodies – proteins the body produces to fight off the infection – the person is HIV-positive (also referred to as HIV infected or seropositive). Several rapid HIV tests are available, including ones developed for use with oral fluid or plasma specimens. " All rapid tests provide results in less than 30 minutes; however, positive results require confirmatory tests.

HIV Transmission
HIV does not survive well outside the body. Therefore, it cannot be transmitted through casual, everyday contact. Mosquitoes and other insects do not transmit HIV. HIV can be spread through certain sexual behaviours with an infected person, by sharing needles, syringes and/or other injecting equipment and, less commonly (and now very rarely in countries where blood is screened for HIV antibodies), through transfusions of infected blood or blood clotting factors. Babies born to HIV-infected women may become infected before or during birth or through breast-feeding after birth.

Alarming Trends

  • Every six and a half seconds, another person is infected with HIV.
  • Every ten seconds, one person dies of AIDS-related illness.
  • There are an estimated 11,200 new HIV infections and nearly 8,000 deaths every day.
  • Sub-Saharan Africa is the region of the world that has been most severely impacted by HIV (in terms of the percentage of the region’s population that is infected). This is followed by the Caribbean.
  • Only one-tenth of the world’s population lives in sub-Saharan Africa, yet almost
  • 64% of those infected with HIV live in this region.
  • India and China, the world’s most populous countries, are experiencing rapid growth of HIV in certain subpopulations and geographic areas.
  • More than two-thirds of those infected with HIV from Asia live in India.
  • There has been a major increase in HIV infection in Eastern Europe and the nations of the former Soviet Union, a region which has among the fastest rates of new infections in the world.
  • The majority of people living with HIV/AIDS in Eastern Europe live in the Ukraine or the Russian Federation.
  • The total number of people living with HIV continues to rise in high-income countries. In the US, for example, HIV prevalence reached its highest level to date in 2005.
  • Even with a 3% increase in school enrolment, over the past four years, there has continued to remain a gender gap in education. An estimated 113 million school-age children are not currently in school, 54% of which are girls. In high prevalence countries, girls’ enrolment in school has decreased in the past decade. Girls are often taken out of school to care for sick relatives or to look after young siblings.
  • Access to basic prevention services is inadequate. Less than one in five people at risk for HIV infection has access to prevention services.
  • As of December 2005, an estimated 20% of people living with HIV/AIDS in low- and middle-income countries (1.3 million) received appropriate HIV treatment (including antiretroviral medicines).

Opportunistic Infections (OIs) are illnesses caused by organisms that do not usually cause disease in persons with normal immune systems. The most common OIs in people living with HIV/AIDS include:

  • Candidiasis (Thrush), a fungal infection that usually affects the mouth, throat, lungs or vagina;
  • Cryptosporidiosis (Crypto), a diarrheal disease caused by the protozoal infection;
  • Cryptococcal Meningitis, a fungal infection of the membranes surrounding the brain and spinal cord;
  • Cytomegalovirus (CMV), a herpes virus that can cause infections in most organs of the body, though HIV-infected people are most susceptible to CMV retinitis (infection of the eye), which can lead to blindness;
  • Herpes simplex viruses (HSV), which can cause oral or genital herpes. (These are common infections, but outbreaks for people living with HIV/AIDS can be more frequent and more severe.);
  • Mycobacterium avium Complex (MAC or MAI), a bacterial infection that can cause recurring fevers, problems with digestion and serious weight loss;
  • Pneumocystis carinii pneumonia (PCP), now known as Pneumocystis jiroveci pneumonia, is a fungal infection that can cause a fatal pneumonia;
  • Toxoplasmosis (Toxo), a protozoal infection that can infect many parts of the body but most commonly causes an infection of the brain; and
  • Tuberculosis (TB), a bacterial infection that attacks the lungs and can cause meningitis.
    TB is the leading cause of death for people living with HIV/AIDS worldwide.

Prevention
Microbicides are substances that can substantially reduce transmission of one or more sexually transmitted diseases (STDs). They work by either destroying the microbes or preventing them from establishing an infection. An HIV microbicide would provide a usercontrolled method of prevention. Scientists are currently exploring microbicide development as a potential HIV prevention method.

Condom use is one of the least expensive, most cost-effective methods for preventing HIV transmission. Consistent, correct use of condoms significantly reduces the risk of transmission of HIV and other STDs.

Vaccines to prevent HIV infection or improve the ability of the immune system to defend itself are being tested by researchers. Global investment in HIV vaccine research in 2004 was US$ 682 million, but it is likely that a successful vaccine is still a number of years away.6 It is estimated at least US $1.2 billion per year is needed to mount an accelerated search for a safe and effective vaccine.

Mother-to-child transmission (MTCT) of HIV can be reduced significantly through the use of antiretrovirals by HIV-positive women during pregnancy and delivery, and by their infants following birth. These regimens reduce the risk of MTCT by decreasing viral replication in the mother and through prophylaxis of the infant during and after exposure to the virus.

Post-exposure prophylaxis (PEP) involves the short-term use of antiretrovirals to prevent infection in people who have recently been exposed (such as health care workers through needlestick injuries or women who have been raped). PEP significantly reduces the risk of infection, but is not 100% effective.

Socio-behavioural interventions are educational programs designed to encourage individuals to change their behaviour to reduce their exposure to HIV and risk for infection.

Such efforts include encouraging proper and consistent condom use, a reduction in the number of sexual partners, abstinence and the delaying of sexual initiation among youth.

Pre-Exposure Prophylaxis (PREP): Pre-exposure prophylaxis involves taking antiretrovirals before engaging in behaviour(s) that place one at risk for HIV infection (such as unprotected sex or sharing needles) in order to reduce or prevent the possibility of HIV infection. The effectiveness of PREP as an HIV prevention tool in humans is as yet unproven; large-scale clinical trials are underway in several countries to determine the safety and efficacy of PREP.

Treatments
ARV stands for antiretroviral and refers to a type of drug that works by interfering with the replication of HIV. The four classes of antiretroviral drugs currently available are:

  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs), which block the replication of HIV by interfering with a protein called Reverse Transcriptase (RT), essential for the reproduction of HIV;
  • Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs), which also block RT, but in a slightly different way than NRTIs;
  • Protease Inhibitors (PIs), which block the function of a protein called protease, essential for HIV reproduction; and
  • Entry Inhibitors, which block HIV from entering target cells. There is currently just one licensed entry inhibitor available – a fusion inhibitor – though other types are currently being tested.

Combination Therapy is a course of antiretroviral treatment that involves two or more ARVs in combination.

HAART (Highly Active Antiretroviral Treatment) is a modality of antiretroviral treatment that involves the use of three or more ARVs. HAART interferes with the virus’ ability to replicate, which allows the body’s immune system to maintain or recover its ability to produce the white blood cells necessary to respond to opportunistic infections.

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