Source: World Health Organization (WHO) http://www.who.int/topics/hiv_aids/en/
There is no known cure for or vaccine; however, antiretroviral treatment of adult HIV infection can slow the course of the disease and may lead to a near-normal life expectancy. While antiretroviral treatment reduces the risk of death and complications from the disease, these medications are expensive and may be associated with side effects of their own.
 |
| The Red ribbon is a symbol for solidarity with HIV-positive people and those living with AIDS. Image© Gary van der Merwe. |
Statistics (2011) Worldwide
Source: amfAR, The Foundation for AIDS Research http://www.amfar.org/About_HIV_and_AIDS/Facts_and_Stats/Statistics__Worldwide/
- More than 34 million people now live with HIV/AIDS.
- 3.4 million of them are under the age of 15.
- In 2011, an estimated 2.5 million people were newly infected with HIV.
- 330,000 were under the age of 15.
- Every day nearly 7,000 people contract HIV—nearly 300 every hour.
- In 2011, 1.7 million people died from AIDS.
- 230,000 of them were under the age of 15.
- Since the beginning of the epidemic, more than 60 million people have contracted HIV and nearly 30 million have died of HIV-related causes.
"Scientists believe HIV came from a particular kind of chimpanzee in Western Africa. Humans probably came in contact with HIV when they hunted and ate infected animals. Recent studies indicate that HIV may have jumped from monkeys to humans as far back as the late 1800s."
Signs and Symptoms
There are three main stages of HIV infection: acute infection, clinical latency and AIDS.
Acute Infection
The initial period following contracting HIV is called acute HIV infection, primary HIV or acute retroviral syndrome. Many individuals develop an influenza-like illness or a mononucleosis-like illness 2–4 weeks post-exposure while others have no significant symptoms. These symptoms occur in 40–90% of cases and most commonly include: fever, large tender lymph nodes, throat inflammation, a rash, headache, and sores of the mouth and genitals. The rash is classically maculopapular and on the trunk, occurring in 20–50% of cases. Some people also develop opportunistic infections at this point in time. Other symptoms may include include: nausea, vomiting, diarrhea, and neurological problems such as peripheral neuropathy and Guillain-Barre syndrome. The duration of symptoms varies, but is usually one or two weeks.
Because of the nonspecific nature of these symptoms, they are often not recognized as signs of HIV infection. Even if people go to their doctors or a hospital, they will often be misdiagnosed as having one of the more common infectious diseases with the same symptoms. Thus it is recommended that HIV be considered in those with an unexplained fever and risk factors for the disease.
Clinical Latency
After the initial symptoms HIV enters into a stage called clinically latent or 'silent' phase, asymptomatic HIV or chronic HIV. Without treatment the secondary stage of HIV infection lasts anywhere from five years to greater than 20 years (average is about eight years). While typically there are few or no symptoms initially near the end of this stage many people develop fever, weight loss, gastrointestinal problems and muscle pain. Between 50–70% of people also develop persistent generalized lymphadenopathy, which tends to occur in a couple of different areas for more than three to six months for which no other reason can be found.
A small percentage (~5%) of HIV-1 infected individuals retain high levels of CD4+ T-cells without antiretroviral therapy for more than 5 years. However, most have detectable viral load and will eventually progress to AIDS without treatment. These individuals are classified as HIV controllers or long-term nonprogressors (LTNP). People who maintain CD4+ T cell counts and also have low or undetectable viral load without anti-retroviral treatment are known as elite controllers or elite suppressors.
AIDS
AIDS is defined as either a CD4+ T cell numbers below 200 cells per µL or is based on the occurrence of specific diseases in association with an HIV infection. Around half of people infected with HIV will develop AIDS within ten years if not treated. The most common initial conditions that alert to the presence of AIDS are PCP pneumonia (40%), HIV wasting syndrome (20%) and esophageal candidiasis. Other common symptoms include recurring respiratory tract infections (such as pneumonia).
Opportunistic infections may be caused by viruses, yeast, parasites, fungi, tuberculosis, malaria, and bacterial infections that are normally controlled by the immune system. Which infections occur partly depends on what organism are common in the persons environment. These infections may affect nearly every organ system.
"Classic AIDS-defining illnesses such as Pneumocystis jirovecii pneumonia (PCP), cerebral toxoplasmosis, and Kaposi’s sarcoma, are now well known." Kaposi's sarcoma is the most common cancer occurring in 10–20% of people with HIV.
 |
| This brown cutaneous nodule represents a Kaposi's sarcoma lesion commonly found in patients with AIDS. Before the onset of the AIDS pandemic, Kaposi’s sarcoma was an uncommon malignancy found mainly amongst Mediterranean men, African children and Ashkenazi Jews, but became the most common neoplasm found in those with AIDS. This media comes from the Centers for Disease Control and Prevention Public Health Image Library (PHIL), with identification number #6436. |
Both these cancers are associated with human herpesvirus 8 (HHV-8).
Cervical cancer occurs more frequently in those with AIDS due to its association with human papillomavirus (HPV).
Additionally, they frequently have systemic symptoms like a prolonged fevers, sweats (particularly at night), swollen lymph nodes, chills, weakness, rash, and weight loss. Chronic diarrhea is another common symptoms present in ~90% of people with AIDS.
Transmission
Average per act risk of getting HIV by exposure route to an infected source (exposure route and chance of infection):
- Blood transfusion 90%;
- Childbirth (mother-to-child) 25%;
- Needle-sharing injection drug use 0.67%;
- Percutaneous needle stick 0.30%;
- Receptive anal intercourse* 0.04–3.0%;
- Insertive anal intercourse* 0.06–0.056%;
- Receptive penile-vaginal intercourse* 0.05–0.30%;
- Insertive penile-vaginal intercourse* 0.01–0.38%;
- Receptive oral intercourse** 0–0.04%;
- Insertive oral intercourse** 0-0.005%.
There is no cure for HIV, but you can prevent HIV infection. HIV is transmitted from one person to another:
- By having sex (anal, vaginal, or oral) with a person who has HIV. HIV can be transmitted through blood, pre-seminal fluid, semen, and vaginal fluid.
- By sharing needles, syringes, or other injection equipment with a person who injects drugs and has HIV.
- Through pregnancy, birth, or breastfeeding. Women who have HIV can give the disease to their babies before or during birth or through breast-feeding after birth.
Sexual
The majority of HIV infections are acquired through unprotected sexual relations where one partner has HIV. Worldwide, sexual contact between members of the opposite sex, rather than between members of the same sex, result in most cases of transmission. In the United States, as of 2009, most sexual transmission occurred in men who have sex with men (MSM) with this population accounting for 61% of all new cases.
In high-income countries, the risk of female-to-male transmission is ~0.04% per act and male-to-female transmission is ~0.08% per act. For various reasons, these rates are four to ten times higher in low-income countries with rates of female-to-male transmission is ~0.38% per act and male-to-female transmission is ~0.30% per act. The risk from anal intercourse is ~1.7% per act and while the risk of transmission from oral sex is less it is still present. Per act risk is estimated at 0–0.04% for receptive oral intercourse. Case reports have documented the "Although oral transmission of HIV is far less common than vaginal and rectal transmissions, infections through this route do occur through oral sex.".
Risk increases in the presence of many sexually transmitted infections and genital ulcers. Genital ulcer disease (GUD) increases the risk approximately fivefold and there is a lesser increase in risk from sexually transmitted infections (STIs) such as gonorrhea, chlamydia, syphilis, trichomoniasis, and bacterial vaginosis. Rough sex also appears to increase the risk.
The viral load of an infected person is important both in heterosexual and vertical transmission. During the first 2.5 months of an HIV infection a persons infectiousness is twelve-fold higher due to this high viral load. Where the person is in the late stages of infection rates of transmission are approximately eightfold greater.
Commercial sex exposure impact risk with rates of female-to-male transmission of ~2.4% per act and male-to-female transmission is ~0.08% per act. Sexual assault is believed to have an increased risk of HIV transmission as condoms are rarely employed, physical trauma to the vagina or rectum may occur, and there may be a greater risk of concurrent sexually transmitted infections. The percentage of those who are HIV positive and in jail for sexual assault in the United States is roughly 1%. Care of the Adult Patient after Sexual Assault
Body Fluids
The second most frequent mode of HIV transmission is via blood and blood products. It is not possible for mosquitoes to transmit HIV.
The risk from sharing a needle during drug injection is between 0.63 to 2.4% (ave. 0.8%). The risk of acquiring HIV from a needle stick from an HIV-infected person is about 0.3% (~1 in 333) and the risk following mucus membrane exposure to infected blood is 0.09% (~1:1000). In the United States intravenous drug users make up 12% of all new cases of HIV in 2009 and in some areas more than 80% of people who inject drugs are HIV positive.
Blood transfusions with infected blood result in transmission of infection ~93% of the time. In developed countries the risk of acquiring HIV from a blood transfusion is extremely low (less than one in half a million) where improved donor selection and HIV screening is performed. In the UK the risk is reported at one in five million. However, in low income countries only half of the blood used for transfusions may be appropriately screened (as of 2008). It is estimated that up to 15% of HIV infections come from transfusion of infected blood and blood products in these areas (5% and 10% of global infections). "Each year, unsafe transfusion and injection practices cause an estimated 8 to 16 million hepatitis B virus infections, 2.3-4.7 million hepatitis C virus infections, and 80 000 to 160 000 HIV infections".
Mother-to-Child
HIV can be transmitted from mother-to-child during pregnancy, during delivery, and after delivery via breastfeeding. It is the third most common way HIV is transmitted globally. In the absence of treatment, the risk of transmission before or during birth is around 20% and in those who also breastfeed 35%. As of 2008, vertical transmission is the route of infection in 90% of children. With appropriate treatment this risk can be reduced to ~1%. "Mother-to-child transmission (MTCT) is almost entirely preventable with a combination of interventions—antiretroviral prophylaxis during pregnancy, intrapartum and neonatally, elective caesarean section and avoidance of breastfeeding". Many of these measures are however not available in the developing world.
A less common mode of transmission includes "eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. This appears to be a rare occurrence and has only been documented among infants whose caregiver gave them pre-chewed food".
Virology
The HIV virus is the cause of the spectrum of disease known as HIV/AIDS. "Primarily, HIV infects and kills CD4+ T lymphocytes, which function as regulators and amplifiers of the immune response".
 |
| A diagram of the HIV virus. Date: 3 June 2005. US National Institute of Health (redrawn by en:User:Carl Henderson). Permission: PD-USGov-HHS-NIH. This image is a work of the National Institutes of Health, part of the United States Department of Health and Human Services. As a work of the U.S. federal government, the image is in the public domain. |
HIV is a member of the genus Lentivirus, part of the family of Retroviridae. Lentiviruses have many morphologies and biological properties in common. Many species are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with a long incubation period. Lentiviruses are transmitted as single-stranded, positive-sense, enveloped RNA viruses. Upon entry into the target cell, the viral RNA genome is converted (reverse transcribed) into double-stranded DNA by a virally encoded reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded integrase and host co-factors. Once integrated, the virus may become latent, allowing the virus and its host cell to avoid detection by the immune system. Alternatively, the virus may be transcribed, producing new RNA genomes and viral proteins that are packaged and released from the cell as new virus particles that begin the replication cycle anew.
Two types of HIV have been characterized: HIV-1 and HIV-2. HIV-1 is the virus that was initially discovered and termed both LAV and HTLV-III. It is "significantly more infectious than HIV-2", and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2 compared to HIV-1 implies that fewer of those exposed to HIV-2 will be infected per exposure. "The epicentre of HIV-1 infection is East Africa. In contrast, HIV-2 is restricted primarily to West Africa, although the prevalence of HIV-2 is a growing concern in certain parts of Europe and in the southwestern region of India".
Pathophysiology
After the virus enters the body there is a period of rapid viral replication, leading to an abundance of virus in the peripheral blood. During primary infection, the level of HIV may reach several million virus particles per milliliter of blood.
 |
| Scanning electron micrograph of HIV-1 budding (in green) from cultured lymphocyte. This image has been colored to highlight important features; see PHIL 1197 for original black and white view of this image. Multiple round bumps on cell surface represent sites of assembly and budding of virions. Date: 1984. This media comes from the Centers for Disease Control and Prevention Public Health Image Library (PHIL), with identification number (#10000). Photo Credit: C. Goldsmith. Content Providers: CDC/ C. Goldsmith, P. Feorino, E. L. Palmer, W. R. McManus. Permission: PD-USGov-HHS-CDC. |
This response is accompanied by a marked drop in the numbers of circulating CD4+ T cells. This acute viremia is associated in virtually all people with the activation of CD8+ T cells, which kill HIV-infected cells, and subsequently with antibody production, or seroconversion. The CD8+ T cell response is thought to be important in controlling virus levels, which peak and then decline, as the CD4+ T cell counts rebound. A good CD8+ T cell response has been linked to slower disease progression and a better prognosis, though it does not eliminate the virus.
"The pathophysiology of illness is incompletely understood, but is in large part related to destruction of helper, CD4 lymphocytes". Ultimately, HIV causes AIDS by depleting CD4+ T helper lymphocytes. This weakens the immune system and allows opportunistic infections. T lymphocytes are essential to the immune response and without them, the body cannot fight infections or kill cancerous cells. "Qualitatively different mechanisms of CD4+ T-cell depletion prevail during the acute, chronic and advanced phases of infection depending on the availability of the target-cell population and competence of the immune system".
During the acute phase, HIV-induced cell lysis and killing of infected cells by cytotoxic T cells accounts for CD4+ T cell depletion, although apoptosis may also be a factor. During the chronic phase, the consequences of generalized immune activation coupled with the gradual loss of the ability of the immune system to generate new T cells appear to account for the slow decline in CD4+ T cell numbers.
Although the symptoms of immune deficiency characteristic of AIDS do not appear for years after a person is infected, the bulk of CD4+ T cell loss occurs during the first weeks of infection, especially in "the gastrointestinal (GI) mucosa". The reason for the preferential loss of mucosal CD4+ T cells is that a majority of mucosal CD4+ T cells express the CCR5 coreceptor, whereas a small fraction of CD4+ T cells in the bloodstream do so.
HIV seeks out and destroys CCR5+ CD4+ T cells during acute infection. A vigorous immune response eventually controls the infection and initiates the clinically latent phase. CD4+ T cells in mucosal tissues remain particularly effected.
Continuous HIV replication results in a state of generalized immune activation and inflammation persisting throughout the chronic phase. Immune activation, which is reflected by the increased activation state of immune cells and release of pro-inflammatory cytokines, results from the activity of several HIV gene products and the immune response to ongoing HIV replication. Another cause is the breakdown of the immune surveillance system of the mucosal barrier caused by the depletion of mucosal CD4+ T cells during the acute phase of disease.
Diagnosis
HIV and AIDS are diagnosed via laboratory testing and than clinically staged based on the presence of certain signs or symptoms. "HIV testing should be offered to all patients at high risk for HIV infection and all persons newly diagnosed with a sexually transmitted disease". In many areas of the world a third of people only discover they have HIV when the disease is already advanced. In developing countries, the World Health Organization's staging system is primarily used while in developed countries the U.S. Center for Disease Control and Prevention's classification system is more frequently used.
HIV Test
Most people infected with HIV develop antibodies (seroconvert) within three to twelve weeks of the initial infection. Diagnosis of primary HIV before seroconversion is done by measuring HIV-RNA or p24 antigen. Positive results obtained by antibody or PCR testing are confirmed by either a second different antibody or PCR test.
Antibody tests in those younger than 18 months are typically inaccurate due to the continued presence of maternal antibodies. Thus HIV infection can only be diagnosed by PCR testing for HIV RNA or DNA or via testing for the p24 antigen. Much of the world lacks access to reliable PCR testing and many places simply wait until either symptoms develop or the child is old enough for accurate antibody testing. sub-Saharan Africa remains the area most heavily affected by the HIV epidemic. Out of the total number of people living with HIV worldwide in 2009, 34% resided in 10 countries of Southern Africa. UNAIDS 2010 Global Report: HIV Fact sheet - sub-Saharan Africa.
World Health Organization (WHO)
The World Health Organization first proposed a definition for AIDS in 1986 (Background, p. 6). A number of updates and expansions have taken place between then and the most recent revision in 2007.
Primary HIV infection: May be either asymptomatic or associated with acute retroviral syndrome.
Stage I: HIV infection is asymptomatic with a CD4+ T cell count of greater than 500/uL. May include generalized lymph node enlargement.
Stage II: Mild symptoms which may include minor mucocutaneous manifestations and recurrent upper respiratory tract infections. A CD4+ T cell count of less than 500/uL.
Stage III: Advanced symptoms which may include unexplained chronic diarrhea for longer than a month, severe bacterial infections including tuberculosis of the lung as well as a CD4+ T cell count of less than 350/uL.
Stage IV or AIDS: severe symptoms which includes toxoplasmosis of the brain, candidiasis of the esophagus, trachea, bronchi or lungs and Kaposi's sarcoma. A CD4+ T cell count of less than 200/uL.
Center for Disease Control: CDC classification system for HIV infection
The United States Center for Disease Control and Prevention revised their classification system for HIV/AIDS in 2007. In this system HIV infections are classified based on CD4+ T cell count and clinical symptoms.
Stage 1: CD4+ T cell count ≥ 500 cells/uL and no AIDS defining conditions
Stage 2: CD4+ T cell count 200 to 500 cells/uL and no AIDS defining conditions
Stage 3: CD4+ T cell count ≤ 200 cells/uL or AIDS defining conditions
Unknown: if insufficient information is known to make one of the above classifications
The AIDS diagnosis still stands even if, after treatment, the CD4+ T cell count rises to above 200 per µL of blood or other AIDS-defining illnesses are cured.
Prevention of HIV and AIDS
Sexual Contact
Consistent condom use reduces the risk of HIV transmission by approximately 80% over the long-term. Where one partner of a couple is infected, consistent condom use results in rates of HIV infection for the uninfected person of below 1% per year. Some data supports the equivalence of female condoms to latex condoms however the evidence is not definitive. The use of the spermicide nonoxynol-9 may increase the risk of transmission due to the fact that it causes vaginal and rectal irritation. A vaginal gel containing Truvada® (Emtricitabine®/Tenofovir Disoproxil Fumarate®), a reverse transcriptase inhibitor, when used immediately before sex, reduce infection rates by approximately 40% among African women.
In sub-Saharan African heterosexual men, "there is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months". Based on these studies, the World Health Organization (WHO) and UNAIDS both recommended male circumcision as a method of preventing female-to-male HIV transmission in 2007. "Male circumcision (MC) can prevent female-to-male HIV transmission and has the potential to significantly alter HIV epidemics", and among men who have sex with men is undetermined. Some experts fear that a lower perception of vulnerability among circumcised men may result in more sexual risk-taking behavior, thus negating its preventive effects. Women who have undergone female genital mutilation have an increased risk of HIV.
Programs encouraging sexual abstinence do not appear to effect subsequent HIV risk. Evidence for a benefit from peer education is equally poor. Comprehensive sexual education provided at school may decrease high risk behavior. A substantial minority of adolescents continue to engage in high-risk practices despite HIV/AIDS knowledge, underestimating their own risk of becoming infected with HIV. It is not known if treating other sexually transmitted infections is effective in preventing HIV.
Pre-exposure
Early treatment of HIV-infected people with oral antiretroviral medicines protected 96% of partners from infection. Pre-exposure prophylaxis with a daily dose of the medications Truvada® (Emtricitabine®/Tenofovir Disoproxil Fumarate®) is effective in a number of groups including: men who have sex with men, couples where one is HIV positive, and young heterosexuals in Africa.
Universal precautions within health-care settings are believed to be effective in decreasing the risk of HIV transmissions. Intravenous drug use is an important risk factor and harm reduction strategies such as needle-exchange programs and opioid substitution therapy appear effective in decreasing this risk.
Post-exposure
A course of antiretrovirals administered within 48 to 72 hours after exposure to HIV positive blood or genital secretions is referred to as post-exposure prophylaxis. The use of the single agent Combivir® (Lamivudine®; Zidovudine®) reduces the risk of subsequent HIV infection fivefold following a needle stick injury. Treatment is recommended after sexual assault when the perpetrators is known to be HIV positive but is controversial when their HIV status is unknown. Current treatment regimes typical use Kaletra® (Lopinavir®/Ritonavir®) and Combivir® (Lamivudine®/Zidovudine®) or Truvada® (Emtricitabine®/Tenofovir Disoproxil Fumarate®) and may decrease the risk further. The duration of treatment is usually four weeks and is associated with significant rates of adverse effects (for Combivir® ~70% including: nausea 24%, fatigue 22%, emotional distress 13%, headaches 9%).
Mother-to-child
Programs to prevent the transmission of HIV from mother-to-child can reduce rates of transmission by 92–99%. This primarily involves the use of a combination of antivirals during pregnancy and after birth in the infant but also potentially include bottle feeding rather than breastfeeding. If replacement feeding is acceptable, feasible, affordable, sustainable and safe mothers should avoid breastfeeding their infants however exclusive breastfeeding is recommended during the first months of life if this is not the case. If exclusive breastfeeding is carried out the provision of extended antiretroviral prophylaxis to the infant decreases the risk of transmission.
Vaccination
As of 2012 there is currently no cure or effective vaccine for HIV or AIDS. "In 2009, results from a trial in Thailand—RV144—showed a 31.2% vaccine efficacy in preventing HIV infections". This HIV vaccine clinical trial has stimulated optimism in the research community regarding developing a truly effective vaccine. Further trials of the vaccine are ongoing.
Management of HIV and AIDS
As per the World Health Organization's 2010 revision of "Antiretroviral therapy for HIV infection in adults and adolescents" treatment consists of highly active antiretroviral therapy (HAART) which slows progression of the disease, and as of 2010 more than 6.6 million people were taking ART in low and middle income countries. Treatment also includes preventative and active treatment of opportunistic infections.
Antiretroviral Therapy
Current highly active antiretroviral therapy (HAART) options are combinations or "cocktails" consisting of at least three medications belonging to at least two types, or "classes," of antiretroviral agents. Initially treatment is typically, a non-nucleoside reverse transcriptase inhibitor (NNRTI) plus two nucleoside analogue reverse transcriptase inhibitors (NRTIs). Typical NRTIs include: zidovudine (AZT) or tenofovir (TDF) and lamivudine (3TC) or emtricitabine (FTC). Combinations of agents which include a protease inhibitors (PI) are used if the above regime loses effectiveness.
When to start antiretroviral therapy is subject to debate. Both the World Health Organization (WHO), European guidelines, and the United States recommends antiretrovirals in all adolescents, adults, and pregnant women with a CD4+ T cell count less than 350/uL or those with symptoms regardless of CD4+ T cell count. This is supported by the fact that beginning treatment at this level reduces the risk of death. The United States in addition recommends them for all HIV infected people regardless of CD4+ T cell count or symptoms, however makes this recommendation with less confidence for those with higher counts. While the WHO also recommends treatment in those who are co-infected with tuberculosis and those with chronic active hepatitis B. Once treatment is begun it is recommended that it is continued without breaks or "holidays". Many people are diagnosed only after when treatment ideally should have begun.
The desired outcome of treatment is a long term plasma HIV-RNA count below 50 copies/mL. Levels to determine if treatment is effective are initially recommended after four weeks and once levels fall below 50 copies/mL checks every three to six months are typically adequate. Inadequate control is deemed to be greater than 400 copies/mL. Based on these criteria treatment is effective in more than 95% of people during the first year.
Benefits of treatment include a decreased risk of progression to AIDS and a decreased risk of death. In developing countries treatment also improves physical and mental health. With treatment there is a 70% reduced risk of acquiring tuberculosis. Additional benefits include a decreased risk of transmission of the disease to sexual partners and a decrease in mother to child transmission.
The effectiveness of treatment depends to a large part on adherence. Reasons for non-adherence include: poor access to medical care, inadequate social supports, mental illness and drug abuse. As well the complexity of treatment regimens (due to pill numbers and dosing frequency) and adverse effects may create intentional non-adherence. Adherence is however just as good in low income as high income countries.
"All antiretroviral drugs can have both short-term and long-term adverse events. The risk of specific side effects varies from drug to drug, from drug class to drug class, and from patient to patient". Some relatively common side effects include: lipodystrophy syndrome, dyslipidemia, and diabetes mellitus especially with protease inhibitors. Other common symptoms include: diarrhea, and an increased risk of cardiovascular disease. Adverse events are however less with some of the newer recommended treatments. Cost may be an issue with some medications being expensive, however as of 2010, 47% of those who needed them were taking them in low and middle income countries. Certain ART medications may be associated with birth defects and thus not suitable for those women who are pregnant or those women who are planning on becoming pregnant.
In children, treatment recommendations vary somewhat from adults. In developing countries, as of 2010, 23% of children who were in need of treatment had access. Both the World Health Organization (WHO) and the United States recommends treatment in all children less than twelve months of age. The United States recommends in those between one year and five years of age treatment in those with HIV RNA counts of greater than 100,000 copies/mL, and in those more than five years treatments when CD4 counts are less than 500/ul.
Opportunistic Infections
Measures to prevent opportunistic infections, such as Pneumocystis Pneumonia (PCP), are effective in many people with HIV and AIDS. Treatment with antiviral medicines often improves current, as well as decreases the risk of future, opportunistic infections. Vaccination against hepatitis A and B is advised for all people at risk of HIV before they become infected however may also be given after infection. Trimethoprim/sulfamethoxazole (TMP/SMX) prophylaxis between four to six weeks of age and finishing breastfeeding in infant born to HIV positive mothers is recommended in resource limited settings. It is also recommended to prevent PCP when peoples CD4+ count is below 200 cells/uL and in those who have or have previously had PCP. People with substantial immunosuppression are also advised to receive prophylactic therapy for Toxoplasmosis (Toxoplasma infection) and Cryptococcus meningitis. As per the Centers for Disease Control and Prevention, "worldwide, approximately 1 million new cases of cryptococcal meningitis occur each year, resulting in 625,000 deaths. Most cases are opportunistic infections that occur among people with HIV/AIDS", and "In the United States it is estimated that 22.5% of the population 12 years and older have been infected with Toxoplasma. In various places throughout the world, it has been shown that up to 95% of some populations have been infected with Toxoplasma".
Complementary and Alternative Medicine (CAM) Therapy
In the US, approximately 60% of people with HIV use various forms of complementary or alternative medicine (CAM). However, "data are insufficient for demonstrating effectiveness" for most of these therapies. With respect to dietary advice and AIDS some evidence has shown a benefit from micronutrient supplementation. Evidence for supplementation with selenium as a adjunct therapy is mixed with some tentative evidence of benefit. There is some evidence that vitamin A supplementation in children reduces mortality and improves growth. In Africa in nutritionally compromised pregnant and lactating women a multivitamin supplementation improved outcomes for both mothers and children. Dietary intake of micronutrients at RDA levels by HIV-infected adults is recommended by the World Health Organization (WHO). WHO further states that several studies indicate that supplementation of vitamin A, zinc, and iron can produce adverse effects in HIV positive adults. "There is insufficient evidence to support the use of herbal medicines in HIV-infected individuals and AIDS patients".
World Health Organization (2003: Geneva, Switzerland) - Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation.
Prognosis
HIV and AIDS has become a chronic rather than an acutely fatal disease in many areas of the world. Prognosis varies between people and both the CD4+ count and viral load are useful for predicted outcomes. Without treatment, "Progression and mortality of untreated HIV-positive individuals living in resource-limited settings" is estimated to be 9 to 11 years, depending on the HIV subtype. After the diagnosis of AIDS, if treatment is not available, survival ranges between 6 and 19 months. HAART and appropriate prevention of opportunistic infections reduces the death rate by 80%, and raises the life expectancy for a newly diagnosed young adult to 20–50 years. This is between two thirds and nearly that of the general population. If treatment is started late in the infection prognosis is not as good, for example if treatment is begun following the diagnosis of AIDS life expectancy is ~10–40 years. Half of infants born with HIV die before two years of age without treatment.
- Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies
- HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries?
- Global HIV/AIDS Response: Epidemic update and health sector progress towards universal access - Progress Report 2011.
The primarily causes of death from HIV and AIDS is opportunistic infections and cancer both of which are frequently the result of the progressive failure of the immune system. Risk of cancer appears to increase once the CD4+ count get below 500/uL. The rate of clinical disease progression varies widely between individuals and has been shown to be affected by a number of factors such as a persons susceptibility and immune function, access to health care, and co-infections, as well as which particular strain of the virus is involved.
Tuberculosis co-infection is one of the leading causes of sickness and death in those with HIV and AIDS being present in a third of all HIV infected people and resulting in 25% of HIV related deaths. HIV is also the most important risk factors for tuberculosis. Hepatitis C is another very common co-infection where each disease increases the progression of the other.
World Health Organization (WHO) Report 2011 | Global Tuberculosis Control - Executive summary: sixteenth global report on tuberculosis (TB)
The two most common cancers associated with HIV/AIDS are Kaposi's sarcoma and AIDS-related non-Hodgkin's lymphoma. Life expectancy has fallen in the worst-affected countries due to HIV and AIDS; for example, in 2006 it was estimated that it had dropped from 65 to 35 years in Botswana.
Even with antiretroviral treatment, over the long term HIV-infected people may experience neurocognitive disorders, osteopenia and osteoporosis, peripheral neuropathy, cancers, nephropathy, and cardiovascular disease. It is not clear whether these conditions result from the HIV infection itself or are adverse effects of treatment.
Epidemiology of HIV and AIDS
HIV infections are considered pandemic by the World Health Organization (WHO). As of 2010 approximately 34 million people have HIV globally. Of these approximately 16.8 million are women and 3.4 million are less than 15 years old. It results in about 1.8 million death in 2010 down from 3.1 million in 2001.
Sub-Saharan Africa is the region most affected. In 2010, an estimated 68% (22.9 million) of all HIV cases and 66% of all deaths (1.2 million) occurred in this region. This means that about 5% of the adult population is infected and it is believed to be the cause of 10% of all deaths in children. Here in contrast to other regions women compose nearly 60% of cases. South Africa has the largest population of people with HIV of any country in the world at 5.9 million.
South and South East Asia is the second most affected; in 2010 this region contained an estimated 4 million cases or 12% of all people living with HIV resulting in approximately 250,000 deaths. Approximately 2.4 million of these cases are in India. Prevalence is lowest in Western and Central Europe at 0.2% and East Asia at 0.1%.
In 2008 in the United States approximately 1.2 million people were living with HIV, resulting in about 17,500 deaths. The Center for Disease Control and Prevention estimated that in 2008 20% of infected Americans were unaware of their infection. In 2009, "The number of people living with HIV in the UK reached an estimated 86,500. A quarter of these people were unaware of their infection". "It was estimated that at the end of 2008, there were approximately 65,000 (54,000 to 76,000) people living with HIV (including AIDS) in Canada, of whom 26% were unaware of their infection".
History of HIV and AIDS
Discovery
AIDS was first clinically observed in 1981 in the United States. The initial cases were a cluster of injection drug users and homosexual males with no known cause of impaired immunity showed symptoms of Pneumocystis pneumonia (PCP), a rare opportunistic infection that was known to occur in people with very compromised immune systems. Soon thereafter, additional homosexual males developed a previously rare skin cancer called Kaposi's sarcoma (KS). Many more cases of PCP and KS emerged, alerting the U.S. Centers for Disease Control and Prevention (CDC) and a CDC task force was formed to monitor the outbreak.
In the beginning, the CDC did not have an official name for the disease, often referring to it by way of the diseases that were associated with it, for example, persistent, generalized lymphadenopathy, the disease after which the discoverers of HIV originally named the virus. They also used Kaposi's Sarcoma and opportunistic infections, the name by which a task force had been set up in 1981. In the general press, the term GRID, which stood for gay-related immune deficiency, had been coined. "The CDC, in search of a name, and looking at the infected communities coined “the 4H disease,” as it seemed to single out Haitians, homosexuals, hemophiliacs, and heroin users". However, after determining that AIDS was not isolated specifically to the gay community, it was realized that the term GRID was misleading and AIDS was introduced at a meeting in July 1982. By September 1982 the CDC started using the name AIDS.
 |
| Robert Gallo, co-discoverer of the HIV virus, in the early eighties among (from left to right) Sandra Eva, Sandra Colombini, and Ersell Richardson.Date: circa Early 1980's. This image is a work of the National Institutes of Health, part of the United States Department of Health and Human Services. As a work of the U.S. federal government, the image is in the public domain. |
In 1983, two separate research groups led by Robert Gallo and Luc Montagnier independently declared that a novel retrovirus may have been infecting AIDS patients, and published their findings in the same issue of the journal Science. Gallo claimed that a virus his group had isolated from an AIDS patient was strikingly similar in shape to other human T-lymphotropic viruses (HTLVs) his group had been the first to isolate. Gallo's group called their newly isolated virus HTLV-III. At the same time, Montagnier's group isolated a virus from a patient presenting with swelling of the lymph nodes of the neck and physical weakness, two classic symptoms of AIDS. Contradicting the report from Gallo's group, Montagnier and his colleagues showed that core proteins of this virus were immunologically different from those of HTLV-I. Montagnier's group named their isolated virus lymphadenopathy-associated virus (LAV). HIV was chosen as a compromise between the two claims (LAV and HTLV-III).
Origins
Known as zoonotic diseases (NZDs), both HIV-1 and HIV-2 are believed to have originated in non-human primates in West-central Africa and were transferred to humans in the early 20th century. HIV-1 appears to have originated in southeastern and south central Cameroon through the evolution of SIV(cpz), a simian immunodeficiency virus (SIV) that infects wild chimpanzee (HIV-1 descends from the SIVcpz endemic in the common chimpanzee species and subspecies Pan troglodytes ssp. troglodytes). The closest relative of HIV-2 is SIV(smm), a virus of the Sooty mangabey (Cercocebus atys ssp. atys), an Old World monkey living in litoral West Africa (from southern Senegal to western Ivory Coast). New World monkeys such as the owl monkey are resistant to HIV-1 infection, possibly because of a genomic fusion of two viral resistance genes. HIV-1 is thought to have jumped the species barrier on at least three separate occasions, giving rise to the three groups of the virus, pandemic (group M) and nonpandemic (group N). "The source of HIV-1 group O remains unknown but will probably yield to further study of wild ape populations not yet sampled".
There is evidence that humans who participate in bushmeat activities, either as hunters or as bushmeat vendors are subject to a higher potential for infection with simian immunodeficeincy virus (SIV). However, SIV is a weak virus, it is typically suppressed by the human immune system within weeks of infection. It is thought that several transmissions of the virus from individual to individual in quick succession are necessary to allow it enough time to mutate into HIV. Furthermore, due to its relatively low person-to-person transmission rate, it can only spread throughout the population in the presence of one or more of high-risk transmission channels, which are thought to have been absent in Africa prior to the 20th century.
Specific proposed high-risk transmission channels, allowing the virus to adapt to humans and spread throughout the society, depend on the proposed timing of the animal-to-human crossing. Genetic studies of the virus suggest that the most recent common ancestor of the HIV-1 (group M) dates back to circa 1910. Proponents of this dating link the HIV epidemic with the emergence of colonialism and growth of large colonial African cities, leading to social changes, including a higher degree of sexual promiscuity, the spread of prostitution, and the accompanying high frequency of genital ulcer diseases (such as syphilis) in nascent colonial cities. While transmission rates of HIV during vaginal intercourse, are low under regular circumstances, they are increased many fold if one of the partners suffers from an sexually transmitted infection resulting in genital ulcers. Early 1900s colonial cities were notable due to their high prevalence of prostitution and genital ulcers, to the degree that, as of 1928, as many as 45% of female residents of eastern Kinshasa were thought to have been prostitutes, and, as of 1933, around 15% of all residents of the same city were infected by one of the forms of syphilis.
An alternative view holds that unsafe medical practices in Africa during years following World War II, such as unsterile reuse of single use syringes during mass vaccination, antibiotic and anti-malaria treatment campaigns, were the initial vector that allowed the virus to adapt to humans and spread.
The origins of acquired immune deficiency syndrome viruses: where and when?
The earliest well documented case of HIV in a human dates back to 1959 in the Congo. The virus may have been present in the United States as early as 1966, but the vast majority of infections occurring outside sub-Saharan Africa (including the U.S.) can be traced back to a single unknown individual who got infected with HIV in Haiti and then brought the infection to the United States some time around 1969. The epidemic then rapidly spread among high-risk groups (initially, sexually promiscuous men who have sex with men). By 1978, the prevalence of HIV-1 among gay male residents of New York and San Francisco was estimated at 5%, suggesting that several thousand individuals in the country had been infected.
Between the first recognition of AIDS in 1981 and 2009 it has led to nearly 30 million deaths.
Society and Culture
Stigma: Discrimination against people with HIV and AIDS
AIDS stigma and sexual prejudice exists around the world in a variety of ways, including ostracism, rejection, discrimination, and avoidance of HIV infected people; compulsory HIV testing without prior consent or protection of confidentiality; violence against HIV infected individuals or people who are perceived to be infected with HIV; and the quarantine of HIV infected individuals. Stigma-related violence or the fear of violence prevents many people from seeking HIV testing, returning for their results, or securing treatment, possibly turning what could be a manageable chronic illness into a death sentence and perpetuating the spread of HIV.
AIDS stigma has been further divided into the following three categories:
- Instrumental AIDS stigma—a reflection of the fear and apprehension that are likely to be associated with any deadly and transmissible illness.
- Symbolic AIDS stigma—the use of HIV/AIDS to express attitudes toward the social groups or lifestyles perceived to be associated with the disease.
- Courtesy AIDS stigma—stigmatization of people connected to the issue of HIV/AIDS or HIV- positive people.
In many developed countries, there is an association between AIDS and homosexuality or bisexuality, and this association is correlated with higher levels of sexual prejudice such as anti-homosexual/bisexual attitudes. There is also a perceived association between AIDS and all male-male sexual behavior, including sex between uninfected men.
Economic Impact of HIV and AIDS and Cost of HIV Treatment
HIV/AIDS affects the economics of both individuals and countries. The gross domestic product of the most effected countries have decreased due to the lack of human capital. Without proper nutrition, health care and medicine, large numbers of people die from AIDS-related complications. They will not only be unable to work, but will also require significant medical care.
The Impact of Aids - a report prepared by the United Nations Department of Economic and Social Affairs, Population Division
By affecting mainly young adults, AIDS reduces the taxable population, in turn reducing the resources available for public expenditures such as education and health services not related to AIDS resulting in increasing pressure for the state's finances and slower growth of the economy. This results in a slower growth of the tax base, an effect that is reinforced if there are growing expenditures on treating the sick, training (to replace sick workers), sick pay and caring for AIDS orphans. This is especially true if the sharp increase in adult mortality shifts the responsibility and blame from the family to the government in caring for these orphans.
On the level of the household, AIDS results in both loss of income and increased spending on healthcare. This leaves less income to spend education.
Religion and HIV and AIDS
The topic of religion and HIV and AIDS has become highly controversial in the past twenty years, primarily because many prominent religious leaders have publicly declared their opposition to the use of condoms. The religious approach to prevent the spread of AIDS according to a report by Matthew Hanley titled The Catholic Church & the Global Aids Crisis argues that cultural changes are needed including a re-emphasis on fidelity within marriage and sexual abstinence outside of it.
In addition to prevention, some religious groups have interrupted the treatment of HIV and AIDS. According to the African Health Policy Network, some churches in London claim that prayer will cure HIV and the Homerton University Hospital: CSSHH (Centre for the Study of Sexual Health and HIV) reports that several people have stopped taking their medication, sometimes on the direct advice of their pastor, leading to a number of deaths. The Synagogue Church Of All Nations (SCOAN) advertise "anointing water" to promote God's healing, although the group deny advising people to stop taking medication.
Media Portrayal of HIV and AIDS
The media in different places at different times has portrayed HIV and AIDS in different ways. A trend in societal awareness of HIV and AIDS is that the media everywhere has tended to be shy about presenting it initially and that key events or people tend to cause widespread discussion about the disease in various populations.
One of the first high profile cases of AIDS was Rock Hudson, a gay American actor who had been married and divorced earlier in life, who died on 2 October 1985 having announced that he was suffering from the virus on 25 July that year. It had been diagnosed during 1984. A notable British casualty of AIDS that year was Nicholas Eden, a gay Member of Parliament and son of the late prime minister [Robert] Anthony Eden. The virus claimed perhaps its most famous person yet on November 24, 1991, when British rock star Freddie Mercury, lead singer of the band Queen, died from an AIDS-related bronchial pneumonia having only announced that he was suffering from the illness the previous day. However he had been diagnosed as HIV positive during 1987. One of the first high profile heterosexual cases of the virus was Arthur Ashe, the American tennis player. He was diagnosed as HIV positive on 31 August 1988, having contracted the virus from blood transfusions during heart surgery earlier in the 1980s. Further tests within 24 hours of the initial diagnosis revealed that Ashe had AIDS, but he did not tell the public about his diagnosis until April 1992. He died, aged 49, as a result on 6 February 1993.
Denial, Conspiracies and Misconceptions about HIV and AIDS
A small group of individuals continue to dispute the connection between HIV and AIDS, the existence of HIV itself, or the validity of HIV testing and treatment methods. These claims, known as AIDS denialism, have been examined and rejected by the scientific community. However, they have had a significant political impact, particularly in South Africa, where the government's official embrace of AIDS denialism was responsible for its ineffective response to that country's AIDS epidemic, and has been blamed for hundreds of thousands of avoidable deaths and HIV infections.
- Blattner and Colleagues Respond to Duesberg: HIV is Not the Cause of AIDS.
- The Duesberg Phenomenon: A Berkeley virologist and his supporters continue to argue that HIV is not the cause of AIDS. A 3-month investigation by Science evaluates their claims.
- Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy.
- HIV Denial in the Internet Era.
Operation INFEKTION was a worldwide Soviet campaign to "implicate the United States in the emergence of the AIDS pandemic that appeared in the early 1980s". Surveys show that a significant number of people believed – and continue to believe – in such claims.
"A number of misconceptions have arisen surrounding HIV/AIDS". Three of the most common are that AIDS can spread through casual contact, that sexual intercourse with a virgin will cure AIDS, and that HIV can infect only homosexual men and drug users. Other misconceptions are that any act of anal intercourse between two uninfected gay men can lead to HIV infection, and that open discussion of homosexuality and HIV in schools will lead to increased rates of homosexuality and AIDS.
Research
Research to improve current treatments includes decreasing side effects of current drugs, further simplifying drug regimens to improve adherence, and determining the best sequence of regimens to manage drug resistance. However, only a vaccine is thought to be able to halt the pandemic. This is because a vaccine would cost less, thus being affordable for developing countries, and would not require daily treatment. However, after over 20 years of research, HIV-1 remains a difficult target for a vaccine.
Stem cell Transplantation
In 2007, Timothy Ray Brown, a 40-year-old HIV-positive American man living in Berlin, Germany, was given a stem cell transplant by Dr. Gero Hütter as part of his treatment for acute myeloid leukemia (AML). A second transplant was made a year later after a relapse. The donor was chosen not only for genetic compatibility but also for being homozygous for a CCR5-Δ32 mutation that confers resistance to HIV infection. After 20 months without antiretroviral drug treatment, it was reported that HIV levels in Brown's blood, bone marrow, and bowel were below the limit of detection. The virus remained undetectable over three years after the first transplant. Although the researchers and some commentators have characterized this result as a cure, others suggest that the virus may remain hidden in tissues such as the brain (a viral reservoir). Stem cell therapies/treatments remain investigational because of its anecdotal nature, the disease and mortality risk associated with stem cell transplants, and the difficulty of finding suitable donors.
Immunomodulatory Agents
Complementing efforts to control viral replication, immunotherapies that may assist in the recovery of the immune system have been explored in past and ongoing trials, including IL-2 and IL-7.
"Path to an Effective HIV Vaccine". Creating an effective HIV vaccine is a task of the utmost importance that facing many obstacles based on the complex nature of the virus. Research emerging from the University of Texas Medical School led by Dr. Sudhir Paul.
The failure of vaccine candidates to protect against HIV infection and progression to AIDS has led to a renewed focus on the biological mechanisms responsible for HIV latency. A limited period of therapy combining antiretrovirals with drugs targeting the latent reservoir may one day allow for total eradication of HIV infection. Researchers have discovered an abzyme that can destroy the protein gp120 CD4 binding site. This protein is common to all HIV variants as it is the attachment point for B lymphocytes and subsequent compromising of the immune system.
External Links
HIV/AIDS: Understanding HIV/AIDS - National Institute of Allergy and Infectious Diseases.
HIV/AIDS - Mayo Foundation for Medical Education and Research.
HIV/AIDS Basics - Centers for Disease Control and Prevention.
HIV/AIDS Fact Sheets - Centers for Disease Control and Prevention.
Questions and Answers on HIV and AIDS - Centers for Disease Control and Prevention.
Diagnosis/Symptoms
Frequently Asked Questions about HIV and HIV Testing - Centers for Disease Control and Prevention.
HIV Antibody Test - American Association for Clinical Chemistry.
HIV Testing - Mayo Foundation for Medical Education and Research.
HIV/AIDS Policy Fact Sheet: AIDS Testing in the United States - Henry J. Kaiser Family Foundation.
HIV/AIDS - Signs and Symptoms - Healthy Roads Media.
HIV/AIDS Basics - Testing for HIV/AIDS - Healthy Roads Media.
p24 Antigen Test - American Association for Clinical Chemistry.
Vaccines, Blood & Biologics: Testing for HIV - U.S. Food and Drug Administration.
Treatment
HIV/AIDS - Treatment - Healthy Roads Media.
AIDS Vaccines - New Mexico AIDS Education and Training Center.
Prevention/Screening
Condoms - Mayo Foundation for Medical Education and Research.
Get Tested for HIV: The Basics - Office of Disease Prevention and Health Promotion.
HIV and AIDS: Are You at Risk? - Centers for Disease Control and Prevention.
HIV Transmission Risk - Centers for Disease Control and Prevention.
HIV Transmission - Centers for Disease Control and Prevention.
HIV/AIDS - Prevention - Healthy Roads Media.
Pre-Exposure Prophylaxis (PrEP) - Centers for Disease Control and Prevention.
Safer Sex Guidelines - New Mexico AIDS Education and Training Center.
Treatment After Exposure to HIV - New Mexico AIDS Education and Training Center.
Complementary and Alternative Medicine (CAM) Therapy
Alternative and Complementary Therapies - New Mexico AIDS Education and Training Center.
Disease Management
CD4 and CD8 - American Association for Clinical Chemistry.
HIV Resistance Testing - New Mexico AIDS Education and Training Center.
HIV Viral Load - American Association for Clinical Chemistry.
HIV/AIDS - CD4 Count - Healthy Roads Media.
Specific Conditions
Acute HIV Infection - New Mexico AIDS Education and Training Center.
Pictures/Photographs
Human Immunodeficiency Virus (HIV) Primary Infection - Logical Images.
Videos
Drugs + HIV > Learn the Link - National Institute on Drug Abuse.
HIV/AIDS - CD4 Count - Healthy Roads Media.
HIV/AIDS Basics - How You Get HIV/AIDS - Healthy Roads Media.
HIV/AIDS Basics - Prevention of HIV/AIDS - Healthy Roads Media.
HIV/AIDS - Signs and Symptoms - Healthy Roads Media.
HIV/AIDS Basics - Testing for HIV/AIDS - Healthy Roads Media.
HIV/AIDS - Treatment - Healthy Roads Media.
HIV/AIDS - Substance Abuse - Healthy Roads Media.
A Need to Know: The Importance of HIV Testing and Treatment - Centers for Disease Control and Prevention.
Anatomy/Physiology
The HIV Life Cycle - AIDSinfo.
Clinical Trials
Acquired Immunodeficiency Syndrome, HIV Infections, HIV Infections and Vaccines, HIV Infections and Women, HIV/AIDS Infections and Men, HIV Infections and Heterosexual Men - National Institutes of Health.
HIV/AIDS Network Clinical Trials Units (CTU) and Clinical Research Sites (CRS) - National Institute of Allergy and Infectious Diseases.
Participating in a Clinical Trial - New Mexico AIDS Education and Training Center.
What Is an AIDS Clinical Trial? - AIDSinfo.
Research
NIAID's HIV/AIDS Research Program - Department of Health and Human Services, National Institute of Allergy and Infectious Diseases.
amfAR :: The Foundation for AIDS Research.
Answers about HIV Vaccine Research - National Institute of Allergy and Infectious Diseases.
HIV-Infected Astrocytes Disrupt Blood-Brain Barrier, Contribute to Cognitive Impairment - National Institute of Mental Health.
How HIV Causes AIDS - National Institute of Allergy and Infectious Diseases.
Microbicides - New Mexico AIDS Education and Training Center.
Dictionaries/Glossaries
AIDSinfo Glossary - AIDSinfo.
HIV Vaccine Glossary - National Institute of Allergy and Infectious Diseases.
Directories
National HIV and STD Testing Resources - Centers for Disease Control and Prevention.
HIV/AIDS Information: Specialized Information Services - National Library of Medicine.
Organizations
AIDS.gov.
AIDSinfo - Dept. of Health and Human Services.
HIV/AIDS- Centers for Disease Control and Prevention.
Division of Acquired Immunodeficiency Syndrome (DAIDS) - National Institute of Allergy and Infectious Diseases.
Statistics
HIV/AIDS Basic Statistics and Surveillance - Centers for Disease Control and Prevention.
Key Facts on Global HIV Epidemic and Progress in 2010 - World Health Organization (WHO).
NCHHSTP Atlas - Centers for Disease Control and Prevention.
State Profiles: HIV/AIDS, Viral Hepatitis, STD, and TB Prevention - Centers for Disease Control and Prevention.
NCHHSTP National Profile - Centers for Disease Control and Prevention.
Children
Children and HIV - New Mexico AIDS Education and Training Center.
HIV and AIDS - Nemours Foundation.
Teenagers
Drugs + HIV > Learn the Link - National Institute on Drug Abuse.
HIV and AIDS - Nemours Foundation.
How Do People Get AIDS? - Nemours Foundation.
Men
HIV among Gay and Bisexual Men - Centers for Disease Control and Prevention.
Women
HIV and Women FAQs - American College of Obstetricians and Gynecologists.
HIV/AIDS - Dept. of Health and Human Services, Office on Women's Health.
HIV Infection in Women - National Institute of Allergy and Infectious Diseases.
Women and HIV - Food and Drug Administration.
HIV/AIDS among Women Who Have Sex with Women - Centers for Disease Control and Prevention.
Pregnancy
HIV and Pregnancy - AIDSinfo.
AIDS/HIV - Eunice Kennedy Shriver, National Institute of Child Health and Human Development.
HIV and Pregnancy - American College of Obstetricians and Gynecologists.
Anti-HIV Medications for Use in Pregnancy - AIDSinfo.
Safety of Anti-HIV Medications during Pregnancy - AIDSinfo.
One Test. Two Lives. HIV Testing during Pregnancy - Centers for Disease Control and Prevention.
Women Infected with HIV and Their Babies After Birth - AIDSinfo.
Mother-to-Child (Perinatal) HIV Transmission and Prevention - Centers for Disease Control and Prevention.
Pregnancy and Childbirth - Centers for Disease Control and Prevention.
Seniors
HIV, AIDS, and Older People - National Institute on Aging.
Older People and HIV - New Mexico AIDS Education and Training Center.
Articles
Scientists see AIDS vaccine within reach after decades (July, 15 2012) - Reuters.
Clue to Why Human Body Can't Fight HIV Discovered (July 12, 2012) - MyHealthNewsDaily Staff | LiveScience.com.
References
"HIV/AIDS Today". http://www.cdcnpin.org/scripts/hiv/hiv.asp. Centers for Disease Control and Prevention, National Prevention Information Network (CDCNPIN.org). Retrieved 3 August 2012.
"Health Topics: HIV/AIDS". http://www.who.int/topics/hiv_aids/en/. World Health organization (WHO). Retrieved 3 August 2012.
"2012 Progress Reports Submitted by Countries." http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/. UNAIDS. Retrieved 3 August 2012.
"Statistics Worldwide." http://www.amfar.org/About_HIV_and_AIDS/Facts_and_Stats/Statistics__Worldwide/. amfAR, The Foundation for AIDS Research. Retrieved 3 August 2012.
Thompson MA, Aberg JA, Hoy JF, et al. Antiretroviral Treatment of Adult HIV Infection: 2012 Recommendations of the International Antiviral Society–USA Panel. http://jama.jamanetwork.com/article.aspx?articleid=1221704. JAMA. 2012;308(4):387-402. doi:10.1001/jama.2012.7961.
"What is HIV/AIDS? Where did HIV come from?". http://aids.gov/hiv-aids-basics/hiv-aids-101/what-is-hiv-aids/. AIDS.gov. Retrieved 3 August 2012.
"Opportunist Infections." http://www.aids.org/topics/aids-factsheets/aids-background-information/what-is-aids/hiv-testing/cd4-t-cell-tests/opportunistic-infections/. AIDS.org. Retrieved 3 August 2012.
"Guillain-Barre syndrome." http://www.mayoclinic.com/health/guillain-barre-syndrome/DS00413. Mayo Foundation for Medical Education and Research. Retrieved 3 August 2012.
Opportunistic Infections. http://www.aids.org/topics/aids-factsheets/aids-background-information/what-is-aids/hiv-testing/cd4-t-cell-tests/opportunistic-infections/. Aids.org. Retrieved 27 August 2012.
Parasites - Toxoplasmosis (Toxoplasma infection). http://www.cdc.gov/parasites/toxoplasmosis/. Centers for Disease Control and Prevention. Retrieved 27 August 2012.
Cryptococcus: Screening for Opportunistic Infection among People Living with HIV/ AIDS. http://www.cdc.gov/fungal/pdf/at-a-glance-508c.pdf. Centers for Disease Control and Prevention. Retrieved 27 August 2012.
Global HIV/AIDS Response: Epidemic update and health sector progress towards universal access - Progress Report 2011. http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20111130_UA_Report_en.pdf. UNAIDS.org., World Health Organization, Unicef. Retrieved 27 August 2012.
Sepkowitz KA (June 2001). "AIDS—the first 20 years". N. Engl. J. Med. 344 (23): 1764–72. doi:10.1056/NEJM200106073442306. PMID 11396444.
Markowitz, edited by William N. Rom ; associate editor, Steven B. (2007). Environmental and occupational medicine (4th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 745. ISBN 978-0-7817-6299-1.
"HIV and Its Transmission". Centers for Disease Control and Prevention. 2003. Archived from the original on February 4, 2005. Retrieved May 23, 2006.
Sharp, PM; Hahn, BH (2011 Sep). "Origins of HIV and the AIDS Pandemic". Cold Spring Harbor perspectives in medicine 1 (1): a006841. doi:10.1101/cshperspect.a006841. PMC 3234451. PMID 22229120.
Gallo RC (2006). "A reflection on HIV/AIDS research after 25 years". Retrovirology 3: 72. doi:10.1186/1742-4690-3-72. PMC 1629027. PMID 17054781.
"Global Report Fact Sheet". UNAIDS. 2010.
Kallings LO (2008). "The first postmodern pandemic: 25 years of HIV/AIDS". J Intern Med 263 (3): 218–43. doi:10.1111/j.1365-2796.2007.01910.x. PMID 18205765.(subscription required)
"Stages of HIV". U.S. Department of Health & Human Services. Dec 2010. Retrieved 13 June 2012.
Diseases and disorders.. Tarrytown, NY: Marshall Cavendish. 2008. p. 25. ISBN 978-0-7614-7771-6.
Vogel, M; Schwarze-Zander, C; Wasmuth, JC; Spengler, U; Sauerbruch, T; Rockstroh, JK (2010 Jul). "The treatment of patients with HIV". Deutsches Ärzteblatt international 107 (28–29): 507–15; quiz 516. doi:10.3238/arztebl.2010.0507. PMC 2915483. PMID 20703338.
Evian, Clive (2006). Primary HIV/AIDS care: a practical guide for primary health care personnel in a clinical and supportive setting (Updated 4th ed.). Houghton [South Africa]: Jacana. p. 29. ISBN 978-1-77009-198-6.
Radiology of AIDS. Berlin [u.a.]: Springer. 2001. p. 19. ISBN 978-3-540-66510-6.
Elliott, Tom (2012). Lecture Notes: Medical Microbiology and Infection. John Wiley & Sons. p. 273. ISBN 978-1-118-37226-5.
Blankson, JN (2010 Mar). "Control of HIV-1 replication in elite suppressors". Discovery medicine 9 (46): 261–6. PMID 20350494.
Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA (2003). "Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa". Clin. Infect. Dis. 36 (5): 656–662. doi:10.1086/367655. PMID 12594648.
Chu, C; Selwyn, PA (2011-02-15). "Complications of HIV infection: a systems-based approach". American family physician 83 (4): 395–406. PMID 21322514.
Mandell, Bennett, and Dolan (2010). Chapter 169.
"AIDS". MedlinePlus. A.D.A.M.. Retrieved 14 June 2012.
Sestak K (July 2005). "Chronic diarrhea and AIDS: insights into studies with non-human primates". Curr. HIV Res. 3 (3): 199–205. doi:10.2174/1570162054368084. PMID 16022653.
Smith, DK; Grohskopf, LA; Black, RJ; Auerbach, JD; Veronese, F; Struble, KA; Cheever, L; Johnson, M; Paxton, LA; Onorato, IM; Greenberg, AE; U.S. Department of Health and Human, Services (2005 Jan 21). "Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services.". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control 54 (RR-2): 1-20. PMID 15660015.
Coovadia H (2004). "Antiretroviral agents—how best to protect infants from HIV and save their mothers from AIDS". N. Engl. J. Med. 351 (3): 289–292. doi:10.1056/NEJMe048128. PMID 15247337.
Kripke, C (2007 Aug 1). "Antiretroviral prophylaxis for occupational exposure to HIV.". American family physician 76 (3): 375-6. PMID 17708137.
Dosekun, O; Fox, J (2010 Jul). "An overview of the relative risks of different sexual behaviours on HIV transmission.". Current opinion in HIV and AIDS 5 (4): 291-7. PMID 20543603.
Cunha, Burke (2012). Antibiotic Essentials 2012 (11 ed.). Jones & Bartlett Publishers. pp. 303. ISBN 9781449693831.
Boily, MC; Baggaley, RF; Wang, L; Masse, B; White, RG; Hayes, RJ; Alary, M (2009 Feb). "Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies.". The Lancet infectious diseases 9 (2): 118-29. PMID 19179227.
Baggaley, RF; White, RG; Boily, MC (2008 Dec). "Systematic review of orogenital HIV-1 transmission probabilities.". International journal of epidemiology 37 (6): 1255-65. PMID 18664564.
van der Kuyl, AC; Cornelissen, M (2007-09-24). "Identifying HIV-1 dual infections". Retrovirology 4: 67. doi:10.1186/1742-4690-4-67. PMC 2045676. PMID 17892568.
HIV in the United States: An Overview". Center for Disease Control and Prevention. March 2012.
Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, Alary M (February 2009). "Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies". The Lancet Infectious Diseases 9 (2): 118–129. doi:10.1016/S1473-3099(09)70021-0. PMID 19179227.
Beyrer, C; Baral, SD; van Griensven, F; Goodreau, SM; Chariyalertsak, S; Wirtz, AL; Brookmeyer, R (2012 Jul 28). "Global epidemiology of HIV infection in men who have sex with men.". Lancet 380 (9839): 367-77. PMID 22819660.
Yu, M; Vajdy, M (2010 Aug). "Mucosal HIV transmission and vaccination strategies through oral compared with vaginal and rectal routes". Expert opinion on biological therapy 10 (8): 1181–95. doi:10.1517/14712598.2010.496776. PMC 2904634. PMID 20624114.
Stürchler, Dieter A. (2006). Exposure a guide to sources of infections. Washington, DC: ASM Press. pp. 544. ISBN 9781555813765.
al.], edited by Richard Pattman ... [et (2010). Oxford handbook of genitourinary medicine, HIV, and sexual health (2nd ed. ed.). Oxford: Oxford University Press. pp. 95. ISBN 9780199571666.
Dosekun, O; Fox, J (2010 Jul). "An overview of the relative risks of different sexual behaviours on HIV transmission". Current opinion in HIV and AIDS 5 (4): 291–7. doi:10.1097/COH.0b013e32833a88a3. PMID 20543603.
Ng, BE; Butler, LM; Horvath, T; Rutherford, GW (2011-03-16). Butler, Lisa M. ed. "Population-based biomedical sexually transmitted infection control interventions for reducing HIV infection". Cochrane database of systematic reviews (Online) (3): CD001220. doi:10.1002/14651858.CD001220.pub3. PMID 21412869.
Anderson, J (2012 Feb). "Women and HIV: motherhood and more". Current opinion in infectious diseases 25 (1): 58–65. doi:10.1097/QCO.0b013e32834ef514. PMID 22156896.
Klimas, N; Koneru, AO; Fletcher, MA (2008 Jun). "Overview of HIV". Psychosomatic Medicine 70 (5): 523–30. doi:10.1097/PSY.0b013e31817ae69f. PMID 18541903.
Draughon, JE; Sheridan, DJ (2012). "Nonoccupational post exposure prophylaxis following sexual assault in industrialized low-HIV-prevalence countries: a review". Psychology, health & medicine 17 (2): 235–54. doi:10.1080/13548506.2011.579984. PMID 22372741.
Baggaley, RF; Boily, MC; White, RG; Alary, M (2006-04-04). "Risk of HIV-1 transmission for parenteral exposure and blood transfusion: a systematic review and meta-analysis". AIDS (London, England) 20 (6): 805–12. doi:10.1097/01.aids.0000218543.46963.6d. PMID 16549963.
"Will I Need Blood". National Health Services.
"Blood safety ... for too few". WHO. 2001. Retrieved January 17, 2006.
Reid, SR (2009-08-28). "Injection drug use, unsafe medical injections, and HIV in Africa: a systematic review". Harm reduction journal 6: 24. doi:10.1186/1477-7517-6-24. PMC 2741434. PMID 19715601.
"Basic Information about HIV and AIDS". Center for Disease Control and Prevention. April 2012.
"Why Mosquitoes Cannot Transmit AIDS [HIV virus]". Rci.rutgers.edu. Retrieved 2010-07-28.
Coutsoudis, A; Kwaan, L; Thomson, M (2010 Oct). "Prevention of vertical transmission of HIV-1 in resource-limited settings". Expert review of anti-infective therapy 8 (10): 1163–75. doi:10.1586/eri.10.94. PMID 20954881.
Thorne, C; Newell, ML (2007 Jun). "HIV". Seminars in fetal & neonatal medicine 12 (3): 174–81. doi:10.1016/j.siny.2007.01.009. PMID 17321814.
Alimonti JB, Ball TB, Fowke KR (2003). "Mechanisms of CD4+ T lymphocyte cell death in human immunodeficiency virus infection and AIDS". J. Gen. Virol. 84 (7): 1649–1661. doi:10.1099/vir.0.19110-0. PMID 12810858.International Committee on Taxonomy of Viruses (2002). "61.0.6. Lentivirus". National Institutes of Health. Archived from the original on 2006-04-18. Retrieved 2012-06-25.
International Committee on Taxonomy of Viruses (2002). "61. Retroviridae". National Institutes of Health. Archived from the original on 2006-06-29. Retrieved 2012-06-25.
Lévy, J. A. (1993). "HIV pathogenesis and long-term survival". AIDS 7 (11): 1401–10. doi:10.1097/00002030-199311000-00001. PMID 8280406.
Smith, Johanna A.; Daniel, René (Division of Infectious Diseases, Center for Human Virology, Thomas Jefferson University, Philadelphia) (2006). "Following the path of the virus: the exploitation of host DNA repair mechanisms by retroviruses". ACS Chem Biol 1 (4): 217–26. doi:10.1021/cb600131q. PMID 17163676.
MartÃnez, edited by Miguel Angel (2010). RNA interference and viruses : current innovations and future trends. Norfolk: Caister Academic Press. pp. 73. ISBN 9781904455561.
Immunology, infection, and immunity. Washington, D.C.: ASM Press. 2004. pp. 550. ISBN 9781555812461.
Gilbert, PB et al. (28 February 2003). "Comparison of HIV-1 and HIV-2 infectivity from a prospective cohort study in Senegal". Statistics in Medicine 22 (4): 573–593. doi:10.1002/sim.1342. PMID 12590415.
Reeves, J. D. and Doms, R. W (2002). "Human Immunodeficiency Virus Type 2". J. Gen. Virol. 83 (Pt 6): 1253–65. doi:10.1099/vir.0.18253-0. PMID 12029140.
Piatak, M., Jr, Saag, M. S., Yang, L. C., Clark, S. J., Kappes, J. C., Luk, K. C., Hahn, B. H., Shaw, G. M. and Lifson, J.D. (1993). "High levels of HIV-1 in plasma during all stages of infection determined by competitive PCR". Science 259 (5102): 1749–1754. Bibcode 1993Sci...259.1749P. doi:10.1126/science.8096089. PMID 8096089.
Pantaleo G, Demarest JF, Schacker T, Vaccarezza M, Cohen OJ, Daucher M, Graziosi C, Schnittman SS, Quinn TC, Shaw GM, Perrin L, Tambussi G, Lazzarin A, Sekaly RP, Soudeyns H, Corey L, Fauci AS. (1997). "The qualitative nature of the primary immune response to HIV infection is a prognosticator of disease progression independent of the initial level of plasma viremia". Proc Natl Acad Sci U S A. 94 (1): 254–258. Bibcode 1997PNAS...94..254P. doi:10.1073/pnas.94.1.254. PMC 19306. PMID 8990195.
Guss DA (1994). "The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1". J Emerg Med 12 (3): 375–84. doi:10.1016/0736-4679(94)90281-X. PMID 8040596.
Hel Z, McGhee JR, Mestecky J (June 2006). "HIV infection: first battle decides the war". Trends Immunol. 27 (6): 274–81. doi:10.1016/j.it.2006.04.007. PMID 16679064.
Arie J. Zuckerman et al. (eds) (2007). Principles and practice of clinical virology (6th ed.). Hoboken, N.J.: Wiley. p. 905. ISBN 978-0-470-51799-4.
Mehandru S, Poles MA, Tenner-Racz K, Horowitz A, Hurley A, Hogan C, Boden D, Racz P, Markowitz M (September 2004). "Primary HIV-1 infection is associated with preferential depletion of CD4+ T cells from effector sites in the gastrointestinal tract". J. Exp. Med. 200 (6): 761–70. doi:10.1084/jem.20041196. PMC 2211967. PMID 15365095.
Brenchley JM, Schacker TW, Ruff LE, Price DA, Taylor JH, Beilman GJ, Nguyen PL, Khoruts A, Larson M, Haase AT, Douek DC (September 2004). "CD4+ T cell depletion during all stages of HIV disease occurs predominantly in the gastrointestinal tract". J. Exp. Med. 200 (6): 749–59. doi:10.1084/jem.20040874. PMC 2211962. PMID 15365096.
editor, Julio Aliberti, (2011). Control of Innate and Adaptive Immune Responses During Infectious Diseases.. New York, NY: Springer Verlag. p. 145. ISBN 978-1-4614-0483-5.
Appay V, Sauce D (January 2008). "Immune activation and inflammation in HIV-1 infection: causes and consequences". J. Pathol. 214 (2): 231–41. doi:10.1002/path.2276. PMID 18161758.
Brenchley JM, Price DA, Schacker TW, Asher TE, Silvestri G, Rao S, Kazzaz Z, Bornstein E, Lambotte O, Altmann D, Blazar BR, Rodriguez B, Teixeira-Johnson L, Landay A, Martin JN, Hecht FM, Picker LJ, Lederman MM, Deeks SG, Douek DC (December 2006). "Microbial translocation is a cause of systemic immune activation in chronic HIV infection". Nat. Med. 12 (12): 1365–71. doi:10.1038/nm1511. PMID 17115046.
Kellerman, S; Essajee, S (2010 Jul 20). "HIV testing for children in resource-limited settings: what are we waiting for?". PLoS medicine 7 (7): e1000285. doi:10.1371/journal.pmed.1000285. PMC 2907270. PMID 20652012.
Schneider, E; Whitmore, S; Glynn, KM; Dominguez, K; Mitsch, A; McKenna, MT; Centers for Disease Control and Prevention, (CDC) (2008-12-05). "Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 18="18" 2008="2008" aged="aged" aids="aids" among="among" and="and" children="children" for="for" hiv="hiv" i="i" infection="infection" months="months" states="states" to="to" years--united="years--united">MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control57 (RR–10): 1–12. PMID 19052530. Crosby, R; Bounse, S (2012 Mar). "Condom effectiveness: where are we now?". Sexual health 9 (1): 10–7. doi:10.1071/SH11036. PMID 22348628.
"Condom Facts and Figures". WHO. August 2003. Retrieved January 17, 2006.
Gallo, MF; Kilbourne-Brook, M; Coffey, PS (2012 Mar). "A review of the effectiveness and acceptability of the female condom for dual protection". Sexual health 9 (1): 18–26. doi:10.1071/SH11037. PMID 22348629.
Celum, C; Baeten, JM (2012 Feb). "Tenofovir-based pre-exposure prophylaxis for HIV prevention: evolving evidence". Current opinion in infectious diseases 25 (1): 51–7. doi:10.1097/QCO.0b013e32834ef5ef. PMC 3266126. PMID 22156901.
Baptista, M; Ramalho-Santos, J (2009-11-01). "Spermicides, microbicides and antiviral agents: recent advances in the development of novel multi-functional compounds". Mini reviews in medicinal chemistry 9 (13): 1556–67. doi:10.2174/138955709790361548. PMID 20205637.
Siegfried, N; Muller, M; Deeks, JJ; Volmink, J (2009-04-15). Siegfried, Nandi. ed. "Male circumcision for prevention of heterosexual acquisition of HIV in men". Cochrane database of systematic reviews (Online) (2): CD003362. doi:10.1002/14651858.CD003362.pub2. PMID 19370585.
"WHO and UNAIDS announce recommendations from expert consultation on male circumcision for HIV prevention". World Health Organization. Mar 28, 2007.
Larke, N (2010 May 27 – Jun 9). "Male circumcision, HIV and sexually transmitted infections: a review". British journal of nursing (Mark Allen Publishing) 19 (10): 629–34. PMID 20622758.
Eaton, L; Kalichman, SC (2009 Nov). "Behavioral aspects of male circumcision for the prevention of HIV infection". Current HIV/AIDS reports 6 (4): 187–93. doi:10.1007/s11904-009-0025-9. PMID 19849961.(subscription required).
Kim, HH; Li, PS, Goldstein, M (2010 Nov). "Male circumcision: Africa and beyond?". Current opinion in urology 20 (6): 515–9. doi:10.1097/MOU.0b013e32833f1b21. PMID 20844437.
Templeton, DJ; Millett, GA, Grulich, AE (2010 Feb). "Male circumcision to reduce the risk of HIV and sexually transmitted infections among men who have sex with men". Current opinion in infectious diseases 23 (1): 45–52. doi:10.1097/QCO.0b013e328334e54d. PMID 19935420.
Wiysonge, CS.; Kongnyuy, EJ.; Shey, M.; Muula, AS.; Navti, OB.; Akl, EA.; Lo, YR. (2011). Wiysonge, Charles Shey. ed. "Male circumcision for prevention of homosexual acquisition of HIV in men". Cochrane Database Syst Rev (6): CD007496. doi:10.1002/14651858.CD007496.pub2. PMID 21678366.
Eaton LA, Kalichman S (December 2007). "Risk compensation in HIV prevention: implications for vaccines, microbicides, and other biomedical HIV prevention technologies". Curr HIV/AIDS Rep 4 (4): 165–72. doi:10.1007/s11904-007-0024-7. PMC 2937204. PMID 18366947.
Utz-Billing I, Kentenich H (December 2008). "Female genital mutilation: an injury, physical and mental harm". J Psychosom Obstet Gynaecol 29 (4): 225–9. doi:10.1080/01674820802547087. PMID 19065392.
Underhill K, Operario D, Montgomery P (2008). Operario, Don. ed. "Abstinence-only programs for HIV infection prevention in high-income countries". Cochrane Database of Systematic Reviews (4): CD005421. doi:10.1002/14651858.CD005421.pub2. PMID 17943855.
Tolli, MV (2012-05-28). "Effectiveness of peer education interventions for HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people: a systematic review of European studies". Health education research. doi:10.1093/her/cys055. PMID 22641791.
Ljubojević, S; LipozenÄ�ić, J (2010). "Sexually transmitted infections and adolescence". Acta dermatovenerologica Croatica : ADC 18 (4): 305–10. PMID 21251451.
Patel VL, Yoskowitz NA, Kaufman DR, Shortliffe EH (2008). "Discerning patterns of human immunodeficiency virus risk in healthy young adults". Am J Med 121 (4): 758–764. doi:10.1016/j.amjmed.2008.04.022. PMC 2597652. PMID 18724961.
National Institute of Allergy and Infectious Diseases (NIAID), "Treating HIV-infected People with Antiretrovirals Protects Partners from Infection", NIH News, 2011 May.
Anglemyer, A; Rutherford, GW; Baggaley, RC; Egger, M; Siegfried, N (2011-08-10). Rutherford, George W. ed. "Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples". Cochrane database of systematic reviews (Online) (8): CD009153. doi:10.1002/14651858.CD009153.pub2. PMID 21833973.
Centers for Disease Control (CDC) (August 1987). "Recommendations for prevention of HIV transmission in health-care settings". MMWR 36 (Suppl 2): 1S–18S. PMID 3112554.
Kurth, AE; Celum, C; Baeten, JM; Vermund, SH; Wasserheit, JN (2011 Mar). "Combination HIV prevention: significance, challenges, and opportunities". Current HIV/AIDS reports 8 (1): 62–72. doi:10.1007/s11904-010-0063-3. PMC 3036787. PMID 20941553.
(April 2012). "HIV exposure through contact with body fluids". Prescrire Int 21 (126): 100–1, 103–5. PMID 22515138.
Linden, JA (2011-09-01). "Clinical practice. Care of the adult patient after sexual assault". The New England Journal of Medicine 365 (9): 834–41. doi:10.1056/NEJMcp1102869. PMID 21879901.
Young, TN; Arens, FJ; Kennedy, GE; Laurie, JW; Rutherford, G (2007-01-24). Young, Taryn. ed. "Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure". Cochrane database of systematic reviews (Online) (1): CD002835. doi:10.1002/14651858.CD002835.pub3. PMID 17253483.
Siegfried, N; van der Merwe, L; Brocklehurst, P; Sint, TT (2011-07-06). Siegfried, Nandi. ed. "Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection". Cochrane database of systematic reviews (Online) (7): CD003510. doi:10.1002/14651858.CD003510.pub3. PMID 21735394.
"WHO HIV and Infant Feeding Technical Consultation Held on behalf of the Inter-agency Task Team (IATT) on Prevention of HIV – Infections in Pregnant Women, Mothers and their Infants – Consensus statement" (PDF). October 25–27, 2006. Archived from the original on April 9, 2008. Retrieved March 12, 2008.
Horvath, T; Madi, BC; Iuppa, IM; Kennedy, GE; Rutherford, G; Read, JS (2009-01-21). Horvath, Tara. ed. "Interventions for preventing late postnatal mother-to-child transmission of HIV". Cochrane database of systematic reviews (Online) (1): CD006734. doi:10.1002/14651858.CD006734.pub2. PMID 19160297.
UNAIDS (May 18, 2012). "The quest for an HIV vaccine".
Reynell, L; Trkola, A (2012-03-02). "HIV vaccines: an attainable goal?". Swiss medical weekly 142: w13535. doi:10.4414/smw.2012.13535. PMID 22389197.
U.S. Army Office of the Surgeon General (March 21, 2011). "HIV Vaccine Trial in Thai Adults". ClinicalTrials.gov. Retrieved June 28, 2011.
U.S. Army Office of the Surgeon General (June 2, 2010). "Follow up of Thai Adult Volunteers With Breakthrough HIV Infection After Participation in a Preventive HIV Vaccine Trial". ClinicalTrials.gov.
May, MT; Ingle, SM (2011 Dec). "Life expectancy of HIV-positive adults: a review". Sexual health 8 (4): 526–33. doi:10.1071/SH11046. PMID 22127039.
Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. World Health Organization. 2010. pp. 19–20. ISBN 978-92-4-159976-4.
Sax, PE; Baden, LR (2009-04-30). "When to start antiretroviral therapy—ready when you are?". The New England Journal of Medicine 360 (18): 1897–9. doi:10.1056/NEJMe0902713. PMID 19339713.
Siegfried, N; Uthman, OA; Rutherford, GW (2010-03-17). Siegfried, Nandi. ed. "Optimal time for initiation of antiretroviral therapy in asymptomatic, HIV-infected, treatment-naive adults". Cochrane database of systematic reviews (Online) (3): CD008272. doi:10.1002/14651858.CD008272.pub2. PMID 20238364.
Panel on Antiretroviral Guidelines for Adults and Adolescents (2009-12-01). Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. United States Department of Health and Human Services. p. i.
When To Start, Consortium; Sterne, JA; May, M; Costagliola, D; de Wolf, F; Phillips, AN; Harris, R; Funk, MJ; Geskus, RB; Gill, J; Dabis, F; Miró, JM; Justice, AC; Ledergerber, B; Fätkenheuer, G; Hogg, RS; Monforte, AD; Saag, M; Smith, C; Staszewski, S; Egger, M; Cole, SR (2009-04-18). "Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies". Lancet 373 (9672): 1352–63. doi:10.1016/S0140-6736(09)60612-7. PMC 2670965. PMID 19361855.
Beard, J; Feeley, F; Rosen, S (2009 Nov). "Economic and quality of life outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review". AIDS care 21 (11): 1343–56. doi:10.1080/09540120902889926. PMID 20024710.
Orrell, C (2005 Nov). "Antiretroviral adherence in a resource-poor setting". Current HIV/AIDS reports 2 (4): 171–6. doi:10.1007/s11904-005-0012-8. PMID 16343374.
Malta, M; Strathdee, SA; Magnanini, MM; Bastos, FI (2008 Aug). "Adherence to antiretroviral therapy for human immunodeficiency virus/acquired immune deficiency syndrome among drug users: a systematic review". Addiction (Abingdon, England) 103 (8): 1242–57. doi:10.1111/j.1360-0443.2008.02269.x. PMID 18855813.
Nachega, JB; Marconi, VC; van Zyl, GU; Gardner, EM; Preiser, W; Hong, SY; Mills, EJ; Gross, R (2011 Apr). "HIV treatment adherence, drug resistance, virologic failure: evolving concepts". Infectious disorders drug targets 11 (2): 167–74. PMID 21406048.
Nachega, JB; Mills, EJ; Schechter, M (2010 Jan). "Antiretroviral therapy adherence and retention in care in middle-income and low-income countries: current status of knowledge and research priorities". Current opinion in HIV and AIDS 5 (1): 70–7. doi:10.1097/COH.0b013e328333ad61. PMID 20046150.
Montessori, V., Press, N., Harris, M., Akagi, L., Montaner, J. S. (2004). "Adverse effects of antiretroviral therapy for HIV infection". CMAJ 170 (2): 229–238. PMC 315530. PMID 14734438.
Burgoyne RW, Tan DH (March 2008). "Prolongation and quality of life for HIV-infected adults treated with highly active antiretroviral therapy (HAART): a balancing act". J. Antimicrob. Chemother. 61 (3): 469–73. doi:10.1093/jac/dkm499. PMID 18174196.
Barbaro, G; Barbarini, G (2011 Dec). "Human immunodeficiency virus & cardiovascular risk". The Indian journal of medical research 134 (6): 898–903. doi:10.4103/0971-5916.92634. PMC 3284097. PMID 22310821.
Orsi, F; d'almeida, C (2010 May). "Soaring antiretroviral prices, TRIPS and TRIPS flexibilities: a burning issue for antiretroviral treatment scale-up in developing countries". Current opinion in HIV and AIDS 5 (3): 237–41. doi:10.1097/COH.0b013e32833860ba. PMID 20539080.
"Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection" (PDF). The Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children. Aug 11,2011.
Antiretroviral therapy for HIV infection in infants and children. World Health Organization. 2010. p. 2. ISBN 978-92-4-159980-1.
Laurence J (2006). "Hepatitis A and B virus immunization in HIV-infected persons". AIDS Reader 16 (1): 15–17. PMID 16433468.
Huang, L; Cattamanchi, A; Davis, JL; den Boon, S; Kovacs, J; Meshnick, S; Miller, RF; Walzer, PD; Worodria, W; Masur, H; International HIV-associated Opportunistic Pneumonias (IHOP), Study; Lung HIV, Study (2011 Jun). "HIV-associated Pneumocystis pneumonia". Proceedings of the American Thoracic Society 8 (3): 294–300. doi:10.1513/pats.201009-062WR. PMC 3132788. PMID 21653531.
"Treating opportunistic infections among HIV-infected adults and adolescents. Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America.". Department of Health and Human Services. February 2, 2007.
Smith, [edited by] Blaine T. (2008). Concepts in immunology and immunotherapeutics (4th ed.). Bethesda, Md.: American Society of Health-System Pharmacists. p. 143. ISBN 978-1-58528-127-5.
Littlewood RA, Vanable PA (September 2008). "Complementary and alternative medicine use among HIV-positive people: research synthesis and implications for HIV care". AIDS Care 20 (8): 1002–18. doi:10.1080/09540120701767216. PMC 2570227. PMID 18608078.
Mills E, Wu P, Ernst E (June 2005). "Complementary therapies for the treatment of HIV: in search of the evidence". Int J STD AIDS 16 (6): 395–403. doi:10.1258/0956462054093962. PMID 15969772.
Irlam, JH; Visser, MM; Rollins, NN; Siegfried, N (2010-12-08). Irlam, James H. ed. "Micronutrient supplementation in children and adults with HIV infection". Cochrane database of systematic reviews (Online) (12): CD003650. doi:10.1002/14651858.CD003650.pub3. PMID 21154354.
Stone, CA; Kawai, K; Kupka, R; Fawzi, WW (2010 Nov). "Role of selenium in HIV infection". Nutrition Reviews 68 (11): 671–81. doi:10.1111/j.1753-4887.2010.00337.x. PMC 3066516. PMID 20961297.
Forrester, JE; Sztam, KA (2011 Dec). "Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?". The American journal of clinical nutrition 94 (6): 1683S–1689S. doi:10.3945/ajcn.111.011999. PMC 3226021. PMID 22089440.
World Health Organization (2003-05). Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation. Geneva. Archived from the original on March 25, 2009. Retrieved March 31, 2009.
Liu JP, Manheimer E, Yang M (2005). Liu, Jian Ping. ed. "Herbal medicines for treating HIV infection and AIDS". Cochrane Database Syst Rev (3): CD003937. doi:10.1002/14651858.CD003937.pub2. PMID 16034917.
Knoll B, Lassmann B, Temesgen Z (2007). "Current status of HIV infection: a review for non-HIV-treating physicians". Int J Dermatol 46 (12): 1219–28. doi:10.1111/j.1365-4632.2007.03520.x. PMID 18173512.
UNAIDS, WHO (December 2007). "2007 AIDS epidemic update" (PDF). Retrieved 2008-03-12.
Morgan D, Mahe C, Mayanja B, Okongo JM, Lubega R, Whitworth JA (2002). "HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries?". AIDS 16 (4): 597–632. doi:10.1097/00002030-200203080-00011. PMID 11873003.
Zwahlen M, Egger M (2006) (PDF). Progression and mortality of untreated HIV-positive individuals living in resource-limited settings: update of literature review and evidence synthesis. UNAIDS Obligation HQ/05/422204. Archived from the original on April 9, 2008. Retrieved March 19, 2008.
Antiretroviral Therapy Cohort Collaboration (2008). "Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies". Lancet 372 (9635): 293–9. doi:10.1016/S0140-6736(08)61113-7. PMC 3130543. PMID 18657708.
Schackman BR, Gebo KA, Walensky RP, Losina E, Muccio T, Sax PE, Weinstein MC, Seage GR 3rd, Moore RD, Freedberg KA. (2006). "The lifetime cost of current HIV care in the United States". Med Care 44 (11): 990–997. doi:10.1097/01.mlr.0000228021.89490.2a. PMID 17063130.
van Sighem, AI; Gras, LA; Reiss, P; Brinkman, K; de Wolf, F; ATHENA national observational cohort, study (2010-06-19). "Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals". AIDS (London, England) 24 (10): 1527–35. doi:10.1097/QAD.0b013e32833a3946. PMID 20467289.
Cheung, MC; Pantanowitz, L; Dezube, BJ (2005 Jun–Jul). "AIDS-related malignancies: emerging challenges in the era of highly active antiretroviral therapy". The oncologist 10 (6): 412–26. doi:10.1634/theoncologist.10-6-412. PMID 15967835.
Tang J, Kaslow RA (2003). "The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy". AIDS 17 (Suppl 4): S51–S60. doi:10.1097/00002030-200317004-00006. PMID 15080180.
Lawn SD (2004). "AIDS in Africa: the impact of co-infections on the pathogenesis of HIV-1 infection". J. Infect. Dis. 48 (1): 1–12. doi:10.1016/j.jinf.2003.09.001. PMID 14667787.
Campbell GR, Pasquier E, Watkins J et al. (2004). "The glutamine-rich region of the HIV-1 Tat protein is involved in T-cell apoptosis". J. Biol. Chem. 279 (46): 48197–48204. doi:10.1074/jbc.M406195200. PMID 15331610.
Campbell GR, Watkins JD, Esquieu D, Pasquier E, Loret EP, Spector SA (2005). "The C terminus of HIV-1 Tat modulates the extent of CD178-mediated apoptosis of T cells". J. Biol. Chem. 280 (46): 38376–39382. doi:10.1074/jbc.M506630200. PMID 16155003.
"Tuberculosis". World Health Organization. March 2012.
World Health Organization (2011). "The sixteenth global report on tuberculosis".
Pennsylvania, Editors, Raphael Rubin, M.D., Professor of Pathology, David S. Strayer, M.D., Ph.D., Professor of Pathology, Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University Philadelphia, Pennsylvania ; Founder and Consulting Editor, Emanuel Rubin, M.D., Gonzalo Aponte Distinguished Professor of Pathology, Chairman Emeritus of the Department of Pathology and Cell Biology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, (2011). Rubin's pathology : clinicopathologic foundations of medicine (Sixth ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 154. ISBN 978-1-60547-968-2.
Woods, S.; Moore, D.; Weber, E.; Grant, I. (2009). "Cognitive neuropsychology of HIV-associated neurocognitive disorders". Neuropsychology review 19 (2): 152–168. doi:10.1007/s11065-009-9102-5. PMC 2690857. PMID 19462243.
Nicholas PK, Kemppainen JK, Canaval GE et al. (February 2007). "Symptom management and self-care for peripheral neuropathy in HIV/AIDS". AIDS Care 19 (2): 179–89. doi:10.1080/09540120600971083. PMID 17364396.
Boshoff C, Weiss R (2002). "AIDS-related malignancies". Nat. Rev. Cancer 2 (5): 373–382. doi:10.1038/nrc797. PMID 12044013.
Yarchoan R, Tosato G, Little RF (2005). "Therapy insight: AIDS-related malignancies – the influence of antiviral therapy on pathogenesis and management". Nat. Clin. Pract. Oncol. 2 (8): 406–415. doi:10.1038/ncponc0253. PMID 16130937.
Post, F. .; Holt, S. . (2009). "Recent developments in HIV and the kidney". Current opinion in infectious diseases 22 (1): 43–48. doi:10.1097/QCO.0b013e328320ffec. PMID 19106702.
Tarantola, D. (2000). "Reducing HIV/AIDS risk, impact and vulnerability". Bull World Health Organ 78 (2). doi:10.1590/S0042-96862000000200013. ISSN 0042-9686.
Centers for Disease Control and Prevention, (CDC) (2011-06-03). "HIV surveillance—United States, 1981–2008". MMWR. Morbidity and mortality weekly report 60 (21): 689–93. PMID 21637182.
Health Protection Agency (2010). HIV in the United Kingdom: 2010 Report.
Surveillance; riques, Risk Assessment Division = Le VIH et le sida au Canada : rapport de surveillance en date du 31 décembre 2009 / Division de la surveillance et de l'évaluation des (2010). HIV and AIDS in Canada : surveillance report to December 31, 2009. Ottawa: Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control, Surveillance and Risk Assessment Division. ISBN 978-1-100-52141-1.
Gottlieb MS (2006). "Pneumocystis pneumonia—Los Angeles. 1981". Am J Public Health 96 (6): 980–1; discussion 982–3. PMC 1470612. PMID 16714472. Archived from the original on April 22, 2009. Retrieved March 31, 2009.
Friedman-Kien AE (October 1981). "Disseminated Kaposi's sarcoma syndrome in young homosexual men". J. Am. Acad. Dermatol. 5 (4): 468–71. doi:10.1016/S0190-9622(81)80010-2. PMID 7287964.
Hymes KB, Cheung T, Greene JB et al. (September 1981). "Kaposi's sarcoma in homosexual men-a report of eight cases". Lancet 2 (8247): 598–600. PMID 6116083.
Basavapathruni, A; Anderson, KS (December 2007). "Reverse transcription of the HIV-1 pandemic". The FASEB Journal 21 (14): 3795–3808. doi:10.1096/fj.07-8697rev. PMID 17639073.
Centers for Disease Control (CDC) (1982). "Persistent, generalized lymphadenopathy among homosexual males". MMWR Morb Mortal Wkly Rep. 31 (19): 249–251. PMID 6808340. Retrieved August 31, 2011.
Barré-Sinoussi F, Chermann JC, Rey F et al. (1983). "Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS)". Science 220 (4599): 868–871. Bibcode 1983Sci...220..868B. doi:10.1126/science.6189183. PMID 6189183.
Centers for Disease Control (CDC) (1982). "Opportunistic infections and Kaposi's sarcoma among Haitians in the United States". MMWR Morb Mortal Wkly Rep. 31 (26): 353–354; 360–361. PMID 6811853. Retrieved August 31, 2011.
Altman LK (May 11, 1982). "New homosexual disorder worries health officials". The New York Times. Retrieved August 31, 2011.
"Making Headway Under Hellacious Circumstances" (PDF). American Association for the Advancement of Science. July 28, 2006. Retrieved June 23, 2008.
Kher U (July 27, 1982). "A Name for the Plague". Time. Archived from the original on March 7, 2008. Retrieved March 10, 2008.
Centers for Disease Control (CDC) (1982). "Update on acquired immune deficiency syndrome (AIDS)—United States". MMWR Morb Mortal Wkly Rep. 31 (37): 507–508; 513–514. PMID 6815471.
RC Gallo, PS Sarin, EP Gelmann, M Robert-Guroff, E Richardson, VS Kalyanaraman, D Mann, GD Sidhu, RE Stahl, S Zolla-Pazner, J Leibowitch, and M Popovic (1983). "Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS)". Science 220 (4599): 865–867. Bibcode 1983Sci...220..865G. doi:10.1126/science.6601823. PMID 6601823.
Barre-Sinoussi, F; Chermann, J.; Rey, F; Nugeyre, M.; Chamaret, S; Gruest, J; Dauguet, C; Axler-Blin, C et al. (1983). "Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS)". Science 220 (4599): 868–871. Bibcode 1983Sci...220..868B. doi:10.1126/science.6189183. PMID 6189183.
Aldrich, ed. by Robert; Wotherspoon, Garry (2001). Who's who in gay and lesbian history.. London: Routledge. pp. 154. ISBN 9780415229746.
Gao F, Bailes E, Robertson DL et al. (February 1999). "Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes". Nature 397 (6718): 436–41. Bibcode 1999Natur.397..436G. doi:10.1038/17130. PMID 9989410.
Keele, B. F., van Heuverswyn, F., Li, Y. Y., Bailes, E., Takehisa, J., Santiago, M. L., Bibollet-Ruche, F., Chen, Y., Wain, L. V., Liegois, F., Loul, S., Mpoudi Ngole, E., Bienvenue, Y., Delaporte, E., Brookfield, J. F. Y., Sharp, P. M., Shaw, G. M., Peeters, M., and Hahn, B. H. (28 July 2006). "Chimpanzee Reservoirs of Pandemic and Nonpandemic HIV-1". Science 313 (5786): 523–6. Bibcode 2006Sci...313..523K. doi:10.1126/science.1126531. PMC 2442710. PMID 16728595.
Goodier, J., and Kazazian, H. (2008). "Retrotransposons Revisited: The Restraint and Rehabilitation of Parasites". Cell 135 (1): 23–35. doi:10.1016/j.cell.2008.09.022. PMID 18854152.(subscription required).
Sharp, P. M.; Bailes, E.; Chaudhuri, R. R.; Rodenburg, C. M.; Santiago, M. O.; Hahn, B. H. (2001). "The origins of acquired immune deficiency syndrome viruses: where and when?". Philosophical Transactions of the Royal Society B: Biological Sciences 356 (1410): 867–76. doi:10.1098/rstb.2001.0863. PMC 1088480. PMID 11405934.
Kalish ML, Wolfe ND, Ndongmo CD, McNicholl J, Robbins KE et al. (2005). "Central African hunters exposed to simian immunodeficiency virus". Emerg Infect Dis 11 (12): 1928–30. doi:10.3201/eid1112.050394. PMC 3367631. PMID 16485481.
Marx PA, Alcabes PG, Drucker E (2001). "Serial human passage of simian immunodeficiency virus by unsterile injections and the emergence of epidemic human immunodeficiency virus in Africa". Philos Trans R Soc Lond B Biol Sci 356 (1410): 911–20. doi:10.1098/rstb.2001.0867. PMC 1088484. PMID 11405938.
Worobey, Michael; Gemmel, Marlea; Teuwen, Dirk E.; Haselkorn, Tamara; Kunstman, Kevin; Bunce, Michael; Muyembe, Jean-Jacques; Kabongo, Jean-Marie M. et al. (2008). "Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960". Nature 455 (7213): 661–4. doi:10.1038/nature07390. PMID 18833279. (subscription required).
Sousa, João Dinis de; Müller, Viktor; Lemey, Philippe; Vandamme, Anne-Mieke; Vandamme, Anne-Mieke (2010). Martin, Darren P.. ed. "High GUD Incidence in the Early 20th Century Created a Particularly Permissive Time Window for the Origin and Initial Spread of Epidemic HIV Strains". PLoS ONE 5 (4): e9936. doi:10.1371/journal.pone.0009936. PMC 2848574. PMID 20376191.
Chitnis, Amit; Rawls, Diana; Moore, Jim (2000). "Origin of HIV Type 1 in Colonial French Equatorial Africa?". AIDS Research and Human Retroviruses 16 (1): 5–8. doi:10.1089/088922200309548. PMID 10628811.(subscription required).
Donald G. McNeil, Jr. (September 16, 2010). "Precursor to H.I.V. Was in Monkeys for Millennia". New York Times. Retrieved 2010-09-17. "Dr. Marx believes that the crucial event was the introduction into Africa of millions of inexpensive, mass-produced syringes in the 1950s. ... suspect that the growth of colonial cities is to blame. Before 1910, no Central African town had more than 10,000 people. But urban migration rose, increasing sexual contacts and leading to red-light districts."
Zhu, T., Korber, B. T., Nahmias, A. J., Hooper, E., Sharp, P. M. and Ho, D. D. (1998). "An African HIV-1 Sequence from 1959 and Implications for the Origin of the epidemic". Nature 391 (6667): 594–7. Bibcode 1998Natur.391..594Z. doi:10.1038/35400. PMID 9468138.
Kolata, Gina (28 October 1987). "Boy's 1969 Death Suggests AIDS Invaded U.S. Several Times". The New York Times. Retrieved 11 February 2009.
Gilbert, M. Thomas P.; Rambaut, Andrew; Wlasiuk, Gabriela; Spira, Thomas J.; Pitchenik, Arthur E.; Worobey, Michael (November 20, 2007). "The emergence of HIV/AIDS in the Americas and beyond" (PDF). PNAS 104 (47): 18566–18570. doi:10.1073/pnas.0705329104. PMC 2141817. PMID 17978186.
"The impact of AIDS on people and societies" (PDF). 2006 Report on the global AIDS epidemic. UNAIDS. 2006. ISBN 92-9173-479-9. Retrieved June 14, 2006.
Ogden J, Nyblade L (2005). "Common at its core: HIV-related stigma across contexts" (PDF). International Center for Research on Women. Retrieved February 15, 2007.
Herek GM, Capitanio JP (1999). "AIDS Stigma and sexual prejudice" (PDF). American Behavioral Scientist 42 (7): 1130–1147. doi:10.1177/0002764299042007006. Retrieved March 27, 2006.
Snyder M, Omoto AM, Crain AL (1999). "Punished for their good deeds: stigmatization for AIDS volunteers". American Behavioral Scientist 42 (7): 1175–1192. doi:10.1177/0002764299042007009.
Sharma, A.K.. Population and society. New Delhi: Concept Pub. Co.. pp. 242. ISBN 9788180698187.
Herek, GM; Capitanio, JP; Widaman, KF (2002 Mar). "HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999". American journal of public health 92 (3): 371–7. doi:10.2105/AJPH.92.3.371. PMC 1447082. PMID 11867313.
De Cock, KM; Jaffe, HW; Curran, JW (2012 Jun 19). "The evolving epidemiology of HIV/AIDS.". AIDS (London, England) 26 (10): 1205-13. PMID 22706007.
Bell C, Devarajan S, Gersbach H (2003) (PDF). The long-run economic costs of AIDS: theory and an application to South Africa. World Bank Policy Research Working Paper No. 3152. Retrieved April 28, 2008.
Greener R (2002). "AIDS and macroeconomic impact". In S, Forsyth (ed.). State of The Art: AIDS and Economics. IAEN. pp. 49–55.
Over M (1992) (PDF). The macroeconomic impact of AIDS in Sub-Saharan Africa, Population and Human Resources Department. The World Bank. Archived from the original on May 27, 2008. Retrieved May 3, 2008.
"AIDS Stigma". News-medical.net. Retrieved November 1, 2011.
"Thirty years after AIDS discovery, appreciation growing for Catholic approach". Catholicnewsagency.com. June 5, 2011. Retrieved November 1, 2011.
"Church HIV prayer cure claims 'cause three deaths'". BBC News. October 18, 2011. Retrieved October 18, 2011.
"Rock Hudson announces he has AIDS – History.com This Day in History – 7/25/1985". History.com. Retrieved November 1, 2011.
"Anthony Eden". Nndb.com. Retrieved November 1, 2011.
Coleman, Brian (June 25, 2007). "Thatcher the gay icon". New Statesman. Retrieved November 1, 2011.
"November 24, 1991: Giant of rock dies". BBC On This Day (BBC News). Retrieved November 1, 2011.
"Freddie Mercury". Nndb.com. Retrieved November 1, 2011.
Bliss, Dominic. "Frozen In Time: Arthur Ashe". iTENNISstore.com. Retrieved June 25, 2012.
"Tributes to Arthur Ashe". The Independent (London). February 8, 1993. Retrieved July 24, 2012.
Cosgrove, Ben. "Behind the Picture: The Photo That Changed the Face of AIDS". LIFE magazine. Retrieved 16 August 2012.
Duesberg, P. H. (1988). "HIV is not the cause of AIDS". Science 241 (4865): 514, 517. Bibcode 1988Sci...241..514D. doi:10.1126/science.3399880. PMID 3399880.Cohen, J. (1994). "The Controversy over HIV and AIDS" (PDF). Science 266 (5191): 1642–1649. Bibcode 1994Sci...266.1642C. doi:10.1126/science.7992043. PMID 7992043. Retrieved 2009-03-31.
Kalichman, Seth (2009). Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy. New York: Copernicus Books (Springer Science+Business Media). ISBN 978-0-387-79475-4.
Smith TC, Novella SP (August 2007). "HIV Denial in the Internet Era". PLoS Med. 4 (8): e256. doi:10.1371/journal.pmed.0040256. PMC 1949841. PMID 17713982. Retrieved 2009-11-07.
Various (Last updated January 14, 2010). "Resources and Links, HIV-AIDS Connection". National Institute of Allergy and Infectious Diseases. Retrieved 2009-02-22.
Watson J (2006). "Scientists, activists sue South Africa's AIDS 'denialists'". Nat. Med. 12 (1): 6. doi:10.1038/nm0106-6a. PMID 16397537.
Baleta A (2003). "S Africa's AIDS activists accuse government of murder". Lancet 361 (9363): 1105. doi:10.1016/S0140-6736(03)12909-1. PMID 12672319.
Cohen J (2000). "South Africa's new enemy". Science 288 (5474): 2168–70. doi:10.1126/science.288.5474.2168. PMID 10896606.
Operation INFEKTION – Soviet Bloc Intelligence and Its AIDS Disinformation Campaign. Thomas Boghardt. 2009.
Blechner MJ (1997). Hope and mortality: psychodynamic approaches to AIDS and HIV. Hillsdale, NJ: Analytic Press. ISBN 0-88163-223-6.
Kirby DB, Laris BA, Rolleri LA (March 2007). "Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world". J Adolesc Health 40 (3): 206–17. doi:10.1016/j.jadohealth.2006.11.143. PMID 17321420.
Ferrantelli F, Cafaro A, Ensoli B (December 2004). "Nonstructural HIV proteins as targets for prophylactic or therapeutic vaccine". Curr. Opin. Biotechnol. 15 (6): 543–56. doi:10.1016/j.copbio.2004.10.008. PMID 15560981.
Karlsson Hedestam GB, Fouchier RA, Phogat S, Burton DR, Sodroski J, Wyatt RT (February 2008). "The challenges of eliciting neutralizing antibodies to HIV-1 and to influenza virus". Nat. Rev. Microbiol. 6 (2): 143–55. doi:10.1038/nrmicro1819. PMID 18197170.
"German HIV patient cured after stem cell transplant". Belfast Telegraph. December 15, 2010. Retrieved December 15, 2010.
Allers, K; Hütter, G; Hofmann, J; Loddenkemper, C; Rieger, K; Thiel, E; Schneider, T (2011-03-10). "Evidence for the cure of HIV infection by CCR5Δ32/Δ32 stem cell transplantation". Blood 117 (10): 2791–9. doi:10.1182/blood-2010-09-309591. PMID 21148083.
Mark Schoofs (November 7, 2008). "A Doctor, a Mutation and a Potential Cure for AIDS". The Wall Street Journal. Retrieved 2008-11-09.
Hütter G, Nowak D, Mossner M, Ganepola S, Ganepola A, Allers K, Schneider T, Hofmann J, Kücherer C, Blau O, Blau IW, Hofmann WK, Thiel E (2009). "Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation". N Engl J Med 360 (7): 692–698. doi:10.1056/NEJMoa0802905. PMID 19213682. Retrieved 2009-03-31.
Levy JA (2009). "Not an HIV Cure, but Encouraging New Directions". N Engl J Med 360 (7): 724–725. doi:10.1056/NEJMe0810248. PMID 19213687. Retrieved 2009-03-31.
Nath, A; Clements, JE (2011-03-13). "Eradication of HIV from the brain: reasons for pause". AIDS (London, England) 25 (5): 577–80. doi:10.1097/QAD.0b013e3283437d2f. PMID 21160414.(subscription required).
Lunzen, J.; Fehse, B.; Hauber, J. (2011). "Gene Therapy Strategies: Can We Eradicate HIV?". Current HIV/AIDS Reports 8 (2): 78–84. doi:10.1007/s11904-011-0073-9. PMID 21331536.(subscription required).
Tincati, C; d'Arminio Monforte, A; Marchetti, G (2009 Jan). "Immunological mechanisms of interleukin-2 (IL-2) treatment in HIV/AIDS disease". Current molecular pharmacology 2 (1): 40–5. doi:10.2174/1874467210902010040. PMID 20021444.
Bowman MC, Archin NM, Margolis DM. (2009). "Pharmaceutical approaches to eradication of persistent HIV infection". Expert Reviews in Molecular Medicine 11 (e6): e6. doi:10.1017/S1462399409000970. PMID 19208267.
Planque S, Nishiyama Y, Taguchi H, Salas M, Hanson C, Paul S (June 2008). "Catalytic antibodies to HIV: Physiological role and potential clinical utility". Autoimmun Rev 7 (6): 473–9. doi:10.1016/j.autrev.2008.04.002. PMC 2527403. PMID 18558365.
DISCLAIMERThesestatements have not been approved by the U.S. Food and Drug Administration(FDA). This information is not intendedto diagnose, treat, cure or prevent any disease. Information conveyed herein isbased on pharmacological and other records - both ancient and modern. No claimswhatsoever can be made as to the specific benefits accruing from the use of anyherb, essential oil, or nutritional supplement.
HolisticLifestyle Community Blog has provided this material for information andeducation purposes only. It is not intended as a substitute for or to take theplace of medical advice. We encourage you to discuss any decisions about yourinterest in, questions about, treatment or care, or the use of complementaryand alternative medicine (CAM), or any other therapy, and what may be best foryour overall health with a licensed physician or other qualified health careprovider. The mention of any product, service, or therapy is not an endorsementby Holistic Lifestyle Community Blog. Any mention in the Holistic LifestyleCommunity Blog of a specific brand name is not an endorsement of the product.
Hiç yorum yok:
Yorum Gönder