I.

HIV/AIDS

HIV stands for human immunodeficiency virus. It is the virus that can lead
to acquired immunodeficiency syndrome, or AIDS, if not treated. Unlike some other
viruses, the human body can’t get rid of HIV completely, even with treatment. So once
you get HIV, you have it for life.

HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which
help the immune system fight off infections. Untreated, HIV reduces the number of CD4
cells (T cells) in the body, making the person more likely to get other infections or
infection-related cancers. Over time, HIV can destroy so many of these cells that the
body can’t fight off infections and disease. These opportunistic infections or cancers take
advantage of a very weak immune system and signal that the person has AIDS, the last
stage of HIV infection.

AIDS is the most severe phase of HIV infection. People with AIDS have such badly
damaged immune systems that they get an increasing number of severe illnesses,
called opportunistic infections.

II. Pathophysiology / Etiology

Etiology

HIV is a retrovirus that infects and replicates primarily in human CD4+ T cells and
macrophages. HIV can be transmitted via blood, blood products, sexual fluids, other
fluids containing blood, and breast milk. Most individuals are infected with HIV through
sexual contact, before birth or during delivery, during breast-feeding, or when sharing
contaminated needles and syringes (intravenous drug users). Sexual intercourse is the
most common, albeit inefficient, mode of HIV transmission. The risk of transmission per
exposure is low; estimates are on the order of 0.1% per contact for heterosexual
transmission, but this varies considerably and increases with concurrent ulcerative STDs,
high HIV viral load in the host, and lack of antiretroviral therapy.
Pathophysiology

The virus gains entry to the cells by attaching to the CD4 receptor and a coreceptor
(CCR5 or CXCR4) via its envelope glycoproteins. It is called a retrovirus because it
encodes the enzyme reverse transcriptase, allowing a DNA copy to be made from viral
RNA. The reverse transcriptase enzyme is inherently error-prone, resulting in a high rate
of HIV mutation, which can rapidly lead to viral resistance in those on treatment.
Once integrated into the cellular DNA the provirus resides in the nucleus of infected
cells and can remain quiescent for extended periods of time. Alternatively it can become
transcriptionally active (especially where immune activity is occurring) and can use the
human host cell machinery to replicate itself. Viral RNA is then spliced singly or
multiply to make a variety of structural and regulatory and accessory proteins. Viral pro
teases further process proteins and mature viral particles are formed when the virus buds
through the host cell membrane.
Within a few weeks of infection there is a high level of viral replication in the blood
that can exceed 10 million viral particles per micro liter of plasma. There is a
concomitant decline in CD4 T cells. However, an immune response to HIV develops that
curtails viral replication, resulting in a decrease in viral load and a return of CD4 T-cell
numbers to near normal levels. The immune control is thought to be dependent on killer
T cells and neutralizing antibodies. Depending on how effective this control is, the viral
load is known as the set point and this is thought to be prognostic of natural history
outcomes for the infected person.
Research suggests that the host's initial response to HIV infection is critical and
genetically determined. A small number of patients show unusually slow or no immune
damage. These long-term controllers are being carefully studied with the hope of
developing immune-based therapies for HIV.

III. Signs and Symptoms:

Early Symptoms:
Objective: Subjective:

1. Chills 5. Fever
2. Rash 6. Muscle aches
3. Night sweats 7. Mouth ulcers
4. Fatigue 8. Sore throat
9. Swollen lymph nodes

Late Symptoms:

Objective:

1. Rapid weight loss 4. Recurring fever or profuse night

2. Sores of the mouth, anus, or
genitals
3. Red, brown, pink, or purplish
blotches on or under the skin or
inside the mouth, nose, or eyelids
sweats
5. Extreme and unexplained
tiredness
6. Prolonged swelling of the lymph
glands in the armpits, groin, or
neck
7. Diarrhea that lasts for more than
a week
8. Pneumonia
9. Memory loss, depression, and
other neurologic disorders

Subjective:

IV. Treatment/ Medication

HIV treatment involves taking medicines that slow the progression of the virus in
your body. HIV is a type of virus called a retrovirus, and the drugs used to treat it are
called antiretrovirals (ARV). These drugs are always given in combination with other
ARVs; this combination therapy is called antiretroviral therapy (ART). Many ART drugs
have been used since the mid-1990s and are the reason why the annual number of deaths
related to AIDS has dropped over the past two decades.
 Although a cure for HIV does not yet exist, ART can keep you healthy for many
years, and greatly reduces your chance of transmitting HIV to your partner(s) if taken
consistently and correctly. ART reduces the amount of virus (or viral load) in your blood
and body fluids. ART is recommended for all people living with HIV, regardless of how
long they’ve had the virus or how healthy they are.

V. Medical Management/ Intervention

Anyone can get HIV, but you can take steps to protect yourself from HIV infection.

Get tested and know your partner’s HIV status. Talk to your partner about HIV
testing and get tested before you have sex. Use this testing locator from the Centers for
Disease Control and Prevention (CDC) to find an HIV testing location near you.

Have less risky sex. HIV is mainly spread by having anal or vaginal sex without a
condom or without taking medicines to prevent or treat HIV.

Use condoms. Use a condom correctly every time you have vaginal, anal, or oral sex.
Read this fact sheet from CDC on how to use condoms correctly.

Limit your number of sexual partners. The more partners you have, the more likely
you are to have a partner with HIV whose HIV is not well controlled or to have a partner
with a sexually transmitted disease (STD). Both of these factors can increase the risk of
HIV transmission. If you have more than one sexual partner, get tested for HIV regularly.

Get tested and treated for STDs. Insist that your partners get tested and treated too.
Having an STD can increase your risk of becoming infected with HIV or spreading it to
others.

Talk to your health care provider about pre-exposure prophylaxis (PrEP). PrEP is
an HIV prevention option for people who don’t have HIV but who are at high risk of
becoming infected with HIV. PrEP involves taking a specific HIV medicine every day. For
more information, read the AIDSinfo fact sheet on Pre-Exposure Prophylaxis (PrEP).

Don’t inject drugs. But if you do, use only sterile drug injection equipment and water and
never share your equipment with others.

Members:

Toleran, Sean Ryan

Tagurigan, Adrian

Umadhay, Josseth Marie