Today’s 10 big news of corona – lockdown, virus PM Modi breaking news dls news 4 october news Today’s 10 big news of corona – lockdown, virus PM Modi breaking news dls news 4 october news 4 october 2020 today breaking news dls news corona news . 10/4/2020 DLS News Today Breaking News | DLS News aaj ki taja khabar 1. NCB deputy director KPS Malhotra who questioned Deepika Padukone in drugs case tests Covid-19 positive – NCB officer Corona positive who questioned Deepika Padukone in drugs case 2. Officer KPS Malhotra interrogating Deepika, Sara and Shraddha gets corona infection | Deepika, Sara and Shraddha are interrogated by the officer being coronated. Hindi News, Country 3. Coronavirus Outbreak India Cases LIVE Updates; Maharashtra Pune Madhya Pradesh Indore Rajasthan Uttar Pradesh Punjab Bihar Novel Corona (COVID 19) Death Toll India Today 04 October Mumbai Delhi Coronavirus News | In 7 states including Punjab, Maharashtra and Gujarat, the death rate is around 2-3%, higher than the national rate, in 14 states it is less than 1%; 65.47 lakh cases so far – Dainik Bhaskar 4. Coronavirus: More Than 70 Million People Tested in the Country So Far, Falling Infection Rate | Corona virus: More than 70 million people have been tested in the country so far, the rate of falling infection is 5. Coronavirus Novel Corona Covid 19 3 oct | Coronavirus Novel Corona Covid 19 News World Cases Novel Corona Covid 19 | The next 48 hours are crucial to improving Corona positive Trump’s health; 3.49 crore cases in the world so far – Dainik Bhaskar 6. Mamta Banerjee admitted, Corona reached the level of community transmission in Bengal – West Bengal Chief Minister Mamata Banerjee admits corona reached stage of community transmission durga puja – AajTak 7. mamata-banerjee- sixteen_nine.jpg (1200 × 675) 8. Coronavirus: Corona Figures in Country Exceed 65 Lakhs | Corona virus: 75,829 new cases reported in 24 hours in the country, corona infects exceed 65 lakhs 9. COVID-19 Analytics Center, COVID-19 Data Center: Interactive coronavirus tracker (corona virus tracker) of cases in India and the world | Kovid-19 Analytics Center 10. Corona Infected Nepals Prime Minister KP Oli, Prime Ministers Residence Sanitized | Corona infected Nepal’s Prime Minister KP Oli, Prime Minister’s residence sanitized 11. 5 tips for older person know how to stop ageing in older person in coronavirus pandemic | The elderly are most at risk of infection from corona, by making these 5 changes in diet, the effect of increasing age can be reduced and can avoid major diseases – Dainik Bhaskar.

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Close to 80% of HIV-positive individuals are shown to be virally suppressed through their most recent test results, according to data from 2016 through 2018,¹ as well as 32% to 63% of adults older than 24 years.² Youth with a new HIV diagnosis, however, come in at only 12%.³ In addition, this last group has high viral loads and advanced infection when they receive their diagnosis, because they have not been receiving the necessary care to control HIV, and almost half do not know they are infected, according to study results that recently appeared in the Journal of Acquired Immune Deficiency Syndromes.³

In the United States, with close to 25% of new HIV diagnoses showing up in individuals aged 13 to 24 years,³ the level of viral suppression (VS) is an alarming statistic, and it highlights the importance of targeting the HIV care continuum among this demographic to improve their overall health outcomes. Therefore, the investigators conducted the ATN 116 study, using data from the Strategic Multistate Initiative for the Identification, Linkage and Engagement in Care of HIV-infected (SMILE) youth, a collaboration of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the CDC, the Health Resources and Services Administration, and the NICHD-funded Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN).

“Providers for HIV-infected adolescents and young adults face substantial challenges in identifying those who are undiagnosed, linking and engaging them in care, and in helping HIV-infected youth achieve adequate adherence to their antiretroviral medications to realize health benefits. Given recent studies suggesting that prompt HIV treatment is important for health, survival, and the prevention of HIV transmission to others, tracking viral suppression has become increasingly important,” the authors emphasized.

Using SMILE data for October 2012 through September 2014 from 13 ATN sites for youth aged 12 to 24 years, their patient population consisted of 1411 HIV-infected youth. From this group, 75% (n = 1053) were linked to HIV care resources, 59% (n = 830) were engaged with their care, 34% (n = 473) were retained in care at an ATN site, and 34% (n = 474) started antiretroviral treatment (ART). Only a scant 12% reached VS; however, among this group, during the study period, 69% (n = 114) achieved VS at least once and 31% (n = 52) reached VS at 2 or more visits.³

Positive correlates of VS included the following measurements³:

• Lower viral load at baseline (HR, 1.56; 95% CI, 1.32-1.89; P = .0001)
• Recent ART (HR, 3.10; 95% CI, 1.86-5.18; P = .0001)
• Less time between HIV test and referral to a care coordinator (7 days to 6 weeks: HR, 2.52; 95% CI, 1.50-4.23; P = .0005; 6 weeks to 3 months: HR, 2.08; 95% CI, 1.08-4.04; P .0294)

The most notable negative correlate was recent substance use (HR, 0.68; 95% CI, 0.48-0.95; P = .024).³

“Cross-sectional analyses of data previously obtained in the ATN also suggested that prompt referral to linkage services after diagnosis was associated with better and more successful engagement and that adolescent-friendly services are important for youth to successfully link to care,” the authors noted.

They posited that the low rates of ART and VS could be due to psychosocial and socioeconomic comorbidities connected to the locations of the SMILE clinics the patients attended. To overcome these challenges, the authors suggested several solutions³:

1. Faster link to care after diagnosis
2. Adolescent-friendly services
3. More intensive case management
4. More frequent contact with clinic staff (eg, text messages and social media)
5. Address unmet behavioral health needs early

 

“Whether current simpler, more potent regimens may favorably influence ART initiation, adherence, and viral suppression rates in youth are a focus of ongoing ATN research,” they concluded. “Innovative solutions to eliminate barriers at each of the individual, provider, clinic, community and structural (eg, health system) levels are urgently needed to most effectively address the HIV epidemic among youth in the [United States] and most appropriately address the youth mission of the US [National HIV/AIDS Strategy].”

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However, Public Health England (PHE) said challenges around the virus remain, with figures showing that almost half the people newly diagnosed last year were at a late stage of infection, increasing their risk of death.

Diagnoses fell by just over a quarter (28%) from 6,271 in 2015 to 4,484 in 2018, PHE said, adding that the continued decline in the virus was down to the success of preventive measures.

These include HIV testing, condom provision, more use of the pre-exposure prophylaxis (PrEP) drug – taken before sex by HIV-negative people at high risk of contracting the virus – and drugs that keep the level of HIV in the body low and prevent the virus being passed on, known as anti-retroviral therapy (ART).

The biggest falls in new diagnoses have been among gay and bisexual men, particularly those who are white, born in the UK, aged between 15 and 24 and living in London, the figures show.

During the same period, between 2015 and 2018, diagnoses fell by 24% among people who got HIV through heterosexual contact.

Last year, 43% of people were diagnosed at a late stage of infection. Late diagnoses increase the risk of death within a year up to tenfold, compared with people diagnosed promptly, PHE said.

The public health minister, Jo Churchill, welcomed the overall drop in diagnoses, but vowed not to be complacent as the government works towards a target of having no new HIV transmissions by 2030.

She said: “I am delighted to see new figures released today which show we are well on our way to achieving our ambition of zero HIV transmissions in England by 2030, with HIV diagnoses at their lowest level since 2000.

“This decline in diagnoses is a result of our unwavering commitment to prevention which has led to more people getting tested, and has allowed people with HIV to benefit from effective treatment, stopping the virus from spreading further.

“However, I am not complacent and remain dedicated to ensuring we reach our target of zero new HIV transmissions by 2030.”

The Terrence Higgins Trust has called for wider access to the three-year PrEP trial, which recruited more than 13,000 participants by June this year and is scheduled to end next year.

Ian Green, the chief executive at the trust, said: “In light of today’s data from Public Health England, we’re urging NHS England, the Department of Health and local councils to immediately begin planning for PrEP to be given a home as part of routine sexual health services.

“Raising awareness of PrEP outside of the gay community will also go a long way in helping us to reach zero transmissions by 2030.”

The drug is almost 100% effective at preventing HIV when taken as prescribed. It involves a pill containing a combination of two anti-HIV drugs, emtricitabine and tenofovir, taken daily or around the time of sexual activity.

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Ear, nose and throat specialist, Dr. Kevin Jensen, will be the first full-time medical provider at the Wasilla offices of Ear, Nose and Throat Specialists of Alaska. Dr. Jensen joined the Valley medical community on June 18 and will be treating patients at his clinic on Seward-Meridian Parkway and at Mat-Su Regional Medical Center.

Jensen, or Dr. J as he prefers to be called, offers a broad spectrum of otolaryngology services, including endoscopic sinus surgery, thyroid surgery, and obstructive sleep apnea surgery. Thanks to his military background, he also has experience in endoscopic Eustachian tube balloon dilation, and is one of the first providers in Alaska to offer this procedure.

“We were able to take this new technology, which doesn’t have its own billing procedure code yet and use it to help our patients,” Jensen said. Many civilian physicians have not yet adopted this technique, he said, because it is too new to be covered by insurance plans.

More inside
The dilation can help those with Eustachian tube dysfunction, including people who have chronic ear infections or retracted ear drums, those with difficulty clearing their ears during altitude changes, and people who have had long-term use of ear tubes.

The procedure is done by pushing an endoscope through the nose into the opening of the Eustachian tube. An inflated balloon is used to fill space which dilates the Eustachian tube for two minutes before it is relaxed and released. Over time this procedure helps relieve symptoms of chronic ear problems such as fluid build-up.

Jensen believes that the FDA will approve the procedure soon so that it can be covered by insurance. For now he offers the service through self-pay.

Early on in his education, Jenson saw himself headed in the direction of Family Medicine. He liked the idea of treating all ages, from senior citizens and adults to children. It was while he was undertaking a rotation in Ear, Nose and Throat (ENT) care in medical school that he realized how drawn he was to surgery, as well. Now he sees how the hands-on nature of being a surgeon is an ideal match for his personality.

“I really was drawn to being able to work with my hands and using techniques with my hands,” he said.

Jensen is currently one of the only Doctors of Osteopathic Medicine in the ENT field of Alaska, a fact that he feels sets him apart from other providers due to the more holistic and whole-body approach to medicine that comes with being a DO.

When his career took off, people began to call him Dr. J after his basketball hero, Julius Erving, and it has since become his preferred title.

“It really rings in my ear when I hear people say Dr. J,” Jenson said.

Jensen began his career in the military, where he received most of his medical education. He served as a US Air Force Flight Surgeon for three years. Jensen was born and raised in New Mexico, but has lived all over the United States. His family has moved so often that each of his six children was born in a different state.

Dr. J completed 14 years of military service and looks forward to transitioning his medical practice to the civilian community. Several years ago he was stationed as an ENT doctor at Elmendorf Air Force Base, which is how he caught the Alaska Bug.

“Hook, line and sinker…then they moved me to Las Vegas against my will,” said Jensen.

Now he looks forward to returning to Alaska and taking part in his favorite outdoor activities with his family.

“We’re all excited about moving back to Alaska and participating in everything that Alaska has to offer in the outdoors and just the prime, quality people.”

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HIV is a virus that targets and alters the immune system, increasing the risk and impact of other infections and diseases. Without treatment, the infection might progress to an advanced disease stage called AIDS.
However, modern advances in treatment mean that people living with HIV in countries with good access to healthcare very rarely develop AIDS once they are receiving treatment.

The life expectancy of a person who carries the HIV virus is now approaching that of a person that tests negative for the virus, as long as they adhere to a combination of medications called antiretroviral therapy (ART) on an ongoing basis.

A Kaiser Permanente study in 2016 suggested that between 1996 and 2016, the gap in life expectancy between people who are HIV positive and HIV negative closed from 44 years to 12 years.

The World Health Organization (WHO) also advises that a person living with HIV can resume a high quality of life with treatment, and that 20.9 million people worldwide were receiving ART as of mid-2017.

In this article, we explain HIV and AIDS, their symptoms, causes, and treatments.

What is HIV?
doctor discusses HIV with patient
While HIV is a life-changing illness, a person can live a long and full live with it.
Human immunodeficiency virus (HIV) is a virus that attacks immune cells called CD4 cells, which are a type of T cell.

These are white blood cells that move around the body, detecting faults and anomalies in cells as well as infections. When HIV targets and infiltrates these cells, it reduces the body’s ability to combat other diseases.

This increases the risk and impact of opportunistic infections and cancers. However, a person can carry HIV without experiencing symptoms for a long time.

HIV is a lifelong infection. However, receiving treatment and managing the disease effectively can prevent HIV from reaching a severe level and reduce the risk of a person passing on the virus.

What is AIDS?
AIDS is the most advanced stage of HIV infection. Once HIV infection develops into AIDS, infections and cancer pose a greater risk.

Without treatment, HIV infection is likely to develop into AIDS as the immune system gradually wears down. However, advances in ART mean than an ever-decreasing number of people progress to this stage.

By the close of 2015, around 1,122,900 people were HIV-positive. To compare, figures from 2016 show that medical professionals diagnosed AIDS in an estimated 18,160 people.

Causes
People transmit HIV in bodily fluids, including:

blood
semen
vaginal secretions
anal fluids
breast milk
In the United States, the main causes of this transfer of fluids are:

anal or vaginal intercourse with a person who has HIV while not using a condom or PrEP, a preventive HIV medication for people at high risk of infection
sharing equipment for injectable illicit drugs, hormones, and steroids with a person who has HIV
A woman living with HIV who is pregnant or has recently given birth might transfer the disease to her child during pregnancy, childbirth, or breastfeeding.

The risk of HIV transmitting through blood transfusions is extremely low in countries that have effective screening procedures in place for blood donations.

Undetectable = untransmittable
To transmit HIV, these fluids must contain enough of the virus. If a person has ‘undetectable’ HIV, they will not transmit HIV to another person, even if after a transfer of fluids.

Undetectable HIV is when the amount of HIV in the body is so low that a blood test cannot detect it. People may be able to achieve undetectable levels of HIV by closely following the prescribed course of treatment.

Confirming and regularly monitoring undetectable status using a blood test is important, as this does not mean that the person no longer has HIV. Undetectable HIV relies on the person adhering to their treatment, as well as the effectiveness of the treatment itself.

Progression to AIDS
The risk of HIV progressing to AIDS varies widely between individuals and depends on many factors, including:

the age of the individual
the body’s ability to defend against HIV
access to high-quality, sanitary healthcare
the presence of other infections
the individual’s genetic inheritance resistance to certain strains of HIV
drug-resistant strains of HIV
Symptoms
For the most part, infections by other bacteria, viruses, fungi, or parasites cause the more severe symptoms of HIV.

These conditions tend to progress further in people who live with HIV than in individuals with healthy immune systems. A correctly functioning immune system would protect the body against the more advanced effects of infections, and HIV disrupts this process.

Early symptoms of HIV infection
early HIV sweats
Sweats are an early sign of HIV, but many people do not know they have the disease for years.
Some people with HIV do not show symptoms until months or even years after contracting the virus.

However, around 80 percent of people may develop a set of flu-like symptoms known as acute retroviral syndrome around 2–6 weeks after the virus enters the body.

The early symptoms of HIV infection may include:

fever
chills
joint pain
muscle aches
sore throat
sweats. particularly at night
enlarged glands
a red rash
tiredness
weakness
unintentional weight loss
thrush
These symptoms might also result from the immune system fighting off many types of viruses.

However, people who experience several of these symptoms and know of any reason they might have been at risk of contracting HIV over the last 6 weeks should take a test.

Asymptomatic HIV
In many cases, after the symptoms of acute retroviral syndrome, symptoms might not occur for many years.

During this time, the virus continues to develop and cause immune system and organ damage. Without medication that prevents the replication of the virus, this slow process can continue for an average of around 10 years.

A person living with HIV often experiences no symptoms, feels well, and appears healthy.

Complying rigidly to a course of ART can disrupt this phase and suppress the virus completely. Taking effective antiretroviral medications for life can halt on-going damage to the immune system.

Late-stage HIV infection
Without medication, HIV weakens the ability to fight infection. The person becomes vulnerable to serious illnesses. This stage is known as AIDS or stage 3 HIV.

Symptoms of late-stage HIV infection may include:

blurred vision
diarrhea, which is usually persistent or chronic
dry cough
a fever of over 100 °F (37 °C) lasting for weeks
night sweats
permanent tiredness
shortness of breath, or dyspnea
swollen glands lasting for weeks
unintentional weight loss
white spots on the tongue or mouth
During late-stage HIV infection, the risk of developing a life-threatening illness increases greatly. A person with late-stage HIV can control, prevent and treat serious conditions by taking other medications alongside HIV treatment.

Opportunistic infections
toxoplasmosis opportunistic infection
Toxoplasmosis, found in cat and animal feces, is a dangerous opportunistic infection for people who have AIDS.
HIV treatment is nowadays often effective enough to keep many infections at bay.

In reducing the activity of the immune system, late-stage HIV reduces the ability of the body to combat a range of infections, diseases, and cancers. Infections that caused minimal or no health problems before the development of AIDS might pose a serious health risk once the condition has weakened the immune system.

Medical professionals refer to these as opportunistic infections (OIs). Once any of these infections occur, a doctor will diagnose AIDS.

These include:

Candidiasis of the bronchi, trachea, esophagus, and lungs: As a fungal infection that normally occurs in the skin and nails, this frequently causes serious problems in the esophagus and lower respiratory tract for people with AIDS.

Invasive cervical cancer: This type of cancer begins in the cervix and spreads to other areas in the body. Regular checks with a cancer care team can help prevent the cancer or limit the spread.

Coccidioidomycosis: People sometimes refer to the self-limited version of this disease in healthy individuals as valley fever. Inhalation of the fungus Coccidioides immitis causes this infection.

Cryptococcosis: Cryptococcus neoformans is a fungus that can infect any part of the body, but most often enters the lungs to trigger pneumonia or the brain to cause swelling.

Cryptosporidiosis: The protozoan parasite Cryptosporidium causes this infection that leads to severe abdominal cramps and watery diarrhea.

Cytomegalovirus disease (CMV): CMV can cause a range of diseases in the body, including pneumonia, gastroenteritis, and encephalitis, a brain infection. However, CMV retinitis is of particular concern in people with late-stage HIV, and it can infect the retina at the back of the eye, permanently removing sight. CMV retinitis is a medical emergency.

HIV-related encephalopathy: An acute or chronic HIV infection can trigger this brain disorder. While doctors do not fully understand the cause, they consider it to be linked to post-infection inflammation in the brain.

Herpes simplex (HSV): This virus, usually sexually transmitted or passed on in childbirth, is extremely common and rarely causes health issues or causes self-limiting recurrences in people with healthy immune systems. However, it can reactivate in people with HIV, causing painful cold sores around the mouth and ulcers on the genitals and anus that do not resolve. The sores, rather than a herpes diagnosis, are an indicator of AIDS. HSV can also infect the breathing tube, lungs, or esophagus of people with AIDS.

Histoplasmosis: The fungus Histoplasma capsulatum causes extremely severe, pneumonia-like symptoms in people with advanced HIV. This condition can become progressive disseminated histoplasmosis and can impact on organs outside of the respiratory system.

Chronic intestinal isosporiasis: The parasite Isospora belli can infect the body through contaminated food and water, causing diarrhea, fever, vomiting, weight loss, headaches, and abdominal pain.

Kaposi’s sarcoma (KS): Kaposi’s sarcoma herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8), causes a cancer that leads to the growth of abnormal blood vessels anywhere in the body. If KS reaches organs, such as the intestines or lymph nodes, it can be extremely dangerous. KS appears as solid purple or pink spots on the surface of the skin. They might be flat or raised.

Lymphoma: People refer to cancer of the lymph nodes and lymphoid tissues as lymphoma, and many different types might occur. However, Hodgkin and non-Hodgkin lymphoma have strong links to HIV infection.

Tuberculosis (TB): The bacteria Mycobacterium tuberculosis causes this disease and can transfer in droplets if a person with an active form of the bacteria sneezes, coughs, or speaks. TB causes a severe lung infection as well as weight loss, fever, and tiredness, and can also infect the brain, lymph nodes, bones, or kidneys.

Mycobacteria, including Mycobacterium avium and Mycobacterium kansasii: These bacteria occur naturally in the environment and pose few problems for people with fully-functioning immune systems. However, they can spread throughout the body and cause life-threatening health issues for people with HIV, especially in its later stages.

Pneumocystis jirovecii pneumonia (PJP): A fungus called Pneumocystis jirovecii causes breathlessness, dry cough, and high fever in people with suppressed immune systems, including those with HIV.

Recurrent pneumonia: Many different infections can cause pneumonia, but a bacteria called Streptococcus pneumoniae is one of its most dangerous causes in people with HIV. Vaccines are available for this bacteria, and every person who has HIV should receive vaccination for Streptococcus pneumoniae.

Progressive multifocal encephalopathy (PML): The John Cunningham (JC) virus occurs in a vast number of people, usually lying dormant in the kidneys. However, in people with compromised immune systems, either due to HIV or medications, such as those for multiple sclerosis (MS), the JC virus attacks the brain, leading to a dangerous conditon called progressive multifocal leukoencephalopathy (PML). PML can be life-threatening, causing paralysis and cognitive difficulties.

Recurrent Salmonella septicemia: This type of bacteria often enters the body in contaminated food and water, circulates the entire body, and overpowers the immune system, causing nausea, diarrhea, and vomiting.

Toxoplasmosis (toxo): Toxoplasma gondii is a parasite that inhabits warm-blooded animals, including cats and rodents, and leaves the body in their feces. Humans contract the diseases by inhaling contaminated dust or eating contaminated food, but it can also occur in commercial meats. T. gondii causes severe infection in the lungs, retina, heart, liver, pancreas, brain, testes, and colon. Take care to wear protective gloves while changing cat litter and thoroughly wash the hands afterward.

Wasting syndrome: This occurs when a person involuntarily loses 10 percent of their muscle mass through diarrhea, weakness, or fever. Part of the weight loss may also consist of fat loss.

Prevention
Preventing OIs is key to extending life expectancy with late-stage HIV. Aside from managing HIV viral load with medications, a person who lives with the disease must take precautions, including the following steps:

Wear condoms to prevent other STIs.
Receive vaccinations for potential OIs. Discuss these with your primary care physician.
Understand the germs in your surrounding environment that could lead to an OI. A pet cat, for example, could be a source of toxoplasmosis. Limit exposure and take precautions, such as wearing protective gloves while changing litter
Avoid foods that are at risk of contamination, such as undercooked eggs, unpasteurized dairy and fruit juice, or raw seed sprouts.
Do not drink water straight from a lake or river or tap water in certain foreign countries. Drink bottled water or use water filters.
Ask your doctor about work, home, and vacation activities to limit exposure to potential OIs.
Antibiotic, antifungal, or antiparasitic drugs can help treat an OI.

HIV and AIDS myths and facts
Many misconceptions circulate about HIV that are harmful and stigmatizing for people with the virus.

The following cannot transmit the virus:

shaking hands
hugging
kissing
sneezing
touching unbroken skin
using the same toilet
sharing towels
sharing cutlery
mouth-to-mouth resuscitation or other forms of “casual contact”
the saliva, tears, feces, and urine of a person with HIV
HIV and AIDS: Transmission myths and facts
HIV and AIDS: Transmission myths and facts
Click here to learn more about HIV transmission and how it works.
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Diagnosis
The Centers for Disease Control and Prevention (CDC) estimates that about 1 in every 7 HIV-positive Americans is unaware of their HIV status.

Becoming aware of HIV status is vital for commencing treatment and preventing the development of more severe immune difficulties and subsequent infections.

HIV blood tests and results
A doctor can test for HIV using a specific blood test. A positive result means that they have detected HIV antibody in the bloodstream. The blood is re-tested before a positive result is given.

After potential exposure to the virus, early testing and diagnosis is crucial and greatly improves the chances of successful treatment. Home testing kits are also available.

HIV might take 3 – 6 months to show up in testing, and re-testing may be necessary for a definitive diagnosis. People at risk of infection within the last 6 months can have an immediate test. The test provider will normally recommend another test within a few weeks.

Treatment
woman taking pill
Adhering to antiretroviral treatment can reduce HIV to an undetectable viral load.
No cure is currently available for HIV or AIDS.

However, treatments can stop the progression of the condition and allow most people living with HIV the opportunity to live a long and relatively healthy life.

Starting ART early in the progression of the virus is crucial. This improves quality of life, extends life expectancy, and reduces the risk of transmission, according to the WHO’s guidelines from June 2013.

More effective and better-tolerated treatments have evolved that can improve general health and quality of life by taking as little as one pill per day.

A person living with HIV can reduce their viral load to such a degree that it is no longer detectable in a blood test. After assessing a number of large studies, the CDC concluded that individuals who have no detectable viral load “have effectively no risk of sexually transmitting the virus to an HIV-negative partner.”

Medical professionals refer to this as undetectable = untransmittable (U=U).

Emergency HIV pills, or post-exposure prophylaxis
If an individual believes they have been exposed to the virus within the last 3 days, anti-HIV medications, called post-exposure prophylaxis (PEP), may be able to stop infection. Take PEP as soon as possible after potential contact with the virus.

PEP is a treatment lasting a total of 28 days, and physicians will continue to monitor for HIV after the completion of the treatment.

Antiretroviral drugs
The treatment of HIV involves antiretroviral medications that fight the HIV infection and slows down the spread of the virus in the body. People living with HIV generally take a combination of medications called highly active antiretroviral therapy (HAART) or combination antiretroviral therapy (cART).

There are a number of subgroups of antiretrovirals, such as:

Protease inhibitors

Protease is an enzyme that HIV needs to replicate. These medications bind to the enzyme and inhibit its action, preventing HIV from making copies of itself.

These include:

atazanavir/cobicistat (Evotaz)
lopinavir/ritonavir (Kaletra)
darunavir/cobicistat (Prezcobix)
Integrase inhibitors

HIV needs integrase, another enzyme, to infect T cells. This drug blocks integrase. These are often the first line of treatment due to their effectiveness and limited side effects for many people.

Integrase inhibitors include:

elvitegravir (Vitekta)
dolutegravir (Tivicay)
raltegravir (Isentress)
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)

These drugs, also referred to as “nukes,” interfere with HIV as it tries to replicate.

This class of drugs includes:

abacavir (Ziagen)
lamivudine/zidovudine (Combivir)
emtricitabine (Emtriva)
tenofovir disproxil (Viread)
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

NNRTIs work in a similar way to NRTIs, making it more difficult for HIV to replicate.

Chemokine co-receptor antagonists

These drugs block HIV from entering cells. However, doctors in the U.S. do not often prescribe these because other drugs are more effective.

Entry inhibitors

Entry inhibitors prevent HIV from entering T cells. Without access to these cells, HIV cannot replicate. As with chemokine co-receptor antagonists, they are not common in the United States.

People will often use a combination of these drugs to suppress HIV.

A medical team will adapt the exact mix of drugs to each individual. HIV treatment is usually permanent, lifelong, and based on routine dosage. A person living with HIV must take pills on a regular schedule. Each class of ARVs has different side effects, but possible common side effects include:

nausea
fatigue
diarrhea
headache
skin rashes
Complementary or alternative medicine
Although many people who have HIV try complementary, alternative, or herbal options, such as herbal remedies, no evidence confirms them to be effective.

According to some limited studies, mineral or vitamin supplements may provide some benefits in overall health. It is important to discuss these options with a healthcare provider because some of these options, even vitamin supplements, may interact with ARVs.

Prevention
To prevent contracting HIV, healthcare professionals advise precautions related to the following.

Sex using a condom or PrEP: Having sex without a condom or other preventive measures, such as PrEP, can drastically increase the risk of transmitting HIV and other sexually transmitted infections (STIs).

Use condoms or PrEP during every sexual act with a person outside of a trusted relationship in which neither partner has HIV.

Drug injection and needle sharing: Intravenous drug use is a key factor for HIV transmission in developed countries. Sharing needles and other drug equipment can expose users to HIV and other viruses, such as hepatitis C.

Certain social strategies, such as needle-exchange programs, can help to reduce the infections as a result of drug abuse. Recovering from a substance use disorder can improve health a quality of life for many reasons, but it can dramatically reduce potential exposure to HIV.

People using a needle to take medications should use a clean, unused, unshared needle.

Body fluid exposure: A person can limit their potential exposure to HIV by taking precautions to reduce the risk of exposure to contaminated blood.

Healthcare workers should use gloves, masks, protective eyewear, shields, and gowns in situations where exposure to bodily fluids is a possibility.

Frequently and thoroughly washing the skin immediately after coming into contact with blood or other bodily fluids can reduce the risk of infection. Healthcare works should follow a set of procedures known as universal precautions to prevent transmission.

Pregnancy: Certain antiretrovirals might harm an unborn fetus during pregnancy.

However, an effective, well-managed treatment plan can prevent mother-to-fetus HIV transmission. Delivery through caesarean section may be necessary.

Women who are pregnant but have HIV might also pass on the virus through their breast milk. However, regularly taking the correct regimen of medications greatly reduces the risk of transmitting the virus.

Discuss all options with a healthcare provider.

Education: Teaching people about known risk factors is vital to equip them with the tools to avoid exposure to HIV.

Living with HIV
man drinks after exercising
A person with HIV can live a full and active life, as long as they adhere to treatment.
Due to the added risk of other infections and disease, people living with HIV must make lifestyle adjustments to accommodate their reduced immunity.

Adherence: Taking HIV medication as prescribed is absolutely essential to effective treatment. Missing even a few doses might jeopardize the treatment.

Program a daily, methodical routine to fit the treatment plan around any existing lifestyle and schedule. Treatment plans will be different between people. People sometimes refer to “adherence” as “compliance”.

HIV medications can cause particularly severe side effects that often deter people from adherence. Learn more about the adverse effects of HIV medication by clicking here.

If side effects are becoming too severe, speak to your medical team rather than simply stopping medication. They can switch the regimen to a better-tolerated drug.

General health: Taking steps to avoid illness and other infections is key. People living with HIV should seek to improve overall health through regular exercise, a balanced, nutritious diet, and the cessation of any drugs, including tobacco.

Additional precautions: People living with AIDS should take extra precautions to prevent any exposure to infection, especially around animals. Avoid coming into contact with animal feces and pet litter.

Doctors also recommend the meticulous and regular washing of hands. Antiretrovirals reduce the need for these precautions.

Regular contact with doctors: HIV is a lifelong condition, so regular contact with a healthcare team is important for updating treatment in line with advancing age and other conditions. The healthcare team will regular review and adjust treatment accordingly.

Psychological effects: Common misconceptions about AIDS and HIV are reducing as understanding of the disease increases.

However, stigma around the condition continues in many parts of the world. People living with HIV may feel excluded, persecuted, and isolated.

An HIV diagnosis can be very distressing, and feelings of anxiety or depression are common. If you feel anxious or have symptoms of depression, seek medical help immediately.

Takeaway
HIV is a misunderstood and potentially dangerous disease that reduces the effectiveness of the immune system in combatting other infections.

Advances in modern medicine person living with HIV can have a near-normal life expectancy and active lifestyle. A person receiving antiretroviral therapy must adhere strictly to their regime for the most effective results.

HIV transmits in bodily fluids, such as semen or vaginal secretions during sex, or blood. In the United States, HIV most frequently transmits through sexual intercourse without a condom or PrEP and sharing needles when injecting drugs.

However, if a person has a viral load that HIV tests cannot detect, they cannot transmit the virus to another person.

If HIV advances, for example in situations where a person is not aware of their HIV status or does not receive treatment, it can progress to a late stage known as AIDS.

AIDS can open the door to a range of infections known as opportunistic infections that pose a severe risk to health. Some are extreme or prolonged presentations of infections that would normally resolve quickly in a person with healthy immune function.

Others might occur due to microbes that occur naturally in the environment and would not normally cause infection at all.

The post Explaining HIV and AIDS appeared first on MyMedicPlus.

Sex workers are 13 times more at risk of becoming HIV positive than the general population globally. But, in Australia, where sex work is decriminalised, we have the same rate of infection as the general population. This is evidence of the importance of the legal environment” says Jules Kim, head of the Scarlet Alliance, the Australian Sex Workers Association.

The Human Rights Council first examined the question of HIV and human rights 29 years ago, in 1990. Since then, it has been steadfast in its assertion that progress in the response to the AIDS epidemic is indissociable from progress on human rights issues. Today, as it discusses new recommendations on human rights and HIV, its work is more important than ever.

A total of 48 countries and territories still maintain travel restrictions on people living with HIV. One in five people living with HIV report having been refused health care because of their HIV status, and in many parts of the world, people who use drugs and sex workers live in fear of arrest for being in possession of clean syringes or condoms.

Adolescent girls and young women are among those worst affected because of a lack of respect for their rights. In 2017, 79% of new infections among 10-19 year-old young people in eastern and southern Africa were among females. Inequalities and institutional barriers increase vulernabilities and decrease access to services. Young people in 45 countries are unable to access sexual and reproductive health services or HIV testing services without parental permission.

At a meeting held on the sidelines of the 41st session of the Human Rights Council, co-convened by Brazil, Colombia, Mozambique, Portugal and Thailand, UNAIDS Deputy Executive Director, Shannon Hader, called on countries to dismantle barriers that prevent people accessing essential services. “It has been four years since the world committed to ending the AIDS epidemic by 2030 and three years since the United Nations General Assembly adopted the High-Level Political Declaration on Ending AIDS, which included a commitment to remove human rights barriers by 2020. We have less than two years to deliver on that promise”.

The event marks the presentation of a report and recommendations on HIV and human rights being presented by Michelle Bachelet to the Human Rights Council on July 1. The report, resulting from consultations with civil society, experts, governments and UN mandate holders in February, includes best practise examples, including on the training of health workers on ending stigma and discrimination, on decriminalizing drug use and same-sex sexual activity, model laws on HIV, the training of judges and lawyers, civil society advocacy, and international funding opportunities specifically for human rights programming.

“We cannot address the human rights dimensions of HIV without civil society, who play a critical role” stated Rui Macieira, Ambassador of Portugal to the United Nations in Geneva.

“The 2030 Agenda for Sustainable Development is an important agenda for people, planet, prosperity, peace and partnership. In order not to leave anyone behind. States should increase their efforts to reach the most marginalized,” said Peggy Hicks, director of the Thematic Engagement, Special Procedures and Right to Development Division of the Office of the High Commissioner for Human Rights.

Member states will examine the recommendations that highlight how reforming criminal laws is critical to advancing progress towards the elimination of HIV, including laws criminalizing gender expression or adult consensual sex, including sex work and same sex relations, as well as drug use. The recommendations include a call for strengthening cooperation at regional, sub-regional and global levels to support and invest in programmes and services that promote the right to health and rights of people living with HIV. This is important in the context of shrinking donor funding for HIV and health programmes, including in newly transitioned middle-income countries.

“I live with HIV, I come from a very small community, a slum area of a Kenyan city. If the recommendations of this report are implemented in a facility that I walk to everyday – a health facility, a police station, then it will work and provide us with the services we need and deserve as a basic human right.” concludes Lucy Wanjiku, a young woman living with HIV.

The post No end to AIDS without respecting human rights appeared first on MyMedicPlus.

The Centers for Disease Control and Prevention report that of the estimated 1.1 million people in the United States who have the HIV infection, 1 in 7 don’t know their status.

That is especially true for youth ages 13 to 24 that make up 21% of the nearly 40,000 new HIV diagnoses made in 2017. More than 50% of youth who have HIV don’t know about their infection.

Only 9% of high school students report having been tested for HIV. Many people do not get tested because of lack of access to health care, fear and misperceptions about HIV risk and the testing process, and health care settings that lack HIV testing as a routine part of care.

As a nurse at a clinic that treats sexually transmitted infectious diseases, I frequently saw patients visit the clinic requesting HIV testing because their provider did not want to test them for HIV, or their provider said they did not offer HIV testing. We would also see young people at the clinic because they could not always be assured of confidentiality at their doctors’ offices.

Nurse practioners play a valuable role in testing of HIV in youth. A colleague and I recently published an article on HIV testing that showed nurse practitioners are less likely to perform HIV testing on people younger than 18 years of age. That may be in part because of issues related to patient confidentiality, consent, and linkage to care when a person tests positive.

Nurse practitioners are in a unique position to educate youth about HIV, refer youth to health services including HIV testing and perform HIV testing. But currently, nurse practitioners do not have full practice authority in all states. One way to increase HIV testing for all persons might be to include giving nurse practitioners the full authority under state regulations and practice acts to test for HIV.

Testing a major breakthrough
The development of testing technologies has been one of the two leading breakthroughs to the possibility of ending the HIV epidemic; the other is pharmacological interventions that effectively manage the disease and prevent transmission. Our nurse practitioner study concluded that nurse practitioners have an important role to increase HIV testing rates and could help put an end to HIV.

Nevertheless, many people don’t know if they should be tested, and so they are not.

Although it has been nearly 40 years since the beginning of the HIV crisis, the CDC reports that the infection continues to affect gay, bisexual and other men who have sex with men of all races and ethnicities; black and Latino men and women; people who inject drugs; people aged 25-34; and people in the Southern U.S. disproportionately.

There are national recommendations and practice guidelines for nurse practitioners to test for HIV. However, the rate at which they screen for HIV is low, as my colleague Gale Spencer and I reported in our recent study.

We found that the strongest predictor of nurse practitioner HIV testing behavior was the practice setting’s social pressures that influence HIV testing. In other words, when office staff supported routine HIV screening, then nurse practitioners were more likely to test for HIV, even when it took more time.

Also, nurse practitioners believed that when “consent from a parent/guardian should be obtained before screening for HIV in a person younger than 18 years,” they were less likely to screen for HIV. This means that better policy and procedures are needed to help guide providers for testing those younger than 18. We believe this is pivotal, given that among young people between the ages 13 and 24 with HIV, nearly half are not aware of their status.

Testing guidelines for all

A blood test can reveal the presence of the HIV virus. Room’s Studio/Shutterstock.com
According to the CDC recommendations, everyone should be tested at least once between the ages of 13 and 64 as part of routine health care.

Also, if you are pregnant or planning to get pregnant, the CDC recommends that you should get tested as early as possible.

You should also get tested at least once a year if:

You are a sexually active gay or bisexual man
You have had sex with an HIV-positive partner
You have had more than one partner since your last HIV test
You have shared needles or “works” to inject drugs
You have exchanged sex for drugs or money
You have another sexually transmitted disease, hepatitis or tuberculosis
You have had sex with anyone who has done anything in this list, or with someone whose sexual history you do not know.
Also, the CDC recommends testing before having sex for the first time with a new partner. The agency also recommends that you talk about sexual and drug-use history.

In January, 2019, the World Health Organization made the proposal to declare 2020 the “Year of the Nurse and Midwife.” Nurses provide the essential link between the people of the community and the complex health care system. With their help, more youth – and others – can get tested.

The post Should you be tested for HIV? appeared first on MyMedicPlus.

Researchers at The Westmead Institute for Medical Research have discovered brand new immune cells that are at the frontline of HIV infection. Known as CD11c+ dendritic cells, these new cells are more susceptible to HIV infection and can then transmit the virus to other cells.

CD11c+ dendritic cells are a subset of dendritic cells (a type of immune cell) that are only found in human genital tissues, specifically at the epithelial level (the thin layer of tissue that forms the surface) of the vagina, inner foreskin and anus. This location in genital tissue often means that these newly discovered CD11c+ dendritic cells are the first immune cells to interact with HIV.

One of the lead researchers on this project, Associate Professor Andrew Harman from The Westmead Institute for Medical Research says that the role of these newly discovered CD11c+ dendritic cells is to capture any incoming disease-causing virus or bacteria (pathogen), and then deliver it to CD4 T cells.

“CD4 T cells are responsible for driving an immune response to the pathogen. Interestingly, they are also the primary HIV target cells in which the virus replicates.

“Once dendritic cells capture a pathogen, they communicate what they have found to CD4 T cells in the lymph nodes, essentially giving the immune system a constant update. This information prepares the immune system to either tolerate a bacteria or virus, or attack it.

“However, if CD4 T cells fall below critical levels (e.g. in HIV positive patients), then the body is no longer able to mount an immune response, leading to a diagnosis of AIDS.

“Our research team has shown that the newly discovered CD11c+ dendritic cells are more susceptible to HIV infection than any other known dendritic cell. We have also shown that CD11c+ dendritic cells interact with CD4 T cells more efficiently than any other dendritic cells. Importantly CD11c+ dendritic cells transfer the virus to CD4 T cells, making them key drivers of HIV infection. As these dendritic cells are so efficient at interacting with CD4 T cells, they are also important vaccine candidates.

The team from The Westmead Institute for Medical Research were able to discover these CD11c+ dendritic cells using donated genital tissues.

Associate Professor Harman says, “We were able to look at the tissue only 30 minutes after it had been surgically removed from the body and also developed ground breaking RNAscope technology which allowed us to watch as living CD11+c dendritic cells took up the virus and delivered it to the CD4 T cells,” says Associate Professor Harman.

According to co-lead author and Executive Director of The Westmead Institute for Medical Research, Professor Tony Cunningham, this discovery has unlocked two new avenues for medical researchers to pursue in the search for more effective HIV treatments.

“This finding opens up a potential for the development of strategies to block the transmission of HIV. If we can block HIV’s ability to bind to the CD11+c dendritic cells, which are often the first immune cells to encounter the HIV virus, then we can stop their ability to transmit the virus to the CD4T cells. In a situation where there are low levels of CD4 T cells, this could stop the virus from spreading.

“Another avenue is to use this new information to develop a HIV vaccine. If HIV fragments or inactivated HIV were targeted at these CD11+c dendritic cells, this would have the potential to prime an immune response against HIV as soon as it enters the body,” says Professor Cunningham.

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