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HIV/AIDS
Published in Patricia G. Melloy, Viruses and Society, 2023
There is no cure for HIV, but current treatments have in effect turned an HIV-positive status into a “manageable chronic condition,” one that never progresses to acquired immunodeficiency syndrome (AIDS) if antiretroviral therapy (ART) is taken, albeit for life (WHO 2021b). In this chapter, we will look at the characteristics of the HIV retrovirus, how it is transmitted, how it can damage the immune system to cause AIDS, and how it can be treated. Of the 37 million people in the world living with HIV, 73% are keeping HIV at bay with ART (WHO 2021b). We will explore how HIV was discovered as the cause of AIDS and the scientific progress made on treating and finding a cure for HIV infection. Like no other virus, HIV has been referenced in the products of popular culture in the late 20th and early 21st centuries such as books, television, and movies. We will explore the public perception of HIV and AIDS, and how that changed over time when an HIV-positive status no longer became a death sentence.
Health Professionals and Modern Human Research Ethics
Published in Howard Winet, Ethics for Bioengineering Scientists, 2021
In the early 1980s a new and fatal infectious disease appeared, first affecting a youthful urban male population. AIDS is caused by the human Immunodeficiency virus (HIV) attacking CD4 T lymphocytes and thereby rendering the adaptive immune system powerless to fight infections. No vaccine was available to fight a disease that attacked the very system vaccines are supposed to activate. Many of the early anti-AIDS drugs were toxic to an extent reminiscent of early cancer chemotherapy treatments, and toxicity often could not be detected in preclinical trials because their target was the DNA of a primate-specific virus.
Antiseptics, antibiotics and chemotherapy
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
One method to prevent the disease would be the application of an AIDS vaccine. A live attenuated vaccine based on a strain of Simian immunodeficiency virus had long been considered the best hope. However, it was discovered in 1995 that the weakened virus eventually triggered the Simian version of AIDS when given to baby monkeys (Gottlieb, 1998).
Mycobacterium avium complex and Cryptococcus neoformans co-infection in a patient with acquired immunodeficiency syndrome: a case report
Published in Acta Clinica Belgica, 2022
Emilien Gregoire, Benoit François Pirotte, Filip Moerman, Antoine Altdorfer, Laura Gaspard, Eric Firre, Martial Moonen, Gilles Darcis
MAC disease is a non-tuberculous mycobacterial infection that also usually affects AIDS patients with CD4 + T-cell count below 100 cell/µL, and even often below 50 cells/µL. Its incidence among people living with HIV in HIC has been drastically reduced since the ART era [13]. In AIDS patients, it often presents clinically as disseminated MAC infection, with several weeks of early symptoms such as prolonged fever, fatigue, weight loss, abdominal pain, diarrhoea and hepatosplenomegaly. Lymphadenopathies are less frequent. In ART-treated AIDS patients with a good immunological response, when it has not been diagnosed and treated before, MAC infection often presents through immune reconstitution inflammatory syndrome (IRIS), whose presentation is usually lymphadenitis or soft tissue abscesses [14]. In our case, the diagnosis of disseminated MAC infection was made before IRIS occurred. The patient had nonspecific symptoms of fever and weight loss that could have been explained by HIV itself or by the cryptococcal disease. Nonetheless, a thoraco-abdominal CT scan was carried out to explore these symptoms thoroughly and exclude another OI or a neoplasm associated with AIDS. An adenomegaly was detected in the mediastinum and it was biopsied. The culture was positive for Mycobacterium avium-paratuberculosis-silvaticum. This resulted in the diagnosis of disseminated MAC infection, which was treated promptly.
Model-based computational precision medicine to develop combination therapies for autoimmune diseases
Published in Expert Review of Clinical Immunology, 2022
Emiko Desvaux, Audrey Aussy, Sandra Hubert, Florence Keime-Guibert, Alexia Blesius, Perrine Soret, Mickaël Guedj, Jacques-Olivier Pers, Laurence Laigle, Philippe Moingeon
Consequently, while the ultimate cause(s) of clinical autoimmunity remain(s) unexplored at an individual patient level, it results from the accumulation of multiple pathogenic autoreactive effector mechanisms that promote inflammation and tissue destruction [10]. A difficulty in diagnosing patients with AIDs is attributable in part to some similarities in clinical manifestations between these diseases, particularly during early stages [1]. A limited knowledge of molecular drivers of the disease represents the greatest obstacle to improve diagnosis and stratify patients in homogeneous subsets to apply better tailored treatments [11]. Diagnosis is thus often only established after a long patient journey and remains a huge challenge for clinicians despite the development of validated disease classification instruments.
Understanding and avoiding late presentation for HIV diagnosis – study protocol of a trial using mixed methods (FindHIV)
Published in AIDS Care, 2021
Frederik Valbert, Eva Wolf, Stefan Preis, Sven Schellberg, Knud Schewe, Nikola Hanhoff, Birgit Mück, Christine Kögl, Paul Lauscher, Jürgen Wasem, Silke Neusser, Anja Neumann
Current antiretroviral therapy (ART) allows disease control in many cases, not only preventing disease progression, but also allowing the reconstitution of the immune system and preventing further transmission of the virus (A Working Group of the Office of AIDS Research Advisory Council (OARAC), 2017; Cohen et al., 2016; Rodger et al., 2016). Starting therapy as early as possible is ideal for optimal therapy success. However, many cases with HIV infection are diagnosed in later stages of the illness. Late presenters (LPs) have been defined as individuals that have a CD4 cell count of less than 350 cells/µL and/or the acquired immunodeficiency syndrome (AIDS) at the time of HIV diagnosis (Antinori et al., 2010). Late presentation (LP) is associated with increased morbidity, mortality, and healthcare costs. The rate of LP for Germany is estimated at 44.0–63.5%; estimates for Europe are similar (Bickel et al., 2020; Kittner et al., 2015; Mocroft et al., 2015; Schäfer et al., 2016; Valbert et al., 2020; Zoufaly et al., 2011).