FREE ESSAY ON AIDS

AIDS

Acquired immunodeficiency syndrome (AIDS). Today, despite the continuing production of
better antibiotics since the discovery of penicillin, we are facing an infectious disease
against which all these drugs are virtually powerless. This disease is spreading
inexorably, killing more people and more people each year. AIDS does not know no national
boundaries and does not discriminate by race or sex. It is rampaging not only throughout
the United States, but also through Africa, India, China, Russia, Europe, South America,
and the Caribbean countries. Even infants and children are at risk. AIDS is similar to
the bubonic plague or the BLACK DEATH that killed perhaps one-third in Europe in the 14th
century. Yet, the difference from the Black Death and AIDS is that it is in slow motion
because the infectious agent that causes AIDS can remain dormant in a person's body for
several years before it causes illness, and because death from AIDS can be slow and drawn
out once symptoms appear.
AIDS is essentially a disease of the immune system. The body's defenses are destroyed and
the patient becomes prey to the infections and cancers that would normally be fought off
without any trouble. In 1984 it was proved that AIDS is caused by the human
immunodeficiency virus (HIV). A virus is a minute infectious particle that enters and
kills the immune cells, or lymphocytes. Because it destroys the very mechanism humans
rely on for protection, prior to 1996 contracting Aids was considered a death sentence.
For many years, 85 to 90 percent of all AIDS patients died within three years. They might
have recovered from one infection only to succumb to another a few months later. Between
infections they remain weak, emaciated and unable to work or carry on normal activities.
In late 1996, almost 15 years after the first reported AIDS cases, researchers made the
discovery that a certain combination of newly developed drugs could substantially prolong
life in some AIDS patients. But AIDS is a fiendish virus. When researchers cleared it out
of a patient's bloodstream, it hid in the lymph nodes. Scientists, figured out how to
banish it from the lymph nodes, they found the virus lurking in the brain. Although,
there is hope for a cure because they have done some experiments isolating a gene and it
has had good results in some people infected with AIDS. The area that many people are
concerned is with Southeast Asia-particularly India. At 900 million, India's population
is almost double that sub-Saharan Africa, which, with 13.3 million HIV-positive adults,
accounts for 60 percent of the world's total adult infections. 
The major reasons for such spread in India and following Africa is the high rate of their
population, poverty rate, and other risk factors all point to a likely explosion. The
number of HIV infections worldwide doubled between 1991 and 1996-and that number is
expected to double again by the year 2000. By the turn of the century, about 44 million
people will have fallen victim to the virus that causes AIDS. The signs of hope do not
stop by the reason of Prevention Programs which they have succeeded in reducing
HIV-infection rates dramatically among young men in Thailand and young women in
Uganda-two of the countries hit hardest by the3 disease. The rate of new infections have
also dropped sharply among gay men in the United States, Australia, Canada, and western
Europe.
However, many ingredients of the AIDS epidemic are still mystery. The cause of AIDS
remained uncertain for several years after its discovery. Even now, there are questions
about how efficiently the AIDS virus spreads, whether it will kill everyone who gets it,
and why the virus is do devastating to the immune system. It's initial spread was in the
United States was among groups that are frowned upon by society-homosexuals and
intravenous(drug users)- AIDS has a stigma associated with it. This makes the disease
difficult to confront rationally. However, people are terrified even by the word of AIDS.
The virus does not get transmitted by any body contact neither through the air. However,
the disease does not pass from one person to another through the air, by sneezing, on
eating utensils, by shaking hands, or through body contact in sports. There are only four
ways it can be spread: through injection with a needle contaminated with HIV, which it
can happen when drug addicts share needles; by receiving a transfusion of contaminated
blood; or-in the case of infant with an HIV-positive mother-having the virus transmitted
through the placenta before birth, or the mother's milk after birth.
For years, some people to refused to admit AIDS was a problem. Although, the disease
first received national attention in 1982, when the Centers of Disease Control (CDC)
noticed an alarming rate of rare cancer (Kaposi's sarcoma) in otherwise healthy gay men.
SOUNDING THE FIRST ALARM
Three patients examined by Dr.Gottlieb were very ill. Interestingly, they had several
striking features in common. All had unusual infections such as thrush, which is the
growth in the throat of a fungus called Candida; or a rare type of pneumonia caused by a
parasite called Pneumocystis. Also, they had been infected by less-common viruses, such
as Epstein-Barr virus, which causes mononucleosis, or by cytomegalovirus (CMV). Taken
together, the infections pointed to a serious defect in the patients' immune systems.
Sure enough, when Dr. Gottlieb drew a vial blood from each patient and measured special
kind of immune cell called a T-helper lymphocyte, all three patients' tests gave the same
startling result. They were virtually devoid of T-helper cells, Dr. Gottlieb found. It
was clear that they had seriously deficient immune systems.
The three men had something else in common: they were all homosexuals. At that time it
was not clear that the patients' homosexuality was related to the illness; a patients'
sexual preference had never before been considered the determining factor of a medical
disorder. That situation was about to change radically.
SIGNS AND SYMPTOMS OF AIDS
Early symptoms of HIV, lasting between one and four weeks, can mimic that of
mononucleosis, with symptoms such as swellings of the lymph nodes, headache, fever, loss
of appetite, weight loss, sweating and sore throat. Often of these symptoms are mistaken
for the flu or another viral-type infection, so people may not even be aware that they
have been infected with HIV. Even if the patient has seen a doctor, the physician may
dismiss the symptoms as a viral infection. In nearly all the cases, this stage dissipates
due to the healthy immune system's ability to fight the initial infection. Early symptoms
may include:
*Herpes zoster (shingles), a skin rash that appear on the chest, abdomen, and/or back.
*Herpes simplex, a common sexually transmits disease that affects the rectal, genital,
esophageal regions of the body. Painful lesions can erupt into ulceration's of the area.
In HIV/AIDS patients, this may become a chronic condition.
*Thrush, a white coating on the walls of the mouth, gums, and on the tongue, that is
caused by a fungus called Candida Albicans.
*Excessive bruising and bleeding that occurs when a person develops antibodies which
attack the body's platelets-cells which help blood to clot. This condition can go
unnoticed, and is often not detected until a routine blood test is performed.
*Chronic or intermittent diarrhea, found both in early and late stages of HIV infection.
As the immune system becomes increasingly compromised, the body is not able to fight off
more serious infections that a normal intact immune system could suppress. Some of these
life threatening infection include:
*Pneumocystis pneumonia (PCP), caused by parasite called pneumoncytis carinii. Symptoms
include fever and respiratory complications that often lead to death.
*Kaposi's sarcoma, a condition in which tumors of the blood vessels develop on the skin,
in the gastrointestinal tract, mouth, lungs, groin, brain liver, and lymph glands. The
mall, nonpainful lesions usually are a red, brown, or purple color.
*Tuberculosis (TB), which can occur in both early and late stages of HIV. Symptoms
include night sweats, fever, cough, and weight loss. One of the major problems with this
aspect of the disease is the development of TB strains resistant to drugs, making it
harder and harder to treat.
*Mycobacterium avium complex, which produces fatigue, chills, night sweats, fever, weight
loss, diarrhea, and abdominal pain.
*HIV related lymphoma, swollen lymph glands in the neck, groin region, or under the arms.
This requires radiation and chemotherapy treatment.
*Toxoplasmosis encephalitis, caused by a parasite, which produces an infection in the
brain leading to neuro logical impairment and seizures. Symptoms include headaches,
fever, lethargy, confusion, and loss of balance or coordination.
*Cytomegalovirus (CMV) infection, a viral infection distributed to all parts of the body
through bloodstream and causing infections in the eyes, lungs, and other organs. About 90
percent of AIDS patients eventually develop cytomegalovirus.
*Crytococcosis. Produced by a fungus found in the soil. This causes a brain infection.
Symptoms include fatigue, fever, nausea and vomiting, altered mental state, memory loss,
confusion, and behavioral changes.
*Crytosporidosis, an infection developed drinking and contaminated water, produces severe
diarrhea and weight loss.
KAPOSI'S SARCOMA
If the infectious disease specialists were puzzled, several New York dermatologist were
even more perplexed. These doctors, who specialize in skin diseases, were seeing a number
of patients with an extremely rare kind of cancer called Kaposi's sarcoma spot on the
skin, further examination reveals the presence of the cancer in an internal organ, such
as the stomach, as well.
Kaposi's sarcoma had been a disease of elderly men in the Mediterranean origin; in New
York City it began to appear in young men of every ethnic background. It had been known
as a slow-growing cancer that could be treated successfully; in these new, young patients
the sarcoma was spreading fast and damaging internal organs.
A cancer of the skin and internal organs does not sound like it would be related to rare
infections of the lung and the brain. But there is a strong connection-the immune system.
It is one of the principles of the science of immunology that immune cells are essential
in protecting the body from tumor cells. If a small colony of cancers, a tumor, become
established, lymphocytes (part of the immune system) are supposed to find it and destroy
it before it can grow. So Kaposi's sarcoma in these young gay men could be seen as
opportunistic cancer, taking advantage of the breakdown in the patients' defenses, just
as the infectious organisms were doing.
There was also a more concrete reason for the doctors to know that the cases of Kaposi's
sarcoma in young gay men signaled a breach of these person's protective mechanisms:
Kaposi's is relatively common in patients whose immune systems were surprised by medical
treatment. Patients taking drugs that suppress the immune system are also prone to
lymphoma, or cancer of the immune system, Soon this cancer started showing in gay men,
too.
WHY HOMOSEXUALS?
Dr. Currant's statement implied two things. One, that there was an infectious organism
underlying the unusual diseases (perhaps an infectious organism that attacked the immune
system). Two, that the homosexual lifestyle was somehow unique. It would be three years
before the suspicion of an infectious agent that attacked immune cells was verified by
the isolation of the AIDS virus. But it was already known that gay men's sexual habits
differed from those of the most heterosexuals. They found that two other diseases were
very common in homosexual men and that are sexually transmitted-hepatitis B and
gonorrhea. The first thought was that the occurrence of the Pneumocystis pneumonia and
Kaposi's sarcoma in homosexual men might involve sexual transmission. The men with
Kaposi's reported having an average of 61 different partners in the previous year; the
public clinic patients and the men from private physicians said they had had 25 different
sexual partners in the past year. Both of these numbers are much higher than the two to
five sexual partners per year common among nonmonogamous (sexually active with more than
one partner)heterosexuals. The ill men reported contacting a much higher percentage of
their partners in gay baths, public places where gay men can go for anonymous sex. The
men with Kaposi's had met with half of their partners in the baths; the clinic patients
had made one-fourth of their sexual contacts in the baths; and the healthy private
patients averaged only one anonymous partner per year.
Homosexual men have higher rates of sexually transmits diseases than heterosexual men and
women because gay men tend to have larger numbers of different sexual partners, more
often engage in furtive (anonymous) sexual activities, and more frequently have anal
intercourse.
PUZZLING SYMPTOMS
Any theory of the new disease also had to account for a puzzling factor: the variety of
symptoms seen in AIDS patients before they entered the final phase of complete
susceptibility to opportunistic infections and cancers. Interviews with AIDS patients
revealed many had been very sick for up to a year before they developed their first case
of Pneumocystis pneumonia or showed their first Kaposi's spot, both signs of AIDS. 
One form of illness that preceded outright AIDS was a state called lymphadenopathy
syndrome, or as LAS, in which the patient had several swollen lymph nodes for three
months or more. These swollen lymph nodes might be in the neck, in the throat, or under
the armpits. Swollen lymph nodes are a sign that the immune system is fighting an
infection. Did any patients with swollen lymph nodes get better, indicating a successful
fight? Or was the struggle always futile? Several physicians recruited patients with LAS
and examined them every few months to learn the answer.
A more serious condition was AIDS-related complex (ARC), a stage of the illness no longer
considered separately. It had been defined in 1983 as the presence of two or more
unexplained clinical symptoms of AIDS and at least two abnormal lab tests for the related
signs. Patients with ARC might lose a large amount of weight, have frequent fevers, sweat
a lot at night, feel very fatigued, and suffer untreatable diarrhea. It seemed that the
presence of ARC signaled that outright AIDS was inevitable. But what phase of the AIDS
disease process did ARC represent? The Center for Disease Control never officially
recognized ARC for it's reporting purposes, but the term was useful in describing what
appeared to be on the set of AIDS. Better terminology has followed from medical advances,
however, and the symptoms of what was called ARC are viewed as just another of the
AIDS-related illness rather than as a distinct stage of the disease.
INTRAVENOUS DRUG USERS
Heroin addicts have an illegal habit and are dedicated primarily to getting their next
fit. Many do not stay in one place long enough to be studied. Most of them would rather
use their money for drugs than for medical care, so they do not often enter the
traditional medical system. Hence, relatively, little is known about the medical
condition of those who populate the drug culture.
Striking a needle into your vein after someone else has used it is an easy way to get any
infectious diseases that the other person may have. It is like giving yourself a
transfusion of infected blood. That is why IV drug users have a high rate of hepatitis, a
blood disease that is lethal if left untreated. That is why they become the second group
among whom AIDS rapidly spread. Within a year of the onset of the epidemic, almost 20% of
AIDS patients were found to be IV drug users. But most IV drug users are heterosexuals.
Many female addicts resort to prostitution to support their habit. An infected prostitute
can spread AIDS to any of her customers, and those men can spread it to any women or men
they later have sex with. Former addicts can also transmit AIDS to any person they have a
sexual relationship with, if they acquired the AIDS infection while they are using
drugs.
From these mysterious and frightening beginnings among gay men and IV drug users, AIDS
was about to show its versatility by appearing in several new population groups. Indeed,
epidemiologists were anticipating this development. If the new syndrome could be spread
by sex between two men, they asked themselves, might it also be transmitted by sex
between a man and a woman? And if it could be spread by blood on contaminated needles
used by heroin addicts, could it be spread by blood used for medical purposes, such as
during surgery? The answers to both questions turned out to be affirmative.
Between the end of 1981 and the end 1982, several new groups were rapidly identified who
were at greatly increased risk for contracting AIDS. They were as follows:
*Women who had sex with men who had the AIDS infection.
*Babies born to women infected with the AIDS virus.
*Hemophiliacs who injected blood products containing a clotting factor.
*Surgery patients who were transfused with contaminated blood.
*Newly arrived immigrants from Haiti and their sexual contacts.
In each instance, transmission was either sexual contact or through receiving infected
blood. It is essential to recognize that as each risk group was identified, it fit one of
these patterns of transmission. There was no group of unexplained AIDS cases that could
have been spread by casual contact, such as being sneezed on by person with AIDS or
eating food prepared by a person with AIDS. From May 1981 to the present, all evidence
has confirmed that AIDS is spread only by intimate contact, not by the day-to-day, public
encounters we all have in our business and social lives.
But with the regard of the two ways that AIDS is transmitted, blood and sex, it is clear
the illness does not select particular groups to afflict. It does not matter if you
whether you are a man or women, or what type of lifestyle you practice. If you are
injected or transfused with contagious blood or take into your body other contagious
bodily fluids, such as vaginal secretions or semen, you run a high risk of getting AIDS.
Minute amounts of these fluids pose very little threat to transmitting the virus, and
most nongenital fluids, such as saliva, are currently thought to pose no risk whatsoever
of transmitting it. There is, however, a theoretical risk involved when any fluid is
passed from an infected person, though the relative risk is extremely small. Research is
still being done to prove these conjecture. 80 percent of babies HIV positive did not
develop AIDS although, their mother had AIDS.
HEMOPHILIACS
There are several diseases in which the blood does not clot properly. Those born with
these conditions lack one of the many elements in the blood that are essential to stop
bleeding. Hemophilia A is an inherited clotting disorder that afflicts men almost
exclusively. In a person with severe hemophilia A, internal bleeding or bleeding into
joints can lead to serious complication, possibly even death. Even small cuts clot
slowly. It was persons with severe hemophilia A who were at highest risk to get AIDS. To
control their bleeding tendency, hemophiliacs inject themselves with a concentrated
preparation made from the blood of persons with normal clotting ability. This
preparation, called Factor VIII, is credited with increasing the life expectancy of
hemophiliacs in the last two decades from 35 to 55 years old. Some hemophiliacs have a
mild disorder and use Factor VIII only when they actually have a bleeding episode. But
all hemophiliacs depend on it at some point. Factor VIII, which was life saving for
hemophiliacs, suddenly turned to be an instrument of death. The preparation is made by
pooling blood collected from 2,000 to 5,000donors, then concentrating it, quick-drying
it, and putting it in vials. Because so many people's blood was represented in each vial
of Factor VIII, the possibility existed that at least one donor had AIDS or was harboring
the AIDS organism-especially because drug users (until concerns were raised about
infected donors) often sold their blood for cash. And because each hemophiliac uses 20,
30, or 40 vials of Factor VIIII each year, there was a good chance that he would
encounter a contaminated vial sooner or later.
IDENTIFYING THE VIRUS
In particular, no known infectious agent was capable of producing the specific
destruction of the immune system that AIDS causes. Underlying all the symptoms of AIDS is
one primary defect: loss of a pivotal type of white blood cells called the T4 helper
lymphocyte(The role of T4 lymphocytes is to help other types of immune cells become
active and do their job. Without the T4 helper cells, the immune system virtually shuts
down. And in some AIDS patients there was an almost complete loss of T4 helper cells. 
Viruses are the most minute form of life. Some people would not even call viruses living
organisms. They are many times smaller than bacteria, the other cause of human infectious
disease. Whereas bacteria are independent, able to grow and reproduce outside cells of
the organism they infect, viruses are parasites. In order to make more of their kind,
viruses must enter the cells of the creature they infect and take over the cellular
machinery. They subvert its productive power by making more of their own kind. The cell
dies, but the virus thrives. The virus is an intracellular parasite because it's
structure, unlike that of a bacterium, is too rudimentary to sustain itself-it must live
within another cell (Bacteria are internally complex, containing all the equipment
necessary for life). Viruses contain only the genetic material necessary to propagate
themselves and a tightly wrapped protective coat of proteins. These differences lead to a
crucial medical distinction between bacteria and viruses. Twentieth-century medical
science has developed many antibiotics drugs, such as penicillin, to combat bacterial
infections. But viruses are more difficult to kill. Because they reproduce inside of our
own cells, it is difficult to find a drug to stop the virus from reproducing without
harming the host cell. Progress against diseases caused by viruses-such as small pox,
mumps, measles, and polio-has come through vaccines, which prevent infections.
Latency, means that the infection stays in a person's body for a while before it causes
clinical illness. Because viruses can lie dormant inside cells, they can have long
latency periods. The latency periods for AIDS-the time between exposure to the infection
and the first symptoms-may be as long as eight years, but it is usually three to five
years. In children the latency is much shorter, and in women it may be shorter than in
men. Persistence refers to how long the infectious agent remains after it starts the
disease. With AIDS it is most likely that the agent stays for the person's remaining
lifetime. Despite treatment of each opportunistic infection, the immune system remains
impaired. As fast as new immune cells are made they are destroyed.
One tentative conclusion is that a viral ancestor of HIV evolved in Africa millions of
years ago and affected monkeys. Gradually it changed to the form of HIV we see today. But
this still does not explain why the virus suddenly started causing human disease in the
last quarter of the 20th century.
THE OFFICIAL U.S. DEFINITION OF AIDS
There are two factors which determine the category: T-cell count and history of disease
of symptoms. The T-cell (officially called CD4+T-lymphocyte) is the vulnerable immune
system cell the HIV virus attacks, then uses as a breeding ground. Eventually, the
T-cells killed by the virus. As a person's T-cell count decreases, the risk of severe
disease, or opportunistic illness, increases. The three official levels of T-cell counts
are:
Level 1: a T-cell count greater than 500cells/ml
Level 2: a T-cell count between 200-499 cells/ml
Level 3: a T-cell count less than 200 cells/ml
These categories are based on the lowest T-cell count registered by a person. For
example, someone who once tested at 180 but later received a boost in T-cells from a new
protease inhibitor would still be considered level 3. To determine the three official
government classifications, symptoms are also a factor. For example, a patient is in AIDS
category 1 if he or she is asynmptomatic (no symptoms) and has a level 1 T-cell count. An
AIDS category 2 patient has a level 2 T-cell count and at least one of the early stage
illness but has not developed a later-stage disease, such as pneumonia or Kaposi's
sarcoma. In category 3-full-blown AIDS-the T-cell count has dropped below 200 and the
patient has developed a later-stage disease.
TREATMENT BREAKTHROUGHS
There have been so many attempts to find a solution to end with AIDS but it's too complex
and we know little of it, therefore it's difficult to find a solution. Although, many
experiments have been made for example the cocktail. It's a treatment of vaccines that
combine with an AZT. However, this vaccines does work for some but for others it does not
do anything. Yet, the newest discovery is that some people are born with a certain type
of gene that does not develop AIDS but has the virus. So this person may pass on the
Virus and have it himself but it will not affect him at all.
TABLE OF CONTENTS
1-INTRODUCTION
2-WHAT IS AIDS?
3-WHAT ARE THE SIGNS AND SYMPTOMS OF AIDS
4-KAPOSI'S SARCOMA
5-WHY HOMOSEXUALS?
6-PUZZLING SYMPTOMS
7-INTRAVENOUS DRUG USERS
8-HEMOPHILIACS
9-IDENTIFYING THE VIRUS
10-THE OFFICIAL U.S. DEFINITION OF AIDS
11-TREATMENT BREAKTHROUGHS
BIBLIOGRAPHY 
- Check, William. The Encyclopedia of Health AIDS. Chelsea House Publishers;
Philadelphia: 1999
- Encarta Encyclopedia 97AIDS Microsoft Windows.
- Center For AIDS Prevention Studies:www.caps.ucsf.edu(March 1, 2000)
- JAMA HIV/AIDS Information center:www.ama.assn.org/special/hivhome.htm
(March 1,2000)
- International Association Of Physicians in AIDS Care:www.iapac.org/ (March 1,2000)