HIV/AIDS: An Overview Thereof

Jimmy Le
November 7th, 2014

The Human Immunodeficiency Virus, colloquially referred to as HIV, is a virus in which

the immune system is compromised in its ability to function properly and fight off infection.
Prolonged carrying of this virus will lead to a progressing deterioration of the immune system. In
the latest stages of HIV infection, the individuals immune system has been so suppressed to the
point where the individual is very vulnerable to opportunistic infections and cancers. Disease that
would not normally be fatal becomes much more dire. Those who have reached this latest stage
of HIV infection are defined as having Acquired immunodeficiency syndrome, colloquially
known as AIDS. According to the CDCs HIV Surveillance Supplemental Report, 201, an
estimated 1.14 million persons aged 13 and older are living with HIV infection in the U.S. Of
that amount, approximately 181,000 of those individuals are not aware. On a global scale, the
World Health Organization (WHO) has estimated that a 35.5 million people were living with the
infection by the end of 2012, and an estimated 1.6 million people died of AIDS-related causes by
2012. Because of the scale of the diseases outbreak, it can be considered a pandemic.
One of the earliest case involving HIV/AIDS in the U.S. date back from at least 1981, in
which many previously healthy men becoming afflicted with a rare form of pneumonia
(pneumocystis pneumonia) or a unique form of the cancer Kaposis sarcoma. These debilitations
would only be expected in those with severe immune system complications a characteristic of
AIDS. In its earliest form of recognition, AIDS was referred as gay-related immunodeficiency
(GRID) as those initially diagnosed were commonly homosexual. Later on the name was
changed to its current acronym to reflect that the ailment was not exclusive to homosexual men
as cases involving drug users, blood transfusion recipients, and infants were arising. Research
would suggest that the most common form of HIV was perhaps passed from chimpanzees to
humans in equatorial Africa between 1902 to 1921. As some primates carry a similar simian
immunodeficiency virus (SIV), comparisons between the twos genetic material have determined
to be very alike. Therefore, it is possible that SIV jumped from primates to humans, manifesting
into the strains of HIV we have today: HIV-1 and HIV-2.
The most common ways HIV might be transmitted is through exposure to affected blood
or bodily fluids. This can be the result of anything which may result in the exchange of such
substances, including sexual intercourse, intravenous drug use, or transfusion of blood.
Moreover, it is possible for HIV to be transmitted from mother to child during pregnancy,
delivery, and breastfeeding. Some misconceptions about HIV transmission include: 1) HIV can
be transmitted through casual touch. 2) HIV can be spread through kissing (in the absence of
open sores). 3) Tears and sweat may expose another individual to the virus.
HIV may infect several different cells, although only certain cells have the right receptors
for HIV to bind. In particular, HIV will target T4 or CD4 cells, a class of T lymphocytes (TCells). T4 cells are vital to the immune system, as they produce a series of chemical signals that
are necessary for development and maintenance of the immune system. Like other viruses, HIV
must use a host cell in order to reproduce, as it cannot on its own, and so it beings this process by
binding to the membrane of the cell. This is done via a surface receptor called CD4. This
receptor can be found on many cells on the body, but presents itself in particularly higher
concentration on the surface of T4 or CD4 cells. Additionally, the virus can also use a receptor
called CXCKR4 (also found on the membrane) to facilitate fusion of the virus membrane with
that of the cells membrane. With the viral capsid inside the cell, it will begin to move towards
the cell nucleus. Then an enzyme within the viral capside, reverse transcriptase, copies the HIV
RNA into DNA. Afterwards, it will break down the old RNA replacing it with a complementary
strand for the new DNA. Now that the DNA copy of the HIV genome has been made, it will pass

through to the nucleus and the enzyme integrase will insert the HIV DNA into the host cells
DNA. At this point, when the cell becomes activated, it will essentially become a manufacturer
for the virus to replicate itself. Although the body is constantly making new T4 cells, the rate at
which these are infected and destroyed by HIV is slightly greater. This fact, left unaddressed, is
what contributes to the eventual decline of an individual with HIV into AIDS. Specifically, it is
when the individuals CD4 cell count falls below 200 cells/L that he/she may be classified as
having AIDS.
The way initial symptoms present themselves in the case of a newly infected individual
may initially seem flu-like, as during the acute infection stage (the earliest stage of infection) one
might experience fevers, sweats, body aches, nausea, chills, and headache. Some of these
symptoms may be brought upon by the activation of the immune system in response to the
infection, in which the release of cell-signaling chemicals called cytokines occurs. During this
beginning stage of infection, the body develops antibodies in an attempt to mitigate the infection
however, as this can take some time, (weeks to months) a blood test ran on one suspected to be
recently infected may result in a false positive as the test is dependent on an antibodys presence.
Once the antibody forms, it can be considered that the individual has entered a period of early
infection. At this stage, viral load is kept mostly in check at a more or less constant level. After
that point, the infection will enter a quiet phase, or the period of latency, in which obvious
symptoms may not manifest for months to years. During this latency period, the individuals
number of CD4 cells continues to drop, and the individual will unlikely to suspect HIV if not
previously suspecting before at this point.
For those infected with HIV or AIDS, there is no full-proof cure, nor any sort of
inoculation for those not yet affected. Opportunistic infections must be treated following
guidelines for the individual disease. For those already affected with AIDS, due to the possibility
of taking on multiple opportunistic infections/cancers at the same time, without treatment those
who have progressed to AIDS have a life expectancy of about 3-years. However an anti-HIV
therapy called highly active antiretroviral therapy (HAART), has proven effective in prolonging
the life expentancy of one with AIDS by three to ten years. HIV-positive individuals who
antiretroviral therapy (ART) and manage to maintain a low viral load can have a life expectancy
similar to those who test negative, never reaching full-blown AIDS. Although, due to the nature
of the HIV reverse transcriptase making many mutations during the synthesis of DNA, resistance
to individual anti-HIV drugs is a prevalent issue. This is less so with HAART, as it is a cocktail
therapy, using a combination of multiple drugs, and thus can maintain effectiveness for an
extended period of time. Although more effective treatments are continuously being worked on,
HIV/AIDS proves to be a tenacious disease that clearly demands our utmost attention and effort
if we wish to raise a generation free of HIV/AIDS.

Literature Cited

Bell, Sigall K., Kevin Selby, and Courtney L. McMickens. Aids. Santa Barbara, Calif:
Greenwood, 2011. eBook Collection (EBSCOhost)
De Cock, Kevin M., Harold W. Jaffe, and James W. Curran. "Reflections On 30 Years Of AIDS."
Emerging Infectious Diseases 17.6 (2011): 1044.
McLaughlin, Loretta. "AIDS: An Overview." New England Journal Of Public Policy

24.1

(2013): 15-35.
Meyer, Ralph R., PhD, and Richard, PhD Adler. "Acquired Immunodeficiency Syndrome
(AIDS)." MagillS Medical Guide (Online Edition) (2014): Research Starters.