People suffering from HIV infection. Briefly about what HIV infection is. Terminal stage of HIV infection

This is a disease caused by an RNA virus. HIV infection is a chronic, gradually progressive condition. Its manifestations are associated with damage to the immune system, which begins to work insufficiently and does not protect the body well. This condition is called immunodeficiency.

Human immunodeficiency virus and AIDS are different concepts. Acquired immunodeficiency syndrome is accompanied by clinical symptoms, in particular, enlarged lymph nodes. Subsequently, weakened immunity cannot respond to the entry of bacteria, fungi and other infectious agents into the patient’s body. Secondary infections occur, from which the patient dies. In addition, AIDS is accompanied by the appearance of certain malignant tumors.

The causative agent of the disease is a virus, the genetic material of which is able to integrate into the DNA of immune cells. It is transmitted through sexual contact and blood. In the first decades of the epidemic, manifestations of the disease developed mainly in homosexuals, then in people using drugs intravenously. In recent years, the disease has often been observed in women who became infected through sexual contact.

Infection in children usually occurs due to transmission of viral particles from the mother during pregnancy or childbirth. There have been outbreaks of morbidity caused by transfusions of infected blood. However, now this possibility is practically excluded, since all donor biomaterials are carefully checked.

The human immunodeficiency virus causes the formation of antibodies to it in the body. They are not able to destroy the pathogen embedded in the DNA of immune cells. Detection of such antibodies is part of diagnosing the disease.

How long do people live with HIV infection? If the disease is severe and there is no medical care, death is possible within 3 to 4 years. However, some people who became infected at the beginning of the epidemic in the 1980s are still living. Antiretroviral therapy has been used relatively recently, and it is unknown how much it can prolong a person's normal life.

If a patient learns about his diagnosis in time, is seen by a doctor, and begins the necessary treatment on time, then his risk of dying from complications of the virus is low. Such people are not dangerous to others and can live a full and long life.

Methods of infection

HIV infection can only be transmitted from an infected person. The incubation period of the disease is 30 days, after which the patient feels healthy, but already poses a danger to others. A large amount of the virus is found in the following biological materials:

• blood;
• sperm;
• discharge from the vagina and cervical canal;
• cerebrospinal fluid;
• breast milk;
• internal organs.

There are few viral particles in saliva, urine and tear fluid, and transmission through them is impossible.

There are 2 ways of transmitting the disease: sexual contact and parenteral.

In the first case, the virus enters the body through mucous membranes or damaged skin. Anogenital and orogenital sexual intercourse, as well as unprotected sex in case of inflammatory diseases of the genital organs, are especially dangerous.

How HIV infection is transmitted non-sexually:

• by transfusion of contaminated blood;
• during an organ transplant from a sick donor;
• when using the same non-sterile syringe by different people.

How children become infected: in the prenatal period through the placenta, during childbirth. The probability of giving birth to an infected child to a sick mother ranges from 25 to 40%. The risk increases if a woman is ill in the AIDS stage, has a high viral load, is prematurity, or has a natural birth. The virus can also be transmitted through breastfeeding.

The best way to avoid infection is to take a responsible attitude towards your health and choice of sexual partner. Every person should know how to contract an infection and avoid dangerous situations. A condom protects against the disease in 93–97% of cases of contact with an infected partner, and is therefore considered a reliable means of prevention. If infection does occur, you must regularly visit a doctor at a specialized center.

Signs and manifestations of the disease

Manifestations of infection occur at the acute stage and at the AIDS stage. After infection, nonspecific manifestations of pathology may occur - fever, sore throat, muscle pain, nausea. The patient may develop a skin rash, stomatitis, and enlarged lymph nodes.

The first signs of HIV infection go away on their own within 1 to 3 weeks. A latent period ensues, which can last for years and is not accompanied by symptoms other than enlarged lymph nodes. At this time, the disease can only be detected by changes in blood tests.

With severe suppression of immunity, the AIDS stage develops. It is characterized by the addition of a secondary infection. The patient's condition worsens. A cough occurs - a sign of pneumonia. Characterized by diarrhea lasting more than a month, persistent fever, and weight loss. Candidiasis, tuberculosis, herpes, fungal infections, and toxoplasmosis are also included. Malignant tumors arise - lymphomas, Kaposi's sarcoma. Signs of the disease in women with AIDS include cervical cancer. The nervous system is affected, encephalopathy and dementia develop. As a result, the patient dies from manifestations of one of the associated pathologies.

Stages of human immunodeficiency virus

According to the classification of V.I. Pokrovsky, the following stages of HIV infection are distinguished.

The incubation (initial) period lasts up to 2 months. At this time, there are no antibodies in the patient’s blood, and there are no clinical signs. However, a person can already become a source of infection.

The first stage, or acute period, is accompanied by fever, joint pain and other nonspecific symptoms reminiscent of a cold. Sometimes this phase is asymptomatic. The virus can already be detected in the blood of patients, but antibodies to it are not yet produced in the body.

This is followed by the latent stage. It lasts for several years. The patient is not worried about anything, but when examining his blood, antibodies can be detected, and he himself is the source of infection. At the end of this period, damage to the lymph nodes (lymphadenopathy) occurs. Proper therapy can significantly prolong this stage.

At the AIDS stage, secondary diseases are added:

• bacterial or Pneumocystis pneumonia;
• candidiasis of the mucous membranes and various organs;
• tumors (lymphomas, Kaposi's sarcoma);
• other fungal, microbial or protozoal infections.

Clinical signs of HIV infection are similar in men and women. Manifestations of intoxication, fever, sweating, diarrhea, and rapid weight loss are noted.

In the terminal stage, exhaustion, intoxication, and dementia increase. The patient dies from concomitant infections.

Symptoms of the disease

At first after infection, there may be no symptoms of HIV infection. Some patients mistake them for the flu or other colds. Early clinical signs are called acute retroviral syndrome. It includes the following symptoms:

• stomach pain, nausea or vomiting;
• loose stools;
• enlarged cervical, axillary, inguinal lymph nodes;
• headache;
• pain in joints and muscles;
• skin rashes;
• a sore throat;
• weight loss.

Initial manifestations may vary in severity, but they usually disappear on their own after 2 to 3 weeks. Many patients do not notice them.

After the first signs of the disease disappear, an infected person may feel well for many years.

Patients can only be identified through a blood test. Antibodies to the virus are detected in it. The analysis is prescribed by a doctor before any operation, during hospitalization, for pregnant women and in other cases. Once the diagnosis is confirmed, the patient should be constantly monitored by an infectious disease specialist, regularly examined and, if necessary, begin treatment.

If antiviral therapy is not started in time, AIDS will develop - irreversible damage to the immune system.

Late manifestations of the disease:

• constant diarrhea;
• weakness;
• prolonged fever;
• loss of appetite and weight;
• cough and shortness of breath, signs of pneumonia;
• night sweats;
• swollen lymph nodes;
• pain when swallowing;
• impaired consciousness, difficulty concentrating, personality changes;
• genital herpes;
• tingling and numbness of the limbs;
• sores in the mouth.

In women, infection should be suspected in one of the following conditions:

• more than 3 episodes of vaginal candidiasis during the year, not associated with taking antibiotics;
• recurrent inflammatory diseases of the pelvic organs;
• abnormal Pap test or cervical cancer.

In children, the disease manifests itself no earlier than 4 months of life, often after reaching 5 years of age. Most often observed:

• growth retardation;
• enlarged spleen;
• oral candidiasis;
• fungal skin diseases;
• hemorrhagic rash;
• decreased platelet count, causing bleeding.

Kaposi's sarcoma and other tumors do not occur in children.

Diagnosis of the disease

Recognition of the disease is based on identifying its risk factors (drug addiction, promiscuity) and clinical manifestations. Diagnosis of HIV infection is carried out using laboratory tests.

The first sign of HIV, which appears 3 months after infection, is the appearance of specific antibodies to the virus in the blood. They are detected by enzyme immunoassay (ELISA) in 90–95% of patients. If the reaction is positive, it is necessary to confirm the diagnosis using immunoblotting - detection of antibodies to certain protein structures of the virus. However, false positive results are very rare.

Human immunodeficiency virus can be detected in the blood using the polymerase chain reaction. It determines how many viral particles (copies) are present in 1 μl of plasma. This is how the viral load is measured. Detection of any number of antigens confirms the disease.

To assess the state of immunity in the blood, the number of types of lymphocytes - T-helpers and T-suppressors - is counted. Normally, the helper/suppressor ratio is 1.8 – 2.1. With illness, it decreases to less than 1.0.

Each person is encouraged to use the anonymous testing option. Timely diagnosis of the disease will help to start therapy on time, slow down the course of the disease and save the patient’s life. If the result is negative and doubts persist, it is recommended to repeat the ELISA test after 90 days.

Treatment of the disease

This disease cannot yet be cured. If treatment for HIV infection is carried out according to all the rules, in many patients viral particles are not detected in the blood. However, after stopping antiviral therapy, they reappear. One of the problems of treatment is the resistance (resistance) of the pathogen to drugs. The main reason for this phenomenon is the patient’s reluctance to follow the specialist’s recommendations. Resistance can appear very quickly and be cross-resistance, that is, to several drugs at once. However, in most patients the effectiveness of treatment is very high.

Until recently, it was not entirely clear when and to whom to prescribe this or that medicine for HIV infection. Doctors have now established that antiviral therapy should be prescribed to all patients, regardless of the number of lymphocytes and viral load, when the first signs of infection appear, that is, immediately after the initial diagnosis.

Before starting to use medications, you need to make sure that the patient will take the medications according to the required regimen. The patient must be provided with information about possible side effects of medications. He must understand that medicine against the disease must be taken for life. Drug addiction, depression, and social isolation reduce the likelihood of successful treatment.

The drug for the treatment of human immunodeficiency virus is a combination of two nucleoside reverse transcriptase inhibitors and one non-nucleoside reverse transcriptase inhibitor. There are ready-made dosage forms containing the necessary components in one tablet.

These drugs block the process of integrating the virus's genetic material into the DNA of human immune cells, protecting them from infection. These include zidovudine, stavudine, didanosine, abacavir, lamivudil, zalcitabine, tenofovir. Ready-made combinations can be found under the names Truvada, Combivir, Epzicom or Trizivir.

Non-nucleoside reverse transcriptase inhibitors - delavirdine, efavirenz, nevirapine, etravirine, rilpivirine. They are part of ready-made combinations of Compler and Atripla. This medicine can be taken one tablet per day.

Protease inhibitors block the viral enzyme, resulting in the resulting copies being unable to infect healthy cells. These include amprenavir, atazanavir, indinavir, lopinavir and others. Taking them in combination with other medications can reduce the viral load.

Another group of medications are penetration inhibitors that prevent the virus from entering the cell (enfuvirtide and maraviroc). They are used in addition to the main therapy depending on the severity of the disease.

A special feature of treatment is lifelong medication. Skipping each pill reduces the likelihood of a positive course of the disease. Changing the dosage regimen should be agreed with the attending physician to reduce the risk of complications, including the development of drug resistance.

The treatment regimen is selected for each patient individually. Detailed recommendations for doctors have been developed, taking into account all possible situations. With adequate treatment, a person can lead a normal life and start a family. Women give birth to healthy children. However, this requires constant monitoring by a specialist and compliance with all prescriptions.

The difficulties in treating this infection are due to the fact that each new human immunodeficiency virus formed in the body may have different characteristics than its predecessor. The rapid variability of viral particles and their nucleic acids is the reason for the impossibility to create a vaccine against AIDS to this day.

Prevention

The spread of this disease has long been recognized as an epidemic. Prevention is necessary not only at the level of medical institutions, but also in everyday life. Although some patients have been infected through blood transfusions or medical procedures, individual prevention is aimed at refraining from dangerous behavior. You need to know that the source of infection can be an apparently healthy person. At the same time, viruses are contained in his blood and biological fluids of the body. Prevention measures:

• knowledge of your status among yourself and your partner;
• using latex condoms during any sexual contact with a partner;
• limiting the number of sexual partners;
• cessation of injection drug use;
• Seeing a doctor immediately after suspected infection, since sometimes antiretroviral drugs for prophylaxis can prevent the development of immunodeficiency if taken early.

You need to know that infection does not occur through sweat or tears, shallow kisses, handshakes, household contacts, insect bites, water or air. Prevention of AIDS and HIV infection in medical institutions consists of identifying clinical and laboratory signs of the disease in patients, as well as in women during pregnancy. Careful handling of medical instruments is necessary, and, if possible, the use of disposable devices.

Prevention of the disease at the state level consists of combating drug addiction, providing opportunities for free examination and treatment to all citizens of the country. There is no specific prevention, that is, a vaccine or inoculation against the human immunodeficiency virus.

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AIDS - acquired immunodeficiency syndrome. This disease is caused by the human immunodeficiency virus (HIV). The human immunodeficiency virus weakens the immune system, causing the body to lose its ability to resist various diseases. The term AIDS refers to the final stage of HIV infection; it is characterized by damage to the human immune system, against which concomitant diseases of the lungs, gastrointestinal tract, and brain develop. The disease ends in death.
The abbreviation AIDS stands for Acquired Immune Deficiency Syndrome.

Syndrome is a set of signs and symptoms characteristic of a disease.

Acquired - a disease acquired during life.

Immunodeficiency is insufficient activity of the body's immune system.
The human immunodeficiency virus (HIV) infects and develops in living cells (lymphocytes). Living cells are used as an “incubator” in which viruses divide and multiply. The dimensions of HIV are very small: about 100 thousand viral particles can fit along a line 1 cm long. The virus causes a slow-acting disease with a long latent (incubation) period (from the moment of infection to the appearance of signs of the disease). Therefore, having penetrated the human body, HIV does not manifest itself in any way at first. Staff warn that it may take years for AIDS to develop.

Course of the disease
The insidiousness of HIV lies in the fact that, once it enters the body, it does not manifest itself for a long time, and it can only be detected through laboratory testing. During the course of the disease caused by the human immunodeficiency virus, there are several stages:
First stage- absence of clinical manifestations of HIV infection. This stage lasts from 2 to 15 years. This is called an asymptomatic infection. A person can look and feel healthy and still transmit the infection to others.
The second stage is pre-AIDS. Characterized by the appearance of the first symptoms of the disease: enlarged lymph nodes; weight loss; fever; weakness.
The third stage is AIDS. Lasts from several months to 2 years, ending in the death of the patient. Characterized by the development of severe, life-threatening diseases caused by fungi, bacteria and viruses.

Routes of transmission of HIV infection
HIV does not live in animals. For its vital activity and reproduction, it needs human cells, so it cannot be transmitted from animals to humans. This position was proven by American scientists working in a monkey nursery. In experiments on rats, mice, peacocks and cats, it was never possible to get infected. Therefore, you can only become infected with the virus that causes AIDS from a person who is the source of HIV infection.
In an HIV-infected person, the virus content in different fluids is not the same. The largest amount of virus sufficient to infect another person is found in the blood, semen, vaginal secretions, cerebrospinal fluid, and breast milk of an HIV-infected person. Therefore, we can talk about three ways of transmitting HIV infection:

• sexual;
• parenteral (virus enters the blood);
• vertical (from an HIV-infected mother to a child during pregnancy, childbirth, feeding).

• with friendly hugs and kisses;
• through a handshake;
• when using school supplies, a computer, cutlery, outerwear;
• through sanitary equipment, when using a swimming pool, shower;
• in public transport;
• insects, including blood-sucking ones;
• through industrial and home furnishings;
• by airborne droplets;

The degree of risk of contracting HIV infection. At-risk groups
There are people who are at high risk of becoming infected with HIV. It depends on the person’s behavior, which determines the degree of risk: having a large number of sexual partners; sexual intercourse without a condom; carrying out sexual intercourse in the presence of sexually transmitted diseases; the use of the same needles and syringes by several people when injecting drugs intravenously. Therefore, vulnerable groups include:

• drug addicts;
• homosexuals;
• prostitutes;
• persons with promiscuous sexual relations.

Prevention measures
The world has not yet invented drugs and vaccines that could cure HIV infection or prevent infection. The outcome of the disease is fatal. Only safe behavior and a responsible attitude towards one’s health will protect against infection with the human immunodeficiency virus.
Sexual route of infection. A person who does not have sexual intercourse and does not inject drugs has a zero risk of contracting HIV.
Early sexual intercourse can lead to unwanted pregnancy, infection with sexually transmitted diseases, and AIDS. Do our children need this? Are they ready to become parents themselves? Therefore, the basis for preventing HIV infection should be:

• Safe and responsible behavior, healthy lifestyle.
• Avoid early sexual relations. Abstinence from sexual relations before marriage helps to create truly deep relationships, develop patience and self-control, opens up the opportunity to enjoy youth, helps to realize the uniqueness of marital relationships, and eliminates the fear of contracting sexually transmitted infections and their consequences.
• Maintaining fidelity in marriage.
• Using condoms during casual sex.
• Use of individual personal hygiene items.

HIV-infected and AIDS patients and the ethics of relationships with them
AIDS is not only medical problem, as it leads to various social consequences, creates problems both for HIV-infected people themselves, and for their relatives, friends, and for all people who are in one way or another connected with them.

Legal aspects of the HIV/AIDS problem
Issues of the spread of HIV infection are addressed by a number of legislative acts. Thus, the Criminal Code provides for punishment in the form of imprisonment for a term of up to three years for knowingly placing another person at risk of contracting AIDS; imprisonment for a term of up to seven years for infecting another person with AIDS by a person who knew that he had this disease.
The Law “On State Benefits for Families Raising Children” provides for a pension benefit for children living with HIV and AIDS up to 16 years of age.
The Laws “On Health Care” and “On the Sanitary Welfare of the Population” guarantee:

• provision of free medicines for the treatment of AIDS;
• provision of treatment in any medical institution;
• prevention of dismissal from work, refusal to hire HIV-infected persons;
• the right of citizens to a medical examination, including an anonymous one;
• ensuring medical institution security and confidentiality of the examination.

Based on Internet materials, prepared by dentist O.F. Pirozhnik

HIV infection (infection caused by the human immunodeficiency virus) is a global health problem, the consequences of which kill about a million people every year. For example, in 2014, 1.2 million people died from HIV-related causes. The number of people infected with HIV is in the tens of millions. In Russia, as of the end of January 2016, the number of HIV-infected people reached 1 million people.

AIDS virus

At its core, HIV infection is a slowly progressive viral disease that affects the immune system, the extreme stage of development of which is AIDS (acquired immunodeficiency syndrome). Patients do not die from HIV infection itself, but the suppression of immunity that occurs under the influence of the virus leads to the fact that a person becomes unprotected against cancer and severe infectious diseases that are not dangerous for people with normal immunity.

In this regard, it is extremely important to detect HIV infection in a timely manner and begin treatment, which allows the infected person to live quite actively and productively for decades.

HIV infection is caused by a special retrovirus, the human immunodeficiency virus (HIV). which opened in 1983. It is quite unstable to physical and chemical factors when compared, for example, with hepatitis viruses. Both salivary enzymes and gastric juice are harmful to HIV. Outside the body, it quickly dies - as soon as the blood, sperm and other fluids of the human body dry out. Temperatures above 56 degrees kill this virus instantly. All these factors influence the characteristics of HIV transmission.

HIV is especially prone to attack immune system cells that have specific CD4 receptors on their surface. These cells include T-helper lymphocytes, monocytes, macrophages, dendritic and other cells. The mechanisms by which HIV affects the immune system are quite complex, but the final result is a significant decrease in the number of CD4+ lymphocytes and suppression of the immune system.

Some people are not naturally susceptible to HIV. Their immune cells contain not normal, but partially altered proteins (CCR5) on the membrane, which is why the interaction of cells with the virus simply cannot occur. In addition, among people infected with HIV, about 1-5% are non-progressors. Their HIV infection does not progress, lymphocytes do not die, and AIDS does not develop. This phenomenon serves as an example of asymptomatic carriage, which occurs in other infectious diseases.

How does HIV infection occur?

HIV, in a concentration sufficient to infect another person, is found only in certain environments of the body: blood, pre-ejaculate, semen, vaginal secretions, milk, lymph. When these media come into contact with damaged skin and mucous membranes, or when they penetrate directly into the bloodstream of a healthy person, infection occurs. Saliva, tears and other body fluids do not pose a risk of transmitting infection, provided they do not contain blood.

Intact skin is a reliable barrier to HIV, but mucous membranes are more susceptible because they contain dendritic cells. They have CD4 receptors on their surface and can act as a carrier of a dangerous infection into the lymphatic system. Moreover, even minimal damage to the mucous membrane, which is not always noticeable to the naked eye, is already a high risk of infection. Therefore, with genital infections that provoke the development of inflammatory processes, erosions, ulcers on the genital mucosa, the penetration of HIV into the internal environment of the body is greatly simplified.

Based on all this, it can be argued that HIV infection is most likely possible in the following cases:

• When using contaminated needles. This route of transmission is especially relevant for injection drug users.
• When transfusing insufficiently tested donor blood or its components.
• During unprotected sexual intercourse (if we evaluate the level of danger, then anal sex comes first, then vaginal and oral sex). The risk of infection is always higher with the receiving partner and in the presence of concomitant sexually transmitted infections.
• During pregnancy and childbirth from a sick mother to a child.
• When breastfeeding (in newborns there are no enzymes in the saliva and gastric juice that kill HIV).

It is also worth noting that HIV is not transmitted through:

• shared dishes, bedding, etc.;
• insect bites;
• shaking hands (if there are no open wounds on the hands);
• embrace;
• air;
• food;
• water (for example, in a swimming pool);
• kissing (again, provided that both partners do not have any injuries on the lips or in the oral cavity).

At-risk groups

Some people are at particularly high risk of contracting HIV and should be tested regularly for the infection. These risk groups include:

• Injecting drug addicts and their sexual partners.
• People who practice unprotected sex (in both homosexual and heterosexual couples) and frequently change partners.
• Medical workers who, due to their professional activities, may have direct contact with the blood or mucous membranes of an infected person.
• Persons who have had blood or its components transfused.
• Children born to HIV-infected mothers.

Clinical picture

HIV infection has the following stages of development:

• Incubation period, which lasts from several days to 2-3 weeks.
• Acute phase. It usually lasts 10-14 days and most often occurs in the form of “flu-like” or “mononucleosis-like” syndromes. Patients are concerned about low-grade fever, enlarged and painful lymph nodes, pain in joints and muscles, rash on the body, ulcers on the oral mucosa, sore throat, general weakness. Nausea and diarrhea may also occur. The development of all these symptoms is associated with very active reproduction of virions in lymphoid tissue, high viral load (concentration of viruses in the blood) and a sharp drop in the number of CD4+ lymphocytes. During the acute phase, the patient is considered to be most contagious. It is also worth noting that this phase may be asymptomatic.
• Latent period. At this stage of the disease, almost all the symptoms described above disappear, and the patient’s immune system “comes to its senses” - the number of lymphocytes increases, and for some time the body maintains them at a level that provides adequate immune protection. This period lasts 5-10 years, if the patient receives antiretroviral treatment - for decades. The only sign that in the latent period may indicate that something pathological is happening in the body is an enlargement of the lymph nodes.
• PreAIDS. This stage begins when the level of CD4+ lymphocytes drops critically and approaches 200 cells in 1 μl of blood. As a result of such suppression of the immune system (its cellular component), the patient develops: recurrent herpes and candidiasis of the oral cavity, genitals, herpes zoster, hairy leukoplakia of the tongue (whitish protruding folds and plaques on the lateral surfaces of the tongue). In general, any infectious disease (for example, tuberculosis, salmonellosis, pneumonia) is more severe than in the general population. In addition, this stage of HIV infection is characterized by a progressive decrease in the patient’s weight.
• AIDS. This is already the terminal stage of the disease, which without treatment ends in the death of a person within 1-3 years. The cause of such disastrous consequences of HIV infection are opportunistic infections (those that do not develop in people with normal immunity), severe non-communicable diseases and cancer.

The following factors can accelerate the progression of HIV infection:

• Elderly age.
• The presence of other viral diseases (for example, hepatitis).
• Poor nutrition.
• Unsatisfactory living conditions.
• Stress.
• Bad habits.
• Genetic features.

Signs of HIV infection

Assessing existing symptoms of a disease and making diagnoses is the prerogative of doctors, but every sane person should know Signs that may indicate HIV infection:

• Unreasonable prolonged increase in body temperature.
• Enlarged lymph nodes.
• Sudden unjustified weight loss.
• Prolonged diarrhea of ​​unknown etiology.
• Tendency to chronicity and constant recurrence of bacterial and viral infectious diseases.
• The occurrence of ailments caused by opportunistic bacteria, fungi, protozoa (this indicates an immunodeficiency state).

Who needs HIV testing:

Why you need to know your HIV status:

• In case of a positive result, treatment can be started in a timely manner and the development of AIDS can be prevented.
• To prevent infection of other people if HIV infection is confirmed.

HIV testing is carried out free of charge, voluntarily (with the exception of certain categories of citizens, which in the Russian Federation include the following) and, if desired, anonymously. However, it is worth noting that the anonymous result has no legal force. For example, it cannot be attached to a pregnant woman’s exchange card or provided to migration service agencies.

You can get tested for HIV in specialized centers for the prevention and control of AIDS, as well as in city clinics.

There are two types of HIV tests:

• Indirect, allowing to detect antibodies to the virus in the blood using ELISA (screening tests and confirmatory tests).
• Direct – detection of the virus itself, its antigens and RNA (viral load).

HIV screening tests are quick, accessible and fairly informative tests that are used for mass screening of people. If the screening test is positive, it is repeated to rule out error. A repeated positive result requires confirmation by a more accurate, but also expensive analysis - immunoblotting.

In addition, with HIV infection there is such a thing as a “window” period - this is the time during which, after infection, antibodies to HIV are not detected in the patient’s blood. The duration of this period largely depends on the immune status of the person, that is, an exact figure cannot be given. However, it is believed that modern ELISA test systems can “detect” antibodies within 3-5 weeks after infection in most people. But still, in order not to make a mistake, it is advisable after the first negative examination to undergo 2 more with an interval of 3 months. In rare cases, if a person has problems with the immune system, the “window” period can last up to a year.

As for direct tests for detecting HIV, the most often used in practice is the detection of viral RNA by the polymerase chain reaction (PCR) method. This test can show that a person is infected with HIV even when they are in their window period. But a doctor cannot make a diagnosis of HIV infection based only on this result without confirmation by other tests, except in cases in which the assessment of the patient’s immune response may be incorrect. For example, in children born to HIV-positive mothers. Maternal antibodies are transferred to newborns, which will be detected in the child up to 18 months. In addition, a PCR test (viral load determination) is used during patient treatment to determine the effectiveness of the therapy received.

Treatment

There are no medications that can completely remove HIV from the human body, so this disease is considered incurable. However, highly active antiretroviral therapy (HAART) can significantly slow the progression of the infection. In addition, against the background of antiretroviral therapy, the patient becomes less infectious (this is one of the aspects of preventing HIV infection).

HAART requires the patient to take three or four antiviral drugs (acting at different stages of the virus) for life. It is very important that the patient observes the dosage and regularity of taking medications. Failure to comply with recommendations leads to the virus developing resistance to drugs, and it is necessary to switch to other, often more expensive, treatment regimens.

Drugs used in the treatment of HIV infection include the following:

• Nucleoside reverse transcriptase inhibitors (Zidovudine, Lamivudine, Tenofovir, Abacovir, etc.).
• Non-nucleoside reverse transcriptase inhibitors (Nevirapine, Etravirine, Efavirenz, etc.).
• Protease inhibitors (Amprenavir, Atazanavir, Nelfinavir, Ritonavir, etc.).
• Integrase inhibitors (Dolutegravir, Raltegravir).
• Receptor inhibitors (Maraviroc).
• Fusion inhibitors (Enfuvirtide).

It is worth noting that HAART is not prescribed to everyone infected with HIV. Patients are selected according to three main criteria: the presence of symptoms of immunodeficiency, the concentration of CD4+ lymphocytes and viral load. But in September 2015, WHO issued new recommendations that all people with HIV, as well as those at high risk of infection, should be treated with antiretroviral drugs (this preventive treatment is called pre-exposure prophylaxis). These measures, according to WHO estimates, should save tens of millions of lives and tens of millions more people from contracting a dangerous disease in the near future. WHO recommendations can be read.

Forecast

Without treatment, HIV infection ends in the death of the patient on average after 9-11 years. If HAART is carried out and the patient follows all the doctor’s recommendations regarding lifestyle, bad habits, nutrition, as well as regular monitoring of health, most people with HIV can live to old age.

Prevention of HIV/AIDS

• Using condoms.
• Regular HIV testing of representatives of risk groups.
• Medical circumcision of the foreskin in men.
• Antiretroviral therapy for preventive purposes. This includes pre-exposure prophylaxis for HIV-negative partners of people with HIV and post-exposure prophylaxis after possible exposure.
• Harm reduction for injection drug users (programs to replace used syringes, opioid substitution therapy, HIV testing, etc. should be conducted).
• Eliminating mother-to-child transmission of the virus. To achieve this, all women with HIV and their newborns must be provided with antiretroviral therapy. In such situations, breastfeeding is also not recommended.

In addition, preventive measures include mandatory testing of donor blood, compliance with the appropriate regime in medical institutions, and educational work among the population.

If we talk about preventing HIV infection for a particular person, then the following rules of life should be for him: rejection of casual sex, protected sex and a negative attitude towards drugs.

Good day, dear readers!

In today's article we will look at such a serious disease as HIV infection, and everything connected with it - causes, how it is transmitted, first signs, symptoms, stages of development, types, tests, tests, diagnosis, treatment, medications, prevention and other useful information. So…

What does HIV mean?

HIV infection in children

HIV infection in children is in many cases accompanied by developmental delays (physical and psychomotor), frequent infectious diseases, pneumonitis, encephalopathy, hyperplasia of the pulmonary lymphatics, and hemorrhagic syndrome. Moreover, HIV infection in children acquired from infected mothers is characterized by a more rapid course and progression.

The main cause of HIV infection is infection with the human immunodeficiency virus. The cause of AIDS is also the same virus, because AIDS is the last stage of development of HIV infection.

is a slowly developing virus belonging to the family of retroviruses (Retroviridae) and the genus of lentiviruses (Lentivirus). It is the word “lente” translated from Latin that means “slow”, which partially characterizes this infection, which develops quite slowly from the moment it enters the body until the last stage.

The size of the human immunodeficiency virus is only about 100-120 nanometers, which is almost 60 times smaller than the diameter of a blood particle - an erythrocyte.

The complexity of HIV lies in its frequent genetic changes during the process of self-reproduction - almost every virus differs from its predecessor by at least 1 nucleotide.

In nature, as of 2017, 4 types of virus are known - HIV-1 (HIV-1), HIV-2 (HIV-2), HIV-3 (HIV-3) and HIV-4 (HIV-4), each of which differs in genome structure and other properties.

It is HIV-1 infection that plays a role in the disease of most HIV-infected people, therefore, when the subtype number is not indicated, 1 is implied by default.

The source of HIV is people infected with the virus.

The main routes of infection are: injections (especially injection drugs), transfusions (blood, plasma, red blood cells) or organ transplantation, unprotected sexual contact with a stranger, unnatural sex (anal, oral), trauma during childbirth, feeding a baby with breast milk (if the mother is infected), trauma during childbirth, the use of undisinfected medical or cosmetic items (scalpel, needles, scissors, tattoo machines, dental and other instruments).

For HIV infection and its further spread throughout the body and development, it is necessary that the infected blood, mucus, sperm and other biomaterials of the patient enter the human bloodstream or lymphatic system.

An interesting fact is that some people have an innate defense against the human immunodeficiency virus in their bodies, so they are resistant to HIV. The following elements have such protective properties: the CCR5 protein, the TRIM5a protein, the CAML protein (calcium-modulated cyclophilin ligand), as well as the interferon-inducible transmembrane protein CD317/BST-2 (“tetherin”).

By the way, the CD317 protein, in addition to retroviruses, also actively counteracts arenaviruses, filoviruses and herpesviruses. The cofactor for CD317 is the cellular protein BCA2.

HIV Risk Groups

• Drug addicts, mainly injecting drug users;
• Sexual partners of drug addicts;
• Persons who are promiscuous, as well as those who engage in unnatural sex;
• Prostitutes and their clients;
• Donors and people in need of blood transfusion or organ transplantation;
• People suffering from sexually transmitted diseases;
• Doctors.

The classification of HIV infection is as follows:

Classification by clinical manifestations (in the Russian Federation and some CIS countries):

1. Incubation stage.

2. The stage of primary manifestations, which, depending on the course options, can be:

• without clinical manifestations (asymptomatic);
• acute course without secondary diseases;
• acute course with secondary diseases;

3. Subclinical stage.

4. The stage of secondary diseases caused by damage to the body by viruses, bacteria, fungi and other types of infection that develop against the background of weakened immunity. Downstream it is divided into:

A) body weight decreases by less than 10%, as well as frequently recurring infectious diseases of the skin and mucous membranes - pharyngitis, otitis media, herpes zoster, angular cheilitis ();

B) body weight decreases by more than 10%, as well as persistent and often recurring infectious diseases of the skin, mucous membranes and internal organs - sinusitis, pharyngitis, herpes zoster, fever or diarrhea (diarrhea) for a month, localized Kaposi's sarcoma;

C) body weight is significantly reduced (cachexia), as well as persistent generalized infectious diseases of the respiratory, digestive, nervous and other systems - candidiasis (trachea, bronchi, lungs, esophagus), Pneumocystis pneumonia, extrapulmonary tuberculosis, herpes, encephalopathy, meningitis, cancer tumors (disseminated Kaposi's sarcoma).

All options for the course of the 4th stage have the following phases:

• progression of pathology in the absence of highly active antiretroviral therapy (HAART);
• progression of pathology during HAART;
• remission during or after HAART.

5. Terminal stage (AIDS).

The above classification largely coincides with the classification approved by the World Health Organization (WHO).

Classification by clinical manifestations (CDC - US Center for Disease Control and Prevention):

The CDC classification includes not only the clinical manifestations of the disease, but also the number of CD4 + T-lymphocytes in 1 μl of blood. It is based on the division of HIV infection into only 2 categories: the disease itself and AIDS. If the following parameters meet criteria A3, B3, C1, C2 and C3, the patient is considered as having AIDS.

Symptoms according to CDC category:

A (acute retroviral syndrome) – characterized by an asymptomatic course or generalized lymphadenopathy (GLAP).

B (AIDS-associated complex syndromes) - may be accompanied by oral candidiasis, herpes zoster, cervical dysplasia, peripheral neuropathy, organic lesions, idiopathic thrombocytopenia, leukoplakia or listeriosis.

C (AIDS) – may be accompanied by candidiasis of the respiratory tract (from the oropharynx to the lungs) and/or esophagus, pneumocystosis, pneumonia, herpetic esophagitis, HIV encephalopathy, isosporosis, histoplasmosis, mycobacteriosis, cytomegalovirus infection, cryptosporidiosis, coccidioidosis, cervical cancer, sarcoma Kaposi, lymphoma, salmonellosis and other diseases.

Diagnosis of HIV infection

Diagnosis of HIV infection includes the following examination methods:

• Anamnesis;
• Visual examination of the patient;
• Screening test (detection of blood antibodies to infection using enzyme-linked immunosorbent assay - ELISA);
• A test confirming the presence of antibodies in the blood (blood testing using the immune blotting method (blot)), which is carried out only if the result of the screening test is positive;
• Polymerase chain reaction (PCR);
• Tests for immune status (counting CD4 + lymphocytes - performed using automatic analyzers (flow cytometry method) or manually using microscopes);
• Viral load analysis (counting the number of HIV RNA copies per milliliter of blood plasma);
• Rapid tests for HIV - diagnosis is made using ELISA on test strips, agglutination reaction, immunochromatography or immunological filtration analysis.

Tests alone are not enough to diagnose AIDS. Confirmation occurs only with the additional presence of 2 or more opportunistic diseases associated with this syndrome.

HIV infection - treatment

Treatment of HIV infection is possible only after a thorough diagnosis. However, unfortunately, as of 2017, officially, adequate therapy and medications that would completely eliminate the human immunodeficiency virus and cure the patient have not been established.

The only modern treatment for HIV infection today is highly active antiretroviral therapy (HAART), which is aimed at slowing the progression of the disease and stopping its transition to the AIDS stage. Thanks to HAART, a person’s life can be extended for several decades; the only condition is lifelong use of appropriate medications.

The insidiousness of the human immunodeficiency virus is also its mutation. So, if anti-HIV medications are not changed after some time, which is determined based on constant monitoring of the disease, the virus adapts and the prescribed treatment regimen becomes ineffective. Therefore, at different intervals, the doctor changes the treatment regimen, and with it the medications. The reason for changing the drug may also be the patient’s individual intolerance to it.

Modern drug development is aimed not only at achieving the goal of effectiveness against HIV, but also at reducing side effects from them.

The effectiveness of treatment also increases with changes in a person’s lifestyle, improving its quality - healthy sleep, proper nutrition, avoiding stress, an active lifestyle, positive emotions, etc.

Thus, the following points can be highlighted in the treatment of HIV infection:

• Drug treatment of HIV infection;
• Diet;
• Preventive actions.

Important! Before using medications, be sure to consult your doctor for advice!

1. Drug treatment of HIV infection

At the beginning, we must immediately remind you once again that AIDS is the last stage of the development of HIV infection, and it is at this stage that a person usually has very little time left to live. Therefore, it is very important to prevent the development of AIDS, and this largely depends on timely diagnosis and adequate treatment of HIV infection. We also noted that the only method of treating HIV today is considered to be highly active antiretroviral therapy, which, according to statistics, reduces the risk of developing AIDS to almost 1-2%.

Highly active antiretroviral therapy (HAART)– a method of treating HIV infection based on the simultaneous use of three or four drugs (tritherapy). The number of drugs is related to the mutagenicity of the virus, and in order to bind it at this stage for as long as possible, the doctor selects a complex of drugs. Each of the drugs, depending on the principle of action, is included in a separate group - reverse transcriptase inhibitors (nucleoside and non-nucleoside), integrase inhibitors, protease inhibitors, receptor inhibitors and fusion inhibitors (fusion inhibitors).

HAART has the following goals:

• Virological – aimed at stopping the reproduction and spread of HIV, which is indicated by reducing the viral load by 10 times or more in just 30 days, to 20-50 copies/ml or less in 16-24 weeks, as well as maintaining these indicators for as long as possible;
• Immunological – aimed at restoring the normal functioning and health of the immune system, which is due to the restoration of the number of CD4 lymphocytes and an adequate immune response to infection;
• Clinical – aimed at preventing the formation of secondary infectious diseases and AIDS, which makes it possible to conceive a child.

Medicines for HIV infection

Nucleoside reverse transcriptase inhibitors– the mechanism of action is based on the competitive suppression of the HIV enzyme, which ensures the creation of DNA, which is based on the RNA of the virus. It is the first group of drugs against retroviruses. Well tolerated. Side effects include: lactic acidosis, bone marrow suppression, polyneuropathy and lipoatrophy. The substance is excreted from the body through the kidneys.

Nucleoside reverse transcriptase inhibitors include abacavir (Ziagen), zidovudine (Azidothymidine, Zidovirine, Retrovir, Timazid), lamivudine (Virolam, Heptavir-150, Lamivudine-3TC ", "Epivir"), stavudine ("Aktastav", "Zerit", "Stavudin"), tenofovir ("Viread", "Tenvir"), phosphazide ("Nikavir"), emtricitabine ("Emtriva"), as well as complexes abacavir + lamivudine (Kivexa, Epzicom), zidovudine + lamivudine (Combivir), tenofovir + emtricitabine (Truvada) and zidovudine + lamivudine + abacavir (Trizivir).

Non-nucleoside reverse transcriptase inhibitors– delavirdine (Rescriptor), nevirapine (Viramune), rilpivirine (Edurant), efavirenz (Regast, Sustiva), etravirine (Intelence).

Integrase inhibitors— the mechanism of action is based on blocking the viral enzyme, which is involved in the integration of viral DNA into the genome of the target cell, after which a provirus is formed.

Integrase inhibitors include dolutegravir (Tivicay), raltegravir (Isentress), and elvitegravir (Vitecta).

Protease inhibitors— the mechanism of action is based on blocking the viral protease enzyme (retropepsin), which is directly involved in the cleavage of Gag-Pol polyproteins into individual proteins, after which the mature proteins of the human immunodeficiency virus virion are actually formed.

Protease inhibitors include amprenavir (“Agenerase”), darunavir (“Prezista”), indinavir (“Crixivan”), nelfinavir (“Viracept”), ritonavir (“Norvir”, “Ritonavir”), saquinavir-INV (“ Invirase"), tipranavir ("Aptivus"), fosamprenavir ("Lexiva", "Telzir"), as well as the combination drug lopinavir + ritonavir ("Kaletra").

Receptor inhibitors— the mechanism of action is based on blocking the penetration of HIV into the target cell, which is due to the effect of the substance on the coreceptors CXCR4 and CCR5.

Receptor inhibitors include maraviroc (Celsentri).

Fusion inhibitors (fusion inhibitors)— the mechanism of action is based on blocking the last stage of the introduction of the virus into the target cell.

Among the fusion inhibitors, one can highlight enfuvirtide (Fuzeon).

The use of HAART during pregnancy reduces the risk of transmission of infection from an infected mother to a child to 1%, although without this therapy the percentage of infection of the child is about 20%.

Side effects from the use of HAART medications include pancreatitis, anemia, skin rashes, kidney stones, peripheral neuropathy, lactic acidosis, hyperlipidemia, lipodystrophy, as well as Fanconi syndrome, Stevens-Johnson syndrome and others.

The diet for HIV infection is aimed at preventing the patient from losing weight, as well as providing the body’s cells with the necessary energy and, of course, stimulating and maintaining the normal functioning of not only the immune system, but also other systems.

It is also necessary to pay attention to the certain vulnerability of an immune system weakened by infection, so protect yourself from infection with other types of infection - be sure to follow the rules of personal hygiene and cooking rules.

Nutrition for HIV/AIDS should:

2. Be high in calories, which is why it is recommended to add butter, mayonnaise, cheese, and sour cream to food.

3. Drink plenty of fluids, it is especially useful to drink decoctions and freshly squeezed juices with plenty of vitamin C, which stimulates the immune system - decoction, juices (apple, grape, cherry).

4. Be frequent, 5-6 times a day, but in small portions.

5. Water for drinking and cooking must be purified. Avoid eating expired foods, undercooked meat, raw eggs, and unpasteurized milk.

What can you eat if you have HIV infection:

• Soups - vegetable, cereal, with noodles, meat broth, maybe with the addition of butter;
• Meat - beef, turkey, chicken, lungs, liver, lean fish (preferably sea);
• Cereals – buckwheat, pearl barley, rice, millet and oatmeal;
• Porridge - with the addition of dried fruits, honey, jam;
, and zinc, therefore, special attention should be paid to them when consuming food. In addition, we would like to remind you once again that it stimulates the immune system, which is very important in the fight against infection.

What not to eat if you have HIV infection

If you have the human immunodeficiency virus, you must completely abstain from alcoholic beverages, smoking, weight loss diets, highly allergenic foods, and sweet carbonated drinks.

3. Preventive measures

Preventive measures for HIV infection that must be followed during treatment include:

• Avoiding repeated contact with infection;
• Healthy sleep;
• Compliance with personal hygiene rules;
• Avoiding the possibility of infection with other types of infection -, and others;
• Avoiding stress;
• Timely wet cleaning in the place of residence;
• Avoidance of prolonged exposure to sunlight;
• Complete cessation of alcoholic beverages and smoking;
• Good nutrition;
• Active lifestyle;
• Holidays at sea, in the mountains, i.e. in the most environmentally friendly places.

We will look at additional HIV prevention measures at the end of the article.

Important! Before using folk remedies against HIV infection, be sure to consult your doctor!

St. John's wort. Pour well-dried chopped herbs into an enamel pan and fill it with 1 liter of soft purified water, then put the container on the fire. After the product boils, cook the product for another 1 hour over low heat, then remove, cool, strain and pour the broth into a jar. Add 50 g of sea buckthorn oil to the decoction, mix thoroughly and set aside in a cool place to infuse for 2 days. You need to take the product 50 g 3-4 times a day.

Licorice. Pour 50 g of chopped into an enamel pan, fill it with 1 liter of purified water and place on the stove over high heat. After bringing to a boil, reduce the heat to minimum and simmer for about 1 hour. Then remove the broth from the stove, cool it, strain, pour into a glass container, add 3 tbsp. spoons of natural, mix. You need to drink 1 glass of the decoction in the morning, on an empty stomach.

Cases of AIDS were first reported in 1981 in the United States. After many years of research into this new disease, scientists also discovered that this virus leads to the development of. While the idea was being promoted (there was an active search for a “scapegoat”) that the virus came from one person, the so-called Patient Zero(patient Zero), scientists began to understand that the virus appeared long before 1981, i.e. before it was first discovered.

Who is Patient Zero?

In 1984, a study was published linking the AIDS outbreaks in California and New York to sexual contacts between local homosexuals. This study was carried out in the early days of the discovery of AIDS, then researchers did not yet know this terrible disease. The report stated that AIDS is an infectious agent that can be spread through sexual contact, needle sharing, which is very common among intravenous drug users, and through transfusion of blood components (whole blood, packed red blood cells, plasma, etc.).

Gaetan Dugas - Patient Zero

Patient Zero (zero, O), Gaetan Dugas, was considered a link between AIDS patients in Southern California and New York. It was associated with approximately 40 of the first 248 cases of AIDS reported in the United States. Dugas was dubbed "Patient Zero" by the media as a result of his being labeled "Patient O" on the researchers' outbreak diagram (i.e. mistakenly, in fact, he was not the first AIDS patient!). In the study, the letter O designated him as "out of California" since Dugas was known to be from Canada.

The first outbreak of AIDS

Geetan Dugas was publicly named "Patient Zero" in a book about the AIDS epidemic called And the Orchestra Played On: People, Politicians and the AIDS Epidemic, written by Schilt in 1987. Dugas was a Canadian flight attendant for Air Canada whose extensive travel and promiscuity led researchers to believe he was the first person to bring HIV to the United States. Dugas himself said that he had about 250 different men every year, and in his entire life about 2,500 different lovers. He continued his sexual escapades even after doctors told him he was likely to endanger the lives of his sexual partners.

At this time, the American gay rights movement was rapidly gaining momentum. Homosexuals were afraid of losing the rights they had worked so hard to achieve. And since little was known about the disease, efforts directed against their sexual behavior seemed to them like just another conspiracy.

Book “And the Orchestra Played On: People, Politicians and the AIDS Epidemic”

At the time of Duguay's death in 1984, HIV had not yet been discovered and Duguay had never been diagnosed with AIDS. Dugas never believed that he was infecting his lovers with a fatal disease ( a la). However, more recent data showed that,

although Dugas was one of the first cases, he was not the very first case of AIDS.

The book's editor even admitted that the facts were exaggerated specifically to get as much publicity as possible, saying: "We have descended to yellow journalism." Moreover, although the disease spread largely among gays, it also spread to other “affluent” sections of society. The problem with the one-villain approach was that it targeted the gay community, stigmatized gay people, and gave straight people false security because they thought only homosexuals had the disease. Even Schiltz, author of And the Orchestra Played On, insisted that it was ridiculous to blame one person for the spread of AIDS. At the same time, the publication of the book also played a positive role: it helped increase people’s awareness of HIV, AIDS, methods of infection, prevention, and contributed to the growth of public AIDS activists.

What is HIV?

His baffled doctors preserved 50 tissue samples in small paraffin blocks. When some of the samples were tested in 1990, the cells stored in the wax tested positive for HIV, making Carr's earliest known case of AIDS , possibly infected at least several years before Leopoldwild's 1954 case.

Wistar Institute experts noted that Carr left his naval service and returned to England in early 1957, before the vaccination campaign in Africa began.

“Therefore,” the group said, “it is safe to say that the large polio vaccine trial begun in late 1957 in the Congo was not the source of AIDS.”

The report seemed to exonerate Koprowski. But experts recommended that monkey tissue should never be used in vaccines again due to the risk of contamination by "other monkey viruses that have not yet been discovered."

He also suggested conducting independent tests on a sample of remaining stockpiled vaccines that may have been used in Africa to determine whether they contain any simian immunodeficiency virus.

Rolling Stone later settled Koprowski's claim, publishing a clarification saying that they never intended to even suggest that there was "scientific evidence" of a vaccine transmitting AIDS.

William Hamilton

Despite the findings of the Wistar Commission, Hooper continued his research. He conducted interviews and analyzed all recordings and eyewitness accounts who participated in vaccinations with the Wistar vaccine in Central Africa.

When he heard that the famous scientist William Hamilton was also intrigued by the tainted polio vaccine theory, Hooper went to visit the professor in a village near Oxford. This meeting was fatal with far-reaching consequences.

In 1992 and 1993, Hamilton received three of science's most prestigious prizes for his work in evolutionary biology: the Wander Prize from the University of Bern, the Kyoto Prize from the Inamori Foundation, and the Krfoord Prize from the Swedish Academy of Sciences. He was fascinated by the evolutionary aspect of the AIDS virus, especially the fact that its natural host is African primates.

They discussed various theories about the origin of the epidemic. Hamilton encouraged Hooper to continue researching the vaccination theory of AIDS.

Hamilton was not impressed by the Wister Commission report. Shortly after Hooper's visit, he wrote to the editors of the journal Nature and Science, calling the report scientifically weak and with very preliminary conclusions.

What bothered him most, Hamilton wrote, was the reaction of the scientific community to the theory, in particular the refusal of periodicals such as Science and Nature to publish the article and reports of Pascal and other authors who described their doubts about the generally accepted theory of the origin of HIV .

In his letters, Hamilton said he was not yet convinced of the "contaminated vaccine" theory, but he warned that failure by the scientific community to seriously consider this theory before similar vaccination campaigns continue in the future could lead to "hundreds of millions of deaths." .

Hamilton wrote that he was particularly troubled by Koprowski's decision to sue Curtis and Rolling Stone. He compared it to the burning of heretics and the Vatican procession in 1633 during the trial of Galileo, calling it an attempt to silence a truly important scientific debate.

But Hamilton's claims were ignored. Magazines refused to publish his messages.

"River" makes you talk

This was a very inconvenient theory, so for many years respected scientific journals refused to even mention it. But when Hooper’s book “The River” was published in 1999, in which he described in detail the evidence for his hypothesis, the international scientific community could no longer ignore it.

And so the Royal Society of London, the prestigious scientific academy once headed by Sir Isaac Newton, convened the first-ever conference on the origins of the AIDS epidemic, primarily to examine the theory put forward by Hooper, who was not even a scientist but a college professor of American literature. .

The two-day conference attracted some of the world's most renowned medical researchers. By the time the historical research was completed, other competing and contradictory theories had emerged, including one regarding the widespread use of contaminated needles in Africa - and now Hooper was not the only one asking a very uncomfortable question:

“Could modern medicine have let the greatest monster of the 20th century out of the bottle?”

This answer will be given by future generations, who are responsible for the millions of people infected with HIV who have died from AIDS. In the meantime, experts fear that the possibility of other lethal viruses from the cradle of civilization cannot be ruled out.

At the same time, there is some optimism that if AIDS has swept the globe due to human error, perhaps the next, more devastating epidemic can be prevented.

When did HIV transmission first occur?

Earliest known cases of HIV-1 infection were found in the following samples:

• A blood sample taken in 1959 from an adult male in the Democratic Republic of the Congo.
• A lymph node sample taken in 1960 from an adult woman, also from the Democratic Republic of the Congo.
• Tissue sample from an American teenager who died in St. Louis, Missouri in 1969.
• A tissue sample from a Norwegian sailor who died in 1976.

These samples prove that HIV-1 was already in the United States before the cases reported in 1981. A 2008 study compared the genetic sequences of samples taken in 1959 and 1960 and found significant genetic differences between them. This suggests that

the virus was present in Africa much earlier than the 1950s.

Researchers believe that it began to spread in Africa at the beginning of the 20th century, and at first it spread very slowly, but as Central Africa urbanized, the virus accelerated the rate of spread several times.

In 2003, research into HIV-2 suggested that zoonotic transmission of the immunodeficiency virus from white-collar monkeys to humans occurred around the 1940s. Researchers believe that the virus spread during the Guinea-Bissau War of Independence. The country is a former Portuguese colony, and the first European cases of HIV-2 were found in Portuguese veterans of that war.

How did HIV enter the United States?

Although research shows that HIV originated in Africa, it is still unclear how the virus came to America. However, recent research suggests that the virus may have arrived in the US via the Caribbean island of Haiti. Cases of HIV infection were first reported in Haiti in the 1980s. at the same time as the first cases in the United States.

Since little was known about the new virus, Haiti was blamed for the emergence of HIV in the United States. Because of this, many Haitian guest workers have lost their jobs. Indeed, Haitians are at high risk of contracting HIV. Due to political sensitivity, many studies regarding Haiti's role in HIV transmission have been lost to oblivion. However, in 2007, a group of researchers presented data in which they found that HIV-1 group M subtype B (the most common strain found in the United States and Haiti) was likely brought to Haiti in 1966 by workers returning from Africa. The virus slowly spread through individuals on the island and eventually entered the United States sometime between 1969 and 1972. It is likely that the virus has been present in the United States before, but this time it has taken hold and caused an epidemic.

HIV transmission occurred so quickly due to a combination of tourism to Haiti from the US (and back with the virus) and native Haitian health practices (~acupuncture). Since it has become easier to travel, it has become easier for the virus to spread across cities, countries and even continents. Blood transfusions also played an important role. At that time, blood for transfusion was not tested, and there were many cases where people who received blood transfusions became HIV-positive.

Intravenous drug users using unsterile needles have also become infected with HIV. As of 2004, intravenous drug use still accounts for about 20% of all HIV infections in the United States. In the United States, syringe exchange programs have proven effective in reducing the transmission of HIV and other blood-borne infectious diseases.

Since anal intercourse has an 18 times higher risk of transmitting HIV than vaginal intercourse, the virus easily spread among the gay community. Gay bathhouses (yes, these are bathhouses where homosexuals gathered and actively “socialized”) provided a convenient platform for orgies and contributed to the rapid and widespread spread of transmission of the virus.

It is important to note that early HIV transmission was not the fault of any one individual or group. At that time, little was known about the virus, and people infected with HIV did not know the deadly danger they were carrying. And even today, according to a 2012 study conducted by the CDC (American Center for Disease Control), about 14% of HIV-infected people in the United States are still unaware of their infection.