The Human Immunodeficiency Virus (HIV) is a blood-borne that is transmitted through unprotected sexual intercourse with an infected partner, by sharing intravenous drug paraphernalia, and through mother-to-child transmission at birth or during breastfeeding. On the other hand, the Acquired Immune Deficiency Syndrome (AIDS) is a condition that results after a long time when one has been diagnosed with HIV virus. This condition results after the body’s immune system are compromised such that the CD4 helper T-cells fall below the required number in the blood. Due to low immunity, the body is prone to opportunistic infections. The essay provides a comparison and contrast between HIV and AIDS by highlighting their pathophysiology, clinical manifestations, medical management, and prognosis.
Pathophysiology of HIV and AIDS
HIV is known to be responsible for producing cellular immune depleting features that clear the helper T lymphocytes or the CD4+ cells. The reduction of the T helper cells results in the development of more opportunistic infections (Brunetta, Hudspeth, & Mavilio, 2010). Both HIV type 1 and 2 are viruses of the Retroviridae family known as the Lentivirus genus. The viruses are enveloped and diploid with single strands. They are positive RNA viruses that have a DNA intermediate that can persist within a host’s DNA cell (Brunetta et al., 2010).
HIV majorly has three genes namely the gag, pol, and env. The genes ensure that they remain in the host cell by an encoding mechanism. The gag ,for instance, encodes antigens that are specific to groups that form the inner structural protein while the pol is responsible for coding polymerase, which is then produced as a C-terminal extension of the gag protein (Brunetta et al., 2010).
Lastly, the env encodes the envelope that covers the virus or the outer structural proteins that give it the cell-type specificity. The viral envelope protein that holds (or binds) to the host T helper cells is then formed. Both HIV 1 and 2 have distinct genes that perform different functions. The accessory proteins and further aids in its progress predominantly carry out the replication of HIV type 1 and 2. Both types have outer layers that are composed of long terminal repeats (LTRs) (Brunetta et al., 2010).
The LTRs form sequences that ensure gene transcription and splicing, the packaging of the genomic RNA of the viruses as well as their sequence of dimerization for packaging two RNA genomes. There is a linking technique between dimerization, aging, and gene-transcription processes. When one process is destroyed, the subsequent processes are also affected. Close examinations of LTRs show that they are only available in the pro-viral DNA genome. The RNA genomes of the viruses only contain portions of each LTR (Simon, Ho, & Karim, 2006). Complete LTRs are only recreated during the process of reverse transcription before integration takes place in the host DNA. The categories of HIV infection are grouped into three by the Centers for Disease Control and Prevention (CDC) (Simon et al., 2006). The categories include the following.
- Category A: This class is asymptomatic HIV infection with no symptoms or physical conditions (Simon et al., 2006).
- Category B: It is a symptomatic stage where symptoms seen are linked to HIV infections (Simon et al., 2006).
- Category C: this category is the HIV infection with opportunistic infections that are manifested due to AIDS (Simon et al., 2006).
An elaboration of the AIDS condition can be shown through close examination of the CD4+ helper T cells. The reduction of the helper cells leads to the inversion of the normal ratio of CD4 and CD8 T-cells. This set of changes also result in the deregulation of the production of B-cell antibodies. The outcome is the reduced response of antigens in the host cells that further fails to react adequately to opportunistic infections as well as the regular harmless organisms such as the pneumocystis, Candida species, or tuberculosis in the body. This situation is due to the reduced immunity that has already occurred within the cells (Simon et al., 2006).
A clinical manifestation of HIV and AIDS is revealed through the diagnosis of various signs and symptoms. At the onset of an infection, an HIV positive patient experiences some short illnesses that have flu-like characteristics in the first 2 to 6 weeks after acquiring the disease from an infected person. After such feeling, no symptom is shown for several years. Various warning signs that are associated with HIV infections encompass peeled skin, enflamed glands, muscle and joint exhaustion, and fever among others. The HIV then enters the asymptomatic phase that is benign. Although this stage takes a longer period, the virus is still active in the body. As a result, it causes the depletion of the CD4 cells; hence, the immunity is gradually compromised. Nonetheless, a test should be done to ensure that such symptoms arise from the HIV infection since some diseases also assume similar warning signs (Thompson et al., 2010).
On the other hand, AIDS comes at a later stage after severe damage of the immune system by the HIV virus. This situation often happens after a period of about 10 years after the HIV virus has been detected in the body. The manifestation of AIDS is recurrent, severe, and life threatening due to various opportunistic infections and malignancies. Various symptoms that are common at the late stage of full-blown HIV are weight loss, chronic diarrhea, night sweats, skin infections, and rashes among others. Other opportunistic infections can include extra-pulmonary tuberculosis, HIV encephalopathy, toxoplasmosis, orolabial herpes simplex, esophageal candidiasis, and Kaposi’s sarcoma among others (Thompson et al., 2010).
Medical Management and Prognosis
The most effective medical intervention that should be considered in managing HIV and AIDS is the administration of the antiretroviral therapy (ART). This practice is usually accomplished to increase longevity and prevent the prevalence of opportunistic infections in HIV positive patients (Thompson et al., 2010). The antiretroviral therapy should be administered when the patient’s CD4 cell count is below 350/µL. Pregnant women who are HIV positive, patients who have been found to have HIV-associated nephropathy, and those with hepatitis B viruses should be given ART without regards to CD4 cell counts (Thompson et al., 2010).
A principal method that is well defined for administering ART is the highly active antiretroviral therapy (HAART) due to immune deterioration. This method has classified the agents of ARV into Nucleoside reverse transcriptase (NRTIs), Non-nucleoside reverse transcriptase, Fusion, protease, HIV integrase strand transfer, and CCR5 co-receptor antagonist inhibitors (Centers for Disease Control and Prevention, 2011).
The essay has elaborated the comparison and contrasts that exist between HIV and AIDS. A crucial consideration is that both the illnesses are incurable. A person who has HIV does not necessarily have AIDS. The medical state occurs when a patient’s immune system deteriorates significantly. This situation makes the individual prone to secondary infections. Nonetheless, a person with AIDS must have the HIV virus. Most stages of the HIV progression are asymptomatic with minimal infections while AIDS have several warning signs due to opportunistic infections. Both the infections have no cure. However, they can be managed by administration of ART drugs.
Brunetta, E., Hudspeth, K. L., & Mavilio, D. (2010). Pathologic natural killer cell subset redistribution in HIV-1 infection: new insights in pathophysiology and clinical outcomes. Journal of leukocyte biology, 88(6), 1119-1130.
Centers for Disease Control and Prevention. (2011). Sexually transmitted diseases treatment guidelines, 2010. Annals of Emergency Medicine, 58(1), 67-68.
Simon, V., Ho, D., & Karim, Q. (2006). HIV / AIDS epidemiology, pathogenesis, prevention, and treatment. The Lancet, 368(9534), 489-504.
Thompson, M., Aberg, J., Cahn, P., Montaner, J., Rizzardini, G., Telenti, A.,…& Schooley, R. (2010). Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society–USA panel. Jama, 304(3), 321-333.