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HIV-AIDS – Immunity, Eradication and their victims disappear

(HIV), the retrovirus that causes acquired immunodeficiency syndrome (AIDS) has been around for between 1884 and 1924 (as lentivirus genus belongs HIV, have been around for over 14 million years) when he entered the human population a chimpanzee in southeastern Cameroon for a period of rapid urbanization. At that time, nobody noticed or knew that this would lead to one of the deadliest pandemics. Does anyone realize that some have natural immunity, an appeal would remain a difficult decade to achieve in the 21st century and a significant number of fatalities could be purged of distortion of the mortality statistics of the severity of the pandemic.

As the number of cases of Cameroon distributed to neighboring countries, namely the Democratic Republic of Congo (DRC), Gabon, Equatorial Guinea and the Central African Republic, have attracted little attention, even as victims died scattered numbers a number of complications (eg, Pneumocystis pneumonia (PCP), Kaposi’s sarcoma, etc.), then assigned to AIDS. It was probably due to the limited interaction with the developed Africa to the widespread use of air travel, isolated, low incidence of long incubation period of HIV (up to 10 years) before the onset of AIDS world and the lack of technology, reliable testing methods and knowledge about the virus. The ZR59 based first confirmed case, a blood sample from a patient in Kinshasa, Democratic Republic of Congo in 1959.

The AIDS epidemic has finally attracted the attention of June 5, 1981, after the Centers for Disease Control (CDC) have identified a number of deaths due to PCP in Los Angeles and New York. In August 1982, the incidence of spread, CDC referred to the AIDS epidemic. The retrovirus, HIV was isolated almost a year later (May 1983) by researchers at the Pasteur Institute in France and received its official name in May 1986 the International Committee on Taxonomy of Viruses. During this period, rates of HIV-related mortality have steadily increased in the United States peaked in 1994-1995.

HIV:

HIV is spherical and about 120 nanometers (nm) in diameter (or 60 times smaller than a red blood cell). It consists of two copies of single stranded RNA complex surrounded by a lipid membrane and preventing the conical capsid antibody to bind to it. HIV also consists glycoprotein spikes (gp120 and gp41) and a mutant virus. Its genome changes up to 1% each year, much faster than cytotoxic T “killer” (CD8 +) cells can adapt. It is transmitted through bodily fluids.

Tests CD4 (Sheet Number 124 AIDS Infonet March 21, 2009), when “HIV infects humans,” infects “helper” T-4 (CD4) cells that are essential to resist infection. HIV is merging its genetic code with that of (CD4) T-4. HIV peaks adhere to the surface of T-4 (CD4) for viral envelope to fuse with the membrane. Once cast, glue content HIV DNA in cells with the enzyme of T-4 (CD4), integrase, so that each time T-4 (CD4) breed, producing copies of HIV “,” reduce additional number of T-4 healthy cells (CD4). While the T-4 (CD4) healthy cells, which come in millions of families which refers to the specific pathogens are eliminated, the body becomes defenseless against pathogens “that were designed” to combat Finally, the immune system is overwhelmed.

When the cell (CD4) T-4 falls below 200 cells per cubic mm of blood (or a percentage of 14% of the total lymphocyte counts;? 500-1600 normal range, or 30% -60% of cells), indicative of severe immune system damage, the victim is considered to have AIDS (“the point of infection that is continuous, progressive and pathogenic Richard Hunt, MD (human immunodeficiency virus and AIDS statistics, extreme virology – Chapter 7 Microbiology and Immunology On-line (University of North Carolina School of Medicine, February 23, 2010 South)), and is vulnerable to a number of opportunistic infections. examples are PCP, a fungal infection that is a leading cause of death for people with HIV, Kaposi’s sarcoma, a rare form of cancer, toxoplasmosis, a parasitic infection that attacks the brain and other body parts and cryptococcosis, a fungal infection that attacks the brain and spinal cord (both usually occurs when T-4 (CD4) the number of cells falls below 100), and Mycobacterium avium complex (MAC), a bacterial infection may be localized to a specific organ (typically the bone marrow, intestines, the complex extended liver or lungs) or, in which case it is called disseminated Mycobacterium avium complex (DMAC) (which often occurs when the T-4 (CD4) falls below the cell 50).

Natural immunity:

Since the beginning of the HIV / AIDS in 1981 cases of people with natural immunity to HIV have been documented. Although these people call long-term non-progressors (LTNPs) are infected with HIV who develop AIDS. When LTNPs are infected, some will experience an initial drop in T-4 (CD4) cell. However, when the T-4 cells (CD4) were approximately 500 and stabilizes again never drops preventing the onset of AIDS. Moreover, whereas CD8 + T (even many) cells are not effective against HIV infection (CD4) T-4 in progressors (people with natural immunity to HIV), the National Institutes of Health (NIH) have said in un December 4, 2008 press release that “T CD8 + taken from LTNPs cells [actually can] kill cells infected with HIV at [a] time” in which “a protein, perforin (product only amounts progressors insignificant) produced by CD8 + T-cells causes holes in infected cells “to a second protein,” granzyme B “to penetrate and kill them.

Genetic HIV Resistance decryption (Med-Tech, the January 7, 2005), the roots of this immunity goes back a thousand years because of “a pair of mutated genes – one from each chromosome – that prevent their immune cells grow [chemokine (CC motif) receptor 5 (CCR5) receptor] to leave [enters HIV]. “This mutation probably evolved to provide additional protection against smallpox by Alison Galvani, professor of epidemiology at Yale University. Based on the latest scientific data, the CCR5 gene mutated (also called delta 32 due to the absence or elimination of 32 amino acids cytokine receptor) in Th2 cells, developed in Scandinavia and moved south Central Asia that Vikings expanded their influence. Therefore, up to 1% of Northern Europeans (with the Swedes are the majority), followed by a similar percentage of the countries of Central Asia have this mutation, which if passed by both parents give them complete immunity and another 10-15% of northern Europeans and Central Asia have inherited the mutation of greater relative strength of exposure instead of complete immunity to HIV.

At the same time, although the CCR5 mutation is absent in Africans, a small exhibition also share natural immunity (perhaps developed by exposure) HIV / AIDS – the generation of CD8 + T-Cell, which effectively kills cells infected group HIV and human leukocyte published a (HLA) antigens that covers the surface of CD4 cells) (T-4 to prevent HIV from entering based on an intensive study of 25 prostitutes in Nairobi by people of incredible business with immunity Natural HIV (Softpedia June 27, 2007) have “had sex with hundreds or even thousands of HIV-positive clients’ and showed no signs of HIV.

In addition, people with a higher number of CCL3L1 genes that produce cytokines (proteins that “glue” for CCR5 receptors) to prevent HIV from their (CD4) T-4, genetic resistance of HIV have deciphered greater resistance to HIV compared to others within their ethnic group have lower amounts of CCL3L1 gene and receive “sick as much as 2.6 times faster.”

At the same time, up to 75% of children also have natural immunity (for unknown reasons) in case of exposure to HIV positive blood. Although born with antibodies against HIV – and babies HIV positive “usually lose HIV antibodies acquired from their mothers with HIV within 12-16 – up to 18 months” in his “spontaneous loss of [HIV] antibody “without medical intervention is called seroreversion.” However, with the exception of very rare cases, these children are not infected with HIV “conclusive evidence of natural immunity to HIV. [1] In addition, pregnant women when administered therapy HIV positive highly active antiretroviral (HAART), which lowers the viral concentration of HIV in the blood, a surprising 97% of newborns lose their HIV antibodies through of seroreversion become free of HIV by the National Institute of Child Health and Human Development (NICHD) Eunice Kennedy Shriver as children born to HIV positive mothers (Smartt) published under the control of surveillance ART toxicity study in HIV-negative (Trials.gov clinical March 29, 2008). However, at this time, it is unknown whether these children retain their natural immunity throughout his life.

eradication:

With perhaps an inaccessible resource, the eradication of HIV / AIDS in the same way as smallpox (which has no cure) was eliminated, perhaps more feasible option. According to Dr. Brian Williams modeling South African Centre for Epidemiological analysis, eradication of HIV / AIDS is an achievable goal that could be achieved by 2050 if the current research paradigm of HIV / AIDS has increased to focus on search for a cure to stop transmission.

By Dr. Williams tests such effort would require billions of people every year. Although expensive, the benefits outweigh the costs “from day one”, according to epidemiologist in South Africa. Anyone found with antibodies against HIV be administered immediately antiretroviral therapy (which reduces the concentration of infectivity and HIV 10,000 times 25 times) to stop the transmission, thus ending such transmission by 2015 and eliminate the disease by 2050 most companies will die, estimated. the reason for this optimism by Steve Connor, AIDS: the end is in sight (The Independent, February 22, 2010) is a “study published in 2008 [which] has shown that it is theoretically possible to reduce new HIV infections by 95%, from a? prevalence of 20 1000-1 in 1000, in the 10 years to implement a program [sic] universal testing and prescription [HA] medications art “.

Although clinical trials to test the vision of Dr. Williams will begin in 2010 Somkhele, South Africa, access to HAART is still very improved to purge the disease. Currently, only 42% of people with HIV have access to ARVs.

Also, for the eradication efforts to succeed, prevention programs (which currently reach fewer than 1 in 5 in sub-Saharan Africa, the epicenter of the pandemic in the average life expectancy has fallen below 40 leaving 15 million orphans) should continue to play a key role in stopping transmission. These programs, but not limited to, must include abstinence, condom distribution, education re: transmission, safe sex, etc., and the distribution of syringes for drug users (the latter is much needed by Kate Kelland, no to help drug users drives HIV spread: study (Reuters March 1, 2010) with “over 90% of the 16 million users of injected drugs in the world offered help to avoid contracting AIDS” despite since these users often share needles and 18.75% are considered HIV-positive).

The evidence that these efforts can work is evident when the President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003 for Africa, which provides funding focused on HAART and palliative care for HIV / AIDS education awareness programs on HIV / AIDS (condoms, needle exchange and abstinence) and financial assistance for the care of orphans and other vulnerable children pandemic, is considered. By Michael Smith, mortality rates Cut AIDS PEPFAR Nations in Africa (Med Page Today, April 6, 2009), the “prevented approximately 1.1 million deaths […] of 2004-2007 reduced 10% of neighboring African countries. “

The victims “disappeared”:

Although the reasons for optimism based on the vision of Dr. Williams eradication, the “disappearance” of victims of HIV / AIDS is very worrying. In fact, when the current statistics are compared with past statistics, more than 19 million victims or triple the number of victims killed Holocaust (1933-1945) were purged from the official register (effectively minimize the severity of pandemic) without even a whimper of protest, perhaps because demographically speaking, a statistically significant number of deceased fall into groups that have been and are still the subject of race, gender, cultural, and even religious discrimination. As Charles King, an activist who spoke at San Francisco on World AIDS Day in 2007, it is likely that HIV / AIDS has mainly “took the lives of people considered sustainable” [2] the same mentality used to justify the “final solution” of Hitler and other pogroms.

Back to January 25, 2002, the AIDS death toll “probable” to overcome the bubonic plague, says expert in the British Medical Journal Special Issue on HIV / AIDS (Kaiser Network), which was written, “AIDS – which has killed 25 million people worldwide – will surpass the bubonic plague as “worst pandemic the world” if the 40 million people currently infected with HIV do not have access to drugs that prolong life … “

A year earlier, UNAIDS global deaths appears 21.8 million, up from 3.2 million in 2002. In 2003, based on statistics provided by the World Health Organization (WHO), UNAIDS and the Office of he census of the United States as reported on the global HIV / AIDS: current and future challenges of Jennifer Kates, MA, MPA, Director of HIV policies, Kaiser Family Foundation, the total number of deaths rose to 28 million in February 2003. Add yearly statistics 3 million deaths (2003), 3.1 million (2004 and 2005), 2.9 million (2006), 2.1 million (2007) and 2,000,000 (2008, most recent full year of reporting) by UNAIDS, estimated that total 1.4 million conservative (if another drop of 28% took place between 2006 and 2007 occurred between 2008 and 2009) the number Global died by the end of 2009 would be approximately 45.6 million. However, when UNAIDS published its final report in November 2009, as reported in the Mail & Guardian (South Africa, November 24, 2009) the number of deaths worldwide in 2008 was listed as “25 million” About 19.2 million below the actual brand.

AIDS Cases by falling due to revised data (MSNBC, November 19, 2007), victims ‘disappear’ can be attributed to “a new methodology.” While this may make sense in relation to the prevalence because “[p] Numbers mere existence of AIDS were based largely on the number of infected pregnant women at clinics and screening rates AIDS certain high-risk groups such as drug users to the entire population at risk “of the new methodology that incorporates data from national household surveys”, “not in relation to mortality figures are calculated mainly from national records AIDS and / or death certificates based on the presence of HIV, T-4 (CD4) cell numbers below 200, and death from AIDS-related opportunistic infections arising under these T-4 (CD4) count the number of cells.

In retrospect, if you look 45600000 ballpark figure, some pandemics have they killed over HIV / AIDS – smallpox (which came in waves from 430 BC to the World Health Organization (WHO) certified its eradication in 1979), killed 300-500 million Black death / bubonic plague killed about 75 million in 1340-1771, and the Spanish flu killed between 1918-1919 40-50000000.

Optimism for the future:

Until HIV / AIDS can be certified as eradicated by the WHO, despite the dire economic consequences it has taken, especially in sub-Saharan Africa (due to losing skills, reduced labor, increased medical costs) and other developing regions and its devastating impact on human lives and families, there are reasons to be optimistic.

In December 2008, UNAIDS, 33.4 million people are infected with HIV, an increase of 1.2% over the previous year, with much of the increase was attributable to decreased mortality increased 10 times in the availability of HAART since 2004. Around 2.7 million people were newly infected in 2008, 18% and 30% decline in new HIV infections in the world since 2001 and 1996 respectively. In another promising sign, new HIV infections in sub-Saharan Africa accounts for about 70% of deaths from HIV / AIDS in 2008, declined by 15% since 2001. At the same time, there was about 2 million related to HIV / AIDS deaths in 2008, a reduction of 2004 levels by 35% when the overall mortality rate has peaked.

Currently, HIV / AIDS has begun to decline or stabilize in most regions. The declines were recorded in sub-Saharan Africa and Asia (although the mortality rate increases in East Asia), while the pandemic has stabilized in the Caribbean, Latin America, North America and Western and Central Europe. The only part of the world where HIV / AIDS is worsening in Eastern Europe (especially in Ukraine and Russia) and the region of Central Asia.

Declines are expected to continue as new methods of prevention and treatment are developed. NLTPS studies based on a new class of treatments focused on gene therapy to delete 32 amino acids of CCR5 receptors stimulate production perforin and granzyme B, and protease inhibitors developed to provide immunity to HIV and halt its spread may be hereafter developed.

Although it is still far and potentially very expensive (up to $ 20,000 per treatment), Med Drugs.com News reported in gene therapy shows promise against HIV (19 February 2010), when the researchers removed immune cells infected eight HIV, altered their genetic code and reintegrate “HIV levels fell below expected levels in seven of eight patients [with] the signs of the virus disappear [ing] all in one”, even if HAART treatment was interrupted . a study by researchers at the AIDS Institute at UCLA, which eliminated the CCR5 receptor “transplanting a small RNA molecule known as short hairpin RNA (shRNA), which induce RNA interference in human stem cells to inhibit the expression of CCR5 in human immune cells “mimicking those of LTNPs using a” humanized mouse model, “as reported February 26, 2010 News Today in the medical stem cell gene therapy-Based Removes cell receptor precisely attracting HIV, similar success has shown that resulted in a “stable reduction of CCR5 long term.”

Meanwhile, as announced in HIV / puzzle cracked AIDS drugs (Kate Kelland, Reuters February 1, 2010), the British and American scientists succeeded (after 40,000 failed attempts) growing a crystal to decipher the structure integrase , an enzyme that HIV and other retroviruses are. This will lead to a better understanding of how integrase inhibitor drugs work, and perhaps to a more efficient generation of treatments that could prevent HIV paste a copy of your genetic code in the DNA of T-4 (CD4) cells of the victims.

Similarly, the layer structure of HIV may help develop new drugs (Health News, November 13, 2009) Scientists at the University of Pittsburgh School of Medicine “to find the complex structure” capsid layer (see its “overall shape and atomic details”) “surrounding HIV” that could allow “scientists to design therapeutic compounds” to block infection.

Meanwhile, researchers at the School of Medicine of the University of Texas may have finally discovered the vulnerability to HIV, the Achilles heel of HIV found (Ani, July 2008) – “a small stretch of amino acids numbered 421-433 of gp120, “which must remain constant to attach to (CD4) T-4 cells. To hide his weakness and evade an effective immune response, HIV tricks the body attacks its regions changing, and rapidly changing, ineffective antibodies are produced until the immune system is overwhelmed. Based on this finding, the researchers created a abzyme (antibody with catalytic or enzymatic activity useful) derived from blood samples taken in HIV-negative people with lupus (a chronic autoimmune disease that can attack any part of the body – the skin, joints, and / or organs) and LTNPs HIV-positive, which has proved effective in neutralizing HIV in laboratory testing, offering the promise of developing an effective vaccine or microbicide (gel to protect against transmission sexual). Although clinical trials in humans have to follow, it would not be until 2015 or 2020 before abzymatic treatments are available.

Elsewhere, International AIDS Vaccine Initiative (IAVI), scientists recently isolated two antibodies in a patient African HIV positive NLTP – PG9 and PG16 (called broad-spectrum neutralizing antibodies (broadly neutralizing antibodies) that bind to gp120 of HIV viral peak and gp41 compound to block the virus from infecting (CD4) T-4. Monica Hoyos flight, a new starting point for the design of HIV vaccine (Nature reviews, Macmillan Publishers Limited, November 2009) “PG9 and PG16 during a test against a larger panel of virus [HIV] neutralized 127 and 116, respectively virus “provide additional hope for development of an effective vaccine and new schemes that induce the body to produce broadly neutralizing antibodies currently only NLTPS immune system can create.

At the same time, studies seroreversion newborns and medically induced production of human leukocyte group A (HLA) antigens that coat the surface of T-4 (CD4) cells could also lead to an HIV vaccine could protect billions people.

Meanwhile, until these changes are paying off, HAART (despite his mild symptoms such as nausea and headaches in some people and severe side effects that threaten life on other side effects) has proven extremely effective to contain HIV with, for Gerald Pierone Jr., MD at the end of drug development against HIV we know? (The Body Pro: The literature on HIV for health professionals, February 18, 2010) reports, “nearly 80% of patients receiving HAART [] achieve an undetectable viral load.” In addition, better access to antiretrovirals, for drop in HIV infections and deaths (BBC News, 24 November 2009) “has helped reduce the number of deaths from HIV by more than 10%” from 2004 to 2008 and recorded more than 3 million lives based on statistics from UNAIDS and WHO. HAART also reduces the rate of age-adjusted mortality of over 70% in July 2007 according to the profile of HIV / AIDS Kaiser Family Foundation because of its effectiveness to delay or even prevent the onset of AIDS.

Despite the cost of HAART ($ 10,000 to $ 15,000 per patient per year), the State of California in a report entitled, HIV / AIDS in California from 1981-2008 called “dramatic and save lives” any more than the results of early intervention in over half T4 counts (CD4) cells translate into fewer opportunistic infections and death. This also results in a real cost savings because of the strong inverse relationship between T-4 (CD4) cell numbers and associated medical costs.

In conclusion, despite HIV / AIDS “disappeared” victims, there are reasons to be optimistic. Last year, during the investigation offered several promising leads – the underlying cause of the immunity of NLTPS was discovered, the structure of solving the HIV and weakness found – while improving access to antiretrovirals and measures of education and prevention HIV / AIDS (except to treat IDUs) have made significant progress in reducing infection and death victims purchase additional years and a better quality of life.

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