HIV: What do we know?
By: Saipriya V
The Human Immunodeficiency Virus (HIV), was first detected in non-human primates in Sub-Saharan Africa and was transferred to humans during the late 19th or early 20th century (1). This transmission was due to the practice of “bushmeat”, were hunters kill the wild life for meat, eventually becoming a host for the virus (1).
In 1981, the Centers for Disease Control (CDC),United States ,received reports of unusually high rates of the rare diseases Pneumocystis carinii pneumonia (PCP) and Kaposi’s sarcoma in young gay men (2). The disease is initially called Gay-Related Immune Deficiency (GRID) because it is thought it only affects gay men (2). Later in 1982, the disease was renamed as Acquired Immune Deficiency Syndrome (AIDS), and was found that the infection can be sexually transmittable (2).
The first effective treatment was the nucleoside reverse transcriptase inhibitor (NRTI) zidovudine (AZT) against HIV was approved by FDA in 1987, subsequently many NRTI’s were developed but were unable to supress the virus. Later in 1996 Highly Active Anti-retroviral Therapy (HAART) was introduced as a standard treatment for HIV (2).
After the advent of HAART medication, people living with HIV (who have access to HAART) are living longer and healthier lives. However ,due to the HIV infection and the side effects of the medication, people living with HIV experience a number of comorbidities including, fatigue, diarrhea, nausea, muscle weakness, decreased muscle mass, stress, depression, lipodystrophy, neuro-cognitive impairment, peripheral neuropathy (3).
Individuals aging with HIV often have an earlier onset of diseases such as diabetes, heart disease, obesity, stroke, diseases affecting bone such as osteoporosis, osteoarthritis, inflammatory arthritis and cancer (3). In particular, women living with HIV may have irregular menstrual cycle, emotional changes and changes in their hair and skin (4,5). Women living with HIV may also experience early menopause, which further increases the risk of osteoporosis , lipid and glucose disturbances (4,5). Neuro cognitive impairment such as problems with memory,concentration,depression were also more commonly reported among women living with HIV compared to men (4,5).
Problems with memory and depression among women could lead to reduced adherence to medication, which could further impair their neurocognitive health (4,5). Women living with HIV are more likely to have human papilloma virus (HPV) which causes cervical dysplasia and cancer among women (4,5).
Overall, the goal of the health care for is to help people living with HIV to age as healthy as possible.Hence, healthcare providers caring for people living with HIV must be knowledgeable not only about HIV treatment but also about the management of other comorbidities in the context of HIV.
1. Bushmeat crisis task force . What is bushmeat ? http://www.bushmeat.org/bushmeat_and_wildlife_trade/what_is_the_bushmeat_crisis
2. Canada’s source for HIV and hepatitis C information. A history of HIV/AIDS. http://www.catie.ca/en/world-aids-day/history
3. O’Brien K, Wilkins A, Zack E, Solomon P. Scoping the field: identifying key research priorities in HIV and rehabilitation. AIDS Behav. 2010;14(2):448–58.
4. Loutfy MR, Sherr L, Sonnenberg-Schwan U, Walmsley SL, Johnson M, Monforte ADA. Caring for women living with HIV: Gaps in the evidence. J Int AIDS Soc. 2013;16:1–14.
5. Kojic EM, Cu-Uvin S. Special Care Issues of Women Living with HIV-AIDS. Infect Dis Clin North Am. 2007;21(1):133–48.