Table
of Contents
|
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About the Author |
iii |
|
|
A Quarter Century of
AIDS and Counting: a
Humanitarian Crisis |
ix |
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|
AIDS Update 2009 |
xvi |
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Preface |
xviii |
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|
Histories of Global Pandemics,
AIDS, its Place in History, Overview of HIV/AIDS, International AIDS
Conferences and Means of Remembering—The AIDS Quilt, Candlelight Memorial,
and World AIDS Day |
1 |
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|
Three
Words Echo Around the World: AIDS Crisis
Worsens! |
1 |
|
|
History
of Global Pandemics and Epidemics |
1 |
|
|
Fear,
Ignorance and Condemnation: Who
is to Blame? |
2 |
|
|
Imagine
a World without AIDS |
2 |
|
|
Overview
of HIV/AIDS |
4 |
|
|
AIDS: a Unique Disease |
5 |
|
|
AIDS:
A Cause of Death |
5 |
|
|
Another
Anniversary |
6 |
|
|
A New
Anniversary |
6 |
|
|
International
AIDS Conferences |
6 |
|
|
Means
of Remembering |
7 |
|
|
The
25th Candlelight Memorial |
9 |
|
|
Walking
to Change the Course of the HIV/AIDS Epidemic—United States |
10 |
|
|
Bicycle
Riding to Change the Course of the HIV/AIDS Epidemic—United States |
12 |
|
|
World
AIDS Day: an International Day
of Coordinated Action: a Time
to Recharge and Reconnect |
12 |
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|
The
World Health and UNAIDS Organizations |
14 |
|
|
The
Future |
14 |
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|
National
AIDS Hotlines |
16 |
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|
Useful
Internet Addresses |
16 |
|
1 |
AIDS: Denning the Disease and Finding its
Cause |
19 |
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|
The
New Millennium |
19 |
|
|
AIDS: a Disease or a Syndrome? |
20 |
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|
First
Reaction to AIDS: Denial |
21 |
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|
What
Causes AIDS? |
22 |
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|
How
Does HIV Cause AIDS? |
23 |
|
|
The
Centers for Disease Control and Prevention Reports |
25 |
|
|
Discovery
of the AIDS Virus |
25 |
|
|
Defining
the Illness: AIDS Surveillance |
27 |
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|
Summary |
29 |
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|
Review
Questions |
29 |
|
2 |
What Causes AIDS: Origin of the AIDS Virus |
30 |
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|
The
Cause of AIDS: the Human
Immunodeficiency Virus (HIV) |
30 |
|
|
Evidence
that HIV Causes AIDS |
35 |
|
|
Origin
of HIV: the AIDS Virus |
37 |
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|
Summary
on the Origin of HIV |
43 |
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|
Summary |
44 |
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|
Review
Questions |
44 |
|
3 |
Biological
Characteristics of the AIDS Virus |
46 |
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|
Viruses
Need a Host Cell in Order to Reproduce |
46 |
|
|
Viruses
are Parasites |
46 |
|
|
Viruses
Specific to Cell Type |
47 |
|
|
Retroviruses |
47 |
|
|
Description
of HIV: How it Attaches to a Host Cell and Buds Out of the Cell |
47 |
|
|
Human
Immunodeficiency Virus (HIV): its
Life Cycle |
50 |
|
|
The
HIV Life Cycle |
50 |
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|
How
HIV Escapes the Infected Cell |
52 |
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|
Basic
Genetic Structure of Retroviral Genomes |
54 |
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|
Genetic
Revolution |
59 |
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|
Formation
of Genetic Recombination in HIV |
59 |
|
|
Distinct
Genotypes (Subtypes/Clades) of HIV-1 Worldwide
Based on ENV and GAG Proteins |
60 |
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|
Summary |
63 |
|
|
Review
Questions |
63 |
|
4 |
Anti-HIV Therapy |
65 |
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|
Anti-HIV
Therapy |
66 |
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|
HIV
Eradication Update—2008 |
67 |
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|
Antiretroviral
Therapy (ART) Drugs with FDA Approval |
67 |
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|
The
HIV Medicine Chest: ART Drugs
Receiving FDA Approval |
69 |
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|
FDA-Approved
Nucleoside/Non-Nucleoside Analog Reverse Transcriptase Inhibitors and
Protease Inhibitors |
71 |
|
|
Use of
Non-Nucleoside Analog Reverse Transcriptase Inhibitors |
74 |
|
|
FDA-Approved
Protease Inhibitors |
74 |
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|
Protease
Inhibitors |
74 |
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|
Entry
Inhibitors and Problems |
76 |
|
|
Integrase
Inhibitors |
77 |
|
|
Development
and Selection of HIV Drug-Resistant Mutants |
78 |
|
|
Development
of HIV Drug Resistance to Protease Inhibitors |
78 |
|
|
How
Combination Drug Therapy can Reduce the Chance of HIV Drug Resistance |
82 |
|
|
HIV
Treatment Regimen Failure |
83 |
|
|
Viral
Load: its Relationship to HIV
Disease and AIDS |
88 |
|
|
Medical
Complications Associated with Anti-HIV Drug Therapies (ART) |
88 |
|
|
The
Smart Trial was Cancelled on January 11, 2006 |
97 |
|
|
Novel
Drugs |
97 |
|
|
Disclaimer |
97 |
|
|
Summary |
99 |
|
|
Some
AIDS Therapy Information Hotlines |
100 |
|
|
Review
Questions |
101 |
|
5 |
The Immunology of HIV
Disease/AIDS |
103 |
|
|
The
Immune System |
103 |
|
|
Human
Lymphocytes: T Cells and B Cells |
105 |
|
|
Antibodies
and HIV Disease |
113 |
|
|
Cellular
Micro-RNAs Contribute to HIV Latency in Resting
Primary CD4+ T Cells |
115 |
|
|
Immune
System Dysfunction |
115 |
|
|
Original
Antigenic Sin |
117 |
|
|
The
Search for Additional Receptors (Coreceptors) to CD4: FUSIN or CXCKR-4(R-4) |
118 |
|
|
CCKR-5
(R-5) Receptor |
118 |
|
|
Emergence
of HIV Strains that Vary in their Lethal Abilities |
119 |
|
|
In
Search of Genetic Resistance to HIV Infection |
119 |
|
|
T4
Cell Depletion and Immune Suppression |
122 |
|
|
Impact
of T4 Cell Depletion |
122 |
|
|
Role
of Monocytes and Macrophages in HIV Infection |
123 |
|
|
Where
Do T4 or CD4+ Cells Become HIV Infected? |
124 |
|
|
Summary |
127 |
|
|
Review
Questions |
127 |
|
6 |
Opportunistic
Infections and Cancers Associated with HIV Disease/AIDS |
128 |
|
|
What
is an Opportunistic Disease? |
128 |
|
|
The
Prevalence of Opportunistic Diseases |
129 |
|
|
Opportunistic
Infections in HIV-Infected People |
129 |
|
|
TB and
HIV |
140 |
|
|
Cancer
or Malignancy in HIV/AIDS Patients |
140 |
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|
Disclaimer |
145 |
|
|
Summary |
145 |
|
|
Review
Questions |
145 |
|
7 |
A Profile of Biological
Indicators for HIV Disease and Progression to AIDS |
146 |
|
|
HIV
Disease Defined |
146 |
|
|
Stages
of HIV Disease (Without Drug Therapy) |
150 |
|
|
HIV
Disease without Symptoms, with Symptoms, and AIDS |
156 |
|
|
Production
of HIV-Specific Antibodies |
157 |
|
|
Prognostic
Biological Markers Related to AIDS Progression |
161 |
|
|
HIV
Infection of the Central Nervous System (CNS) |
167 |
|
|
Neuropathies
in HIV Disease/AIDS Patients |
168 |
|
|
Pediatric
Clinical Signs and Symptoms |
169 |
|
|
Summary |
170 |
|
|
Review
Questions |
171 |
|
8 |
Epidemiology and
Transmission of the Human Immunodeficiency Virus |
172 |
|
|
We
Must Stop HIV Transmission Now! |
174 |
|
|
Epidemiology
of HIV Infection |
174 |
|
|
Transmission
of Two Strains of HIV (HIV-1/HIV-2) |
175 |
|
|
Is HIV
Transmitted by Insects? |
175 |
|
|
HIV
Transmission |
176 |
|
|
HIV
Transmission in Family/Household Settings |
178 |
|
|
Noncasual
Transmission |
178 |
|
|
Gay
Men Putting Themselves at High Risk for HIV Infection |
189 |
|
|
Problem |
194 |
|
|
Injection-Drug
Users and HIV Transmission |
198 |
|
|
United
States: Heterosexual
Injection-Drug Use (IDU) |
202 |
|
|
Cesarean
Section |
215 |
|
|
Conclusion |
216 |
|
|
National
AIDS Resources |
216 |
|
|
Summary |
217 |
|
|
Challenge
Your Assumptions About the HIV Infected |
217 |
|
|
Review
Questions |
217 |
|
9 |
Preventing the
Transmission of HIV |
219 |
|
|
The
AIDS Generation: “I Knew Everything About It, and I Still Got It!” |
220 |
|
|
Prevention,
not Treatment, is the Least Expensive and Most Effective Way to Stop the
Spread of HIV/ AIDS |
220 |
|
|
Global
Prevention |
221 |
|
|
Antiretroviral
Drugs having an Impact on Prevention, But We Can’t Treat Our Way Out of this
Pandemic |
222 |
|
|
Advancing
HIV Prevention: New Strategies
for a Changing Epidemic |
224 |
|
|
Preventing
the Transmission of HIV |
226 |
|
|
Sexual
Risk Taking Depends on Sexual Activity |
229 |
|
|
New
Rules to an Old Game: Promoting
Safer Sex—Nobody has a Body to Die For! |
231 |
|
|
The
Male Condom |
234 |
|
|
The
Female Condom or Femidom (Vaginal Pouch) |
240 |
|
|
An
Alternative to Condoms: Vaginal
Microbicides |
242 |
|
|
Injection-Drug
Use and HIV Transmission: the
Twin Epidemics |
245 |
|
|
HIV
Prevention for Injection-Drug Users |
245 |
|
|
Lifting
the Ban on the Use of Federal Funding to Support Needle Exchange Programs |
247 |
|
|
Prevention
of Blood and Blood Product HIV Transmission |
248 |
|
|
Infection
Control Procedures |
249 |
|
|
Sexual
Partner Notification: Disclosure |
250 |
|
|
The
U.S. Federal Government has Now Adopted Partner Notification as its
Cornerstone in its Effort to Help Control the Spread of HIV |
251 |
|
|
The
First Human Vaccine: the Impact
of Vaccines on Infectious Diseases |
254 |
|
|
HIV
Vaccine Development and its Role in Prevention |
254 |
|
|
Types
of Experimental HIV Vaccines |
258 |
|
|
DNA
Vaccine |
258 |
|
|
Problems
in the Search for HIV Vaccine |
260 |
|
|
Summary |
262 |
|
|
Review
Questions |
263 |
|
10 |
Prevalence of HIV
Infections, AIDS Cases, and Deaths Among Select Groups in the United States
and in Other Countries |
264 |
|
|
A Word
About HIV/AIDS Data |
265 |
|
|
The
Millennium: Year 2009 |
270 |
|
|
Formula
for Estimating HIV Infections |
272 |
|
|
Behavioral
Risk Groups and Statistical Evaluation |
274 |
|
|
Estimates
of AIDS Cases and HIV Infection |
284 |
|
|
Newly
Infected |
286 |
|
|
Shape
of the HIV Pandemic: United
States |
288 |
|
|
Shape
of AIDS Pandemic: United States |
288 |
|
|
Estimates
of Deaths and Years of Potential Life Lost Due to AIDS in the United States |
290 |
|
|
Canada
Estimated HIV/AIDS Cases through 2008:
Population 33,310,000 |
292 |
|
|
Global
Prevalence and Impact of HIV/AIDS |
294 |
|
|
Connected
But Separate |
296 |
|
|
Workforce—South
Africa: Some Examples |
298 |
|
|
Education: Teachers and Students-South Africa
and Some Countries in Southern Africa |
298 |
|
|
Other
HIV/AIDS Time Bombs in Asia: India,
China, and Russia |
299 |
|
|
Summary |
303 |
|
|
Review
Questions |
303 |
|
11 |
Prevalence of HIV
Infection and AIDS Cases Among Women and Children |
305 |
|
|
AIDS
is Defining the Lives of Millions of Women |
306 |
|
|
Female
Vulnerability |
306 |
|
|
Every
Day a Tragedy |
306 |
|
|
Triple
Jeopardy |
306 |
|
|
Annual
International Women’s Day—March 8 |
307 |
|
|
Women: AIDS and HIV Infections Worldwide |
307 |
|
|
Women: HIV-Positive and AIDS Cases—United
States |
308 |
|
|
Childbearing
Women |
323 |
|
|
Internet |
324 |
|
|
Pediatric
HIV-Positive and AIDS Cases—United States:
a Fight We can Win! |
324 |
|
|
Orphaned
Children Due to HIV Infection and AIDS |
325 |
|
|
The
Phenomenon of AIDS Orphans |
326 |
|
|
Summary |
332 |
|
|
Review
Questions |
332 |
|
12 |
Prevalence of HIV
Infection and AIDS Among Young Adults, Ages 13 to 24 |
334 |
|
|
Global
HIV Infections in Young Adults |
334 |
|
|
Addressing
the AIDS Pandemic Among Young Adults |
335 |
|
|
How
Large is the Young Adult Population in the United States? |
336 |
|
|
HIV/AIDS
Won’t Affect Us! |
337 |
|
|
Estimate
of HIV-Infected and AIDS Cases Among Young Adults in the United States |
338 |
|
|
Summary |
346 |
|
|
Internet |
346 |
|
|
Other
Useful Sources |
346 |
|
|
Review
Questions |
346 |
|
13 |
Testing for Human
Immunodeficiency Virus |
347 |
|
|
Determining
the Presence of Antibody Produced When HIV is Present |
348 |
|
|
Requests
for HIV Testing |
348 |
|
|
Reasons
for HIV Testing |
349 |
|
|
Laboratory
Methods for Detecting HIV |
350 |
|
|
Elisa
HIV Antibody Test |
351 |
|
|
Western
Blot Assay |
358 |
|
|
New
Elisa Antibody Testing and Viral Load Procedures Reveal Early versus Late HIV
Infection |
361 |
|
|
Rapid
HIV Testing |
363 |
|
|
FDA
Approves Two Home HIV Antibody Test Kits |
367 |
|
|
Some
Screening and Confirmatory Tests for HIV |
368 |
|
|
Deciding
Who should Get an HIV Test and When |
371 |
|
|
Why is
HIV Test Information Necessary? |
372 |
|
|
Immigration
into the United States |
372 |
|
|
Testing,
Competency, and Informed Consent |
374 |
|
|
Summary |
381 |
|
|
Review
Questions |
382 |
|
14 |
AIDS and Society: Knowledge, Attitudes, and Behavior |
383 |
|
|
HIV/AIDS
is a Story in Our Lifetime |
384 |
|
|
The
New Millennium and HIV/AIDS |
385 |
|
|
HIV/AIDS
is an Unusual Social Disease |
385 |
|
|
Discrimination
vs. Compassion and Support |
385 |
|
|
HIV/AIDS
is Here to Stay |
386 |
|
|
AIDS |
387 |
|
|
Blame
Someone, Déjà Vu |
387 |
|
|
Fear: Panic and Hysteria Over the Spread
of HIV/AIDS in the United States |
388 |
|
|
Whom is
the General Public to Believe? |
389 |
|
|
AIDS
Education and Behavior: Dissipating
Fear with Education |
394 |
|
|
The
Character of Society |
401 |
|
|
Dealing
with Discrimination: the
Americans with Disabilities Act |
406 |
|
|
Federal
and Private Sector Financing: Creation
of an AIDS Industry |
408 |
|
|
U.S.
Government Believes HIV/AIDS is a Threat to National Security |
411 |
|
|
Global
HIV/AIDS Funding for Underdeveloped Nations |
412 |
|
|
Forms
of U.S. Monetary Assistance for HIV/AIDS |
418 |
|
|
Summary |
423 |
|
|
Review
Questions |
424 |
|
|
Answers to Review
Questions |
425 |
|
|
Glossary |
431 |
|
|
References |
439 |
|
|
Index |
461 |
|
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