Table
of Contents
|
|
|
|
About the Author |
iii |
|
A Quarter Century of AIDS and Counting: A Humanitarian Crisis |
x |
|
AIDS Update 2010 |
xix |
|
Preface |
xxi |
Introduction |
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 |
|
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 |
|
Other Anniversaries |
6 |
|
International AIDS Conferences |
6 |
|
Means of Remembering |
7 |
|
The 26th 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- |
12 |
|
World AIDS Day: An International Day of Coordinated Action: A
Time to Recharge and Reconnect |
12 |
|
The World Health and UNAIDS Organizations |
13 |
|
The Future |
13 |
|
National AIDS Hotlines |
15 |
|
Useful Internet Addresses |
15 |
1 |
AIDS: Denning the Disease and Finding its Cause |
18 |
|
The New Millennium |
18 |
|
AIDS: A Disease or a Syndrome? |
19 |
|
First Reaction to AIDS: Denial |
20 |
|
What Causes AIDS? |
20 |
|
How Do CD4+ Cells Relate to HIV Infection and AIDS? |
22 |
|
The Centers for Disease Control and Prevention Reports |
24 |
|
Discovery of the AIDS Virus |
24 |
|
Defining the Illness: AIDS and Surveillance |
26 |
|
Summary |
28 |
|
Review Questions |
28 |
2 |
What Causes AIDS: Origin of the AIDS Virus |
29 |
|
The Cause of AIDS: The Human Immunodeficiency Virus (HIV) |
29 |
|
Dissidents (AIDS Doesn’t Exist or HIV Isn’t the Cause) |
33 |
|
Evidence that HIV Causes AIDS |
33 |
|
Origin of HIV: The AIDS Virus |
37 |
|
Summary on the Origin of HIV |
43 |
|
Summary |
44 |
|
Review Questions |
44 |
3 |
Biological Characteristics of the AIDS Virus |
45 |
|
Viruses Need a Host Cell in Order to Reproduce |
45 |
|
Viruses are Parasites |
45 |
|
Viruses Specific to Cell Type |
46 |
|
Retroviruses |
46 |
|
Description of HIV; How it Attaches to a Host Cell and Buds Out
of the Cell |
46 |
|
Human Immunodeficiency Virus (HIV): its Life Cycle |
49 |
|
The HIV Life Cycle |
49 |
|
How HIV Escapes the Infected Cell |
53 |
|
Basic Genetic Structure of Retroviral Genomes |
53 |
|
Genetic Revolution |
58 |
|
Formation of Genetic Recombination in HIV |
58 |
|
Distinct Genotypes (Subtypes/Clades)
of HIV-1 Worldwide Based on ENV and GAG Proteins |
59 |
|
Summary |
62 |
|
Review Questions |
62 |
4 |
Anti-HIV Therapy |
64 |
|
Exciting Times for Antiretroviral Therapy |
65 |
|
Anti-HIV Therapy |
65 |
|
HIV Eradication Update—Is a Cure Possible? |
69 |
|
Antiretroviral Therapy (ART) Drugs with FDA Approval |
69 |
|
The HIV Medicine Chest: ART Drugs Receiving FDA Approval |
72 |
|
FDA-Approved Nucleoside/Non-Nucleoside Analog Reverse
Transcriptase Inhibitors and Protease Inhibitors |
73 |
|
Use of Non-Nucleoside Analog Reverse Transcriptase Inhibitors |
75 |
|
FDA-Approved Protease Inhibitors |
75 |
|
Entry Inhibitors and Problems |
78 |
|
Integrase Inhibitors |
79 |
|
Development and Selection of HIV Drug-Resistant Mutants |
80 |
|
Development of HIV Drug Resistance to Protease Inhibitors |
81 |
|
How Combination Drug Therapy can Reduce the Chance of HIV Drug
Resistance |
84 |
|
HIV Treatment Regimen Failure |
86 |
|
Viral Load: its Relationship to HIV Disease and AIDS |
91 |
|
Medical Complications Associated with Anti-HIV Drug Therapies
(ART) |
91 |
|
Update 2010 |
96 |
|
Novel Drugs |
99 |
|
Summary |
102 |
|
Disclaimer |
104 |
|
Some AIDS Therapy Information Hotlines |
105 |
|
Review Questions |
105 |
5 |
The Immunology of HIV Disease/AIDS |
107 |
|
The Immune System |
107 |
|
Human Lymphocytes: T Cells and B Cells |
109 |
|
Why CD4+ Cells are Important in HIV Infection—What it Means |
114 |
|
The CD4+ Cell Count—Why it Matters |
114 |
|
Antibodies and HIV Disease |
118 |
|
Cellular Micro-RNAs Contribute to HIV
Latency in Resting Primary CD4+ T Cells |
120 |
|
Immune System Dysfunction |
121 |
|
Original Antigenic Sin |
121 |
|
The Search for Additional Receptors (Coreceptors)
to CD4: |
124 |
|
CCKR-5 (R-5) Receptor |
124 |
|
Emergence of HIV Strains that Vary in their Lethal Abilities |
124 |
|
In Search of Genetic Resistance to HIV Infection |
125 |
|
T4 Cell Depletion and Immune Suppression |
127 |
|
Impact of T4 Cell Depletion |
129 |
|
Role of Monocytes and Macrophages in
HIV Infection |
129 |
|
Where do T4 or CD4+ Cells Become HIV Infected? |
130 |
|
Summary |
133 |
|
Review Questions |
133 |
6 |
Opportunistic Infections and Cancers Associated with HIV Disease/AIDS |
134 |
|
What is an Opportunistic Disease? |
134 |
|
The Prevalence of Opportunistic Diseases |
135 |
|
Opportunistic Infections in HIV-Infected People |
135 |
|
TB: The Leading Cause of Death Among HIV-Positive People
Worldwide |
146 |
|
Cancer or Malignancy in HIV/AIDS Patients |
146 |
|
Disclaimer |
151 |
|
Summary |
151 |
|
Review Questions |
151 |
7 |
A Profile of Biological Indicators for HIV Disease and Progression to
AIDS |
152 |
|
What is Known and What is Missing from Our Understanding of
HIV/AIDS |
152 |
|
HIV Disease Defined |
153 |
|
Stages of HIV Disease (without Drug Therapy) |
157 |
|
HIV Disease without Symptoms, with Symptoms, and AIDS |
162 |
|
Production of HIV-Specific Antibodies |
163 |
|
Prognostic Biological Markers Related to AIDS Progression |
165 |
|
HIV Infection of the Central Nervous System (CNS) |
174 |
|
Neuropathies in HIV Disease/AIDS Patients |
175 |
|
Pediatric Clinical Signs and Symptoms |
175 |
|
Summary |
177 |
|
Review Questions |
177 |
8 |
Epidemiology and Transmission of the Human Immunodeficiency Virus |
178 |
|
We must Stop HIV Transmission Now! |
180 |
|
Epidemiology of HIV Infection |
180 |
|
Transmission of Two Strains of HIV (HIV-1/HIV-2) |
181 |
|
Is HIV Transmitted by Insects? |
181 |
|
HIV Transmission |
183 |
|
HIV Transmission in Family/Household Settings |
184 |
|
Noncasual Transmission |
184 |
|
Gay Men Putting Themselves at High Risk for HIV Infection |
194 |
|
Problem |
200 |
|
Injection-Drug Users and HIV Transmission |
206 |
|
|
206 |
|
Injection-Drug Use and HIV Infections in Other Countries |
209 |
|
Other Means of HIV Transmission |
215 |
|
Influence of Sexually Transmitted Diseases on HIV Transmission
and Vice-Versa |
215 |
|
Pediatric Transmission |
221 |
|
Conclusion |
224 |
|
National AIDS Resources |
224 |
|
Summary |
225 |
|
Challenge Your Assumptions About the HIV Infected |
225 |
|
Review Questions |
225 |
9 |
Preventing the Transmission of HIV |
227 |
|
The AIDS Generation: “I Knew Everything About It, and I Still
Got It!” |
228 |
|
Prevention, Not Treatment, is the Least Expensive and |
228 |
|
Global Prevention |
229 |
|
Antiretroviral Drugs Having an Impact on Prevention, but We
can’t Treat Our Way out of this Pandemic |
230 |
|
Advancing HIV Prevention: New Strategies for a Changing Epidemic |
234 |
|
Preventing the Transmission of HIV |
236 |
|
Sexual Risk Taking Depends on Sexual Activity |
239 |
|
New Rules to an Old Game: Promoting Safer Sex—Nobody has a Body
to Die For! |
241 |
|
The Male Condom |
244 |
|
The Female Condom or Femidom (Vaginal
Pouch) |
250 |
|
An Alternative to Condoms: Vaginal Microbicides
(MI-CRO-BA-CIDES) |
254 |
|
Injection-Drug Use (IDU) and HIV Transmission: The Twin Epidemics |
254 |
|
HIV Prevention for Injection-Drug Users |
255 |
|
Lifting the Ban on the Use of Federal Funding to Support Needle
Exchange Programs |
257 |
|
Prevention of Blood and Blood Product HIV Transmission |
258 |
|
Infection Control Procedures |
258 |
|
Sexual Partner Notification: Disclosure |
260 |
|
The U.S. Federal Government has Now Adopted Partner Notification
as its Cornerstone in its Effort to Help Control the Spread of HIV |
261 |
|
The First Human Vaccine: The Impact of Vaccines on Infectious
Diseases |
264 |
|
HIV Vaccine Development and its Role in Prevention |
264 |
|
Types of Experimental HIV Vaccines |
268 |
|
DNA Vaccine |
270 |
|
Problems in the Search for HIV Vaccine |
270 |
|
Update 2009, September-Breaking News: HIV Vaccine is Safe,
Partly Effective |
271 |
|
Summary |
272 |
|
Review Questions |
273 |
10 |
Prevalence of HIV Infections, AIDS Cases, and Deaths among Select
Groups in the |
274 |
|
A Word About HIV/AIDS Data |
275 |
|
The Millennium: Year 2010 |
279 |
|
Formula for Estimating HIV Infections |
282 |
|
Behavioral Risk Groups and Statistical Evaluation |
282 |
|
September 18: Annual National HIV/AIDS Aging Awareness Day |
293 |
|
Estimates of AIDS Cases and HIV Infection |
294 |
|
Newly Infected |
295 |
|
Shape of the HIV Pandemic: |
295 |
|
Shape of AIDS Pandemic: |
300 |
|
Estimates of Deaths and Years of Potential Life Lost Due to AIDS
in the |
302 |
|
Different Nations/Countries have Different Epidemics. Each Faces
its Own Reality |
302 |
|
|
303 |
|
|
303 |
|
|
303 |
|
Global Prevalence and Impact of HIV/AIDS (See Table 10-7) |
305 |
|
Connected but Separate: Each Country a Different Reality,
Different Countries Similar Questions but Different Answers, Different Epidemics |
307 |
|
Workforce— |
310 |
|
Education: Teachers and Students— |
310 |
|
Other HIV/AIDS Time Bombs in Asia: |
311 |
|
Summary |
315 |
|
Review Questions |
316 |
11 |
Prevalence of HIV Infection and AIDS Cases Among Women and Children |
317 |
|
HIV/AIDS is Defining the Lives of Millions of Women |
318 |
|
Female Vulnerability |
318 |
|
Every Day a Tragedy |
318 |
|
Triple Jeopardy |
318 |
|
Annual International Women’s Day—March 8 |
319 |
|
Women: AIDS and HIV Infections Worldwide |
319 |
|
Asia-Pacific Region, Over 5 Million HIV Positive: 2009 |
320 |
|
Women: HIV-Positive and AIDS Cases— |
320 |
|
Childbearing Women |
335 |
|
Internet |
336 |
|
Pediatric HIV-Positive and AIDS Cases— |
336 |
|
Orphaned Children Due to HIV Infection and AIDS |
337 |
|
The Phenomenon of AIDS Orphans |
339 |
|
Summary |
344 |
|
Review Questions |
345 |
12 |
Prevalence of HIV Infection and AIDS Among Young Adults, Ages 13 to 24 |
346 |
|
Global HIV Infections in Young Adults |
346 |
|
Addressing the AIDS Pandemic Among Young Adults |
347 |
|
How Large is the Young Adult Population in the |
349 |
|
HIV/AIDS Won’t Affect Us! |
350 |
|
Estimate of HIV-Infected and AIDS Cases Among Young Adults in
the |
350 |
|
Summary |
358 |
|
Internet |
358 |
|
Other Useful Sources |
358 |
|
Review Questions |
358 |
13 |
Testing for Human Immunodeficiency Virus |
359 |
|
Determining the Presence of Antibody Produced When HIV is Present |
360 |
|
Requests for HIV Testing |
360 |
|
Reasons for HIV Testing |
361 |
|
Laboratory Methods for Detecting HIV |
362 |
|
ELISA HIV Antibody Test |
363 |
|
Western Blot Assay |
369 |
|
New ELISA Antibody Testing and Viral Load Procedures Reveal
Early versus Late HIV Infection |
373 |
|
Rapid HIV Testing |
375 |
|
FDA Approves Two Home HIV Antibody Test Kits |
378 |
|
Some Screening and Confirmatory Tests for HIV |
380 |
|
Deciding Who Should Get an HIV Test and When |
382 |
|
Why is HIV Test Information Necessary? |
384 |
|
Immigration and Travel Ban into the |
384 |
|
Testing, Privacy, Competency, and Informed Consent |
385 |
|
Summary |
393 |
|
Review Questions |
394 |
14 |
AIDS and
Society: Knowledge, Attitudes, and
Behavior |
395 |
|
HIV/AIDS is a Story in Our Lifetime |
396 |
|
The New Millennium and HIV/AIDS |
397 |
|
HIV/AIDS is an Unusual Social Disease |
397 |
|
Discrimination vs. Compassion and Support |
397 |
|
HIV/AIDS is Here to Stay |
398 |
|
AIDS Comes to the |
399 |
|
Blame Someone, Déjà Vu |
399 |
|
Fear: Panic and Hysteria over the Spread of HIV/AIDS in the |
400 |
|
Whom is the General Public to Believe? |
402 |
|
AIDS Education and Behavior: Dissipating Fear with Education |
406 |
|
The Character of Society |
413 |
|
Dealing with Discrimination: The Americans with Disabilities Act |
418 |
|
Federal and Private Sector Financing: Creation of an AIDS
Industry |
420 |
|
U.S. Government Believes HIV/AIDS is a Threat to National Security |
424 |
|
Global HIV/AIDS Funding for Underdeveloped Nations |
428 |
|
Forms of |
431 |
|
Summary |
438 |
|
Review Questions |
439 |
|
Answers to Review Questions |
440 |
|
Glossary |
446 |
|
References |
454 |
|
Index |
476 |
|
|
|