HIV, or the human immunodeficiency virus, is a disease associated with the penetration of an aggressive pathological agent into the bloodstream, which, developing in its natural environment - cells, tissues, organs - affects their porous membrane, increasing the permeability of all possible infectious antibodies. In addition, due to the reflex decline in protective functions, an HIV-positive patient is much more difficult to tolerate the usual diseases that are standard for many specialists:
Their treatment may take not 3–4 days or a week, but several months, with the preservation of subferal temperature and all signs of inflammation. There are several classifications of HIV. Some of them are presented below.
Detailed feature
All representatives of the class of retroviruses, to which HIV belongs, are highly resistant to temperature extremes (survive even at critical rates), external influences and, getting on the mucous membranes (in open wounds), instantly strengthen, causing a chronic inflammatory process with a long latent period ( more than three months).
At this time, a sick person - a carrier of HIV infection - does not even suspect the presence of a foreign antigen in the blood, continuing to lead a familiar lifestyle. The first alarming signals of serious health problems arise only at the time of third-party infection, for example during hypothermia, when the healing process takes a painfully long time and there are no visible improvements even after a month of intensive treatment.
Stages
The following classification of HIV stages is distinguished :
- The incubation period. Includes infection and the manifestation of the first signs of the disease. The duration of this period is up to three months.
- Acute infection. Duration approximately twelve months. Actively manifested signs.
- Latent. It can last up to twenty years. It all depends on the health of the infected person.
- AIDS. The last stage in which there is a high probability of death.
Clinical classification of HIV infection
Currently, in the differential diagnosis of pathological conditions caused by HIV infection, the 1993 CDC classification of diseases developed in the USA (Atlanta) is used. It includes three virological conditions: A, B, C, respectively. They include not only the pathological characteristics and general depletion of the body, but also the degree of activity of the pathogen SD4 +:
- The presence of the virus was not detected, since too little time has passed to start the diagnosis or the inflammatory process is of a different nature. The symptom complex is characteristic of any infectious lesion;
- Patients who are characterized by the following manifestations of the disease: pathologies of anorectal squamous epithelium (in most cases dysplasia), bacillary angiomatosis, various types of candidiasis (which occur again and again after a short period of time and are difficult to treat), constitutional signs (high body temperature> 38 , 5 ° C or diarrhea lasting more than a month), hairy leukoplakia of the tongue, infection caused by herpes Zoster (at least two separate episodes, or occurring with damage to more than one dermis volumes), idiopathic thrombocytopenic purpura, listeriosis, HIV-associated nephropathy, onychomycosis, pelvic inflammatory diseases (especially complicated by tubo-ovarian abscess), peripheral neuropathy. HIV is freely diagnosed. The beginning of the transition state to phase C is noted.
- Defined as the stage of pre-AIDS and AIDS. Patients in this category are in serious condition. They have total defeats:
- bronchi;
- trachea;
- lymph nodes;
- circulatory system and capillary channels;
- all life support systems - the liver;
- kidney
- urinary tract;
- heart
- central nervous system;
- peripheral fibers and ligamentous apparatus.
At this stage, doctors make the most responsible decision - to prescribe maintenance therapy until the moment of final death or try to save a person by prescribing an intensive care course using the most powerful drugs.
2006 classification
The second, often used classification is an adapted and revised version of the American clinical version - "Classification of HIV - infection by WHO", was created in Russia in 2006. It also includes the stages of the reactive process, the pathological justification of one degree or another (form), the degree of rooting of the virus and the speed of its spread. However, the foreign principle of separation is preferable in many medical centers and laboratories, since it includes a complete list of symptoms at each known stage and reflects a change in indicators according to analytical data.
Pathogenesis
Despite the relationship between the manifestations of the disease and the form of its receipt, HIV infection in each individual patient can manifest itself in different ways (that is, at a different rate). The general postulates of the development of the pathological process with the introduction of reactive agents into the cells and tissues of organs and systems are:
- Infection within 1-5 days.
- Stabilization of the virus and its dangerous spread. Mucous membranes, blood, human waste products are a source of infection.
- The defeat of the lymph nodes, their inflamed state.
- Decreased quality of life due to persistent colds, problems with the gastrointestinal tract, and sexual function.
- Clear signs of a complex inflammatory process. Body temperature rises sharply and also drops sharply. Colds do not go away even under the influence of strong antibiotics. Extreme depletion of the body is observed. Human mental activity is sharply reduced. Constant drowsiness and lethargy are noted.
- Spastic and clonic disorders may occur - convulsions, tremors. For the first time, problems associated with the work of the heart appear - rhythm disturbance, heart rate, blood pressure rises. Respiratory function is gradually inhibited. Lymph nodes are greatly enlarged and make it difficult to swallow food. The stomach is malfunctioning, the excretory system is also weakening.
- A condition associated with an extreme form of the disease when it is almost impossible to save the patient.
Diagnostics
In order to reliably determine the presence of HIV infection, several laboratory tests are carried out, which depend on the classification of HIV by WHO:
- screening diagnosis, which determines the presence of the viral nature of the disease;
- sorting test - reveals the most characteristic agents, including the human immunodeficiency virus ;
- serological tests - reliably confirm or refute the presence of HIV in the human body. In addition, they also establish the degree of influence and the rate of strengthening of the pathological process.
Other laboratory tests that can be applied: PCR diagnostics. This is a direct method for identifying the cellular structure of an external stimulus, its characteristics, and the phase of mutation in the intercellular space. It is carried out in the case of an unmistakable diagnosis, when the clinical picture is most characteristic.
Therapy. Treatment of HIV infection with HAART: concept, goals and principles of the method
Today, treatment of HIV infection has become possible thanks to the use of HAART (Highly Active Antiretroviral Therapy) and ART (Antiretroviral Therapy) methods developed in 1996. They suggest the use of several combination drugs that can affect the virus, making it less mobile, slowing down and stopping the growth of an aggressive environment, preventing HIV from developing into AIDS. Despite the apparent difficulty in using, HAART and ART are most effective and over the decades have shown themselves to be more than positive in relieving people of complex virological attacks.
Goal of treatment
The goal of this therapeutic approach is to cremate virus cells and artificially put them to sleep. If HAART was performed in full before pregnancy (at the planning stage), the baby is born completely healthy and has every chance of full development, further life.
Therapy duration
Treatment should be carried out for life. To stabilize the general condition, diverse medical support is prescribed. The most favorable case is considered to be the early detection of HIV infection, since the dosage and the total time spent on restoring the normal functional state of many vital organs is much less.