AIDS–Page 1–All about HIV-DoctorSpiller.com

What is the difference between HIV and AIDS?

HIV stands for Human Immunodeficiency Virus.  In other words, HIV stands for the organism which attacks the human immune system causing damage which makes the patient more susceptible to other diseases.  AIDS, on the other hand, is an acronym for Acquired Immune Deficiency Syndrome.  A syndrome is simply a grouping of symptoms which occur together.  Whenever a doctor sees a particular grouping of symptoms, he can infer that the patient has a specific disease.  For example, if you come into the office sneezing, with a runny nose and complain of aching muscles and a feeling of tiredness, then the doctor may assume you have a common cold caused by rhinovirus.

Not everyone infected with the virus develops AIDS, and not everyone with the signs and symptoms diagnostic of AIDS harbors the virus, especially in third world countries.  At the present time, there is no cure for the virus (HIV), however the syndrome (AIDS) can be controlled with various combinations of medications.

How does HIV produce AIDS?

HIV attacks the immune system.  Viruses in general are not quite “living” objects.  They have no cellular apparatus of their own to metabolize food or to reproduce.  They are “molecular parasites” which means that they are really just very active chemicals that must infect a living organism in order to take over the cellular components of the host (victim) for their own purposes.  Since they are nothing more than very complex chemical molecules, they have very specific needs with regards to the type of host cells they can infect.

HIV infects a particular component of our immune system called the “T cells”.  T cells are a type of white blood cell (specifically, a type of lymphocyte) which is responsible for protecting our bodies from attack by foreign invaders such as other viruses, bacteria, yeast and various cancer cells which may arise in our bodies from time to time.  It is the ultimate irony that HIV attacks and kills the very cells that are supposed to protect us from viral, as well as other types of infections.  Since HIV kills off an important part of our immune system, an infected individual becomes vulnerable to common diseases which are generally not dangerous to people with intact immune systems.  Thus infected young persons become vulnerable to diseases generally seen only in infants whose immune systems are not fully developed, or the very old, whose immune systems are in decline.

For example, a young healthy adult may have a chronic Herpes Simplex infection resulting in cold sores recurring on his or her lips once or twice a year.  On the other hand, a person with a compromised immune system may get such a severe flare-up of herpes simplex that he could have it all over his entire mouth and even elsewhere, and need hospitalization to recover.  Simple infections that other people can ignore while they heal become life threatening disasters for the AIDS patient.

For those interested in looking at an image of actual HIV virons (virus particles) with a schematic of the structure of the beast and a short discussion on how they infect a host and reproduce, then please click on the thumbnail image below.

CellularHIV

What is the origin of the HIV virus?

The disease entity that later came to be known as the AIDS virus seemed to pop out of nowhere about the year 1981.  For the general public, awareness began as a series of rumors that gay men were getting sick with illnesses that were rarely seen in modern America, and almost never seen in young men.  Many people, including some scientists and journalists attributed it to the gay lifestyle, since it seemed to be confined to that population.  In 1982, the term “AIDS” was first used to describe the syndrome.  It was not until 1984 when Dr. Robert Gallo claimed to have discovered the virus that it became widely known that AIDS was linked to a specific disease causing entity, and not simply to lifestyle issues. (In reality, the virus was first isolated at the Pasteur institute in France the year before, but the full implications of the discovery were not recognized at that time.)  As the biological characteristics of the virus were discovered over the next few years, scientists noted its similarity to SIV (simian immunodeficiency virus).  SIV was already a well known entity, and it began to be suspected that HIV was really a pre existing virus which made the jump from monkeys or apes to humans.  A 2006 news article tells the story of some modern biological sleuthing and confirms that the virus has been traced to a colony of chimpanzees in Cameroon (on the west coast of Africa).

The first human known to be infected with HIV was a man from Kinshasa in the nearby country of Congo who had his blood stored in 1959 as part of a medical study, decades before scientists knew the AIDS virus existed.

Presumably, someone in rural Cameroon was bitten by a chimp or was cut while butchering one and became infected with the ape virus. That person passed it to someone else.

You, your dentist and AIDS (The Acer case)

Although the transmission of HIV in the dental office has become much less of an issue since the late 1990’s when the epidemic broke, it is a subject that still deserves attention even well into the twenty first century.

In September of 1990, Doctor David Acer, a dentist in a small town in Florida died of AIDS. Before his death he sent a letter to all of his patients, informing them of his health status and urging them to take an HIV test. Acer reassured them that he had always followed standard infection-control procedures. Altogether, five deaths have been blamed on the transfer of HIV from Doctor Acer to his patients.

Since that time, there have been no undisputed cases of HIV transfer from any dentist to any patient.   

In 2006, the CDC (A division of the National Institute of health) issued this statement regarding Dr Acer.
There has been only one instance of patients being infected by a health care worker in the United States; this involved HIV transmission from one infected dentist to six patients. Investigations have been completed involving more than 22,000 patients of 63 HIV-infected physicians, surgeons, and dentists, and no other cases of this type of transmission have been identified in the United States.
Even before the wide dissemination of “universal precautions”, when dentists and hygienists did not routinely wear gloves or masks, neither they, nor their patients infected each other in spite the virtual certainty the virus was present in a percentage of both the patients and the dental personnel. Bear in mind that dental personnel all over the country frequently puncture their skin accidentally with dirty dental needles, handpiece burs and other sharp instruments. If there were a perceptible risk in transmitting the AIDS virus in the dental setting, there is no question that some dental personnel would have been occupationally infected by now!
Available information indicates that the risk of HIV transmission (in either direction) in the dental office is very low. Transmission of HIV from three healthcare workers to patients has been confirmed, including one dentist (Dr Acer) who infected six patients. There are >300 reports (102 confirmed) of occupational transmission to healthcare workers, including nine dental workers (unconfirmed). This suggests that health care workers, (who cannot legally discover the HIV status of their patients) are at much greater risk of contracting the virus from a patient than any patient is of contracting the disease from a health care worker!
No one knows what were the circumstances leading to the transfer of HIV from one doctor to not one, but to six of his patients, but it is evident that those circumstances have never been reproduced during the years since Dr. Acer’s death.
The conclusion that can be drawn from this is that HIV is a fragile organism that is not easily transmitted except by aggressive sexual activity with an infected person, by blood to blood contact as in massive large bore needle sticks, or when drug abusers share their needles and syringes.

Cleanliness in a dental office is, of course, important. Even if HIV transmission is unlikely, it is still possible to transfer other diseases such as Hepatitis B which is documented to be transferable between medical personnel and their patients. However, in view of the facts that have come to light over the last ten years, the initial hysteria surrounding the HIV status of physicians, dentists and other health care providers was quite unwarranted.

A note on the spread of AIDS in third world countries

It is very difficult for Americans to understand the huge cultural differences between western civilization and those cultures in which the term “civilization” does not have the same meaning as it does in Europe, Australia, North America and other first world nations. These differences permeate every aspect of the lives of the individuals, especially in the least affluent parts of the the world. They manifest especially in the less formal aspects of peoples’ lives such as their sexual practices and patterns of drug use, both of which may vary significantly from western cultural traditions.  Although things have gotten better all over the world since the first decade of the twenty first century, in many areas of Africa and the poorer areas of some third world nations, HIV is much more prevalent.

Africa

HIV/AIDS is a major public health concern, and is the cause of death in many parts of Africa, especially in sub-Saharan areas . Although the continent is home to about 15.2 percent of the world’s population, Sub-Saharan Africa alone accounted for an estimated 69 percent of all people living with HIV and 70 percent of all AIDS deaths in 2011.

In Sub-Saharan Africa, the AIDS epidemic has a very different epidemiological profile than it does in the west. There, the scale of the problem dwarfs the prevalence of HIV in the rest of the world. In Sub Saharan Africa, over 25 million people are infected. Sixty-four percent of all HIV positive people worldwide and 76 percent of all women with the virus are in sub-Saharan Africa. There, nearly equal numbers of males and females are infected, while males outnumber females by nearly 3 to 1 in Western countries. The reasons for this are complex, and not always easy to ascertain because they involve personal and and in some cases taboo factors that people don’t like to talk about to interviewers. People, when asked about their sex lives simply do not give honest answers.

Infection rates vary widely from country to country on the African continent due to the sometimes stark differences in the cultural affinities of the respective populations. Certainly, the social chaos in areas suffering the agonies of prolonged war, revolution and famine would lead to the wider dissemination of HIV as well as other endemic diseases. Prostitution and polygamy appear to be more widely practiced in some areas of the continent than they are in Western countries. Men are less likely to be circumcised in Sub-Sahara Africa. This increases the likelihood of inflammation and open sores around the head of the penis. These men are more likely to both contract HIV from, and to spread it to their heterosexual partners. In some parts of Sub-Saharan Africa, especially in countries located in the southern third of the continent, heterosexual anal intercourse is said to be a more widely practiced form of birth control than many people admit. (Scientific data on this is sketchy, however a study by researchers at the University of Tuebingen in Germany suggests that this is a major factor in the spread of HIV in southern Africa.) Although women are much less likely to transmit HIV to their sex partners, this mode of sexual intercourse short circuits their otherwise minimized roll in transmitting the disease.

The role of circumcision in the transmission of HIV

As was mentioned above, men are less likely to be circumcised in Sub-Sahara Africa. It has long been suspected that circumcision tends to reduce the likelihood of transmission of HIV to males. Now a study has confirmed this hypothesis.

“Removing the foreskin is thought to harden the glans (head) of the penis, making it less permeable to viruses. Research conducted in 2005 showed the transmission of HIV from women to men during sex was reduced by 60 per cent if the men were circumcised. A study published last month calculated that if all men in sub-Saharan Africa were circumcised, it would prevent almost six million new cases of HIV infection and save three million lives over the next 20 years.”

In addition, there is an increased tendency toward viral shedding in persons with untreated syphilis, gonorrhea, chlamydia, herpes and other less well known STD’s. The lack of proper diagnosis and treatment of these diseases in primitive social conditions increases the risk of spreading the HIV virus. In some sub Saharan countries, the rate of reported STD infection is ten times that reported in the US, and these statistics are based on a much lower standard of surveillance than is the case in western countries.

There is also a widespread belief in some areas of Africa that an infected male can be cured of HIV by having sex with a virgin. This erroneous belief is suspected of increasing the frequency of rape and the spread of the virus. Customs, beliefs and conditions such as these, along with an enormous number of historical, demographic, economic and cultural factors converge to increase the infection rate in Sub-Saharan Africa.

One African bright spot is Uganda. There, the epidemic has been nearly stopped by a campaign promoting abstinence.

“According to a U.S. Agency for International Development study, in Uganda “national HIV prevalence peaked at around 15 percent in 1991, and had fallen to five percent as of 2001. This dramatic decline in prevalence is unique worldwide.”

In the mid-1980s, when it became clear that AIDS was on the rise in Uganda, President Yoweri Museveni adopted a program that, as Arthur Allen has written in The New Republic, “would become known as ABC, for Abstain, Be faithful or wear a Condom — very much in order of emphasis.”

According to a study of one Ugandan district, almost 60 percent of youths age 13-16 reported engaging in sexual activity in 1994, but by 2001, the number had plummeted to less than 5 percent. The USAID study reports that compared with men in other sub-Saharan African countries, Uganda males are “less likely to have ever had sex (in the 15-19-year-old range), more likely to be married and keep sex within marriage, and less likely to have multiple partners.”

The Oral signs Symptoms and abnormalities of HIV==>>

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