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HIV/AIDS
 
  Human immunodeficiency virus infection (HIV) is a viral disorder that progressively destroys a certain type of white blood cell (lymphocyte) and causes acquired immunodeficiency syndrome (AIDS).

Infection by the human immunodeficiency virus eventually results in progressive deterioration of the body's immune system, allowing opportunistic infections and certain cancers to develop. AIDS is the late stage of HIV infection.

AIDS has reached epidemic proportions, with more than 750,000 cases and 400,000 deaths reported in the US. The World Health Organization estimates that 30 to 40 million people worldwide are infected today. More than 1 million people in the US are currently thought to be infected with HIV.

From the late 1970s to the mid-1980s, about half of all people with hemophilia became infected with HIV through blood products. Many of these people have developed AIDS. Currently, 10% to 15% of persons with hemophilia are infected with HIV. The AIDS epidemic has placed great health, economic, ethical and emotional burdens on affected families and the wider bleeding disorders community.

HIV transmission by any factor VIII or IX product in the United States has not occurred since 1986 due to viral inactivation (viral killing) methods that are used to treat blood products. These include heat treatment, solvent-detergent cleansing and monoclonal purification.

The transmission of HIV requires contact with a body fluid that contains infected cells or virus particles, including blood, semen, vaginal secretions, cerebrospinal fluid and breast milk. The virus is transmitted in the following ways:
Injection or infusion of contaminated blood, as occurs with blood transfusions, the sharing of needles or an accidental prick from an HIV-contaminated needle.
Sexual relations with an infected person, during which the mucous membrane lining the mouth, vagina or rectum is exposed to contaminated body fluids.
Transfer of the virus from an infected mother to a child before or during birth or through the mother's milk.

Prevention
Uninfected people should abstain from sex or engage only in safe (protected) sex.
HIV-positive people should abstain from sex or have safe (protected) sex; they should not give blood or donate organs, avoid pregnancy and notify previous and prospective sexual partners.
Drug abusers should halt the practice of sharing or reusing needles and enter a drug treatment program.
Medical and dental professionals should wear latex gloves whenever there is a possibility of contact with body fluids, and properly use and dispose of hollow needles.

There is no current vaccination for HIV, but several new studies hold promise for the future.

Treatment
Many drugs are now available to treat HIV infection. All prevent the virus from reproducing and slow the progression of the disease. The trouble is, HIV usually develops resistance to these drugs when they are used alone.

Treatment seems to be most effective when at least two to three of the drugs are given in combination. Drug combinations may delay the onset of AIDS in HIV-positive people and extend one's life compared with the use of single drugs. Recent studies suggest that these drug combinations can reduce the virus to undetectable levels and restore the immune system to near normal. Doctors aren't certain how soon after infection these drugs should be started, but people with high levels of HIV in their blood should be treated. The cost and side effects of two or three drug treatments may be too great for some people in the US and for many people in less-developed countries. There may also be side effects. Patients should talk to physicians about HIV treatment, as it is changing rapidly.

People with AIDS are usually prescribed drugs to prevent infections, such as pneumonia, as well.

 

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