7.3. AIDS

The word AIDS stands for Acquired Immuno Deficiency Syndrome. This means deficiency of immune system, acquired during the lifetime of an individual indicating that it is not a congenital disease. ‘Syndrome’ means a group of symptoms. AIDS was first reported in 1981 and in the last twenty-five years or so, it has spread all over the world killing more than 25 million persons.

AIDS is a serious health condition caused by the Human Immunodeficiency Virus (HIV), which attacks and progressively weakens the immune system. The term 'acquired' indicates that this condition is not something people are born with; it develops during their lifetime. The concept of 'syndrome' helps to understand that AIDS presents multiple symptoms rather than a single disease. Since its identification in the early 1980s, AIDS has become a global health crisis, resulting in over 25 million deaths, emphasizing the urgent need for awareness and prevention.

Think of the immune system as a castle that protects your body from invading forces like viruses and bacteria. HIV is like a trickster that sneaks into the castle, sabotaging the guards (immune cells) and weakening the defenses over time, leading to various symptoms of AIDS.

AIDS is caused by the Human Immuno deficiency Virus (HIV), a member of a group of viruses called retrovirus. Transmission of HIV-infection generally occurs by (a) sexual contact with infected person, (b) by transfusion of contaminated blood and blood products, (c) by sharing infected needles as in the case of intravenous drug abusers and (d) from infected mother to her child through placenta.

HIV is specifically a type of retrovirus that infects the immune system, primarily targeting CD4+ T-h cells. This can lead to a breakdown of a person's immune defenses. The virus spreads in several ways: through unprotected sexual contact with someone who is infected, through blood transfusions with contaminated blood, by sharing needles among drug users, and from an infected mother to her child during childbirth or breastfeeding.

Imagine receiving a transmission of a virus like getting an email. Just as an email could be sent through common platforms (like sexual contact or sharing files), HIV can spread via bodily fluids. It's crucial to have safe connections (like using a condom or sterile needles) to prevent receiving such harmful 'messages'!

After getting into the body of the person, the virus enters into macrophages where RNA genome of the virus replicates to form viral DNA with the help of the enzyme reverse transcriptase. This viral DNA gets incorporated into host cell’s DNA and directs the infected cells to produce virus particles. Simultaneously, HIV enters into helper T-lymphocytes (T ), replicates and produce progeny viruses. The progeny viruses released in the blood attack other helper T-lymphocytes.

Upon entering the body, HIV targets two main types of cells: macrophages (immune cells that ingest and digest pathogenic microorganisms) and helper T-lymphocytes. The virus uses the enzyme reverse transcriptase to convert its RNA into DNA, which then integrates into the host's DNA. This effectively hijacks the cell's machinery to produce new viruses, thereby leading to further infection of other immune cells, resulting in a decline in their numbers. The reduction of these helper T-cells severely compromises the immune system.

Imagine a factory where products are made. When a hacker (HIV) breaks into the factory (body) and takes control, it can override the staff (immune cells) to produce even more hackers instead of the intended products (immune responses), ultimately shutting down the factory operations (the immune system).

During this period, the person suffers from bouts of fever, diarrhoea and weight loss. Due to decrease in the number of helper T lymphocytes, the person starts suffering from infections that could have been otherwise overcome such as those due to bacteria especially Mycobacterium, viruses, fungi and even parasites like Toxoplasma. A widely used diagnostic test for AIDS is enzyme linked immuno-sorbent assay (ELISA).

As HIV progresses, the reduced number of helper T-cells affects the body's ability to fight infections, leading to symptoms like recurrent fevers, diarrhea, and significant weight loss. The compromised immune system cannot fend off infections that a healthy immune system typically would, making the individual susceptible to opportunistic infections. The ELISA test is a common method to diagnose HIV, as it detects antibodies to the virus in the blood.

Think of the immune system as a security team for a large event. As the number of security personnel (T-cells) diminishes due to repeated attacks, even minor disturbances (bacterial/viral infections) can cause chaos. Just like an event organizer might run checks to assess the security (ELISA test), doctors test for antibodies to identify if an HIV infection exists.

As AIDS has no cure, prevention is the best option. Moreover, HIV infection, more often, spreads due to conscious behaviour patterns and is not something that happens inadvertently, like pneumonia or typhoid. The only excuse may be ignorance.

Since there is currently no cure for AIDS, prevention becomes the primary strategy to combat its spread. This involves educating individuals about the modes of transmission and methods of effectively lowering risk, such as safe sex practices and avoiding shared needles. The prevention efforts are largely impeded by ignorance, which highlights the need for community education and public health initiatives.

Preventing HIV/AIDS is like safeguarding a home. Just as you would use locks, alarms, and surveillance (safe practices) to keep intruders away, awareness and education act as protective measures to keep the disease from entering the community. Ignorance is akin to leaving a window open, which can invite unwanted visitors (infections).

In our country the National AIDS Control Organisation (NACO) and other non-governmental organisation (NGOs) are doing a lot to educate people about AIDS. WHO has started a number of programmes to prevent the spreading of HIV infection.

Organizations like the National AIDS Control Organisation (NACO) and the World Health Organization (WHO) play critical roles in raising awareness, facilitating education, and implementing strategies to combat the spread of HIV. These interventions focus on improving public knowledge about HIV transmission and prevention, as well as promoting safe practices and access to health services.

Consider NACO and WHO as the coaches of a sports team training individuals on how to play safely to avoid injuries (HIV). They help players learn the rules (preventive measures), strengthening the team and allowing everyone to play confidently without fear.

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