Public Health Program in the USA - Assignment Example

of the of the of the Acquired means to get or obtain something, Immunodeficiency means the inability, either inborn or acquired, of the body to produce an adequate immune response to fight disease and finally syndrome connotes a group of symptoms which characterize a specific disease or disorder. In other words AIDS means a disease which completely demolishes the body's immune system, paving the path for acquiring any disease to which such a person is exposed. (Encarta Dictionary Tools). The HIV has a protein structure that recognizes and binds only with a specific structure found on the outer surface of certain cells. HIV attacks any cell with this binding structure. The white blood cells or T cells of the immune system, which coordinate disease-fighting mechanisms, are especially vulnerable to HIV attack. Of these certain T cells known as CD4 cells are most vulnerable. While infecting a CD4 cell, the HIV utilizes the genetic tools within the cell to replicate itself and then leaves the cell, destroying it in the process. Medical treatment cannot eradicate HIV once it has integrated into human cells. Reduction in the number of CD4 cells exposes a person to all infections as these cells assist other types of immune cells to respond to invading organisms. There are about a1, 000 CD4 cells per micro liter of blood in an average healthy person. The HIV destroys CD4 cells over a period of time, diminishing the cells' protective ability and weakening the immune system. The infected person becomes exposed to nearly 26 infections and rare cancers, which take advantage of the weakened immune defenses to cause disease when this density reduces to 200 cells per micro liter of blood (AIDS). Retroviruses were known as RNA tumor viruses as they have RNA and not DNA, genomes. These were known to cause certain cancers in animals. Howard Temin, in the middle of the twentieth century, studied them and discovered the genetic-like stability of the uncontrolled cell growth caused by these viruses. He proposed the provirus hypothesis, in which RNA tumor viruses cause permanent alterations to cells by integrating into host chromosomes, by virion RNAs which first convert into DNAs and then become integrated (Reverse Transcriptase). HIV infection occurs when a person comes into contact with blood, semen, vaginal secretions or breast milk infected with this virus. It is acquired by having sexual relations with an infected person, using hypodermic needles or by the pricking with an infected needle and by the transfer of the virus from an infected mother to her baby during pregnancy, childbirth, or breast-feeding (AIDS). Jerry is suffering from PCP, a kind of pneumonia caused by Pneumocystis carinii (p. carinii). This afflicts People with weak immune systems. It's the most common serious infection in people with advanced HIV disease in the United States. (Pneumocystis carinii Pneumonia (PCP) and HIV). "Pneumocystis pneumonia is caused by P. carinii, a fungus formerly considered to be a protozoan. Its fungal classification is based in part on 16S ribosomal RNA similarities to fungi, particularly ascomycetes, with spore cases. Its staining with the Gomori methenamine silver stain for fungi also supports its new classification"(Warnock. 1999). Hence the blood cultures will be negative for bacteria and antibiotics will be of no avail. Surgeons are at the greatest risk of contact with patients' blood and body fluids. Hence, breaches in gloving material are to be avoided. In a study it was found that 17.4% of the surgeons had skin abrasions. 32glove perforations were observed, of which 22were in the outer glove and 10in the inner glove. Only four outer glove perforations had matching inner glove perforations, thus indicating that in 82% of cases when the outer glove is perforated the inner glove will protect the surgeon's hand from contamination. It is recommended that double gloves are used routinely in all surgical procedures in view of the significantly higher protection it provides (Interoperative glove perforation). Gloves must always be worn while examining and treating any patient with unknown fever because it might be a symptom of hepatitis infection and this virus can also spread through blood and thus infect the hospital staff by a needle stick. With the recent improvement in treatment, people are living longer. People with a healthy lifestyle live longer. People with other medical problems, and a history of substance abuse, may not live as long. People with a positive mental attitude live longer than those with a negative mental attitude. The virulence of the strain of HIV also is important in deciding this issue. People with a drug resistant strain of HIV may not live for long. Persons responding to medications are expected to live longer. People with genetic mutations in their white blood cells (including mutations in the CCR-5 receptor and other receptors) can slow down the progression of the disease. People living for longer periods of time with HIV and not developing AIDS could be said to have partial immunity. It is difficult to determine the exact time for which a person with HIV/AIDS will live. This is more so as the rates of progression from HIV to AIDS differs from person to person. However, it is known that some infected individuals live for many years with the virus ( Live with HIV/AIDS. 27th July 1998). There is no cure or effective vaccine for HIV infection. Preventive steps mainly focus on abstinence and use of condoms, reduction of intravenous drug use and discouragement of the sharing of needles. Three antiretroviral medications are used in treating HIV infection. These are first, inhibitors of the action of an HIV enzyme called protease, like ritronavir, saquinivir, indinavir, amprenivir, nelfinavir, and lopinavir. Secondly, Nucleoside reverse transcriptase (RT) inhibitors (e.g., abacavir (ABC)), zidovudine (AZT), zalcitabine (ddc), didanosine (ddl), stavudine (d4T) and lamivudine (3TC)). Thirdly, non-nucleoside RT inhibitors (e.g., efavirenz, delavirdine, and nevirapine) which inhibit the action of reverse transcriptase. HIV becomes rapidly resistant to any single antiretroviral drug hence a combination treatment is required. Highly active antiretroviral therapy (HAART), a combination of three or more RT and protease inhibitors, has drastically reduced the mortality rate from HIV infection. Albeit, HAART does not eradicate HIV, it halts viral replication to a great extent; this allows the immune system to reconstitute itself. Successfully treated with HAART Patients do not suffer from the AIDS-associated conditions. (Siliciano). The Joint United Nations Programme on HIV/AIDS calculated the number of such patients and in order to provide an effective and coordinated response to this malaise the world community has held a number of Global HIV/AIDS Commitments, which make efforts to integrate efforts of national governments, multilateral organizations and affected communities. "After the UN General Assembly Special Session (UNGASS) on AIDS in June 2001, 189 member states adopted the Declaration of Commitment on HIV/AIDS (DoC), pledging to develop and implement multisectoral national strategies and financing plans to control HIV/AIDS."(HIV/AIDS Monitoring). Works Cited Encarta Dictionary Tools. Microsoft Encarta 2004. AIDS. Microsoft Encarta Library Reference 2004. Reverse Transcriptase. BookRags. Pneumocystis carinii Pneumonia(PCP) and HIV. Familydoctor. Interoperative glove perforation - single versus double gloving in protection against skin contamination. Postgraduate Medical Journal. < http://pmj.bmjjournals.com /cgi/content/full/77/909/458 --> Warnock, Martha L. 1999. Pneumocystis Pneumonia. < http://pathhsw5m54.ucsf.edu /case26/discussion26.html> How long can a person live with HIV/AIDS 27th July 1998. The Body. < http: //www.thebody.com /Forums/AIDS/SafeSex/Archive/Other/Q8790.html> Siliciano, Robert. Aids. Encyclopedia Britannica 2005 Deluxe Edition CD-ROM HIV/AIDS Monitoring. Public Health Program. Open Society Institute. < http://www.soros.org /initiatives/health/focus/phw/programs/hiv_aids>. Reverse transcriptase uses a single-stranded RNA template to create a double-stranded DNA. Read More