HIV-AIDS IS A METAPHYSICAL DISEASE TO WIPE OFF THE EARTH MOST PROMISCUOUS CHILDREN OF THE EVIL ONE WHOSE POPULATION IS NOW TRIPLED WORLWIDE

“HIV-AIDS IS A METAPHYSICAL DISEASE

That is why we cannot find its treatment in physical medicine but in a metaphysical one”

Says:

Dr J. K. Danmbaezue, B.Phil., B.Sc., pjsc, M.Sc., D.Psych.

The International Animator of HAFANI RESEARCH CONSORTIUM

   

This paper was written a decade ago, so please pardon any obsolete references and all typographical errors. Help me this time around. Age is telling on me and I now feel it!

PREAMBLE

The whole world has been fed with the balderdash that the pandemic HIV-AIDS has no cure! This is partially true for it is not purely a physical ailment! Besides, there is now a subliminal politics of HIV discernable by only a few wise men as was revealed to enlightened minds at the 2006 International Conference at Canada. A few intellectuals read between the lines regarding the depositions made by both Bill Gates and Bill Clinton.

The former, who is undoubtedly the greatest financier of the programmes aimed at finding worldwide solutions for the pandemic indicted the scientific community for not providing an effective alternative to the palliative regimen they are busy proliferating worldwide;

“While there is promising research to report, the world, in my view, has not done nearly enough to discover these new tools,…All of us who care about this issue should have focused more attention on these tools, funded more research, and worked harder to overcome the obstacles that make it difficult to run clinical trials. Now we need to make up for lost time.”  

                                 Bill Gates (2006) @ the 16^th International Conference at Toronto, Canada.

The latter, who equally is the greatest advocate of efficient management stratagem for halting the pandemic, has been busy galvanising political support for eradicating it asked this pertinent question:

“Why is it that Americans who take the retroviral drugs these companies produce survive whereas their counterparts suffering from the same illness in Africa and other developing countries die despite taking the drugs?”                                        

                          Bill Clinton (2006) @ the 16^th International Conference at Toronto, Canada.

Could both of them be wrong in accusing the international scientific community of not doing enough to find a more therapeutic regimen for the disease or a permanent cure? This Senior Research Fellow that has led a team of professionals at the University of Nigeria Teaching Hospital, Enugu in an alternative search for therapeutic remedies sourced from the tropics agrees completely with the two world-renowned figures thus;

“Enough has neither been done in terms of objective scientific research nor a free-for–all leverage given for divergent views on research methodology. Equally, there has never been a liberal acceptance of research findings emanating from the developing countries of the world because the western press and pharmaceutical companies involved in the lucrative business of marketing condoms and their own brand of retroviral drugs is fleecing the entire world of its scarce resources. They have combined forces and also contrived a secret agenda aimed at hiding the truth from humanity so as to enrich their multinational industries that are producing the condoms and other allied accessories for holding everyone to ransom. Therefore, we now need alternative management strategies in Africa and other developing countries!”

Dr J. K. Danmbaezue (2007) @, a Symposium on Hafani Research Project 007, UNTH, Enugu.

INTRODUCTION TO THE POLITICS OF HIV-AIDS

The other dimension to the shameful saga is that it is now being used as a biological weapon to balance the population ratio of blacks to whites worldwide! This ulterior motive was very evident in the falsehood some western scientists propagated that the reason why blacks die despite taking their retroviral drugs is because they do not adhere to the dosages prescribed. Bill Clinton declared the findings of a research study he sponsored that debunked the malicious theory at the same International Conference on HIV-AIDS held in Canada!

He emphasised that contrary to the propaganda rural communities took the drug regimen more seriously that urban dwellers and he went on to ask this pertinent question:

Why is it that Americans who take the retroviral drugs these companies produce survive whereas their counterparts suffering from the same illness in Africa and other developing countries die despite taking the drugs? Bill Clinton further pleaded that the western world must show evidence that the drugs shipped to the developing countries are of the same quality, same chemistry and similar milligram dosages as the ones shipped to Europe and North America!

Coming from a former President of the most powerful nation of the world in this twentieth century, could he be speaking with his tongue in his cheek?  Whoever can not comprehend the diplomatic undertones in his depositions or expatiate on their political meaning is not qualified to read this script. Such a person is neither a scientist nor a humanitarian! He/she is definitely a racist and can never be relied upon to tell the truth nor decipher a camouflaged reprimand!

Analyse this excerpt from the keynote address also presented by Mrs Melinda Gates as a statement of the facts on the behaviour of the African political class which underscores the wastage they make of the funds humanitarians laboured so hard to earn and donate to charity;

“When Bill and I visit other countries, we are enthusiastically accompanied by government officials on all our stops – until we go to meet with sex workers,” “At that point, it can become too politically difficult to stay with us, and our official hosts often leave.” “That is senseless,” “People involved in sex work are crucial allies in the fight to end AIDS. We should be reaching out to them, enlisting them in our efforts, helping them protect themselves from infection, and keeping them from passing the virus along to others.”

 Melinda Gates (2006) @ the same International Conference on HIV, Toronto, Canada.

It is in the light of this neo-colonial mentality that we opted to seek alternative remedies from the natural resources in the tropics. Our fore runners in this search in the natural environment for solutions to the pandemic are the colleagues of Dr Conrato S. Dayrit, an Emeritus Professor of Pharmacology at the University of Philippines who discovered that the chemical ingredients in Virgin Coconut Oil retarded the progression of HI-virus.

We have corroborated their research findings, improved on them and added our unique regimen that prevents action of the HIV and gradually halts the spread of AIDS in Sub-Saharan Africa. The members of HAFANI RESEARCH CONSORTIUM have devoted six years to this indigenous and prophylactic approach. We seem to have anticipated the indictments made in the dual keynote addresses of the duo of Bill Gates and his namesake Bill Clinton at the recently concluded 16^th HIV conference at Toronto, Canada.

That HIV-AIDS is not a physical disease can be glimpsed at from its ability to circumvent the normal biology of DNA & RNA synthesis. Whereas other terminal diseases obey the Mendelian Laws, while replicating, HI-Virus defies all known laws in Genetics. This translates into an ailment above the natural laws in creation, and so it must be supernatural. Another way to describe it is that it above the physical laws i.e. METAPHYSICAL! It is this observation that lends credence to our proposition: HIV IS NOT MERELY A PHYSICAL AILMENT!   

  Dr J. K. Danmbaezue (2007) @, the Public Presentation of Hafani Research Findings,

Rotary Hall, UNTH, Enugu.

THE GENESIS OF THE ARGUMENT THAT HIV IS A METAPHYSICAL DISEASE

“That born of the flesh is flesh, but that born of the spirit is spiritual.”

All known diseases that are consequences of transgressing / defying the laws of the physical environment have been studied for centuries and solutions have been found for most of them. The sciences of taxonomy, pharmacognosy, pharmacokinetics, pharmacology and pharmacy have assisted humanity in finding the right diagnosis, treatment and prevention of most diseases. If the international scientific community boldly states; there is no cure for HIV or AIDS for now, and there is no drug discovered to halt the spread of the virus, it boils down to the fact that the disease is not from the physical environment and any discerning adult would look elsewhere for its origin! Could it be a mutant of an already existing virus?

Man is a composite being made up of body, mind and spirit! Only humans communicate by speaking verbal languages that are intelligible to others. Human beings can think or reason and/or discuss! Man can agree or disagree with others in the same genus and family! Of all the other species in creation, only men take decisions at both the individual level and at the group level, thus they arrive at legislation; they make laws, impose rewards and sanctions. This is how most communities; primitive, civilised, religious, military, political and social arrive at constitutions, internationals conventions and human rights. All these, other hominoids do not and can not! That is why zoologists classified man as; Homo sapiens.

Our team affirms that the international scientific community has not done enough to halt the HIV-AIDS pandemic, for I have discovered that there are certain technologies that have been hidden from the entire human race regarding superior therapeutics that can halt the dreaded pandemic. I invite you to sample some of these areas that have not been maximally exploited;

INTERFERON TECHNOLOGY

Interferon is any of a group of antiviral proteins produced by animals, including humans, in response to infection by viruses. First recognised in chick embryo cells by British virologist Alick Isaacs and his Swiss colleague Jean Lindenmann in 1957, interferons were found to block further viral infection of body cells. The active antiviral substance is not the interferons themselves, but proteins that interferons cause other cells to produce. Some of these proteins have been identified, but their manner of operation is not yet well understood. It is clear, however, that interferons play a role in the body’s most important defences against viruses, and that they help fight bacteria and other disease-causing agents.

Interferons may be grouped into three categories;

1. Alpha (leukocyte) interferons are made by white blood cells,
2. Beta (fibroblast) interferons by skin cells, and
3. Gamma (immune) interferons by lymphocytes after stimulation by antigens.

During the 1960s physicians attempted to use interferons to treat virus-caused human diseases, especially colds, but the therapy was determined impractical due to the enormous cost of obtaining minute quantities of interferons from human white blood cells. Researchers then tried to stimulate the body to make its own interferons with inducers such as synthetic nucleic acids. These chemicals worked, but the body quickly became tolerant of them, and they lost their effect. In 1980, however, interferons were made available in sufficient quantities through genetic engineering techniques, and trials testing dosage levels and side effects were begun the following year. Thus far only some alpha interferons have been tested, but they have shown promise against a host of viral diseases. The use of interferons against such cancers as malignant melanoma and renal cell cancer has produced mixed results. The side effects accompanying interferons can range from mild to life-threatening. Beta and gamma interferons have not yet been tested in quantity, but may prove more useful than alpha interferons.

Microsoft ® Encarta ® Encyclopaedia 2004. © 1993-2003 Microsoft Corporation. All rights reserved.

Our Hafani Research Team has simply concentrated efforts at rejuvenating these interferons to perform optimally by employing the divine potentials inherent in plants found in the tropics!

If mankind can not find a cure for the HI-virus in the environment, then it must move up the ladder and explore the next level of his exalted tripartite composition of body, mind and spirit! Solutions not found at the lowest rung of the ladder may be waiting for some wise humans who can decipher the other two levels. The pandemic is an entirely new virus. It has never been in any medical books nor known in history. Therefore, it is an entirely a new being, a novel creation, the latest created virus. Who else can create? And he had made a divine promise that he would never again destroy the world with water or fire as He did in the Old Testament narratives!

This marked the starting block of the race against world opinion, divergent rationalisations and the genesis of the Kenezian Approach to seeking Alternative Management Strategies for HIV-AIDS. After half a decade of intensive meditative theosophy and existential philosophical disputations with enlightened minds, a light was seen at the end of the dark tunnel when two HIV patients responded to a dual therapeutic regimen rather than the monotherapy that has been popularised internationally! We discovered the missing link!

The current thesis that there is a metaphysical dimension to the pandemic did not come easy! It cost the leader of Hafani Researchers physical seclusion, emotional pain, psychosocial denials and months of fasting and prayers before the revelations started tumbling down from above. At this point we enjoin those who are familiar with the Bible to consult; John 3: 5-8, John 4:13 -14 and finally meditate on 1^st Corinthians 2: 8-16, before reading further. Find equivalents in other scriptures you are familiar with.

“5 Jesus answered, "Truly, truly, I say to you, unless one is born of water and the Spirit, he cannot enter the kingdom of God.

6 That which is born of the flesh is flesh, and that which is born of the Spirit is spirit.

7 Do not marvel that I said to you, 'You must be born anew.'

8 The wind blows where it wills and you hear the sound of it, but you do not know whence it comes or whither it goes; so it is with every one who is born of the Spirit."

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13 Jesus said to her, "Every one who drinks of this water will thirst again,

14 but whoever drinks of the water that I shall give him will never thirst; the water I shall give him will become in him a spring of water welling up to eternal life.”

……………………………………………………………………………………………………..

“8 None of the rulers of this age understood this; for if they had, they would not have crucified the Lord of glory.

9 But, as it is written, "What no eye has seen, nor ear heard, nor the heart of man conceived, what God has prepared for those who love him,"

10 God has revealed to us through the Spirit. For the Spirit searches everything, even the depths of God.

11 For what person knows a man's thoughts except the spirit of the man which is in him? So also no one comprehends the thoughts of God except the Spirit of God.

12 Now we have received not the spirit of the world, but the Spirit which is from God, that we might understand the gifts bestowed on us by God.

13 And we impart this in words not taught by human wisdom but taught by the Spirit, interpreting spiritual truths to those who possess the Spirit.

14 The un-spiritual man does not receive the gifts of the Spirit of God, for they are folly to him, and he is not able to understand them because they are spiritually discerned.

15 The spiritual man judges all things, but is himself to be judged by no one.

16 "For who has known the mind of the Lord so as to instruct him?" But we have the mind of Christ.”

 (From the Revised Standard Version of the Holy Bible)

PURIFICATION OF THE INNER MAN BY THE HOLY SPIRIT HEALS COMPLETELY

John 3:5

Verse 5.  Of water and of the Spirit] To the baptism of water a man was admitted when he became a proselyte to the Jewish religion; and, in this baptism, he promised in the most solemn manner to renounce idolatry, to take the God of Israel for his God, and to have his life conformed to the precepts of the Divine law. But the water which was used on the occasion was only an emblem of the Holy Spirit. The soul was considered as in a state of defilement, because of past sin: now, as by that water the body was washed, cleansed, and refreshed, so, by the influences of the Holy Spirit, the soul was to be purified from its defilement, and strengthened to walk in the way of truth and holiness.

When John came baptizing with water, he gave the Jews the plainest intimations that this would not suffice; that it was only typical of that baptism of the Holy Ghost, under the similitude of fire, which they must all receive from Jesus Christ: see Mt 3:11. Therefore, our Lord asserts that a man must be born of water and the Spirit, i.e. of the Holy Ghost, which, represented under the similitude of water, cleanses, refreshes, and purifies the soul. Reader, hast thou never had any other baptism than that of water? If thou hast not had any other, take Jesus Christ's word for it, thou canst not, in thy present state, enter into the kingdom of God. I would not say to thee merely, read what it is to be born of the Spirit: but pray, O pray to God incessantly, till he gives thee to feel what is implied in it! Remember, it is Jesus only who baptizes with the Holy Ghost: see Joh 1:33. He who receives not this baptism has neither right nor title to the kingdom of God; nor can he with any propriety be termed a Christian, because that which essentially distinguished the Christian dispensation from that of the Jews was, that its author baptized all his followers with the Holy Ghost.

Though baptism by water, into the Christian faith, was necessary to every Jew and Gentile that entered into the kingdom of the Messiah, it is not necessary that by water and the Spirit (in this place) we should understand two different things: it is probably only an elliptical form of speech, for the Holy Spirit under the similitude of water; as, in Mt 3:3, the Holy Ghost and fire, do not mean two things, but one, viz. the Holy Ghost under the similitude of fire-pervading every part, refining and purifying the whole.

John 3:6

Verse 6.  That which is born of the flesh is flesh] this is the answer to the objection made by Nicodemus in Joh 3:4. Can a man enter the second time into his mother's womb and be born? Our Lord here intimates that, were even this possible, it would not answer the end; for the plant will ever be of the nature of the seed that produces it-like will beget its like. The kingdom of God is spiritual and holy; and that which is born of the Spirit resembles the Spirit; for as he is who begat, so is he who is begotten of him. Therefore, the spiritual regeneration is essentially necessary, to prepare the soul for a holy and spiritual kingdom.

John 3:8

Verse 8.  The wind bloweth] though the manner in which this new birth is effected by the Divine Spirit, be incomprehensible to us, yet we must not, on this ground, suppose it to be impossible. The wind blows in a variety of directions-we hear its sound, perceive its operation in the motion of the trees, &c., and feel it on ourselves-but we cannot discern the air itself; we only know that it exists by the effects which it produces: so is every one who is born of the Spirit: the effects are as discernible and as sensible as those of the wind; but itself we cannot see. But he who is born of God knows that he is thus born: the Spirit itself, the grand agent in this new birth, beareth witness with his spirit, that he is born of God, Ro 8:16; for, he that believeth hath the witness in himself, 1Jo 4:13; 5:10; Ga 4:6. And so does this Spirit work in and by him that others, though they see not the principle, can easily discern the change produced; for whatsoever is born of God overcometh the world, 1Jo 5:4.

Adam Clarke’s Commentary, from my electronic version of the Power Bible CD

GENEVA BIBLE NOTES ON THE SAME JOHN 3:6

3:6 That which is born of the flesh is (g) flesh; and that which is born of the Spirit is spirit.

(g) That is, fleshly, namely, wholly unclean and under the wrath of God: and therefore this word "flesh" signifies the corrupt nature of man: contrary to which is the Spirit, that is, the man engrafted into Christ through the grace of the Holy Spirit, whose nature is everlasting and immortal, though the strife of the flesh remains.

FOR WANT OF TIME AND SPACE WE CAN ONLY TAKE

ADAM CLAKE’S COMMENTARY ON 1^ST CORINTHIANS 2:14

Verse 14.   But the natural man]  ‘qucikov’, The animal man-the man who is in a mere state of nature, and lives under the influence of his animal passions; for the word ‘quch’, which we often translate soul, means the lower and sensitive part of man, in opposition to ‘nouv’, the understanding or rational part.  The Latins use anima to signify these lower passions; and animus to signify the higher. The person in question is not only one who either has had no spiritual teaching, or has not profited by it; but one who lives for the present world, having no respect to spiritual or eternal things.  This ‘qucikov’, or animal man, is opposed to the pneumatikov, or spiritual man: and, as this latter is one who is under the influence of the Spirit of God, so the former is one who is without that influence.

The apostle did speak of those high and sublime spiritual things to these animal men; but he explained them to those which were spiritual.  He uses this word in this sense, 1Co 3:1; 9:11; and particularly in verse 15 of the present chapter: He that is spiritual judgeth all things.  {1Co 2:15}

But the natural man-The apostle appears to give this-as a reason why he explained those deep spiritual things to spiritual men; because the animal man-the man who is in a state of nature, without the regenerating grace of the Spirit of God, receiveth not the things of the Spirit-neither apprehends nor comprehends them: he has no relish for them; he considers it the highest wisdom to live for this world.  Therefore these spiritual things are foolishness to him; for while he is in his animal state he cannot see their excellency, because they are spiritually discerned, and he has no spiritual mind.

There is no living man or woman on earth today who has not broken most of the rules that the Almighty Creator God gave all of us through our great patriarch Noah;

Genesis 9:1-18

9:1 Then God blessed Noah and his sons, saying to them, "Be fruitful and increase in number and fill the earth.

2 The fear and dread of you will fall upon all the beasts of the earth and all the birds of the air, upon every creature that moves along the ground, and upon all the fish of the sea; they are given into your hands.

3 Everything that lives and moves will be food for you. Just as I gave you the green plants, I now give you everything.

4 "But you must not eat meat that has its lifeblood still in it.

5 And for your lifeblood I will surely demand an accounting. I will demand an accounting from every animal. And from each man, too, I will demand an accounting for the life of his fellow man.

6 "Whoever sheds the blood of man, by man shall his blood be shed; for in the image of God has God made man.

7 As for you, be fruitful and increase in number; multiply on the earth and increase upon it."

8 Then God said to Noah and to his sons with him:

9 "I now establish my covenant with you and with your descendants after you

10 and with every living creature that was with you-- the birds, the livestock and all the wild animals, all those that came out of the ark with you-- every living creature on earth.

11 I establish my covenant with you: Never again will all life be cut off by the waters of a flood; never again will there be a flood to destroy the earth."

12 And God said, "This is the sign of the covenant I am making between me and you and every living creature with you, a covenant for all generations to come:

13 I have set my rainbow in the clouds, and it will be the sign of the covenant between me and the earth.

14 Whenever I bring clouds over the earth and the rainbow appears in the clouds,

15 I will remember my covenant between me and you and all living creatures of every kind. Never again will the waters become a flood to destroy all life.

16 Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth."

17 So God said to Noah, "This is the sign of the covenant I have established between me and all life on the earth."

(From the Holy Bible: New International Version. Copyright (c) 1978 and 1984, by International Bible Society)

To get cured of HIV-AIDS, my patients must confess their transgressions of the dictates contained in verses 5 – 6 and make restitutions where applicable. They also must have a re-birth by the Holy Spirit, memorise and live by the social ethics contained in; The Kenezian Creed, The Letter to All Educationists and The Universal Prayer of the Animator International of INTEGRATIONAL SPIRITAN MOVEMENT. This and only this is the pre-condition for my Alternative HIV-AIDS Management Therapy based on powers inherent in nature’s plants! Any researcher is welcome to interview and interact with my patients to authenticate my formula! See the PowerPoint presentations entitled: CONCISE CASE HISTORIES OF PLWHA TREATED WITH OUR UNIQUE PHARMACOPEIA.

For Use by Bona-fide Members of Happy Family Network International Research Consortium

Dr Jideofo Kenechukwu Danmbaezue, D.Sc. (Psychometrics), FACRS

First Consultant Clinical Psychologist/Family Therapist of Ihiala LGA in Republic of Biafra,

Medical Director and Research Animator of Three Community-Based NGOs

E-mail: saintkenez@yahoo.co.uk Tel: 0803-9097614 or 0805-1764999

APPENDIX

HIV-AIDS MANAGEMENT IN AFRICA

*A Humanistic- Existential Approach to PLWA*

(By Hafani Professionals at UNTH, ENUGU, in 2003 led by Dr J. K. Danmbaezue)

1.1  INTRODUCTION: 

        This is Hafani's official presentation of the results of a three-year research on alternatives to the chemotherapeutic regimen approved for, administered to confirmed patients and sponsored by the Federal Ministry of Health in Nigeria from years 2001 to 2003 at all University Teaching Hospitals under its jurisdiction.

Happy Family Network International; HAFANI for short; is an NGO that caters for family health and a comprehensive social welfare for the less privileged in our rural and urban communities. With its headquarters here in Enugu, and regional branches all over the globe, it focuses attention on the need for Africans not to lose that cherished “Extended Family System” anthropologists have credited them with, for its psycho-sociological benefits in maintaining closely-knit kinship systems!

This research effort has been privately sponsored by the consortium of scientists listed at the end of this report. We are not tied to the apron strings of any national or international organizations! Nevertheless, that does not alienate those who may hereafter; indicate interest in networking with us for the benefit of the human family whom we dearly represent. You are welcome to this organization's interdisciplinary therapeutic orientation towards a non-sectarian and/or across the board approach to human problems.

Our team of medical scientists felt worried that our PLWA were not benefiting much from the much publicized assistance doled out to the patients attending the Thursday clinics at University of Nigeria Teaching Hospital, Enugu; hence the need for this research aimed at exploring other modalities for a more effective and efficient management. “Since this is simply another variant of a terminal illness”, the team argued, “would a professional multidisciplinary approach to its management not produce a better blueprint for our brothers and sisters going through the trauma?”

The answer to that existential question has lasted for one thousand and fifty-five days before the team decided to publish these preliminary findings. You are hereby invited to read, digest and corroborate the research effort before making informed criticisms. We are not holding briefs for any person or group of persons, nor are we protecting any official policies of any government or world organizations! So, feel free to buffet us with erudite questions that can bring out the best in us for the benefit of the human race.

 

We have chosen to demonstrate this interdisciplinary approach even in this official communication with the scientific community, so that enthusiasts of biomedical engineering can participate in proffering pragmatic solutions, if the need arises. Alternative medicine practitioners are also welcome with their varied formularies!

                                       (* See Appendix 1 for the Brochure outlining the Mission Statement of HAFANI*)

1.2 WHAT IS HIV-AIDS?

      For this, our consultant microbiologist, Dr M.E. Ohanu, a Senior Lecturer at the College of Medicine, UNTH has browsed the Internet and, for want of space, came up with the following summary:

The Centre for Disease Control (CDC), based in Atlanta, defines AIDS as a specific group of disease or conditions which are indicative of severe immuno-suppression, that is, the weakening of body defences related to Human Immuno-deficiency Virus (HIV). When the body defences are weakened as a result of the depletion by HIV of T4 lymphocyte cells, (the blood cells responsible for fighting diseases in the body), opportunistic organisms; fungal, bacterial, parasitic and viral, seize the opportunity to invade the individual thereby unleashing lethal infections that give rise to AIDS.

              HIV infection is established by detecting antibodies to the virus, viral antigens, viral RNA/DNA, or by culture. There are two types: HIV-1 and HIV-2, which show 40% to 60% amino acid homology. HIV-1 accounts for nearly all cases except a minority of strains that originate in West Africa. HIV-1 is subdivided into subtypes or clades designated “A to K” (collectively referred to as “M subtypes”) and “O”. Subtype O shows 55% to 70% homology with the M subtypes. A new group of viruses labelled “N” for “new” has been reported (Nat Med 1998; 4:1032; Science 2000; 287:607). Over 98% of HIV-1 infections in the United States are caused by clade B; most non-B subtypes in the United States were acquired in other countries (J Infect Dis 2000; 181:470).

              HIV-2 is another human retrovirus that causes immune deficiency due to depletion of CD4 cells. It is primarily found in West Africa. Compared to HIV-1, HIV-2 is less transmissible (5- to 8-fold less efficient than HIV-1 in early- stage and rarely the cause of vertical transmission), is associated with a lower viral load, and is associated with a slower rate of both CD4 cell decline and clinical progression (Lancet 1994; 344: 1380, J Infect Dis 1999; 180:1116, J AIDS 2000; 24:257, Arch Intern Med 2000; 160:3286)  

     

1.2.1        The Natural History of HIV Disease:

Professor Robert C. Mellors, of Weill Medical College of Cornell University has recently categorized the following as the progression of the pandemic:

1. Primary HIV Infection, which lasts about 3-6 weeks from the date of contact.
2. Acute HIV syndrome (mononucleosis-like/plasma viremia); 1week –3 months.
3. HIV-specific immune response (Serum antibody detectable); 1-2weeks.
4. Clinical latency (commonly called “the window period”) marked by curtailment of viremia, and the decline of CD4 T-cell count; 10 years, median.
5. Clinically apparent disease or AIDS-defining illness, which is the deterioration of the immune system proper.
6. Chronic syndromes, marked by increase in plasma viremia, and finally
7. Death from AIDS, time lapse here varies for individual patients.

Of course, the duration of clinical latency following primary HIV infection varies widely among individual persons depending upon many factors, among them exposure categories (blood, sexual contact, mother-to-child) and portal of entry, viral pathogenicity and mutation, host resistance, intrinsic and specific immune responsiveness, and finally new treatment strategies with combinations of potent antiretroviral drug therapy. There are also some HIV-seropositive, long-term “non-progressors” who have continued to be healthy without evidence of disease or immune defect for 10 or more years after primary HIV infection.

1.2.2   Acute Retroviral Syndrome:

   This mononucleosis-like syndrome develops in 40-70% of patients at 3-6 weeks following primary HIV infection. The presenting fever may include headache, sore throat, erythematous rash, diarrhoea, and generalized lymphadenopathy. Laboratory tests may show leukopenia, anaemia, thrombocytopenia, atypical lymphocytosis, elevated liver enzymes, and hyper-gammaglobulinemia

The peripheral bloodCD4+ T-lymphocyte count (reference normal adult count is usually at least 800/cumm) and the CD4/CD8 ratio (reference normal ratio is about 2) both decline. The acute illness usually resolves spontaneously within 2-3 weeks. HIV viremia, p24 antigenemia, and viral dissemination to, and replication in, the regional and other lymph nodes occur during this early stage of HIV infection,

An HIV-specific antibody and cellular immune response follows the primary infection. Serum testing for HIV antibody, by a screening test such as ELISA (enzyme-linked immunosorbent assay) and confirmatory Western blot (showing 2 or more bands of reactivity with Gag, Env, or Pol proteins), is positive in most individuals within 1 to 3 months after primary infection and in 95% within 6 months. Potentially confounding is of the serum of an uninfected (or infected) infant born to a seropositive mother, which may be expected to contain passively acquired maternal antibody. The HIV-specific immune response is associated with a marked decline in plasma viremia, but HIV replication continues in lymph nodes or other tissue compartments or organs, such as the genital tracts or the brain.

1.2.3   Clinical Latency:

        This is an asymptomatic period of HIV infection and usually has a duration of

several years (median duration of 10 years). The peripheral blood CD4 T-cell count may return to normal, or stabilize at a somewhat lower level, or decline slowly over time.

The plasma level of HIV viremia tends to reach a steady state (termed “viral set point”) at the end of the acute phase following primary infection. The steady-state level of viremia (plasma viral load), as measured by assays for the number of copies of HIV-1 RNA per ml of plasma, is a prognostic indicator for the rate of HIV disease progression, high viral loads correlating with faster, low with slower, rates of disease   progression to AIDS and death, as reported by Mellors, J.W., et al. (1996) cited in (Science 272: 1167 – 1170).

Latent, as well as productive, cellular infection by HIV is active in the lymphoid (cervical and axillary lymph nodes, tonsils, adenoids, etc.) and other tissue compartments during this variably prolonged period before the person becomes clinically ill.

1.2.4   Clinically Apparent Disease

     This is a symptomatic stage, a consequence of secondary manifestation of the progression and profound deterioration of the immune system that occurs time in most patients with HIV.

The CD4 T-cell count continues downward to the range of 200-400/cubic mm. Plasma viremia and p24 antigenemia approach high levels of such as seen in the primary infection. Some of the constitutional symptoms, opportunistic infections, and other manifestations of advanced symptomatic HIV disease are classified by the research team from the Weill Medical College of Cornell University (2003) into three major subheads as given in the following boxed table one of our presentation:

TABLE: 1.

                         MANIFESTATIONS OF ADVANCED SYMPTOMATIC DISEASE.

                                                       (CD4 T-cell count 200 – 400 / cubic mm                                                               

1. Constitutional symptoms:

                                               Fever, Weight loss, Fatigue, Night sweats, Diarrhoea,

                                                Persistent generalized lymphadenopathy.

2. Infections:

                            Oral or Vaginal candidiatis, Oral hairy leukoooplakia, Herpes zoster (shingles),

                         Herpes simplex, Listeriosis

3. Other:

                     Cervical dysplasia, Cervical carcinoma in situ,

                      Idiopathic thrombocytopenic purpura (ITP), Neuropathy, Seborrhea

*Modified from Pantaleo, G., et al., New Eng. J. Med., 328: 327 – 335, (1993), culled from http:// edcenter.med.cornell.edu/CUMC

1.2.5   Standard Laboratory Investigations:

Internationally, there are established routines for the confirmation of HIV infection, that include; Routine Serology, Rapid Test, Salivary Test, Urine Test, PMBC culture, DNA PCR assay, HIV RNA PCR and the most popular which is the CD4 Cell Count.

This is a standard test to stage the disease, formulate the differential diagnosis of patient complaints in order to make therapeutic decisions regarding antiviral treatment and prophylaxis for opportunistic pathogens. It is also a relatively reliable indicator of clinical progression and survival. For now, the alternative which is the CD8 cell counts have not been found to predict outcomes. (N Eng J Med 1990; 322:166)

1.2.6          The Technique, Normal Value & Frequency of Testing:

        The standard method for determining CD4 cell count uses flow cytometers and haematology analysers that are expensive and require fresh blood (<18 hours old). The cost of test ranges from $50 to $150. An alternative system that uses EIA technology is the TRAX CD4 Test Kit (J AIDS 1995; 10: 522). This may be attractive in resource-limited areas.

Normal value for most laboratories is a mean of 800 to 1050/mm³ with a range representing two standard deviations of approximately 500 to 1400/mm³ (Ann Intern Med 1993; 119: 55).

Frequency of testing: CD4 cell count <350mm³ - every 3 to 4 months; CD4 cell count <350mm³ - every 3 to 6 months (Clin Infect Dis 2000; 30:5); <50 cells/mm³ optional. Frequency will vary with individual circumstances.

1.3   LOCAL APPLICATIONS IN NIGERIA:

 For this our Chief Medical Social Worker, Mrs P.N. Nzegwu, of the University of Nigeria Teaching Hospital informs us that the cost of seropositive blood test alone is out of the reach of the masses, hence the decision by the officials of the Federal Ministry of Health who advised that the cost of treatment be subsidised all over the nation. However, this has not changed the scenario as reported by many of the patients that throng our Thursday clinics.

The social stigma of isolation does not help matters as even close relatives would do anything to avoid escorting the patient to the hospital premises least he/she be mistakenly identified as a sufferer along with his/her relative s/he was/is assisting. In addition, they could hardly afford the transport fares back and forth these glorified clinics on a weekly basis were such assistance available. Therefore, the centralisation is not helping the patients nor their care-providers.

Clerking of patients and routine examinations are equally problematic as many of the hospital personnel so far drafted to these clinics are not motivated with the requisite bonus or extra allowance to make them take the risks involved in taking blood samples and conducting other relevant tests on PLWA.

PROPHYLACTIC MANAGEMENT OF HIV/AIDS:

Our Consultant Clinical Psychologist who doubles as the Research Team Leader has done an extensive research in this area and has pieced together the information presented here which rightly belongs to the Department of Preventive & Social Medicine. We had no specialist on board to do the job. According to his summary presented below, there are three basic approaches to the prophylaxis of the HIV/AIDS pandemic, namely:

1.      GLOBAL CAMPAIGN,

2.      PRIMARY HEATH CARE,

3.      PREVENTION OF BLOOD-BORNE HIV TRANSMISSION.

THE GLOBAL CAMPAIGN:

The World Health Organisation launched the global programme on HIV/AIDS in February 1987, to provide support for the inauguration of National Action Control Committees on AIDS in every country of the world. All Presidents or Heads of States were signatories to the UNITED NATIONS ACTION ON AIDS (UN-AIDS) consisting of the following collaborative international agencies: WHO, UNICEF, UNESCO, UNFPA, UNDP, UNDCP, and the WORLD BANK.

Each nation was to form its multidisciplinary action committee and draw up a programme that suits its socio-cultural needs while monitoring the implementation of the recommended global programme tagged ‘HEAP’ meaning, HIV/AIDS EMERGENCY ACTION PLAN. We only hope that this international concern has been reciprocated by the various ministries of health in all nations of the world, both at the national, state and local government community levels. No one cries more than the bereaved.

PRIMARY HEALTH CARE DIMENSION:

HIV/AIDS cuts across all cadres of the social class and so affects all aspects of primary health care, through: Family planning methods, Child rearing practices, Maternal &Child Health and Public Health Education. Any HIV/AIDS control programmes should,  of necessity include budgets that will ensure that these areas are incorporated, carefully monitored and diligently implemented.

Besides radio and television jingles, there must be on ground visible and effective health care personnel that teach the public the rudiments of the aetiology, incidence, prognosis and the management of those opportunistic infections, which herald the full blown cases of the scourge. Knowledge is power. There is no other place to demonstrate that than in this fight against the extinction of the human race. Primary, secondary and tertiary institutions must have curricula that include the rudiments of the knowledge of the history and development of the pandemic if the global campaign must succeed. 

Public Health Education on safety practices such as avoidance of indiscriminate sex, abstinence from sexual intercourse until marriage, self-discipline and the restriction to one sexual partner are starting blocks for the race against the pandemic. International and national campaigns should be geared towards these natural methods of controlling the spread of the virus rather than the current advertisement of condoms. Preventive medicine is known all over the world as more beneficial and economical than curative medicine. People must be taught to avoid sharing razors, toothbrushes, needles, syringes and hair clippers or other and barbing instruments especially when blood is spilled while utilising any of them.

PREVENTION OF BLOOD-BORNE HIV TRANSMISSION:

This involves:  i. Proper Screening of all Blood samples before Storage.

                     

                      ii. The proper use of Autologous Blood Transfusion &

                    

                     iii. Sterile Disposable Syringes / Needles / Hand gloves and Facemasks.

Many health workers, cutting across various professional and allied medical cadres are at risk of contracting HIV/AIDS in the course of their routine duties. Surgical procedures, dressing of wounds, routine injections, setting up intravenous fluids, infant circumcisions and child deliveries are all critical exposures to the virus. They all involve very close contact with blood and so put all health personnel so involved at greater risks than some other medical workers do not perform such duties.

Moreover, the window period camouflages immediate awareness of incidental infection that could arise in such a subtle manner that a health worker may even be a transmitter of the virus without being aware of doing so! To reduce these risks and the incidence of iatrogenic infections among health providers, the following measures should be observed:

·        Every patient being attended to should be assumed to be HIV-positive until proven otherwise and so should be handled with caution.

·        Vaginal examinations, drawing samples of blood for laboratory tests, intravenous transfusions and any such medical procedures must be performed with sterilised hand gloves and face masks.

·        Avoidance of needle pricks, scalpel cuts or incisions since all may be modes of contamination.

·        Sores, bruises, fractures, the stitching of cuts in accident cases and other minor abrasions should be cleaned with methylated spirits or strong disinfectants and subsequently covered with air-tight and/or water proof plasters if the need arises.

·        If infected blood, semen or vaginal fluid comes in contact with exposed skins, immediate washing off with medicated soap and water treated with disinfectant destroys HIV-virus.

·        Gloved hands are strongly recommended when examining each patient, whether in the wards or at any of the outpatients’ clinics. If however your hands are not in gloves, they can be washed as described above in between routine examinations.

·        Every sharp instrument used should be disposed of immediately by discarding them into special containers with hygienic covers and subsequently incinerated properly.

·        Needles should not be uncapped from their syringes or their protective plastic covers until they are needed for immediate use, if uncapped in error they must be disposed of at once.

·        Re-usable instruments should be decontaminated by submerging them into a 5% solution of sodium hypochlorate for ten minutes, then washed and sterilised by vacuum pressure heater or in boiling water for twenty minutes.

·        Surgery should be performed using double gloves, protective masking, gowning or goggles where affordable.

·        Contaminated theatre floor should be washed with Jik bleach, Strong Izal or Dettol, and then mopped. To ensure thoroughness, this procedure could be done twice if the resources are available.

·        Hospital and clinic rubbish should be collected in a container with a cover, and disposal done by burial or incineration at least a hundred metres away from where people often mill around.

·        All linen soaked with blood or other stains must be soaked in 5% solution of sodium hypochlorate for thirty minutes then boiled for ten minutes, properly washed and dried in the sun.

·        If pricked by a needle or cut by any sharp object within the vicinity of any hospital or clinic, immediate washing with 5% solution of Jik bleach is highly recommended before any drug treatment. This is also applicable to being exposed to any contaminated fluid from any and every patient.     

Further reading by every health provider is highly recommended here, since no one can ever be over meticulous in a delicate matter of the magnitude, as no curative drug for HIV/AIDS has so far been found. Patient to medical staff infection has been widely reported in international journals, so be on the alert and save your loved ones / yourself from the embarrassment of becoming a victim.

“EUREKA, WE’VE FOUND THE INSURANCE FOR HIV-AIDS”

•        “People living with HIV-AIDS, (PLWHA), despite their predicament are still useful and responsible members of the society. They deserve our empathy, encouragement, quality care and optimal management strategies for prolonged existence, so that their professional skills can still be utilized to develop their communities. Together, a team of dedicated medical experts can make a difference. This is what our multidisciplinary team, HAFANI RESEARCH CONSORTIUM is really championing. Join us today!”

Excerpt from the Inaugural Speech of Dr J. K. Danmbaezue on the Foundation Day, 11^th March 2001; (53^rd Birthday).

 

2003 Members of the Hafani Research Consortium @ UNTH, Enugu include:

DANMBAEZUE. J. K, EZEOKE A.C.J, EZIKE C. A,  IBE. B. C, OHANU M. E,

OHOTU E, OZUMBA N. A, UGOCHUKWU C., UGONABO M.C,

Our Administrative assistants;

ONWUBUYA B.N., MBAEZUE A.N.C

And our Internet collaborating colleagues resident in the USA

MBAEZUE N.N., OKOROHA L. E.  & OZIGBOH Q. C.

ENCYCLOPAEDIA BRITANNICA ENTRY ON AIDS

Introduction

AIDS ( is an abbrev.) that translates into;  acquired immunodeficiency syndrome transmissible disease of the immune system caused by the human immunodeficiency virus (HIV). HIV slowly attacks and destroys the immune system, the body's defence against infection, leaving an individual vulnerable to a variety of other infections and certain malignancies that eventually causes death. AIDS is the final stage of HIV infection, during which time fatal infections and cancers frequently arise.

  

Diagram of Human immunodeficiency virus (HIV), colour-enhanced electron microscope image, 24,000× …

The emergence of AIDS

AIDS was first reported in 1981 by investigators in New York and California. Initially most cases of AIDS in the United States were diagnosed in homosexual men, who contracted the virus primarily through sexual contact, and in intravenous drug users, who became infected mainly by sharing contaminated hypodermic needles. In 1983 French and American researchers isolated the causative agent, HIV, and by 1985 serological tests to detect the virus had been developed.
HIV/AIDS spread to epidemic proportions in the 1980s, particularly in Africa, where the disease may have originated. Spread was likely facilitated by several factors, including increasing urbanization and long-distance travel in Africa, international travel, changing sexual mores, and intravenous drug use. According to the United Nations 2004 report on AIDS, some 38 million people are living with HIV, approximately 5 million people become infected annually, and about 3 million people die each year from AIDS. Some 20 million people have died of the disease since 1981.

People living in sub-Saharan Africa account for some 70 percent of all infections, and in some countries of the region the prevalence of HIV infection of inhabitants exceeded 10 percent of the population. Rates of infection are lower in other parts of the world, but the epidemic is spreading rapidly in Eastern Europe, India, South and Southeast Asia, Latin America, and the Caribbean. Rates of infection are also on the rise in the United States and Western Europe. In the United States nearly one million people are living with HIV, and half of all new infections are among African Americans. In Asia the sharpest increases in HIV infections are found in China, Indonesia, and Vietnam. Access to retroviral treatment for AIDS remains limited around the world, and the World Health Organization estimates that 9 out of 10 people needing treatment will not receive it.

Transmission

HIV is transmitted by the direct transfer of bodily fluids, such as blood and blood products, semen and other genital secretions, or breast milk, from an infected person to an uninfected person. The primary means of transmission worldwide is heterosexual intercourse with an infected individual; the virus can enter the body through the lining of the vagina, penis, rectum, or mouth.
HIV frequently is spread among intravenous drug users who share needles or syringes. Prior to the development of screening procedures and heat-treating techniques that destroy HIV in blood products, transmission also occurred through contaminated blood products; many people with haemophilia contracted HIV in this way. Today the risk of contracting HIV from a blood transfusion is extremely small.
In rare cases transmission to health care workers may occur by an accidental stick with a needle used to obtain blood from an infected person. The virus also can be transmitted across the placenta or through the breast milk from mother to infant; administration of antiretroviral medications to both the mother and infant around the time of birth reduces the chance that the child will be infected with HIV.
HIV is not spread by coughing, sneezing or casual contact (e.g., shaking hands). HIV is fragile and cannot survive long outside of the body. Therefore, direct transfer of bodily fluids is required for transmission. Other sexually transmitted diseases, such as syphilis, genital herpes, gonorrhoea, and chlamydia, increase the risk of contracting HIV through sexual contact, probably through the genital lesions that they cause.
AIDS is a zoonosis, an infection that is shared by humans and lower vertebrate animals. A virus that is genetically similar to HIV has been found in chimpanzees in western equatorial Africa. Interestingly, this virus, known as simian immunodeficiency virus (SIV), does not readily cause disease in chimpanzees. The practice of hunting and butchering chimpanzees for meat may have allowed transmission of the virus to humans, probably in the first half of the 20th century. A different form of SIV that infects African green monkeys may have given rise to the virus called HIV-2. HIV-2 can cause AIDS, but it does so more slowly than HIV-1.
Worldwide, the most common human immunodeficiency virus is HIV-1 found in Europe and the Americas. HIV-2 is found mostly in Asia and Western Africa.

Life cycle of HIV

The main cellular target of HIV is a special class of white blood cells critical to the immune system known as helper T lymphocytes, or helper T cells. Helper T cells are also called CD4+ T cells because they have on their surfaces a protein called CD4. Helper T cells play a central role in normal immune responses by producing factors that activate virtually all the other immune system cells. These include B lymphocytes, which produce antibodies needed to fight infection; cytotoxic T lymphocytes, which kill cells infected with a virus; and macrophages and other effector cells, which attack invading pathogens. AIDS results from the loss of most of the helper T cells in the body.

Diagram was here in the original text but blogs omit them, so search for the relevant references shown here

Through receptor molecules on their surfaces, lymphocytes are able to bind antigens (foreign substances or micro-organisms that the host recognizes as “non-self”) and help remove them from the body. Each lymphocyte bears receptors that bind to a specific antigen. The ability to respond to virtually any antigen comes from the enormous variety of lymphocyte populations that the body contains, each of them with a receptor capable of recognizing a unique antigen.

HIV is a retrovirus, one of a unique family of viruses that consist of genetic material in the form of RNA (instead of DNA) surrounded by a lipoprotein envelope. HIV cannot replicate on its own and instead relies on the mechanisms of the host cell to produce new viral particles. HIV infects helper T cells by means of a protein embedded in its envelope called gp120. The gp120 protein binds to a molecule called CD4 on the surface of the helper T cell, an event that initiates a complex set of reactions that allow the HIV genetic information into the cell. Entry of HIV into the host cell also requires the participation of a set of cell surface proteins that normally serve as receptors for chemokines (hormone-like mediators that attract immune system cells to particular sites in the body). It appears that the binding of gp120 to CD4 exposes a region of gp120 that interacts with the chemokine receptors. This interaction triggers a conformational change that exposes a region of the viral envelope protein gp41, which inserts itself into the membrane of the host cell so that it bridges the viral envelope and the cell membrane. An additional conformational change in gp41 pulls these two membranes together, allowing fusion to occur. After fusion the viral genetic information can enter the host cell.
Once the virus has infected a T cell, HIV copies its RNA into a double-stranded DNA copy by means of the viral enzyme reverse transcriptase; this process is called reverse transcription because it violates the usual way in which genetic information is transcribed. Because reverse transcriptase lacks the “proofreading” function that most DNA synthesizing enzymes have, many mutations arise as the virus replicates, further hindering the ability of the immune system to combat the virus. These mutations allow the virus to evolve very rapidly, approximately one million times faster than the human genome evolves. This rapid evolution allows the virus to escape from antiviral immune responses and antiretroviral drugs. The next step in the virus life cycle is the integration of the viral genome into the host cell DNA. Integration occurs at essentially any accessible site in the host genome and results in the permanent acquisition of viral genes by the host cell. Under appropriate conditions these genes are transcribed into viral RNA molecules. Some viral RNA molecules are incorporated into new virus particles, while others are used as messenger RNA for the production of new viral proteins. Viral proteins assemble at the plasma membrane together with the genomic viral RNA to form a virus particle that buds from the surface of the infected cell, taking with it some of the host cell membrane that serves as the viral envelope. Embedded in this envelope are the gp120/gp41 complexes that allow attachment of the helper T cells in the next round of infection. Most infected cells die quickly (in about one day). The number of helper T cells that are lost through direct infection or other mechanisms exceeds the number of new cells produced by the immune system, eventually resulting in a decline in the number of helper T cells. Physicians follow the course of the disease by determining the number of helper T cells (CD4+ cells) in the blood. This measurement, called the CD4 count, provides a good indication of the status of the immune system. Physicians also measure the amount of virus in the bloodstream—i.e., the viral load—which provides an indication of how fast the virus is replicating and destroying helper T cells.
Because of the high rate at which the genetic material of HIV mutates, the virus in each infected individual is slightly different. Genetic variants of HIV have been categorized into several major subtypes or clades, which have different geographical distributions. Variation occurs throughout the genome but is especially pronounced in the gene encoding the gp120 protein. By constantly changing the structure of its predominant surface protein, the virus can avoid recognition by antibodies produced by the immune system.

  

Course of infection

The course of HIV infection involves three stages: primary HIV infection, the asymptomatic phase, and AIDS. During the first stage the transmitted HIV replicates rapidly, and some persons may experience an acute flu like illness that usually persists for one to two weeks. During this time a variety of symptoms may occur, such as fever, enlarged lymph nodes, sore throat, muscle and joint pain, rash, and malaise. Standard HIV tests, which measure antibodies to the virus, are initially negative because HIV antibodies generally do not reach detectable levels in the blood until a few weeks after the onset of the acute illness. This is because as the immune response to the virus develops the level of HIV in the blood decreases.
The second phase of HIV infection, the asymptomatic period, lasts an average of 10 years. During this period the virus continues to replicate, and there is a slow decrease in the CD4 count (the number of helper T cells). When the CD4 count falls to about 200 cells per microlitre of blood (in an uninfected adult it is typically about 1,000 cells per microlitre), patients begin to experience opportunistic infections—i.e., infections that arise only in individuals with a defective immune system. This is AIDS, the final stage of HIV infection. The most common opportunistic infections are Pneumocystis carinii pneumonia, tuberculosis, Mycobacterium avium infection, herpes simplex infection, bacterial pneumonia, toxoplasmosis, and cytomegalovirus infection. In addition, patients can develop dementia and certain cancers, including Kaposi sarcoma and lymphomas. Death ultimately results from the relentless attack of opportunistic pathogens or from the body's inability to fight off malignancies.
A small proportion of individuals infected with HIV has survived longer than 10 years without developing AIDS. It may be that such individuals mount a more vigorous immune response to the virus or that they are infected with a weakened strain of the virus.

Diagnosis, treatment, and prevention

Tests for the disease check for antibodies to HIV, which appear from four weeks to six months after exposure. The most common test for HIV is the enzyme-linked immunosorbent assay (ELISA). If the result is positive, the test is repeated on the same blood sample. Another positive result is confirmed using a more specific test such as the Western blot. A problem with ELISA is that it produces false positive results in people who have been exposed to parasitic diseases such as malaria; this is particularly troublesome in Africa, where both AIDS and malaria are rampant.
POLYMERASE CHAIN REACTION (PCR) tests, a screening test for viral RNA that promotes the detection of the virus after a very recent exposure, as well as SINGLE USE DIAGNOSTIC SCREENING (SUDS) are other options. Because these tests are very expensive, they are often out of reach for the majority of the population at risk for the disease. Pharmaceutical companies are developing new tests that are less expensive and that do not need refrigeration, allowing for a greater testing of the at-risk population around the world.
There is no cure or effective vaccine for HIV infection. Efforts at prevention have focused primarily on changes in sexual behaviour such as the practice of abstinence and the use of condoms. Attempts to reduce intravenous drug use and to discourage the sharing of needles have also led to a reduction in infection rates in some areas. HIV infection is treated with three classes of antiretroviral medications.

·          PROTEASE INHIBITORS, which inhibit the action of an HIV enzyme called protease, include ritonavir, saquinivir, indinavir, amprenivir, nelfinavir, and lopinavir.

·          NUCLEOSIDE reverse transcriptase (RT) inhibitors (e.g., abacavir [ABC], zidovudine [AZT], zalcitabine [ddC], didanosine [ddI], stavudine [d4T], and lamivudine [3TC]) and

·          NON-NUCLEOSIDE RT INHIBITORS (e.g., efavirenz, delavirdine, and nevirapine) both inhibit the action of reverse transcriptase.

Each drug has unique side effects, and, in addition, treatment with combinations of these drugs leads to additional side effects including a fat-redistribution condition called lipodystrophy.
Because HIV rapidly becomes resistant to any single antiretroviral drug, combination treatment is necessary for effective suppression of the virus. Highly active antiretroviral therapy (HAART), a combination of three or more RT and protease inhibitors, has resulted in a marked drop in the mortality rate from HIV infection in the United States and other industrialized states since its introduction in 1996. Because of its high cost, HAART is generally not available in regions of the world hit hardest by the AIDS epidemic. Although HAART does not appear to eradicate HIV, it largely halts viral replication, thereby allowing the immune system to reconstitute itself. Levels of free virus in the blood become undetectable; however, the virus is still present in reservoirs, the best-known of which is a latent reservoir in a subset of helper T cells called resting memory T cells. The virus can persist in a latent state in these cells, which have a long life span due to their role in allowing the immune system to respond readily to previously encountered infections. These latently infected cells represent a major barrier to curing the infection. Patients successfully treated with HAART no longer suffer from the AIDS-associated conditions mentioned above, although severe side effects may accompany the treatment. Patients must continue to take all of the drugs without missing doses in the prescribed combination or risk developing a drug-resistant virus; viral replication resumes if HAART is discontinued.

 Contributed by: Robert Siliciano & Kenez Danmbaezue

Social, legal, and cultural aspects

As with any epidemic for which there is no cure, tragedy shadows the disease's advance. From wreaking havoc on certain populations (such as the gay community in San Francisco in the 1980s) to infecting more than one-third of adults in sub-Saharan African countries such as Botswana, Swaziland, and Zimbabwe at the turn of the 21st century, AIDS has had a devastating social impact. Its collateral cultural effect has been no less far-reaching, sparking new research in medicine and complex legal debates, as well as intense competition among scientists, pharmaceutical companies, and research institutions. Since the the mid-1980s, the International AIDS Society has held regular conferences at which new research and medical advances were discussed.
In order to raise public awareness, advocates promote the wearing of a loop of red ribbon to indicate their concern. Activist groups lobby governments for funding for education, research, and treatment, and support groups provide a wide range of services including medical, nursing, and hospice care, housing, psychological counselling, meals, and legal services. Those who have died of AIDS have been memorialized in the more than 44,000 panels of the AIDS Memorial Quilt, which has been displayed worldwide both to raise funds and to emphasize the human dimension of the tragedy. The United Nations designated December 1 as World AIDS Day.
Regarding access to the latest medical treatments for AIDS, the determining factors tend often to be geographic and economic. Simply put, developing nations often lack the means and funding to support the advanced treatments available in industrialized countries. On the other hand, in many developed countries specialized health care has caused the disease to be perceived as treatable or even manageable. This perception has fostered a lax attitude toward HIV prevention (such as safe sex practices or sterile needle distribution programs), which in turn has led to new increases in HIV infection rates.
Because of the magnitude of the disease in Africa, and in sub-Saharan Africa in particular, the governments of this region have tried to fight the disease in a variety of ways. Some countries have made arrangements with multinational pharmaceutical companies to make HIV drugs available in Africa at lower costs. Other countries, such as South Africa, have begun manufacturing these drugs themselves instead of importing them. Plants indigenous to Africa are also being scrutinized for their usefulness in developing various HIV treatments.
In the absence of financial resources to pay for new drug therapies, many African countries have found education to be the best defence against the disease. In Uganda, for example, songs about the disease, nationally distributed posters, and public awareness campaigns starting as early as kindergarten have all helped to stem the spread of AIDS. Prostitutes in Senegal are licensed and regularly tested for HIV, and the clergy, including Islamic religious leaders, work to inform the public about the disease. Other parts of Africa, however, have seen little progress. For example, the practice of sexually violating very young girls has developed among some HIV-positive African men because of the misguided belief that such acts will somehow cure them of the disease. In the opinion of many, only better education can battle the damaging stereotypes, misinformation, and disturbing practices associated with AIDS.
Laws concerning HIV and AIDS typically fall into four broad categories: mandatory reporting, mandatory testing, laws against transmission, and immigration. The mandatory reporting of newly discovered HIV infections is meant to encourage early treatment. Many countries, including Canada, Switzerland, Denmark, and Germany, have enacted mandatory screening laws for HIV. Some countries, such as Estonia, require mandatory testing of prison populations (in response to explosive rates of infection among the incarcerated). Most of the United States requires some form of testing for convicted sex offenders. Other legal and international issues concern the criminalization of knowing or unknowing transmission (more prevalent in the United States and Canada) and the rights of HIV-positive individuals to immigrate to or even enter foreign countries.
In the United States some communities have fought the opening of AIDS clinics or the right of HIV-positive children to attend public schools. Several countries—notably Thailand, India, and Brazil—have challenged international drug patent laws, arguing that the societal need for up-to-date treatments supersedes the rights of pharmaceutical companies. At the start of the 21st century many Western countries were also battling the reluctance of some governments to direct public awareness campaigns at high-risk groups such as homosexuals, prostitutes, and drug users out of fear of appearing to condone their lifestyles.
For the world of art and popular culture, HIV/AIDS has been double-edged. On the one hand, AIDS removed from the artistic heritage many talented photographers, singers, actors, dancers, and writers in the world. On the other hand, as with the tragedy of war and even the horror of the Holocaust, AIDS has spurred moving works of art as well as inspiring stories of perseverance. From Paul Monette's Love Alone, to John Corigliano's Symphony No. 1, to the courage with which American tennis star Arthur Ashe publicly lived his final days after acquiring AIDS from a blood transfusion—these, as much as the staggering rates of infection, constitute the legacy of AIDS.

Contributed by: Keith Dorwick & Kenez Danmbaezue

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HUMAN LYMPHOCYTE

 Diagram was here in the original text but blogs omit them, so search for the relevant references shown here

     

type of leukocyte (white blood cell) that is of fundamental importance in the immune system because lymphocytes are the cells that determine the specificity of the immune response to infectious microorganisms and other foreign substances. In humans lymphocytes make up 25 to 33 percent of the total number of leukocytes. They are found in the circulation and also are concentrated in central lymphoid organs and tissues, such as the spleen, tonsils, and lymph nodes, where the initial immune response is likely to occur.

The two primary types of lymphocytes are B lymphocytes and T lymphocytes, or B cells and T cells. Both originate from stem cells in the bone marrow and are initially similar in appearance. Some lymphocytes migrate to the thymus, where they mature into T cells; others remain in the bone marrow, where—in humans—they develop into B cells. Most lymphocytes are short-lived, with an average life span of a week to a few months, but a few live for years, providing a pool of long-lived T and B cells. These cells account for immunologic “memory,” a more rapid, vigorous response to a second encounter with the same antigen.

• The basic structure of a typical T-cell antigen receptor.

See diagram on page 10 above

Through receptor molecules on their surfaces, lymphocytes are able to bind antigens (foreign substances or micro-organisms that the host recognizes as “non-self”) and help remove them from the body. Each lymphocyte bears receptors that bind to a specific antigen. The ability to respond to virtually any antigen comes from the enormous variety of lymphocyte populations that the body contains, each of them with a receptor capable of recognizing a unique antigen.

                                              Clonal selection of a B cell

                                                          See the diagram on page 11

Once stimulated by binding to a foreign antigen, such as a component of a bacterium or virus, a lymphocyte multiplies into a clone of identical cells. Some of the cloned B cells differentiate into plasma cells that produce antibody molecules. These antibodies are closely modelled after the receptors of the precursor B cell, and, once released into the blood and lymph, they bind to the target antigen and initiate its neutralization or destruction. Antibody production continues for several days or months, until the antigen has been overcome. Other B cells, the memory B cells, are stimulated to multiply but do not differentiate into plasma cells; they provide the immune system with long-lasting memory.

                      Stimulation of immune response by activated helper T cells,

See diagram on page 15

In the thymus, T cells multiply and differentiate into helper, regulatory, or cytotoxic T cells or become memory T cells. They are then seeded to peripheral tissues or circulate in the blood or lymphatic system. Once stimulated by the appropriate antigen, helper T cells secrete chemical messengers called cytokines, which stimulate the differentiation of B cells into plasma cells, thereby promoting antibody production. Regulatory T cells act to control immune reactions, hence their name. Cytotoxic T cells, which are activated by various cytokines, bind to and kill infected cells and cancer cells.

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lymphocyte. (2007). Encyclopædia Britannica. Encyclopædia Britannica 2007 Ultimate Reference Suite. Chicago: Encyclopædia Britannica.

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 "lymphocyte." Encyclopædia Britannica from Encyclopædia Britannica 2007 Ultimate Reference Suite. (2007).

·         Human lymphocyte (phase-contrast microphotograph).

LEUKOCYTE also spelled  leucocyte (English USA) , also called  white blood cell  or  white corpuscle a cellular component of the blood that lacks hemoglobin, has a nucleus, is capable of motility, and defends the body against infection and disease by ingesting foreign materials and cellular debris, by destroying infectious agents and cancer cells, or by producing antibodies. Leukocytes are found within tissues, where they fight infections, and in circulation. On the basis of their appearance under a light microscope, leukocytes are grouped into three major classes—lymphocytes, granulocytes, and monocytes—each of which carries out somewhat different functions. 


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LYMPHOCYTES, which are further divided into B and T cells, are responsible for the specific recognition of foreign agents and their subsequent removal from the host. B lymphocytes secrete antibodies, which are proteins that bind to foreign micro-organisms in body tissues and mediate their destruction. Typically, T cells recognize virally infected or cancerous cells and destroy them, or they serve as helper cells to assist the production of antibody by B cells. Also included in this group are natural killer (NK) cells, so named for their inherent ability to kill a variety of target cells. In a healthy person, about 25 to 33 percent of white blood cells are lymphocytes.

Granulocytes, the most numerous of the leukocytes, rid the body of large pathogenic organisms such as protozoans or helminths and are also key mediators of allergy and other forms of inflammation. These cells contain many cytoplasmic granules, or secretory vesicles, that harbour potent chemicals important in immune responses. They also have multi-lobed nuclei, and because of this they are often called polymorphonuclear cells. On the basis of how their granules take up dye in the laboratory, granulocytes are subdivided into three categories: neutrophils, eosinophils, and basophils. The most numerous of the granulocytes—making up 50 to 80 percent of all leukocytes—are neutrophils. They are often one of the first cell types to arrive at a site of infection, where they engulf and destroy the infectious micro organisms through a process called phagocytosis. Eosinophils and basophils, as well as the tissue cells called mast cells, typically arrive later. The granules of basophils and of the closely related mast cells contain a number of chemicals, including histamine and leukotrienes that are important in inducing allergic inflammatory responses. Eosinophils destroy parasites and also help to modulate inflammatory responses.
Monocytes, which constitute up to 7 percent of the total number of white blood cells in the blood, move from the blood to sites of infection, where they differentiate further into macrophages. These cells are scavengers that phagocytose whole or killed micro organisms and are therefore effective at direct destruction of pathogens and cleanup of cellular debris from sites of infection (see video). Neutrophils and macrophages are the main phagocytic cells of the body, but macrophages are much larger and longer-lived than neutrophils. Some macrophages are important as antigen-presenting cells, cells that phagocytose and degrade microbes and present portions of these organisms to T lymphocytes, thereby activating the specific acquired immune response.
A healthy adult human has between 4,500 and 11,000 leukocytes per cubic millimetre of blood. The blood leukocyte count rises after exercise, convulsions, and strong emotional reactions; during pain, pregnancy, and labour; and also during many disease states, such as infections and intoxications. Specific types of cells are associated with different illnesses and reflect the special function of that cell type in body defense. A fall in leukocyte count, which is called leukopenia, occurs in states such as debilitation, anaphylaxis, and overwhelming infection. In general, newborns have a high white blood cell count that gradually falls to the adult level during childhood. An exception is the lymphocyte count, which is low at birth, reaches its highest levels in the first four years of life, and thereafter falls gradually to a stable adult level. See also blood cell formation.

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