HIV & progres

Although progress has been in treating HIV infection and AIDS, the epidemic remains a vital public health issue in all communities across the country and around the world. Prevention, early detection, and ongoing treatment remain important aspects of care for great deal with HIV infections and AIDS.Nurses in all settings encounter mass with this disease thus, nurses need an understanding of the disorder, knowledge of the physical and psychological consequences associated with the diagnosis, and expert assessment and clinical care skills to provide optimal care for people with HIV infection and AIDS.In 1987, just 6 years after the first field of studys of AIDS were treated, the U.S. Food and Drug presidential term (FDA) approved the first antiretroviral agent in 1988nthe first randomized controlled trial of primary prophylaxis of Pneumocystis carinii pneumonia appeared in the literature and in 1995 protease inhibitors joined the growing turn of events of antiretroviral agents. Improved treatment of HIV and AIDS has resulted in increased survival times in 1996, 1997, and 1998, age-adjusted death rates fell 29%, 48%, and 21%, respectively.This theme intent toa) describe the modes of transmission of HIV infection.b) describe the pathophysiology of HIV infection.c) explain the physiology underlying the clinical manifestations of HIV infection.d) Describe the management of patients with HIV infection.e) Discuss the interventions allot for patients with HIV infection and AIDS.I. IntroductionSince acquired immunodeficiency syndrome (AIDS) was first recognized more than 20 years ago, remarkable progress has been made in improving the quality and duration of heart of persons with HIV infection.During the first decade, this progress was associated with recognition of opportunistic disease processes, more effective therapy for complications, and introduction of prophylaxis against common opportunistic infections (OIs).The second decade has witnessed progress in d eveloping highly active antiretroviral therapies (HAART) as well as continuing progress in treating OIs (Masur, Kaplan &Holmes, 1999).Since the HIV serologic test (enzyme immuno tab EIA, formerly enzyme-linked immunosorbent assay ALISHA, became available in 1984, allowing early diagnosis of the infection before onset of symptoms, HIV infection has been best managed as a chronic disease and close(prenominal) appropriately managed in an outpatient care setting (Gallant, 2001).II. BackgroundA. EpidemiologyIn fall 1982, the Centers for Disease Control and Prevention (CDC) issued a case definition of AIDS after the first coulomb cases were reported. Since then, the CDC has revised the case definition a number of times (1985, 1987, and 1993) All 50 states, the District of Columbia, U.S. dependencies and possessions, and independent nations in free association with the join States report AIDS cases to the CDC using a uniform surveillance case definition and case report from (CDC, 2000) .Starting in the late 1990s, more states started to implement HIV case reporting in response to the changing epidemic and the need for information on persons with HIV infection who take a crap not developed AIDS.As of December 2001, there were 816,149 reported cases of HIV/AIDS and 506, 154 adults, adolescents, and children in the United States (including U.S. dependencies, possession, and associated nations) living with AIDS. Unprotected sex and sharing of injection drug use equipment are the major subject matter of transmission of HIV.A total of 43, 158 AIDS cases were diagnosed in 2001. For men diagnosed with AIDS during 2001, 59% were in the exposure category of men who have sex with men 24% in injection drug use and 7% in heterosexual contact.In women diagnosed with AIDS during that same period, 44% reported injection drug use and 52% reported heterosexual contact. Comparing race/ethnicity amount the three largest groups diagnosed in 2001, 20,752 were black, not Hispanics (C DC, 2002).The number of people living with AIDS is not evenly distributed throughout the United States. States with the largest number of reported AIDS cases during 2001 were New York (7,476), Florida (5,138), California (4,315), Texas (2,892), and Maryland (1,860) (CDC, 2002).AIDS has reached epidemic proportions in some other parts of the world. According to the Joint United Nations Program on HIV/AIDS, more than 18.3 million people worldwide have died of AIDS and 34.3 million people are infected with HIV, with 5.4 million people newly infected with HIV in 1999 alone (Letvin, Bloom & Hoffman, 2001). UNAIDS (2001) reports that since the epidemic began, more than 60 million people have been infected with the virus, making it the most devastating disease ever.The earliest confirmed case of HIV infection was found in blood drawn from an African man in 1959 (Stephenson, 2003).Although factors associated with the stagger of HIV in Africa in the 1960s however, social changes such as eas ier access to transportation, increasing population density, and more frequent sexual contacts may have been more important (Stephenson 2003).