Human immunodeficiency virus (HIV) is a retrovirus that can lead to acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Previous names for the virus include human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV) or AIDS-associated retrovirus (ARV).

Infection with HIV occurs by the transfer of blood, semen. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. Screening of blood products for HIV in the developed world has largely eliminated transmission through blood transfusions or infected blood products in these countries.

HIV infection in humans is now pandemic. As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics in recorded history. In 2005 alone, AIDS claimed an estimated 2.4–3.3 million lives, of which more than 570,000 were children. It is estimated that about 0.6% of the world's living population is infected with HIV. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty. According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries.

HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4⁺ T cells), macrophages and dendritic cells. HIV infection leads to low levels of CD4⁺ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4⁺ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4⁺ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. If untreated, eventually most HIV-infected individuals develop AIDS (Acquired Immunodeficiency Syndrome) and die; however about one in ten remains healthy for many years, with no noticeable symptoms. Treatment with anti-retrovirals, where available, increases the life expectancy of people infected with HIV. It is hoped that current and future treatments may allow HIV-infected individuals to achieve a life expectancy approaching that of the general public.

CONFLICT AND HIV RISK

New research findings from Uganda cast doubt on the widely held assumption that internally displaced persons and refugees are more likely to be HIV-infected than people in ostensibly more stable settings. Acholiland, in northern Uganda, is home to an estimated two million internally displaced persons. At just over 8%, HIV prevalence in the region is high (Ministry of Health Uganda and ORC Macro, 2006). However, a study among pregnant women in the Gulu, Kitgum and Pader districts has found that women living outside protected camps had a higher risk of being HIV-infected than their displaced counterparts living in protected camps. This might be due to the reduced mobility and increased access to health and prevention services of women in some of the camps (Fabiani et al., 2006). A recent review of HIV literature on displaced persons in eight countries (including Uganda) also failed to find evidence that conflict increases HIV transmission (Spiegel and Harroff-Tavel, 2006).

VERY HIGH MALARIA RATES FOUND IN HIV-INFECTED PERSONS

Unexpectedly high levels of HIV infection are being found in adults seeking treatment for malaria in Uganda. More than 30% of adults presenting at district health centres with uncomplicated falciparum malaria were co-infected with HIV. Clinical treatment for malaria was three times more likely in adults with HIV. The findings are in line with a growing body of evidence from elsewhere in sub-Saharan Africa that malaria tends to occur with increased frequency and severity in HIV-infected adults. This underlines the need for new strategies of HIV testing and counselling for adults with uncomplicated falciparum malaria (Kamya et al., 2006).

ADULTS AND CHILDREN ESTIMATED TO BE LIVING WITH HIV IN 2006

Total: 39.5 (34.1–47.1) million

Sub-Saharan

Africa

24.7 million

(21.8–27.7 million)

Latin America

1.7 million

(1.3–2.5 million)

Caribbean

250 000

(190 000–320 000)

North America

1.4 million

(880 000–2.2 million)

Middle East and North Africa

460 000

(270 000–760 000)

Western and Central Europe

740 000

(580 000–970 000)

Oceania

81 000

(50 000–170 000)

East Asia

750 000

(460 000–1.2 million)

South and South-East Asia

7.8 million

(5.2–12.0 million)

Eastern Europe and Central Asia

1.7 million

(1.2–2.6 million)

ESTIMATED NUMBER OF ADULTS AND CHILDREN NEWLY INFECTED WITH HIV DURING 2006

Total: 4.3 (3.6–6.6) million

Sub-Saharan

Africa

2.8 million

(2.4–3.2 million)

Latin America

140 000

(100 000–410 000)

Caribbean

27 000

(20 000–41 000)

North America

43 000

(34 000–65 000)

Middle East and North Africa

68 000

(41 000–220 000)

Western and Central Europe

22 000

(18 000–33 000)

Oceania

7100

(3400–54 000)

East Asia

100 000

(56 000–300 000)

South and South-East Asia

860 000

(550 000–2.3 million)

Eastern Europe and Central Asia

270 000

(170 000–820 000)

The ranges around the estimates in this table define the boundaries within which the actual numbers lie, based on the best available information. The data is referred from UNAIDS and WHO.

The theme for World AIDS Day 2007

World AIDS Day was originally organised by UNAIDS, who chose the theme after consultation with other organisations. In 2005 UNAIDS handed over responsibility for World AIDS Day to an independent organisation known as The World AIDS Campaign (WAC).

The WAC’s slogan for their work is "Stop AIDS: Keep the Promise". This is an appeal to governments, policy makers and regional health authorities to ensure that they meet the many targets that have been set in the fight against HIV and AIDS, and especially the promise of universal access to HIV treatment, care, support and prevention services by 2010. This campaign will run until 2010, with a related theme chosen for World AIDS Day each year.

The 2007 theme, “leadership”, highlights the need for innovation, vision and perseverance in the face of the AIDS challenge. The campaign calls on all sectors of society such as families, communities and civil society organisations - rather than just governments - to take the initiative and provide leadership on AIDS.

On the eve of World Aids Day (1^st December), lets pray and give psychological support to those who still lives with us. A little care from our side, will bring smiles on the face of those, who will one day, leave our planet and become one with almighty.

Let’s fight this disaster. Let’s make someone smile today. Let’s create a family.

---- MAINAKSWORLD TEAM

Kindly visit our disaster management website:

www.mainaksworld.com