Overview of HIV
, MD, A
, MSN, ARNP,
This article provides an overview and reviews the HIV pandemic, the basic biology and immunology of the virus (e.g., genetic
diversity of HIV and the viral life cycle), the phases of disease progression, modes of HIV transmission, HIV testing, immune
response to the infection, and current therapeutic strategies. HIV is occurring in epidemic proportions, especially in Sub-Saharan
Africa. In the US, men who have sex with men account for over half of AIDS diagnoses; racial and ethnic minorities are
disproportionally affected. Factors influencing the progression and severity of HIV infection include type of immune response,
coinfection (e.g., another sexually transmitted infection, including hepatitis B or C), age and behavioral and psychosocial factors.
Antiretroviral therapies can achieve reduction in blood levels of the HIV virus below the limits of detection by current technology.
However, effective treatment requires adherence to therapy. Patient failure to adhere to treatment regimens results in detectible
circulating virus and in HIV disease progression, and is the primary cause of drug resistance. In addition to research on the
immunology and virology of the disease, other studies focus on behavioral and psychosocial factors that may affect medication
adherence and risk behaviors.
HIV/AIDS, disease progression, immune response, treatment.
Centers for Disease Control and Prevention;
hepatitis C virus;
highly active antiretroviral therapy.
cquired immune deficiency syndrome (AIDS) is caused
by a chronic infection with the HIV. The official start of
the epidemic occurred in the summer of 1981 when the US
Centers for Disease Control and Prevention (CDC) reported
on a cluster of
pneumonia (PCP) in five
homosexual men (1). However, there is substantial evidence
that HIV first crossed the simian-human species barrier much
earlier, possibly in Cameroon in West Africa (2). There is also
evidence that HIV found its way to the Caribbean before the
1980s (3). From 1981, approximately 1.7 million people have
been infected with HIV in the United States,
subsequently died, and 1.2 million are currently living with
HIV/AIDS (4). Despite improved HIV medications and lower
morbidity and death rates in the past decade, there is still great
variability in HIV disease progression (5). This article will
briefly review and provide an overview of the phases of
disease progression, the HIV pandemic, genetic diversity of
HIV, the basic biology of the virus (e.g., the viral life cycle),
modes of HIV transmission, HIV testing, immune response to
the infection, and current therapeutic strategies.