HIV/AIDS is caused by the human immunodeficiency virus (HIV) which attacks CD4 T-cells and weakens the immune system. This leaves individuals vulnerable to opportunistic infections. While there is no cure for AIDS, antiretroviral drug combinations can suppress the virus and allow immune recovery. However, HIV persists in reservoirs and treatment must continue to prevent resurgence. Prevention efforts focus on behavior changes like abstinence and condom use as well as reducing needle sharing. Access to treatment varies globally and developing nations often lack resources for advanced therapies available elsewhere. Education has helped curb transmission in some African countries but challenges remain in combating misinformation and harmful practices.

1. HIV/AIDS, RACING TO THE FINISH POINT
Human Immunodeficiency Virus
The human immunodeficiency virus (HIV), which causes acquired immunodeficiency
syndrome (AIDS), principally attacks CD4 T-cells, a vital part of the human immune system.
HIV is a lentivirus literally meaning “slow virus”; a member of the retrovirus family that
slowly attacks and destroys the immune system, the body's defense against infection, leaving
an individual vulnerable to a variety of other infections and certain malignancies that
eventually cause death. The body’s ability to resist opportunistic viral, bacterial, fungal,
protozoal, and other infection is greatly weakened. Pneumocystis carinii pneumonia is one of
the leading cause of death among people with HIV infection, but the incidence of certain types
of cancers such as B-cell lymphomas and Kaposi’s sarcoma is also increased. Neurological
complications and dramatic weight loss, or “wasting,” are characteristic of end stage HIV
disease (AIDS). HIV can be transmitted sexually; through contact with contaminated blood,
tissue, or needles; and from mother to child during birth or breastfeeding. Although there is no
cure for AIDS, new drugs are available that can prolong the life spans and improve the quality
of life of infected people.
Transmission of HIV the AIDS causing virus occurs most commonly as a result of sexual
intercourse. HIV also can be transmitted through transfusions of HIV-contaminated blood or by
using a contaminated needle or syringe to inject drugs into the bloodstream. Infection with HIV
does not necessarily mean that a person has AIDS. Some people who have HIV infection have
been known to live without developing any of the clinical illnesses that define the full-blown
disease of AIDS for ten years or more. Physicians prefer to use the term AIDS for cases where a
person has reached the final, life-threatening stage of HIV infection.
Details of the origin of HIV remain unclear; however, a lentivirus that is genetically similar to
HIV has been found in chimpanzees in western equatorial Africa. This virus, known as simian
immunodeficiency virus (SIV), does not readily cause disease in chimpanzees. However, AIDS
is a zoonosis, an infection that is shared by humans and lower vertebrate animals. The practice of
hunting, butchering, and eating the meat of chimpanzees may have allowed transmission of the
virus to humans, probably in the first half of the 20th century.
Some documentation show that people living in sub-Saharan Africa account for about 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. Treatment for AIDS remains limited in some
areas of the world, although more people are receiving treatment today than in the past.
HIV-2 is divided into groups A through E, with subtypes A and B being the most relevant to
human infection. HIV-2, which is found primarily in western Africa, can cause AIDS, but it does
so more slowly than HIV-1. There is some evidence that HIV-2 may have arisen from a form of
SIV that infects African green monkeys.

2. 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.
The course of HIV infection involves necessarily about three stages though other documentation
may talk about four: primary HIV infection, the asymptomatic phase, and AIDS. During the first
stage the transmitted HIV replicates rapidly, and some persons may experience an acute flulike
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. 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.
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, which screen for viral RNA and therefore allow
detection of the virus after very recent exposure, and 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

3. 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.
Since 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. 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. The identification of gene variations
in HLA-B, HLA-C, HLA-G, and HCP5 has opened avenues of drug and vaccine development that
had not been previously explored for HIV infection. Scientists anticipate that therapies aimed at
these genes will serve as ways to boost immune response.
As with any epidemic for which there is no cure, tragedy shadows the disease's advance. 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 mid-1980s, the International AIDS Society has
held regular conferences at which new research and medical advances have been 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 counseling, 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.
However, regarding access to the latest medical treatments for AIDS, the determining factors
tend often to be geographic and economic. Developing nations often lack the means and funding
to support the advanced treatments available in industrialized countries. On the other hand, in

4. 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.
As a result 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 defense 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.
The prostitution industry needs to be termed in order to come up with other avenues for putting
more money in the pockets of the afflicted citizens. Prostitutes in Senegal are licensed and
regularly tested for HIV. 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. Other legal and international
issues concern the criminalization of knowing or unknowing transmission and the rights of HIV-
positive individuals to immigrate to or even enter foreign countries. In some unfortunate
circumstances, some people have taken advantage of the naivety of our teenagers and willfully
risked the life of these innocent victims to HIV. The big question towards racing to the finish
point is the debatable nature of proposed solutions and in whose interest decision made is
likely to benefit. We are all either affected or infected and the challenge is for everyone no
matter the status but to offer any little contribution in either behavior change or other means
possible in order to secure a life without HIV for generations to come.
In summary, we are all heroes in the fight against HIV/AIDS if only we work towards
eradication of the pandemic more as an intrinsic choice than as an extrinsic one. They say the
measure of a man’s character is not what he gets from his ancestors but what he leaves for his
descendants. Consequently, an investment in our character and morals may pay off in securing
the destiny of our descendants towards overcoming the spread of HIV. Our government needs to

5. employ a lot of measures to assist those already affected and improve their quality of life by
increasing accessibility to all essential elements available. The clinics dedicated for HIV clients’
needs expansion to allow medical practitioners have more time with clients to clarify most of the
concerns a client may raise as it will promote the quality of health service delivery. The
responsible organs need to publicly give direction to our communities on the herbal medicine
that have a positive value to health and highlight the toxic substance that are a health hazard. All
in all the herbal medicine have helped to give relief to most of people who might have used them
but there is need always to clear out doubt when nothing is brought to light. Our sincere hope is
that when knowledge like this is availed, it should build a sense of responsibility in someone
because the finish point is there at the end of this battle against the pandemic.
JONES. H. MUNANG’ANDU (author)
Motivational speaker,healthcommentator &
Health practitioner
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