HIV-1

HIV-1,

n the abbreviation for
human immunodeficiency virus type 1, which is widely recognized as the causal agent of acquired immunodeficiency syndrome (AIDS). HIV-1 is characterized by its cytopathic effect and affinity for the T4-lymphocyte.

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HIV-1

AIDS-related virus–ARV, Human immunodeficiency virus, human T-cell lymphotrophic virus, type III–HTLV-III, lymphadenopathy-associated virus–LAV The retrovirus intimately linked to AIDS Skin in HIV See HIV dermatopathy Diagnosis PCR, ELISA to screen for anti-HIV IgM antibodies; ELISA-positive sera is subjected to Western immunoblot hybridization See HIV tests Disinfection 750 ppm/1:10 dilution for 40 mins, formaldehyde–2% for 10 hrs; high laundry temps–90% ↓ in viable HIV–eg, 25 mins at 71ºC or 10 mins at 80ºC may be effective; low temperature washing without bleach does not remove HIV– Infections HIV-positivity worsens responses to other infections; T-cell response to infections in HIV-positive subjects may trigger multiplication of dormant HIV; AIDS Pts have an ↑ susceptibility to disseminated vaccinia after immunization, neurosyphilis, TB, herpes and other infections that respond to standard therapy; several viruses may co-infect with HIV-1–eg, herpesvirus, HHV-6, papovavirus, adenovirus and HTLV-I Long term survivors Nonprogressive HIV-1 infection, see there Precautions See Universal blood & body fluid precautions Seroprevalence in Africa Sub-Saharan Africa ♂ 1:40 are infected; ♀ 1:40, regionally up to 1:5; North America ♂ 1:75; ♀ 1:700 Seroprevalence, US 650, 000-1, 400, 000–0.2-0.5% of the population is infected with HIV-1, ranging from 0.1% in rural regions with low 'risk' activities to 7.8% in urban populations; in low prevalence regions, HIV-1 positivity is more common in ♂; in high prevalence regions, the ♂:♀ratio is 2.9:1; 20% of ♂ in such regions are HIV-positive; seropositivity is up to 9-fold greater in those refusing to be tested Army (US) personnel Seroconversion rate in soldiers is 0.29/1000 person-yrs Child-bearing women US inner city 8.0/1000, urban–not inner-city and suburban 2.5/1000 suburban and rural 0.9/1000; 4.5-5.8/1000 in NY, New Jersey, Washington DC and Florida and 1.5/1000 in the US; rate of HIV transmission to the child is 30% ER patients–US, 1987 3% of all and 16% of 25-34 yr-old ER Pts are HIV positive, 80% of whom were unsuspected Health care workers–HCW HIV positivity in HCW reflects HIV positivity in the general population; in the US, < 100 HCW without other known risk behaviors have seroconverted; seroconversion after needle or mucosal exposure to HIV-infected Pts is ± 0.3%; dentists–see Acer cluster  Management Multiagent antiretroviral therapy–eg, protease and reverse transcriptase inhibitors Newborns Rural NY 0.16%+, NY City 1.25%+ Prisoners Prevalence 2-7.6%, ♂; 2.5-14.7%, ♀ Sexually active adults 5% of those with STD are HIV-1 positive, especially if Hx of syphilis or genital herpes  Transmissible fluids/tissues Blood, tissues, breast milk are recognized HIV 'vectors'; casual household contacts, feces, skin, tears and urine are not known to transmit HIV; saliva inhibits the ability of HIV to infect lymphocytes. See Bergalis Transmission Worldwide, most transmission is by heterosexual intercourse. See AIDS, HIV testing, Mosquito connection, Monkey connection, Western blot, Window period, Zagury, Zidovudine.