Photos vich. HIV infection: symptoms, stages and routes of infection What does an HIV cell look like

However, antiretroviral drugs are widely available only in developed and some developing (Brazil) countries.

The Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that 25 million people have died from diseases associated with HIV infection and AIDS since to 25 million. Thus, the HIV pandemic is one of the most devastating epidemics in human history. In 2006 alone, HIV infection caused about 2.9 million deaths. By the beginning of 2007, about 40 million people worldwide (0.66% of the world's population) were carriers of HIV. Two-thirds of the total number of people living with HIV live in sub-Saharan Africa. In countries hardest hit by the HIV and AIDS pandemic, the epidemic hinders economic growth and increases poverty

Discovery history

Transmission electron microscope image of viruses. The structure of the virus is visible, inside of which there is a cone-shaped nucleus.

The human immunodeficiency virus was discovered in 1983 as a result of research into the etiology of AIDS. The first official scientific reports on AIDS were two articles on unusual cases of pneumocystis pneumonia and Kaposi's sarcoma in homosexual men, published in. In July, the term AIDS was proposed for the first time to refer to a new disease. In September of that year, based on a series of opportunistic infections diagnosed in (1) gay men, (2) drug addicts, (3) hemophilia A patients, and (4) Haitians, AIDS was first fully defined as a disease. Between 1981 and 1984, several papers were published linking the danger of developing AIDS with anal sex or with the influence of drugs. In parallel, work was underway on the hypothesis of the possible infectious nature of AIDS. The human immunodeficiency virus was independently discovered in 1983 in two laboratories:

• in France under the direction of Luc Montagnier (fr. Luc Montagnier).
• at the National Cancer Institute in the United States under the direction of Robert Gallo (Eng. Robert C. Gallo).

The results of studies in which a new retrovirus was isolated from patient tissues for the first time were published May 20 in the journal Science. These articles reported the discovery of a new virus belonging to the HTLV group of viruses. The researchers hypothesized that the viruses they isolated could cause AIDS.

In addition, the scientists reported the detection of antibodies to the virus, the identification of previously described in other viruses and previously unknown HTLV-III antigens, and the observation of virus replication in a population of lymphocytes.

In 2008, Luc Montagnier and Françoise Barré-Sinoussi were awarded the Nobel Prize in Physiology or Medicine "for their discovery of the human immunodeficiency virus".

Biology of HIV

Once in the human body, HIV infects CD4+ lymphocytes, macrophages, and some other cell types. Having penetrated into these types of cells, the virus begins to actively multiply in them. This ultimately leads to the destruction and death of infected cells. The presence of HIV over time causes a violation of the immune system due to its selective destruction of immunocompetent cells and suppression of their subpopulation. Viruses that leave the cell are introduced into new ones, and the cycle repeats. Gradually, the number of CD4+ lymphocytes decreases so much that the body can no longer resist pathogens of opportunistic infections that are not dangerous or slightly dangerous for healthy people with a normal immune system.

Classification

The human immunodeficiency virus belongs to the family of retroviruses ( Retroviridae), a genus of lentiviruses ( Lentivirus). Name Lentivirus comes from the Latin word lente- slow. This name reflects one of the features of the viruses of this group, namely, the slow and uneven rate of development of the infectious process in the macroorganism. Lentiviruses also have a long incubation period.

Related viruses

in the genus Lentivirus the following types are distinguished (according to data for 2008).

Abbreviation	English name	Russian name
EIAV	Equine infectious anemia virus	Equine infectious anemia virus
OOP	Ovine Progressive Pneumonia	Sheep copper visna virus
CAEV	Caprine-ovine arthritis-encephalitis virus	Arthritis-encephalitis virus of goats and sheep
BIV	Bovine immunodeficiency virus	bovine immunodeficiency virus
FIV	Feline immunodeficiency virus	Feline Immunodeficiency Virus
PLV	puma lentivirus	Lentivirus pum
SIV	Simian immunedeficiency virus	Simian immunodeficiency virus. Several strains of this virus are known. Each strain is characteristic of one primate species: SIV-agm, SIV-cpz, SIV-mnd, SIV-mne, SIV-mac, SIV-sm, SIV-stm
HIV-1	Human immunodeficiency virus-1	AIDS virus
HIV-2	Human immunodeficiency virus-2	Human immunodeficiency virus-2

The most well studied is HIV.

Varieties of HIV

The human immunodeficiency virus is characterized by a high frequency of genetic changes that occur in the process of self-reproduction. The error rate in HIV is 10 -3 - 10 -4 errors / (genome * replication cycle), which is several orders of magnitude higher than in eukaryotes. The length of the HIV genome is approximately 10 4 nucleotides. It follows from this that almost every virus differs by at least one nucleotide from its predecessor. In nature, HIV exists in the form of many quasi-species, while being one taxonomic unit. In the process of HIV research, nevertheless, varieties were found that differed significantly from each other in several ways, in particular, by a different genome structure. Varieties of HIV are indicated by Arabic numerals. To date, HIV-1, HIV-2, HIV-3, HIV-4 are known.

The global epidemic of HIV infection is mainly due to the spread of HIV-1, HIV-2 is predominantly prevalent in West Africa. HIV-3 and HIV-4 do not play a significant role in the spread of the epidemic.

In the vast majority of cases, unless otherwise specified, HIV refers to HIV-1.

The structure of the virion

The HIV capsid is surrounded by a matrix coat formed by ~2,000 copies of the matrix protein p17. The matrix shell, in turn, is surrounded by a bilayer lipid membrane, which is the outer shell of the virus. It is formed by molecules captured by the virus during its budding from the cell in which it was formed. There are 72 glycoprotein complexes built into the lipid membrane, each of which is formed by three molecules of a transmembrane glycoprotein ( gp41 or TM), serving as the "anchor" of the complex, and three molecules of surface glycoprotein ( gp120 or SU) . Via gp120 the virus attaches to the antigen-CD4 receptor and Co-receptor located on the surface of the cell membrane. gp41 and in particular gp120 are being intensively studied as targets for HIV drug and vaccine development. The lipid membrane of the virus also contains cell membrane proteins, including human leukocyte antigens (HLA) classes I, II, and adhesion molecules.

HIV genome

HIV genome

The genetic material of HIV is represented by two unconnected strands of positive RNA. The HIV genome contains 9,000 base pairs. The ends of the genome are represented by long terminal repeats (LTRs), which control the production of new viruses and can be activated by both viral proteins and infected cell proteins.

HIV infection

HIV
ICD-10	B20. , B21. , B22. , B23. , B24.
ICD-9	-

The period from infection with the human immunodeficiency virus to the development of AIDS lasts an average of 9-11 years. Statistical data from numerous studies conducted in various countries over a period of more than two decades confirm this conclusion. These figures are valid only for cases where HIV infection is not subjected to any therapy.

High risk groups:

• people who inject drugs using shared utensils for drug preparation (spread of the virus through a syringe needle and shared utensils for drug solutions); as well as their sexual partners.
• men - homosexuals and bisexuals, practicing unprotected anal sex;
• heterosexuals of both sexes who practice unprotected anal sex;
• individuals who received a transfusion of unverified donor blood;
• patients with other venereal diseases;
• persons involved in the sale and purchase of the human body in the field of sexual services (and their clients)

Pathogenesis

PreAIDS- Duration 1-2 years - the beginning of the suppression of cellular immunity. Often recurrent herpes - long-term healing ulceration of the oral mucosa, genital organs. Leukoplakia of the tongue (growth of the papillary layer - "fibrous tongue"). Candidiasis - oral mucosa, genital organs.

Resistance (immunity) to HIV

A few years ago, a human genotype resistant to HIV was described. The penetration of the virus into the immune cell is associated with its interaction with the surface receptor: the CCR5 protein. But the deletion (loss of a gene section) of CCR5-delta32 leads to the immunity of its carrier to HIV. It is assumed that this mutation arose about two and a half thousand years ago and eventually spread to Europe.

Now, on average, 1% of Europeans are actually resistant to HIV, 10-15% of Europeans have partial resistance to HIV.

Epidemiology

Brief global data on the epidemic of HIV infection and AIDS

According to the December 2006 report of the Joint United Nations Program on HIV/AIDS.

Number of people living with HIV in 2006 Total - 39.5 million (34.1 - 47.1 million) Adults - 37.2 million (32.1 - 44.5 million) Women - 17.7 million ( 15.1 - 20.9 million) Children under 15 - 2.3 million (1.7 - 3.5 million) Number of people infected with HIV in 2006 Total - 4.3 million (3.6 - 6, 6 million) Adults - 3.8 million (3.2 - 5.7 million) Children under 15 - 530,000 (410,000 - 660,000) Number of deaths from AIDS in 2006 Total - 2.9 million (2.5 - 3 .5 million) Adults - 2.6 million (2.2 - 3.0 million) Children under 15 - 380,000 (290,000 - 500,000)

Adult HIV prevalence by country 15–50% 5–15% 1–5% 0.5–1.0% 0.1–0.5%<0.1% нет данных

At the same time, of the total number of infected, two-thirds (63% - 24.7 million) of all adults and children with HIV in the world live in sub-Saharan Africa, mainly in southern Africa. One third (32%) of all people living with HIV in the world live in this subregion, and 34% of all AIDS-related deaths in 2006 occurred here.

Overview of the global epidemiology of HIV/AIDS

In total, about 40 million people in the world are living with HIV infection. Over two-thirds of them inhabit sub-Saharan Africa. The epidemic began here in the late 1970s and early 1980s. The epicenter is considered to be a strip stretching from West Africa to the Indian Ocean. Then HIV spread south. Most of the HIV carriers in South Africa - about 5 million. But on a per capita basis, the figure is higher in Botswana and Swaziland. In Swaziland, one in three adults is infected.

With the exception of countries in Africa, HIV is spreading fastest today in Central Asia and Eastern Europe. Between 2002 and 2002, the number of infected people here almost tripled. These regions contained the epidemic until the late 1990s, and then the number of infected people began to increase sharply - mainly due to drug addicts.

HIV infection in Russia

The first case of HIV infection in the USSR was discovered in 1986. From this moment begins the so-called period of the emergence of the epidemic. The first cases of HIV infection among citizens of the USSR, as a rule, occurred as a result of unprotected sexual contacts with African students in the late 70s of the XX century. Further epidemiological measures to study the prevalence of HIV infection in various groups living on the territory of the USSR showed that the highest percentage of infection at that time was among students from African countries, in particular from Ethiopia. The collapse of the USSR led to the collapse of the unified epidemiological service of the USSR, but not the unified epidemiological space. A short outbreak of HIV infection in the early 1990s among men who have sex with men did not spread further, also due to the high level of organization and educational level of this risk group. In general, this period of the epidemic was distinguished by an extremely low level of infection (for the entire USSR less than 1000 detected cases) of the population, short epidemic chains from infecting to infected, sporadic introductions of HIV infection and, as a result, a wide genetic diversity of detected viruses. At that time, in Western countries, the epidemic was already a significant cause of death in the age group from 20 to 40 years.

This prosperous epidemic situation led to complacency in some now independent countries of the former USSR, which was expressed, among other things, in the curtailment of some broad anti-epidemic programs, as inappropriate for the moment and extremely expensive. All this led to the fact that in 1993-95 the epidemiological service of Ukraine was unable to localize two outbreaks of HIV infection in time among injecting drug users (IDUs) in Nikolaev and Odessa. As it turned out later, these outbreaks were independently caused by different viruses belonging to different subtypes of HIV-1. Moreover, the transfer of HIV-positive prisoners from Odessa to Donetsk, where they were released, only contributed to the spread of HIV infection. The marginalization of IDUs and the unwillingness of the authorities to carry out any effective preventive measures among them greatly contributed to the spread of HIV infection. In only two years (1994-95) in Odessa and Nikolaev, several thousand HIV-infected people were identified, in 90% of cases - IDUs. From that moment on, the next stage of the HIV epidemic, the so-called concentrated stage, begins on the territory of the former USSR, which continues to the present (2007). This stage is characterized by the level of HIV infection of 5 percent or more in a certain risk group (in the case of Ukraine and Russia, this is IDUs). In 1995, there was an outbreak of HIV infection among IDUs in Kaliningrad, then successively in Moscow and St. Petersburg, then outbreaks among IDUs followed one after another throughout Russia in the direction from west to east. The direction of the concentrated epidemic and molecular epidemiological analysis have shown that 95% of all studied cases of HIV infection in Russia have their origin in the initial outbreaks in Nikolaev and Odessa. In general, this stage of HIV infection is characterized by the concentration of HIV infection among IDUs, the low genetic diversity of the virus, and the gradual transition of the epidemic from the risk group to other populations.

About 60% of HIV infections among Russians occur in 11 out of 86 Russian regions (Irkutsk, Saratov regions, Kaliningrad, Leningrad, Moscow, Orenburg, Samara, Sverdlovsk and Ulyanovsk regions, St. Petersburg and the Khanty-Mansi Autonomous District).

Officially registered cases of HIV infection in Russia

Year	Identified cases of infection	The total number of HIV-infected
1995	203	1 090
1996	1 513	2 603
1997	4 315	6 918
1998	3 971	10 889
1999	19 758	30 647
2000	59 261	89 908
2001	87 671	177 579
2002	49 923	227 502
2003	36 396	263 898
2004	32 147	296 045
2005	35 554	331 599
2006	39 589	374 411
2007	42 770	416 113
2008	33 732 (01.10.2008)	448 000 (01.11.2008)

By September 2005, more than 31,000 HIV-infected people were registered in institutions that are part of the Federal Penitentiary Service of the Russian Federation, which is a thousand more than in 2004.

Virus transmission

HIV can be found in almost all body fluids. However, the amount of virus sufficient for infection is present only in blood, semen, vaginal secretions, lymph and breast milk (breast milk is dangerous only for babies - their stomach does not yet produce gastric juice, which kills HIV). Infection can occur when dangerous biological fluids enter directly into the blood or lymph flow of a person, as well as on damaged mucous membranes (which is due to the suction function of the mucous membranes). If the blood of an HIV-infected person comes into contact with an open wound of another person, from which blood flows, infection usually does not occur.

HIV is an unstable virus - it dies outside the body when the blood (sperm, lymph and vaginal secretions) dries out. Domestic infection does not occur. HIV almost instantly dies at temperatures above 56 degrees Celsius.

However, with intravenous injections, the probability of transmitting the virus is very high - up to 95%. Cases of transmission of HIV to medical staff through needle sticks have been reported. To reduce the likelihood of HIV transmission (to fractions of a percent) in such cases, doctors are prescribed a four-week course of highly active antiretroviral therapy. Chemoprophylaxis may also be given to other individuals at risk of infection. Chemotherapy is prescribed no later than 72 hours after the probable penetration of the virus.

Repeated use of syringes and needles by drug addicts is highly likely to lead to HIV transmission. To prevent this, special charitable points are being created where drug addicts can receive clean syringes for free in exchange for used ones. In addition, young drug addicts are almost always sexually active and prone to unprotected sex, which creates additional prerequisites for the spread of the virus.

Data on HIV transmission through unprotected sex differ greatly from source to source. The risk of transmission largely depends on the type of contact (vaginal, anal, etc.) and the role of the partner (introducer/receiver).

Protected intercourse, in which the condom broke or its integrity was violated, is considered unprotected. To minimize such cases, it is necessary to follow the rules for the use of condoms, as well as use reliable condoms.

A vertical route of transmission from mother to child is also possible. With HAART prophylaxis, the risk of vertical transmission of the virus can be reduced to 1.2%.

The content of the virus in other biological fluids - saliva, tears - is negligible; there is no information on cases of infection through saliva, tears, sweat. Breastfeeding can cause infection because breast milk contains HIV, so HIV-positive mothers are advised not to breastfeed their babies.

Immature and mature forms of HIV (stylized image)

HIV is NOT transmitted through

• bites of mosquitoes and other insects,
• air,
• handshake,
• kiss (any)
• dishes,
• clothes,
• use of a bathroom, toilet, swimming pool, etc.

Anti-HIV creams and gels

The Times, referring to the findings of scientists from the University of Minnesota, reports that "glycerol monolaurate" or "lauric ester" used as a food additive, which is part of cosmetics, probably interferes with the signaling processes in the immune system of monkeys, blocking the virus at a key stage of potential Infection". When the virus enters the body, it captures T-cells and spreads through the blood vessels, and lauric ester acts so that the inflammatory reaction does not develop.

People living with HIV

The term People Living with HIV (PLHIV) is recommended for a person or group of people who are HIV positive, as it reflects the fact that people can live with HIV for many years, leading an active and productive life. The expression “victims of AIDS” is extremely incorrect (this implies helplessness and lack of control), including incorrectly calling children with HIV “innocent victims of AIDS” (this implies that someone from PLHIV is “himself to blame” for their HIV status or "deserved" it). The expression “AIDS patient” is only acceptable in a medical context, because most of the life of PLHIV is not spent in a hospital bed.

Legal Consequences of Infecting Another Person with HIV

Infecting another person with HIV infection or placing him or her at risk of contracting HIV infection is criminalized in a significant number of states. In Russia, the corresponding penalties are provided for in article 122 of the Criminal Code of the Russian Federation.

Sources of information

1. Palella F. J. et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. The New England journal of medicine, 1998, v. 338, p. 853-860.
2. UNAIDS/WHO AIDS Epidemic Update: December 2006 . PDF file, 2.7 MB
3. Greener, R. "AIDS and macroeconomic impact", in S, Forsyth (ed.): State of The Art: AIDS and Economics, IAEN, - 2002, p. 49-55.
4. Wolfgang Hübner (2009). "Quantitative 3D Video Microscopy of HIV Transfer Across T Cell Virological Synapses". Science 323: 1743-1747. DOI:10.1126/science.1167525 http://www.sciencemag.org/cgi/content/full/323/5922/1743
5. Wolfgang Hübner (2009). "Quantitative 3D Video Microscopy of HIV Transfer Across T Cell Virological Synapses". Science 323: 1743-1747. DOI:10.1126/science.1167525 (Photo) http://www.sciencemag.org/content/vol323/issue5922/images/small/323_1743_F1.gif
6. Wolfgang Hübner (2009). "Quantitative 3D Video Microscopy of HIV Transfer Across T Cell Virological Synapses". Science 323: 1743-1747. DOI:10.1126/science.1167525 (Video) http://www.youtube.com/watch?v=1wTCYnWYsCQ
7. Kaposi's sarcoma and Pneumocystis pneumonia among homosexual men--New York City and California. Morbidity and Mortality Weekly Report, 1981, v. 30, p. 305.(English)
8. Centers for Disease Control. Pneumocystis Pneumonia--Los Angeles. Morbidity and Mortality Weekly Report, 1981, v. 30, p. 250.(English)
9. The history of AIDS 1981-1986
10. Centers for Disease Control. Current trends update on acquired immune deficiency syndrome (AIDS) --United States. Morbidity and Mortality Weekly Report, 1982, v. 31, p. 507.(English)
11. Gottlieb et al. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency; N. Engl. J. Med. 1981, 305 1425-1431
12. Durack D. T. Opportunistic infections and Kaposi's sarcoma in homosexual men; N. Engl. J. Med. 1981, 305 1465-1467
13. Goedert et al. Amyl nitrite may alter T lymphocytes in homosexual men; Lancet 1982, 1 412-416
14. Jaffe et al. National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 1, Epidemiologic results; Ann. Int. Med. 1983, 99 145-151
15. Mathur Wagh et al. Longitudinal study of persistent generalized lymphadenopathy in homosexual men: Relation to acquired immunodeficiency syndrome; Lancet 1984, 1, 1033-1038

If you are already tired of sending smart people to Google who thoughtlessly repeat after the Denialists “No one has ever seen or photographed HIV”, then rejoice! Now you can send them to this entry, because there are going to be LOTS of electron microscope pictures of HIV right now. With links to articles from which I picked out these pictures. And for those who are simply bored looking at the pictures, there will be some comments.

Part 0. Discovery of the virus.

The first photographs of HIV were shown in articles by Montagnier and Gallo describing the isolation of HIV in 1983 and 1984, respectively.

The 1983 article by Barre-Sinoussi and Montagnier, for which they later received the Nobel Prize, provides the following picture:

Picture A. The photography, to be honest, is not so hot. But do not forget that at that time the methods of cultivating HIV were still very imperfect and did not allow the virus to be produced in large quantities. But even in this picture, viral particles are clearly visible, passing the assembly near the cell membrane - dark semicircular and annular seals. Montagnier and Sinussi did not see or did not pay attention to the characteristic feature of HIV that distinguishes it from many other viruses: after separation from the cell, it "ripens" and forms a cone-shaped capsid inside it. Depending on how the cut passes through this cone, it may look like a circle, a triangle or a rectangle.

But in Gallo's article, published a year later, the virus is seen much better.

Picture B. Panel A shows (for the entire photo) a macrophage, on the surface of which new viral particles (dense black rings) are being assembled. This process is especially well seen in the upper right corner, which is enlarged in panel B. Panel C shows a close-up of a nearly detached virion. And panel D shows a mature virus, but cut through its cone-shaped capsid so that it looks rectangular in the photo, and Gallo in the article called it cylindrical.

So, almost thirty years have passed since the publication of the first photos of HIV, and the denialists still have not bothered to see them. Since then, HIV has been photographed countless times. Below is just a small selection of the variety of existing photographs.

Part 1. Taking a closer look at the virus.

When the methods for generating the virus were improved, many detailed photographs of HIV appeared, in which its structure is very clearly visible.

Picture 1. A section of the brain of a patient who died of AIDS. Panel A shows a macrophage cell. The arrows show unusual seals protruding out of the cell - these are newly formed viruses. On panel A1 - the same close-up, on panel C - two protrusions from another macrophage. In panel D, we see a number of already formed and detached virus particles. In some, a small "leg" is still visible, connecting the virus and the cell. The newly separated, immature virus has the appearance of a dense black ring (in fact, it is of course a hollow ball, but on the cut it looks like a ring).

Below is a continuation of the same picture, I just cut it into two parts:

Picture 2. On panel B - an interesting formation, several macrophages have merged into one cell. This is not caused by a virus, macrophages have the ability to do it themselves when needed. For example, if they need to "swallow" a particularly large microbe. Black loops inside the cell are macrophage nuclei, and the arrow indicates the place where the virus is assembled. But in panel E we see several mature virus particles. Notice that they look different from immature ones - the dense ring around the edge has disappeared, but a new structure has appeared in the center - the virus capsid. In the average virus, it is clearly seen that the capsid has the shape of a truncated cone. The truncated cone capsid is a characteristic feature of HIV that distinguishes it from most other viruses.

A couple of words about capsid maturation: When a virus is assembled in a cell, all of its internal proteins are part of two long proteins. These long proteins tend to adhere to the cell membrane. Therefore, during the assembly of the virus and immediately after budding, we see a dense black layer under the membrane. Once the virus has separated from the cell, the viral protease cuts these long proteins into their component parts (so the ring around the edge disappears). The released proteins self-assemble into a cone-shaped capsid, inside which is the RNA of the virus and its enzymes.

And in the next article, lymph node biopsies from people with the opportunistic P. carinii infection that originally led to the discovery of AIDS in 1981 were put under a microscope.

Figure 3. In panel A, a P. carnii cyst is labeled. Arrows indicate the sites of virus formation. (B) Two viruses bud from a macrophage. Panel C shows the difference between viruses and simple vesicles formed by P.carnii. The latter are larger and have a lower density. Panel D - viruses inside macrophages, in vacuoles. Until now, there are disputes about whether the virus can form there or whether it is the macrophage that swallows it.

Picture 4. (A) - normal H9 cell (cell line of lymphocytes). (B) - H9 cell infected with HIV. The morphology of the cell has changed radically, instead of long processes we see vesicles called blebs. This "blistering" of infected cells is clearly visible under a normal microscope, but these bubbles are not viruses. Viruses are little bubbles between blebs. The picture was taken with a scanning electron microscope, so it's a three-dimensional picture, but we can't look inside the cell.

Picture 5. The same cell, only close-up. Viruses are very visible here.

Picture 6. Sections were also made in the same article. Panels A and C show two different HIV isolates. A truncated cone is clearly visible on the left, and on the right it turned out to be cut perpendicular to the axis and looks like a circle. In the center is SIVmac, macaque immunodeficiency virus. You can see the resemblance. Pay attention to the proteins of the shell - the prominences protruding outward. They are practically absent on the left, but in the center and on the right they are clearly visible. They didn’t know about it then, but the envelope protein is very unstable and easily falls off the virus, perhaps the sample on the left was not treated gently enough and the virus lost it. We now also know that SIV viral particles usually have more envelope protein than HIV and are more stable.

And the last picture from this article:

Picture 7. Different stages of virus formation. This, of course, is not the same virus, but a selection for illustration. For electron microscopy, the sample must be fixed and therefore it can capture only one moment in the life of each individual virus.

Here it is worth mentioning an article from the Germans, which was also published in 1988, link. It used an interesting, and it seems to me, now rarely used, approach - surface replica electron microscopy. The cells are frozen, then the frozen sample is split open to reveal structures (similar to how ancient fossils are found on chipped stone). Then platinum is sprayed onto this chip, and carbon is deposited on top of it. The sample is then thawed and all biological structures destroyed with a strong acid. As a result, a platinum-carbon imprint remains, which is already being examined under a microscope.

Picture 8. We see about the same thing as in the previous article. On the infected cell H9 appeared blebs, and between them and on them - a large number of newly formed viruses.

But apparently this method (or maybe just a violent imagination) led the authors of this article on the wrong track. They saw some regular patterns in the structure of viruses, which, as we now know, do not exist.

Picture 9. Search for (non-existent) symmetry in the HIV device.

We have already seen HIV-1 and SIV. How about HIV-2, are there pictures of it? Of course have .

Picture 10. HUT78 cell infected with HIV-2. The previously discussed virus assembly sites and the characteristic conical capsids in mature virus particles are visible.

Another fairly detailed study of HIV under an electron microscope was made in 1989. It has some interesting pictures.

Picture 11. On panel A we see a picture already familiar to us. On panels B and C, the authors, apparently believing the article from the Germans, are looking for some regular structures and also seem to find something. What we do see in panel D, however, is something interesting - this is an enlargement of the upper left corner from panel A, in which the authors noticed that the section passed through the viral envelope proteins. If you look closely (and use a little imagination), you can see that the coat protein is a trimer and therefore has a triangular structure when cut. We will return to this.

Picture 12. Quite a lot of information on it. The conclusions drawn from these pictures were partly confirmed later, and partly not. It happens. Most interesting panels:
(A) Immature virus on the left, mature virus on the right. The difference in the amount of envelope protein is visible, the mature virus has lost most of it.
(C) HIV-2.
(E) Variety of virus forms. Particularly interesting is the particle in the lower right corner, in which two capsids have formed. This rarely happens in vivo and is usually an artifact of virus production in cell lines.

By the way, about strange viruses. MT4 cells differ in that the virus in them replicates like crazy, 10 times faster than in others. They just all swell up producing huge amounts of viral particles. Well, as a result, viruses often turn out strange, as, for example, in the article.

Picture 13. Double arrows show strange viral particles, larger than usual and often containing two capsids.

But in these cells, you can accumulate a lot of virus and then carefully clean it, lightly treat it with a detergent (to open the viral membrane) and get beautiful clean capsids.

Picture 14. The cone-shaped structure of the HIV capsid is clearly visible.

Picture 15. Here we have one of the confirmations that the particles we observe are indeed HIV. Anti-HIV antibodies were bound to gold particles (black dots) and applied to the section. Unbound particles were washed away. The appearance of black dots (particles of gold) above this bubble indicates that it contains HIV proteins. There are many more similar pictures in the article, but I will not bring them here.

By the way, remember the hints at the triple organization of the HIV envelope protein in picture 5? The picture from the article shows this much better.

Figure 16. 3D electron microscope tomography allows for multiple "slices" through the virus. Here, from the top left to the bottom right, we are moving through slices of the virus particle taken from top to bottom. It can be seen that on the surface of the virus there is an envelope protein, which is a trimer (triangular shape). Sections through the middle of the virus show that the envelope protein looks like a fungus from the side - a thin stalk near the membrane ends with a hat. (Upd: Here I made a mistake and actually posted a photo of SIV - a related virus to HIV that infects monkeys. HIV will be below)

Picture 16a, for update. And this is how HIV actually looks on a 3D tomography. As I mentioned in the description of picture 11, there are far fewer envelope proteins on the surface of HIV than on SIV. Only two were found on this particle (shown by arrows). On average, they counted 10 per virus (and for SIV above - 70-80 per virus). Interestingly, the same article shows that a large amount of envelope protein on SIV is an artifact caused by the mutation of a virus that has been propagated in culture for a long time. The "wild" SIV also has very little shell protein on the surface. This is one of the virus' strategies to avoid an immune response. Rare proteins on the surface make it difficult for antibodies to bind to the virus.

This is where we end just looking at the virus and move on to studying it.

Part 2. Studying the virus.

The power of "reverse genetics" in microbiology lies in the fact that having a virus genome, we can make mutations in it and see what happens to it, as was done in the article.

Picture 17. (A) and (B) Normal virus. (C) and (D) a virus that cannot mature because it has a mutated protease. As expected, no cones are visible. (E) A virus that can mature but cannot assemble a normal capsid. Instead, a spherical capsid was observed in all viruses. (F-H) - a mutant that has been pretty much broken, so that he cannot collect virus particles at all.

It is possible to intervene in the formation of the virus by influencing the cell. In the article, an inhibitor of proteasomes, special complexes in which proteins are destroyed in the cell, was added to the cells. The virus thus formed more or less normal, but quantitatively there was a noticeable increase in immature particles and particles at a very late stage of assembly, but still connected to the cell with a bridge.

The world has known about the human immunodeficiency virus for more than 30 years. For the first time, they started talking about it massively in the mid-80s of the last century. All this time, scientists have been struggling to unravel its incurability, learn new details about its behavior in the human body, select a therapy that helps HIV-positive people live life to the fullest.

The time has long passed when people from socially disadvantaged groups (drug addicts, people of non-traditional sexual orientation) were infected with HIV. Now the problem of HIV concerns each of us. And this is openly declared by people who have weight in society, who fight for the rights of infected people, do not hesitate to say that HIV is no longer a stigma and a shameful status. This is what we have to live side by side every day.

1. Former British Minister of Culture Chris Smith

From 1997 to 2001 Chris Smith was the British Secretary of State for Culture. At this time, he was already HIV-infected. He learned about his status in 1987. But he openly announced it only in 2005.

I was pushed to this decision by an open statement by former South African President Nelson Mandela, Smith told the British media. - He honestly told the world that his eldest son died of AIDS. The example of Mandela, his call to fight the prejudices of the whole world, which are very strong against people with HIV, all this gave me strength.

Thanks to timely prescribed therapy and the right regimen, Smith remains in shape to this day.

2. Actor Charlie Sheen

The son of actor Martin Sheen, the successor of the acting dynasty, starred in the films "Platoon", "Spirit of Vengeance" and "Wall Street" and, of course, "Hot Shots". And also in the series Spin City and Two and a Half Men, in which he starred from 2003 to 2011. In 2010, he became the highest paid television actor - he was paid $ 1.8 million per episode of the series.

In Hollywood, Charlie is known as a great lover of women and a very scandalous actor. On November 17 last year, Charlie Sheen went public on a live television show that he had HIV. According to him, he was diagnosed about four years ago. "My confession will save me from the 'well-wishers' who blackmailed me with my HIV status," he said.

3. American poet and composer Jerry Herman

Jerry is now over 80 years old. He learned that he was infected in 1985. He became one of the first who did not hide his status from the public, declaring it already in 1987.

All this time, German has been on antiretroviral therapy, has a positive outlook on life and assures: “I am one of the lucky ones who survived and made it possible for people to be convinced that the methods of treatment with experimental drugs lead to success.”

4. American screenwriter and novelist Larry Kramer

Winner of the Pulitzer Prize, a fighter for the rights of people of non-traditional sexual orientation and HIV-infected people, one of the most outrageous writers in America.

A few years ago, he underwent a liver transplant.

5. NBA basketball player Irvin "Magic" Johnson

"The Magician" Johnson is considered one of the best basketball players in the National Basketball Association (NBA) in its history. During his 12-year career, he never cheated on the Los Angeles Lakers club. Johnson's team won the NBA title five times. He personally holds several association records, some of which have yet to be broken.

In 1991, 32-year-old Johnson learned that he had HIV. He publicly announced this on national television, bitterly admitting that his promiscuity was the cause of the disease. The most terrible moment in his life was the road home from the clinic, in which he was informed of the diagnosis. He had to tell this to his young pregnant wife.

Johnson immediately began antiretroviral therapy. His popularity at that time was so great that, despite the warnings of doctors, the cautious attitude of other athletes, he returned to the sport several more times. And he stubbornly said: “A person living with HIV can be an athlete. Playing basketball doesn't mean infecting everyone." And just a year after the start of therapy, in 1992, as part of the American Dream Team, he won gold at the Barcelona Olympics.

In 2002, doctors said that the virus in his blood had dropped to undetectable! At that time, it was a world victory, which all the media wrote about - "The Wizard" Johnson beat AIDS!

And although the basketball player's sports career is over, he continues to fight the development of HIV-AIDS throughout the world, pays great attention to educational activities, including lecturing at schools, colleges and universities. Defends the rights of HIV-positive people, actively participates in charity and assures that a positive attitude, proper medication, diet and moderate exercise are, of course, very important. But it is more important to understand how important the tests are. To understand that HIV will not just go away on its own, that therapy is needed. And, of course, the support of loved ones.

By the way, the wife, having learned about the status of Jones, said that they would fight and survive it all together. Now they have three absolutely healthy children.

6. Four-time Olympic winner and five-time world champion Greg Louganis

American Greg Louganis became a kind of champion. After discovering his HIV status in 1988, this top diver went on to win two more Olympic gold medals. But he openly admitted only eight years later, in 1995, by releasing an autobiographical book.

After this recognition, a serious scandal erupted. The fact is that at one of the Olympics, an athlete broke his head by jumping into the pool. At that time, he was still hiding his HIV status, which means he could put other Olympians in danger. Although doctors assured that infection in such a situation was impossible, Louganis apologized several times on television.

Now Greg Louganis, who has been living with HIV status for 18 years, is known primarily as a writer, an excellent dog handler and showman. In an interview, Greg admitted that depression often covers him, but dogs help him fight it. “At one point, I realized that my depressive waves are caused by antiretroviral drugs. The doctor changed the therapy, and now, if melancholy covers me, I first of all begin to communicate with my dogs. My terrier Nipper has already taken so many gold medals at exhibitions that it’s even disgusting ... "

Greg Louganis teaches at the school of acting, starred in films, plays in the theater. Now the virus has decreased in his blood to undetectable.

7. TV presenter Pavel Lobkov

There were no well-known people in Russia who openly declare their HIV status. Therefore, TV presenter Pavel Lobkov (ex-star of the NTV channel, at one time he hosted the programs "Plant Life", "Hero of the Day", "Profession - Reporter" and many others), who last year openly admitted this on December 1, at the World AIDS Day became a real sensation.

Pavel said that he found out about his HIV status in 2003. According to him, it is necessary to recognize that there are a lot of HIV-infected people in the world, including in Russia. That status is not a shameful stigma, but a disease that needs to be learned to live with, like diabetes.

CELEBRITIES WHO DIED OF AIDS

Fortunately, therapy now helps HIV-infected people to live fully for many years. Alas, 20 - 30 years ago, AIDS claimed the lives of famous people who contracted HIV by accident. Let's remember them.

1. Singer Freddie Mercury

The first rumors that Queen vocalist Freddie Mercury had AIDS appeared back in 1986. However, he officially announced his illness on November 23, 1991. And he died the next day...

But his speech became almost a manifesto: “I speak about my AIDS to protect the peace of my loved ones. The press should not exaggerate rumors, but focus on helping the victims. It is necessary to prevent a wider spread of the disease, and not poison people, often completely innocent of being infected.

2. Ballet dancer and choreographer Rudolf Nureyev

Former Soviet and then British choreographer and dancer Rudolf Nureyev died of AIDS on January 6, 1993. But he found out that he was sick back in 1984. That is, a year before HIV tests became publicly available. He was informed about the diagnosis in one of the Paris clinics, saying that the virus had been developing in his body for more than four years. At that time, there were daily injections that could stop the development of the disease.

But Nureyev refused treatment after a few months, unable to withstand the daily injections. Four years later, he again turned to the doctors to try a new experimental drug. Unfortunately, he did not help him. And in 1991, the disease began to progress rapidly. In the spring of next year, its final stage began. Only those closest to him knew about his illness. Until his death, many in his troupe did not even suspect the diagnosis of the great dancer and choreographer.

3. Science fiction writer Isaac Asimov

A wonderful American writer, one of the most famous geniuses of science fiction, a professor of biochemistry at Boston University, was the victim of a blood transfusion.

Now this seems unthinkable - after all, all donors are mandatory tested for HIV, but in 1983, when Azimov underwent heart surgery, many did not even suspect such a disease.

The brilliant science fiction writer found out that he had HIV in 1989, when he was tested in preparation for another heart operation. He decided not to report the disease to his fans, so as not to sow panic. Isaac Asimov died at 72 on April 6, 1992. But only ten years later, the writer's wife announced the true cause of his death.

4. Actor Rock Hudson

The sex symbol of the 50s, the favorite of women, the most charming actor with a mocking smile, Rock Hudson is known to us from the films "The Mirror Cracked", "When September Comes", "Intimate Talk" and many others.

The actor was unaware of his illness until in 1983 he was diagnosed with Kaposi's sarcoma (a malignant skin disease that can also affect internal organs, is considered the most obvious marker of HIV. - Ed.). Subsequent tests confirmed the diagnosis.

The actor spoke about his illness two years later, in July 1985. And he died two months later.

5. Supermodel Gia Carangi

At 17, Gia left her family's diner and moved to New York City, intending to become a model. She believed that this was her calling. And I was not mistaken.

Gia Carangi has become one of the most famous and highly paid models in the world. Perhaps only Cindy Crawford and Claudia Schiffer were more famous than her. Gia was the first model to pose nude in a photo shoot for Vogue magazine. Hundreds of job offers followed.

A sharp career rise, thousands of contracts ... And despite all this - loneliness. It was it that brought Gia to a completely different world - nightly pleasures in the famous Studio 54 club. She tried to forget. And drugs helped her in this. First cocaine, then heroin. This began to affect her work, photographers noticed that on the set she behaved differently than usual. But Gia's popularity was so great at that moment that no one dared to make comments to her or at least warn her against addiction.

Drugs ruined her modeling career and herself. For seven years she unsuccessfully tried to fight them. In 1986, she was stricken with severe pneumonia. Diganosis was diagnosed immediately - "AIDS". By that time, not only Gia's hands, but also Gia's back were covered with ulcers.

She died at the age of 26 in a hospital bed, surrounded by the love and care of her own mother, who left the family when Gia was only 11 years old. And this became the main tragedy: it was precisely because of the lack of maternal warmth that the girl went into all serious trouble, trying to fill the void.

6. Tennis player Arthur Ashe

Arthur Ashe is a three-time Grand Slam winner. In 1988, he contracted HIV through a blood transfusion. In 1992, he held a press conference at which he publicly announced his terminal illness.

Ash, 49, died of AIDS the very next year after his confession.

7. Football player Jacob Lekheto

BY THE WAY

Public figures who support the fight against HIV

HIV-positive people who struggle with this problem are only one side of the coin. Many famous people support the fight against the spread of AIDS both around the world and in Russia.

Stars take part in photo shoots and promote the idea that HIV is not a fiction, it is a big global problem that cannot be hushed up, that needs to be fought. As a rule, such campaigns are timed to coincide with World AIDS Day, which is celebrated on December 1st. For several years of the existence of such actions in Russia, she was supported by many famous people: actress Marina Aleksandrova, singer Diana Gurtskaya, ballet dancer and choreographer Nikolai Tsiskaridze, writer Maria Arbatova, two-time Olympic champion Svetlana Khorkina, journalist and TV presenter Elena Khanga and many others.

Unfortunately, now this is already a real epidemic, - said Vladimir Pozner, who has been dealing with the topic of HIV-AIDS for more than 20 years, in an interview with one of the central channels. - And it is very important to do prevention - not to be afraid to say the word "condom" in a conversation with a 14-year-old teenager. It cannot be denied that at this age they already have sexual relations. And you need to tell them about safety. Otherwise, having contracted HIV at this age, in 5 - 10 - 15 years they may already have AIDS.

One should not be afraid to talk about this topic, - says the UN Goodwill Ambassador for HIV/AIDS, singer and actress Vera Brezhneva. - We have a lot of people who do not even suspect that they are infected with HIV. Be sure to get tested, take tests to know that you are healthy. I do it regularly. Thanks to modern medicine, it is possible to actually stop HIV at an early stage and reverse it at a later stage.

In Russia, the movement against HIV-AIDS has not yet acquired such proportions as in the rest of the world. Its activists are a lot of famous people: Microsoft founder Bill Gates, actress Sharon Stone, singer Elton John, actor Rupert Everett, singer Annie Lenox, former model Carla Bruni-Sarkozy and other famous personalities.

Many of them are not just UN Goodwill Ambassadors on HIV/AIDS, but also actively participate in charitable campaigns and donate a lot of money to fight this disease.

More than 15 million lives saved thanks to the funds raised for HIV treatment by American taxpayers - it's amazing! says Bono, an Irish rock musician and U2 vocalist who has been raising money for HIV in the Third World for more than three decades. - We shouldn't stop there.

SEE PHOTO GALLERY

In 1983, a group of scientists from the University of Paris, and then their American colleagues, isolated the human immunodeficiency virus (HIV) from the blood of AIDS patients. It attacks the human immune system, rendering it unable to protect the body from disease. For the third decade there has been a fight against dangerous pathogenic protozoa, but we have not yet fully figured out HIV. It is still a mystery how the AIDS virus infects the defense system and why some patients infected with this infection remain completely healthy people for a long time.

Features of cell infection

Only HIV can infect and then kill the cellular tissue of the human immune system. When the virus first enters the blood or mucous membranes, immune cells begin to fight it, but they always lose. HIV can only infect macromeres (cells) that contain special proteins (CD4 receptors) on their surface. A number of human cell tissues contain everything necessary for the virus to be able to penetrate them.

What cells are affected by the AIDS virus? The main target for HIV are T-helpers. But CD4 receptors are also found on the outer surface of other cells (eg, thymocytes, macrophages, intestinal epithelium, cervix).

All of them also serve as target cells for HIV. The impact of the immunodeficiency virus on macromeres depends on their type. So, penetrating into a nerve cell, it almost does not damage its sheath. Therefore, having become infected, it continues to work for a considerable time and serve as a refuge for the virus. Cells that live for a long time can contain many pathogenic organisms and be their repository. In them, HIV is not vulnerable to the action of drugs and the immune system. And for storage cells, this does not pass without a trace, their structure is greatly modified.

The difference between HIV infection and AIDS

Some believe that HIV and AIDS are one and the same. Is it so? HIV (human immunodeficiency virus) damages the immune system, and it ceases to protect the body from infections.

A few years after contracting HIV, a weakened patient develops serious illnesses, then he is diagnosed with AIDS (acquired immunodeficiency syndrome). This means that HIV is a virus that depresses the immune system, and AIDS is a whole bunch of diseases caused by the causative agent of the AIDS virus.

Risk factors

Immunodeficiency is a dangerous and incurable disease. Infection with HIV in most cases occurs due to the wrong behavior of people, and not because they belong to a certain group that has an increased risk of developing the disease.

There are several risk factors that contribute to contracting AIDS.

Main:

• use of one syringe by different persons;
• promiscuous sex;
• unverified donor material;
• contact of medical staff with an infected patient;
• prostitution.

Biological:

• the presence of sexually transmitted diseases (gonorrhea, syphilis, chlamydia, trichomoniasis);
• defects in the structure of the genital organs (injured, narrow, with neoplasms);
• high viral loads (the more virus in the blood, the greater the possibility of infection);
• weak immune system;
• violations of the skin and mucous membranes;
• genetic characteristics of the virus (different strains have different speed of movement, aggressiveness, the ability to defeat cellular material).

Psychological:

• personal qualities of character (pedantry, impulsiveness, risk-taking, ardor, inability to control oneself);
• attitudes towards HIV and AIDS;
• communication style;
• mental disorders;
• depressive state.

How the AIDS virus spreads

Only when a person comes into contact with biological fluids (blood, semen, vaginal secretions) and tissues or organs that contain the virus can AIDS spread.

1. The most dangerous is contact with blood. After a single transfusion of infected blood, human infection occurs in almost 100% of cases.
2. Vertical transmission of the virus (from mother to fetus) ranks second (about 30%).
3. With a single use of medical instruments (needles, syringes) containing HIV-infected blood, the probability of infection with the AIDS virus is about 1%.
4. HIV infection is much less common through sexual contact. Moreover, it was found that infection of a woman from a man happens twice as often as infection of the stronger sex from the weak. It is noticed that the use of condoms significantly reduces the likelihood of infection during sexual contact.
5. The very low possibility of contracting an infection from an accidental needle stick is only 0.3%.

HIV incubation period

In the first stage, AIDS patients do not show any signs of the disease. The virus has just entered the body and did not have time to gain a foothold. It can only be detected by a blood test. The latent period of the disease lasts approximately three months. It depends on the immune system of the patient.

Symptoms

In AIDS patients, the onset of the disease is very difficult to detect. Its earliest symptoms are:

• swollen lymph nodes;
• pathological conditions similar to influenza (cough, fever, appetite disappears, body aches, fatigue, general weakness).

These symptoms may also be present in other diseases. But if a person had sexual intercourse or there was some kind of medical intervention, then a blood test for HIV infection should be taken. An infected patient may not have symptoms, but despite this, he can already infect another person. Sometimes only a few years after infection, when the AIDS virus attacks immune cells, late signs of the disease appear:

• constant night sweats and fever;
• constant fatigue;
• loss of weight and appetite for no reason;
• enlarged and painful lymph nodes;
• tumor formations on the skin, in the mouth and nose of a dark red color;
• frequent acute respiratory infections;
• dry cough, shallow breathing.

Fighting AIDS in men and women

The male sex is much less concerned about their health than the female. Symptoms of HIV infection in them appear earlier, but are blurred and are often perceived as signs of colds. Not taking the problem seriously, men do not go to the doctor in time, and the diagnosis is made when the AIDS virus already infects the cells of the immune system.

Women are much more attentive to their health, and the disease process in them is much slower than in men. Along with the general symptoms of the disease, female representatives may experience vaginal discharge with a mucous structure, pain during menstruation, and breast enlargement. Unlike men, they often have an increase in lymph nodes in the genital area. All this causes a feeling of discomfort, anxiety, insomnia, depression. A woman is forced to see a doctor with existing symptoms that may indicate the presence of the immunodeficiency virus.

Is it true that the AIDS virus dies quickly?

About the "survivability" of HIV, the existing data are often contradictory. It is known that in the open air after a few minutes the virus ceases to exist. But in the inner part of the syringe, its vital activity continues much longer. How long does the AIDS virus live outside the human body? Answering this question, it should be noted that there are many misconceptions and misinterpretations of scientific research.

Under laboratory conditions, when the concentration of the virus exceeds the real value by 100,000 times, the survivability of HIV is from one to three days from the moment the liquid dries. According to these data, the virus outside the body can live only a few minutes. For this reason, infection by domestic means does not occur. But the survivability of pathogenic organisms in a hollow needle and inside a syringe depends on:

• volume of blood in the needle;
• the amount of virus in the blood;
• temperature.

According to the results of the research, it was found that with a high concentration of viral particles in the blood, it can exist for up to 48 days, gradually reducing its vital activity. With low blood volumes, small amounts of virus, and high temperatures, the lifespan of HIV is greatly reduced.

Temperature and HIV

The belief that a virus outside the human body is instantly destroyed at room temperature is erroneous. Of course, HIV is not a bacterium, does not contain spores, and therefore does not live in soil and water for months. Nevertheless, it is covered with a protein shell and in a dry drop of mucus or blood can live for several days, and under suitable conditions for several weeks. Over time, the number of pathogenic organisms decreases significantly, so a small number of them are not able to infect a person. Yes, and the virus from the external environment enters the skin, lungs or digestive tract, and not into the blood.

At what temperature does the AIDS virus die? The immunodeficiency virus is really unstable to elevated temperature. When infected material is heated to 56 degrees for 30 minutes, almost all pathogenic organisms are killed, and when boiled, their death occurs almost instantly. In the presence of a high content of viral particles (blood clots), for neutralization, boiling should be carried out a little longer.

Is there a cure for AIDS?

A patient with an immunodeficiency virus, without resorting to treatment, can live from 5 to 10 years. A magic vaccine for AIDS patients has not yet been found, but scientists are successfully working on its invention. There are already medicines that do not allow the virus to multiply, stop the disease, preventing the transition of HIV into AIDS. Patients using medications are in a satisfactory condition and can work. Doctors believe that their life expectancy will increase significantly.

Prevention

While the search for an effective vaccine against the immunodeficiency virus is underway, the only effective means of combating infection is educational activities among the population. The most effective and effortless method of AIDS prevention is cleanliness in personal relationships. For this you should:

• use only your own personal hygiene products;
• have one partner;
• use condoms;
• avoid sexual intercourse with strangers;
• avoid group contact.

The second direction of prevention is activities in medical institutions:

• examination and control over donors, patients at risk, pregnant women;
• monitoring childbearing of infected women;
• use only sterile medical instruments, disposable syringes and blood transfusion systems.

A healthy lifestyle based on physical activity, reasonable nutrition, real rest, rejection of bad habits and stress is the best prevention of AIDS.

You can get infected not only by leading a “wrong” lifestyle (unprotected sex with unfamiliar partners, taking drugs). The pathogen can enter the bloodstream through medical instruments during surgery, or in the dental office, in the tattoo parlor.

Since an HIV-infected person looks like a longer period of the disease, like a healthy one, it is impossible to visually determine the disease. For this reason, more than 70% of infections occur through sexual contact.

Sharing HIV and AIDS

How to identify an HIV-infected person by appearance and protect yourself? Symptoms of HIV are directly related to the stages of the disease and the viral load. If an infected person has a very low concentration of the pathogen in the blood, the risk of infection is minimal.

Since it is impossible to identify a person with HIV through visual contact, it is important to remember that unprotected sexual contact is a “game of Russian roulette”.

HIV is an infection, and AIDS is a stage of manifestation of a pronounced clinical picture.

Between infection and complete defeat of the immune system are the following stages:

• seronegative window;
• Acute;
• Latent;
• Pre-AIDS.

Since the HIV patient looks different at each stage (symptoms can be confused with other diseases), and the intervals between their manifestations are quite large, it is impossible to diagnose the disease without laboratory methods. With such a diagnosis, leading a healthy lifestyle, a person can live for more than 15 years.

What does an HIV-infected person look like at the initial stage of the disease?

The seronegative window stage is characterized by no symptoms. The virus is in the incubation period and is just beginning to be detected by the immune system.

How to determine an HIV-infected person at this stage is impossible using laboratory research methods, and the disease is not diagnosed by external symptoms. The seronegative period can last from a few weeks to a year, depending on viral load and immune status.

Since a person with HIV looks the same as an uninfected person, with a possible risk of infection, one cannot wait for symptoms to appear - it is necessary to be examined. New generation test systems are able to detect the smallest amount of antibodies in the blood.

Even before you understand that you have HIV, based on external symptoms, you can find out the result of the test. Even if not all the antibodies necessary for making a diagnosis are found in the blood, and the result turns out to be doubtful, the person will be warned about a possible HIV-positive status. In this case, the study must be completed after 3 months.

How to understand that a person has HIV - symptoms at the stage of acute infection

The acute stage of infection is called the seroconversion period, when the immune system begins to fight the infectious agent, actively producing antibodies (cellular immunity is activated).

During this period, the highest In some cases, it even reaches the levels that will be observed at the last stage, but the appearance of a person cannot be compared with how people with AIDS look.

A condition similar to SARS or flu is noted:

• elevated temperature;
• Headache;
• increased sweating;
• skin rash;
• Diarrhea;
• Inflammation of the lymph nodes in the neck.

During this period (it can last from 7-14 days to one and a half months), aching joints are also noted.

How to understand that you have contracted HIV, if the malaise is deceptive and means not the body's struggle with the flu virus, but an immunodeficiency state? The difference in the duration of symptoms.

In most cases, with HIV infection, the above symptoms appear for about a month, then disappear on their own. A week is enough for the immune system to fight the influenza virus or SARS, and then recovery occurs with symptomatic treatment.

Since it is most realistic at this stage to understand that one is HIV-infected, it is urgent to donate blood for an ELISA and immunoblot. During the period of seropreservation, due to the increased viral load, the highest risk of infection transmission is through sexual contact.

How to identify a person with HIV, AIDS in the latent period?

This is the longest stage - from 2 to 10-15 years. The duration of the period depends on the initial immune status, as well as on the general state of health. It is almost impossible to identify an infected person by external symptoms. The only clinical sign is persistent generalized lymphadenopathy.

What do HIV-infected people (see photo) look like at this stage? Lymph nodes simultaneously increase. This is not such a pronounced symptom that it can be determined by visual contact. More often, enlarged lymph nodes are found only on palpation.

Since a person with HIV in the latent period looks like a healthy person (with a CD4 cell count of more than 500/µl), he can lead a normal life and not notify anyone about the presence of the disease. The main thing is not to put others at risk.

Pre-AIDS and AIDS Stage

Pre-AIDS is an early stage of clinical manifestations of HIV infection. How to identify an AIDS patient during this period?

Immunity ceases to fight the pathogen, and various kinds of pathogenic microflora penetrate the body without a barrier, affecting all organ systems. The initial signs are skin lesions and lesions of the mucous membranes.

Appearance is noted:

• seborrheic dermatitis;
• Onychomycosis;
• Leukoplakia of the tongue;
• Herpetic lesions.

What does a person with AIDS look like (see photo)? The clinical picture is expressed not only because of external symptoms (lesions of the dermis, emaciated appearance), but also internal - urogenital infections, fever, accompanied by a body temperature of 38-39 ° C.

Since it is not always possible to understand whether a person has AIDS, due to the absence of the above symptoms, the level of CD4 cells is determined. Appropriate immunological criteria are an indication for the appointment of antiviral therapy and the prevention of OZ.

What do people with AIDS (see photo) look like at the terminal stage? Body weight is significantly reduced, skin lesions do not heal, forming ulcers.

Many are developing:

• Atypical mycobacteriosis;
• Cryptosporidosis;
• Cryptococcosis;
• Candidal exophagitis.

The AIDS stage lasts several years - tumor and other diseases lead to death.