HIV Nursing The human immunodeficiency virus (HIV) is a retrovirus (actually a lentivirus) that eventually causes the acquired immunodeficiency syndrome (AIDS; World Health Organization [WHO], 2014). There are two subtypes of the HIV virus: HIV -- 1 in HIV -- 2 (the agent in the epidemiological triangle). Both are transmitted to the host (humans) via the exchange of bodily fluids such as by sexual contact, rectal contact, blood, or breast milk (Centers for Disease Control [CDC], 2014). According to the World Health Organization (WHO) the biggest risk factor associated with acquiring HIV is unprotected sex (WHO, 2014). Thus, the environment in the epidemiological triangle consists of these human bodily fluids and incubation period lasts from three to six months (Hiv & Long, 2012).

The WHO reports that 85% of HIV transmission occurs through heterosexual intercourse on a global basis and that the other major modes of transmission of the HIV virus are male -- to male sexual contact, intravenous drug use (WHO, 2014). HIV occurring in children is often the result of having an infected mother (WHO, 2014). Thus, the majority of new cases of HIV could be prevented by practicing safe sex and/or using sterile needles.

According to the CDC in 2011 it was estimated that slightly over 1,148,000 adults and adolescent individuals (age 13 and over) were infected with the HIV virus in the United States, with an incidence of approximately 50,000 persons a year (CDC, 2014). The mortality rate is estimated at 2.7 deaths per hundred thousand people (CDC, 2014).

HIV infects cells in the human immune system, particularly CD4+ T cells, as well as dendritic cells and macrophages. The infection results in low levels of these immune cells via several mechanisms such as direct viral destruction of infected cells, CD8 cytotoxic lymphocytes attacking affected cells, and apoptosis of unaffected bystander cells (Hiv & Long, 2012). When the levels of CD4+ cells falls below a critical level the host's cell -- mediated immunity is lost and the individual becomes susceptible to a number of infections that can lead to fatal...

After one experiences these early symptoms they may abate for some time and there may be no overt symptoms. As the rest of the disease continues the person may experience weight loss, fatigue, swollen lymph nodes, fever, night sweats, and may also display other symptoms related to other infections due to the resistance of the body be broken down (Hiv & Long, 2014). Without treatment the mean survival time following infection with the HIV virus is estimated to be between nine and 11 years depending on the subtype (CDC, 2014).
Thus, the communicable disease chain of HIV begins with an infected host who transfers the virus to another typically via sexual intercourse (although this can also occur via blood or other bodily fluid [e.g., infected needles]). The virus lives and reproduces in human immune cells (reservoir) and exits the host through an exchange of bodily fluids.

There is no cure for HIV infection; however, there are currently five classes of drugs used to treat HIV infection:

1. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs): This class of drugs, which are often referred to as "nukes," interfere with DNA production in the virus by blocking reverse transcriptase enzyme production that the virus needs to build new DNA and make copies of itself.

2. Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): "Non- -- nukes" also block reverse transcriptase production by acting directly on the enzyme to alter its function and therefore interfere with the viral reproduction process.

3. Protease Inhibitors (PIs): This class of drugs inhibits the virus' ability to copy itself by interfering with the DNA replication process.

4. Entry/Fusion Inhibitors: This class of drugs blocks the virus from attaching to the receptor sites on the CD4 cells.

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