WHAT IS THE HIV/AIDS?

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Surely you have often heard about AIDS disease! AIDS (Acquired Immune Deficiency Syndrome), in the eyes of the public may be a frightening disease. Yes frightening, but that must be realized is, although scary does not mean we should avoid AIDS patients, or known as PLWHA (People With HIV AIDS). AIDS that resulted in the decline of the immune system, caused by the infected patients by a virus known as HIV (Human Immunodeficiency Virus). The danger is that people who are already infected with HIV, do not immediately experience signs or symptoms (symptom) immediately after infection occurs. Symptoms of AIDS usually begin to appear for 5-10 years after infection, and usually the patient has a health check because it is in a severe state, because it has an opportunistic infection (which accompanies AIDS) because the decline in the immune system and opportunistic diseases is usually an infectious disease.

Structure of HIV
AIDS is an infectious disease, but transmission is not arbitrary, can not pass through the air like tuberculosis (TB). AIDS can be transmitted through sexual contact, through blood transfusions or open wounds that cause HIV to enter the bloodstream and through the placenta from mother to child (maternal). It will be important to know your partner's health condition! This becomes very important, because AIDS in the world is greatest occurs through sexual intercourse husband and wife, a husband who already knows that he has AIDS, deliberately transmitted to his wife who did not know about her husband's condition and the danger is that transmission can occur to the fetus, if the wife they are pregnant, then a pre-marital medical check-up becomes important. Avoiding the cause (act prevetif) is the most correct action than cure (curative) or promotive. If there are people affected by AIDS around you, do not worry, AIDS will not be contagious just by touching hands or hugging, but it could be transmission due to opportunistic infections experienced by people living with HIV.

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Preventive actions that can be taken to avoid HIV infection are:

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• Practicing safe sex.
• Use of condoms during sex.
• Avoid sharing of syringes simultaneously.
• Screening of blood to be transfused.
• HIV screening for people at risk (such as commercial sex workers / CSWs, people who are alternating partners or with drug users).
• Increase public knowledge about awareness and prevention of AIDS.

The diagnosis to detect AIDS can be done in two ways, by examining antibodies to HIV and / or CD4 + (cluster of differentiation 4+) examination, ie glycoproteins expressed in T-helper cells, monocytes, macrophages and dendritic cells or globally can be interpreted as part of the white blood cells that play a role in the body's immune system. This examination is of course not directly done, because generally people living with HIV suffer from various complications of the disease, which makes the confusion of the doctors. If positive, the first thing to do by the closest family is to check blood on the children of PLWHA (especially if the child is still aged 1-10 years) and husband ODHA.

HIV infection occurs in several stages, namely:

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1. The acute stage

• This stage occurs within a few weeks after HIV infection.
• Things that happen at this stage are acute fever, headache, limp (malaise), lymphanodenopati (enlarged lymph nodes), sore throat and redness of the skin.
• Then the symptoms diminish and disappear within a few weeks, then the patient becomes asymptomatic (no symptoms).

2. Asymptomatic Stage (No Symptom)

• Occurs several weeks after the onset of acute infection.
• It lasts for a period of time (usually 5-10 years) where there is no symptom, but persistent destruction of CD4 + resulting in a further weakening of the immune system.

3.Phase Symptomatic

• Occurs when CD4 + levels have dropped dramatically.
• This stage is characterized by the emergence of opportunistic infection, which occurs due to the decline of the immune system. Common opportunistic infections include: pneumocystis pneumonia (infection of the lung), candidiasis (infection of the oral cavity), this infection is a frequent infection in people living with HIV. Other infections are toxoplasma, tuberculosis, Cryptococcal infection (in the brain), Cytomegalovirus (herpes) etc.
• This stage is subdivided into several stages according to CD4 + count.
• Cancer can also occur at this stage, usually affecting the skin, lymph nodes and abdominal cavities.
• In the already severe stage of HIV infection, nerve manifestations, such as dementia (dementia), psychological disorders and loss of control of motor function (movement) are present.

So, be careful if the people near you experience these symptoms. However, do not worry! PLWHA still can live a normal life, asalkam opportunistic infection they are cured and ODHA consume drugs given regularly, to avoid resistance. Despite the need for lifelong treatment, the drug for AIDS is a drug program, the drug provided free of charge by the government. HIV / AIDS drugs are anti-viral drugs, which are classified into protease inhibitor, non-nucleoside reverse transcriptase inhibitor (NNRTI) and nucleoside reverse transcriptase (NRTI) groups and have usually been compiled into fixed combinations. Examples are Lamivudin / Zidovudin, FDC (Lamivudin, stavudine and nevirapin), DDI (Didanosine), LPV-RTV (lopinavir / ritonavir), D4T (Staviral, Stavudine) 3TC (Hiviral, Lamivudin), NVP (Nevirapin), EFV (Efavirenz ), ZDV (Reviral), etc.

Especially for families living with HIV / AIDS should get education about HIV / AIDS, so that families are not afraid of contracting by people living with HIV. The family is a source of strength for people living with HIV, so do not avoid people living with HIV, because PLWHA is not dangerous if we know how to handle it.

Reference:

• Essentials of Pathophysiology for Pharmacist: Acquired Immunodeficiency Syndrome (AIDS) p. 51-58

• Pharmacotherapy Pathophysiological Approach: Human Immunodeficiency Virus Infection p. 2065-2082