What are the risk groups for HIV infection. Groups at risk of HIV infection: how they become infected with HIV, methods of prevention. Clinical picture for the acute phase

There are well-defined groups at increased risk for HIV infection. They include gay men, drug addicts, prostitutes, and hemophiliacs who may receive contaminated blood through transfusions. Having infected a person, the virus can also be transmitted through heterosexual relationships with people who do not fall into any of the high-risk groups. Particularly contribute to the spread of the virus group and anal sex. The virus in the seed easily passes through inflamed or torn membranes. Drug addicts can pick up and spread the virus through shared needles. Those who engage in prostitution to obtain drugs are spreading the virus even more widely. Many hemophiliacs have contracted the virus through contaminated "factor VIII" (produced from the blood), which is used to treat hemophilia. In most countries, donated blood is now tested for HIV.

The prevalence of AIDS is difficult to measure: an infected person may not feel sick and unintentionally continue to spread the virus. Anyone who has sexual intercourse with a person who has had another partner is at risk. The only absolute remedy is chastity. However, condoms made to high standards and used correctly can also prevent the spread of the virus.

Blood tests for HIV infection are now publicly available. About 12 weeks after sexual contact, it is usually possible to tell if the virus has been transmitted. During the first two weeks, flu-like symptoms may be observed, but sometimes without any symptoms. Being a carrier of HIV can be very difficult psychologically; in addition to fear of the possible development of AIDS, patients may suffer from discrimination in the employment service and insurance companies and, possibly, from the loss of social and economic status. Therefore, it is important for patients to seek help and advice, and his family and friends should give him love and support. Being diagnosed with HIV does not mean an immediate death sentence. According to one study, 75% of HIV-positive men felt great and had no symptoms two years after diagnosis.

Approximately 30% of HIV carriers develop persistent swollen lymph nodes. This is often accompanied by fatigue and malaise. Patients may be advised to avoid stress whenever possible and to healthy diet to prevent worsening of symptoms.

Some HIV-infected patients continue to develop overt symptoms immune system, thrush, skin disorders, fever, diarrhea, weight loss and constant fatigue.

Physiotherapy treatment

At the first symptoms of pneumonia at normal body temperature, distracting procedures can be carried out at home: jars, mustard plasters, mustard wraps. To eliminate inflammatory changes, diathermy, inductothermy, microwave, UHF and other physiotherapy are prescribed. The resorption of infiltrates in the lungs is promoted by massage chest and LFC.

Clinical examination

A patient who has had pneumonia is observed by a pulmonologist or therapist for 6 months, but if the disease proceeded with complications, the observation should last at least a year. During this period, it is necessary to regularly undergo an examination, including a blood test, spirography and fluorography.

Indications for hospitalization for pneumonia:

Inability to take oral medications
Involvement of several lobes of the lung (according to chest x-ray)
Severe deviation from the norm of the main physiological parameters (pulse > 125 per minute, systolic blood pressure< 90 мм рт. ст., частота дыхания >30 per min)
Acute disturbances of consciousness
Hypoxemia (PaO2< 60 мм рт. ст. при дыхании атмосферным воздухом)
Secondary suppurative infection (eg, pleural empyema, meningitis, endocarditis)
Severe acute electrolyte, haematological or metabolic disturbances (serum sodium levels< 130 ммоль/л, гематокрит < 30%, число нейтрофилов < 1000 в мкл, уровень АМК>50mg%, creatinine > 2.5mg%)
Comorbidities (eg, suspected myocardial infarction, renal failure, liver disease, malignancy)

Epidemiology.

The HIV pandemic has been going on for more than 20 years, affecting an increasing number of countries and continents. It is important to pay attention to the main trends in the spread of this disease.

Since the first clinical case of AIDS, about 22 million people have already died. In 2006 alone, 2.9 million people died of AIDS.

Currently, the HIV epidemic in Russia has its own characteristics. First, the vast majority of HIV-infected people are young people. Secondly, the sexual route of infection is becoming increasingly important. This indicates that the disease has gone beyond the marginalized groups. Experts predict that in the coming years the number of HIV-infected people in Russia may reach more than a million people.

The HIV epidemic in the Russian Federation continues to develop. In the first 6 months of 2006 alone, just under 13,5000 new cases were detected. The majority of HIV-infected people are young people: about 80% of people living with HIV in the Russian Federation, according to the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, are 15-30 years old.

In Russia, HIV infection has been registered since 1986, initially among foreigners, mainly Africans, and since 1987 among citizens former USSR. Currently, sick and HIV-infected people have been identified in all administrative regions Russian Federation.

The regional picture of the prevalence of HIV infection is very heterogeneous: along with regions characterized by a high degree of the spread of the HIV epidemic, there are subjects of the Federation where the level of infection is still relatively low, and the incidence of HIV infection in different federal districts of the country can vary almost 9 times.

The most unfavorable in terms of damage include the years. St. Petersburg, Moscow, Sverdlovsk, Samara, Irkutsk regions.

The number of people infected with HIV per 100,000 population (“infection”) increased from 187 cases in 2003 to 251.1 in 2006.

Ways of HIV transmission:

during sexual contact with an HIV-infected person;

when transfusing infected blood or blood products (infection is also possible with artificial insemination, skin and organ transplantation);

when using non-sterile needles and syringes that were injected by an HIV-infected person;

From mother to child (during pregnancy, childbirth and breastfeeding).

HIV is not transmitted: mosquitoes, mosquitoes, fleas, bees and wasps. HIV is not transmitted through casual contact. Not a single case of infection through blood-free saliva and lacrimal fluid has been described. Since HIV is not transmitted through saliva, it is not possible to become infected through shared glasses, forks, sandwiches, or fruit. According to leading experts, exposure to intact skin of infected biological fluids (for example, blood) is not enough to transmit the virus.

Sexual contacts.

Sexual intercourse without a condom is the most frequent route of transmission of HIV infection worldwide. The highest risk of infection exists with passive anal intercourse, however, cases of infection after a single active sexual intercourse have been described. Sexually transmitted diseases significantly increase the risk of contracting HIV. The lower the viral load, the less contagious the patient is.

Injection drug use.

The use of unsterilized syringes and needles injected by an HIV-positive person is an important mode of HIV transmission in countries with large numbers of injecting drug users. Unlike accidental (medical) needle sticks, the risk of infection through shared needles is much higher, as the injecting drug user checks for correct needle position by drawing blood into it.

Transmission from mother to child (vertical route).

In the absence of preventive measures, the frequency of transmission HIV from mother to child during pregnancy and childbirth is 15-30%. In about 75% of these cases, HIV transmission occurs on later dates pregnancy and childbirth. About 10% of cases of vertical transmission of HIV occur in the first two trimesters of pregnancy, another 10-15% - during breastfeeding.

Today, vertical transmission of HIV is becoming rare thanks to antiretroviral prophylaxis and planned caesarean sections.

Injection and transfusion of infected blood products.

In most Western countries, cases of transfusion of HIV-infected blood and its products have become rare. With modern methods of diagnostics and screening of donated blood, the risk of HIV infection during a single dose of blood transfusion is 1:1,000,000.

The main manifestations of the epidemic process.

· The first stage (1987-1995) - the importation of HIV into the territory of the republic by foreign citizens and the spread of infection among the population through sexual contacts, the slow pace of development of the epidemic process;

· The second stage (1996-1998) - the rapid spread of infection among people who use drugs; the leading route of transmission is parenteral;

· The third stage (1999 to the present) - is a consequence of the previous one, is formed at the expense of sexual partners of drug users 1 sexually infected persons. The exit of infection from risk groups increases the risk of infection of women and children, the leading route of sexual transmission.

Groups at high risk of HIV infection

High-risk groups for HIV infection are:

1) Persons with risky sexual behavior:

persons with a large number of sexual partners;

persons suffering from sexually transmitted diseases, especially in the presence of ulcerative changes in the mucous membranes;

people who use alcohol and drugs;

women who have sexual intercourse during menstruation;

women who have sexual intercourse during pregnancy;

persons having anal sexual intercourse;

lack of practice of using condoms.

2) Recipients of blood, its products, organs and other biological fluids.

3) Persons who use drugs intravenously.

4) Persons who have had piercings, tattoos.

5) Persons performing ritual procedures of incest.

6) Health workers in areas with high HIV prevalence.

HIV risk groups - this is information that everyone should know. With its help, you can protect yourself from this dangerous disease and warn your relatives and friends. Groups at risk of contracting HIV are people for whom the threat is great in view of their lifestyle, profession, and for a number of other reasons. Who is included in it?

AIDS: risk groups by professional activity

There are several professions whose representatives are at high risk of contracting the immunodeficiency virus. First of all, this applies to medical workers. And surgeons are the first to be at risk of contracting HIV infection. Representatives of this profession, specializing in abdominal operations, often risk their own health. The fact is that only planned patients are subject to mandatory testing for AIDS. Before the operation, or rather during its preparation, they take blood samples for antibodies to the virus. However, medical workers do not always have the opportunity to carry out such a check.

Often, patients are brought to the department already in a critical condition requiring urgent surgical intervention. In this case, surgeons observe increased security measures, since they are at risk of occupational HIV infection. But it is not always possible to protect yourself from infection in the body in this way. So, for example, a careless movement of a scalpel can cause a hand to get hurt even through two pairs of gloves, and the specialist will not have time to urgently treat the wound with alcohol. And there are many such examples.

The risk group for HIV infection is not only surgeons, but also medical workers who take or test blood. We are talking about nurses, employees of laboratories and donor centers. Careless handling of infected or possibly infected blood can also lead to the entry of the virus into the body.

Professional risk groups for HIV infection can also be supplemented by specialists in the field of venereology, urology and gynecology. These doctors do not work with blood, but with secretory fluid secreted from the genitals. And it, as you know, also contains virus cells. By the way, dentists also have a high risk of initiation. Indeed, with some professional manipulations, such specialists also deal with blood. And cells of the immunodeficiency virus can also be contained in the saliva of patients. Therefore, dentists are sometimes among those who become infected and sick with AIDS as a result of their professional activities.

Who can be infected with AIDS among people with other health problems?

Experts in the field of medicine draw conclusions about who is sick with HIV among people with other diseases on the basis of studies that have been conducted over several decades. To date, it has been established that persons with other untreated or undertreated sexually transmitted diseases have a greater risk of infection. Why are such people at risk for HIV infection? First, because sexually transmitted diseases cause a serious blow to the immune system. Secondly, most of them lead to the appearance of ulcers, cracks and erosions on the genitals, which increase the risk of infection during sexual contact.

This risk group for HIV infection also includes patients with hemophilia. This disease affects mainly men. Its treatment is specific and requires frequent administration of globulin and thromboplastin. The latter is a component removed from the plasma in a special way. It is of two types - cryoprecipitate or concentrate. In the preparation of the latter, the plasma of several thousand donors is used. This increases the risk of infection accordingly. Especially if the blood of unverified donors is used. Cryoprecipit is prepared from the plasma of just a few donors. Accordingly, its use allows patients with hemophilia not to be at risk of contracting AIDS.

Other high-risk groups for HIV infection

The remaining high-risk groups in most cases lead an immoral lifestyle. The highest risk of infection in girls and women of easy virtue. A prostitute with AIDS is not uncommon. Infection among representatives of an ancient profession can occur if poor-quality contraceptives are used. It is important to note here that the barrier method of contraception is not one hundred percent able to protect against the penetration of infection into the body.

Prostitutes infected with AIDS often infect their clients. At the same time, sometimes, girls do not know that they are sick, because with their lifestyle, it is necessary to check for the presence of a virus almost every week. But not always infection occurs due to ignorance of a terrible disease. Some HIV-positive prostitutes deliberately infect their clients. In this case, we are talking about mental disorders. After all, they purposefully endanger the lives of others. Someone does it out of revenge, someone out of anger at the whole world and, in particular, at men.

Many people think that HIV infection, if it exists, is somewhere far away and it is impossible for a modern socially adapted person to face it. Indeed, drug users, sexual partners of HIV-infected people, as well as children born to HIV-positive women are at serious risk of becoming infected with the human immunodeficiency virus (hereinafter referred to as HIV).

However, given that more than 50% of the transmission routes of HIV infection are currently sexual, no one can be immune from this infection. This means that any person entering into sexual life or by changing sexual partners is at risk of contracting HIV. It is impossible to contract HIV sexually only if both partners in a couple are not infected with HIV and both remain faithful to each other throughout the entire period of their relationship. Unfortunately, as practice shows, in most cases, people in a couple not only do not know whether their partner is infected with HIV or not, but they themselves do not know about their status, since they are not tested for HIV infection.

The danger of HIV infection also lies in the fact that for a long time an infected person feels completely healthy. The main method of laboratory diagnosis of HIV infection is the detection of antibodies to HIV in blood serum using enzyme immunoassay (ELISA). It can take from 2 weeks to a year from the moment of HIV infection to the moment when the ELISA method can determine the presence of antibodies to HIV in the blood! This period is called the "window period". An analysis for antibodies to HIV during this period will be negative, while the person - the carrier of the virus - is already dangerous to others.

It is necessary to be tested for HIV in the following cases:

After sexual intercourse (vaginal, anal or oral) with a new partner without a condom (or if the condom breaks);

If the sexual partner has had sexual contact with someone else;

After sexual assault;

If the current or past sexual partner is HIV-infected;

If the sexual partner used someone else's needles or was exposed to any other risk of infection;

After the discovery of another sexually transmitted infection (STI), since STIs significantly increase the risk of HIV transmission due to local damage to the mucous membranes;

After using the same needles or syringes for injecting drugs or other substances, or for tattoos and piercings;

After contact with the blood of an HIV-infected person.

At the same time, it must be remembered that the timing of the examination for antibodies to HIV must necessarily take into account the "window period", that is, from the moment of contact, it is advisable to donate blood after 1 month and again after 3, 6 and 12 months. A blood test for antibodies to HIV for citizens of the Russian Federation is free of charge. In the Oryol region, you can be tested for HIV infection, including anonymously, at the Orel AIDS Center Oryol Region or any other budget institution healthcare.

Despite the fact that HIV infection has been spreading around the globe for more than 30 years and the flow of information about it is quite extensive, not everyone knows how HIV infection is transmitted and how HIV infection occurs.

Over 40 million people on Earth are affected by HIV, and the rate of infection is not decreasing at all. Therefore, it is impossible to ignore and remain indifferent to this problem. In this situation, everyone should clearly know how it is possible to become infected with HIV in order to protect themselves and their loved ones.

Features of HIV

The carriers of the human immunodeficiency virus (HIV), according to scientists, were initially monkeys, from which people on the African continent then became infected.

In connection with the migration of the population on a large scale, the virus has spread throughout the world.

HIV is a retrovirus that enters the human body and does not manifest itself in any way, the infected person does not even suspect it. After entering the body, the virus can behave differently. In 70% of those infected (about a month later), the acute phase of HIV infection develops, which manifests itself with symptoms resembling mononucleosis or common acute respiratory infections, and therefore is not diagnosed.

It would be possible to diagnose the disease with the help of PCR, but this rather expensive analysis would have to be prescribed to every patient with acute respiratory infections. The patient quickly recovers and feels absolutely normal, unaware of his infection. This phase is called asymptomatic.

Antibodies to the virus begin to be produced far from immediately after the infection enters the body. Sometimes it takes 3, and sometimes 6 months, until specific antibodies begin to be detected in the blood, confirming the disease. The maximum duration of this period, when the virus is already in the body, but there are no antibodies yet, is 12 months. It is called the seroconversion period or the seronegative window.

This period of imaginary well-being can last 10 or more years. But an infected person can infect others through various ways of transmitting HIV infection.

To do this, it is only necessary to reach a certain concentration of the virus in the body of the infected. And since the virus multiplies at a tremendous speed, soon all the biological fluids of the infected contain HIV, only in different concentrations.

Fortunately, the virus is not stable outside the human body. It dies when heated to 57 0 C in half an hour, and when boiled in the first minute. Alcohol, acetone, and conventional disinfectants also have a destructive effect. On the surface of intact skin, the virus is broken down by enzymes and other bacteria.

The complexity of the fight against HIV lies in the fact that it is very mutant, even in one organism it has different structural variants. Therefore, a vaccine against HIV has not yet been created. Once in the body, HIV infects immune cells, making a person defenseless against any kind of infection.

Ways of spread of the disease

How HIV is transmitted is of concern to many people who live or work near those who are infected. Experts have proven that the concentration of the virus sufficient to infect another person is present in the blood, semen and vaginal secretions, in breast milk. It is with these biological substances that the modes of HIV transmission are associated.

There are 3 ways of HIV transmission:

The most common way HIV is transmitted is sexual path. Infection occurs through unprotected sexual contact. Moreover, the variety of ways of transmitting HIV infection is striking - through homosexual contacts, through vaginal, oral, anal sex.

Numerous relationships of prostitutes, homosexual relationships are the most dangerous. During anal sex, microtraumatic injuries occur in the rectum, which increase the risk of infection. Women during sexual contact with an HIV-infected partner are more vulnerable: she becomes infected in 3p. more often than a man from an infected partner.

The presence of erosion of the cervix, the inflammatory process in the genitals increase the possibility of infection. About 30 sexually transmitted diseases or STDs are known. Many of them develop an inflammatory process, so STDs significantly increase the likelihood of HIV transmission. The possibility of infection increases for both partners during sex during menstruation.

With oral sexual contact, the likelihood of infection is somewhat less, but it is. Many are interested in: is it possible to transmit HIV with a single sexual contact? Unfortunately, the infection can also be transmitted in this case. That is why one of the indications for medical emergency prevention of infection is the rape of a woman.

HIV is also easily transmitted through blood. This route is called parenteral. With this method of infection, the transmission of the virus is possible through blood transfusion, organ or tissue transplantation, manipulation of non-sterile instruments (including syringes).

For infection, it is enough to get one ten-thousandth part of a milliliter of blood into another organism - this amount is invisible to the human eye. If the smallest particle of the blood of an infected person enters the body of a healthy person, then the probability of infection is almost 100%.

Such situations can arise when applying a tattoo, piercing ears, piercing not in a specialized salon, but by random people. Infection can also occur during manicure / pedicure with untreated instruments. Flushing with water is not enough to remove residual blood. Instruments must undergo complete processing (disinfection and sterilization).

Infection through donor blood is unlikely, since the donated blood is rechecked not only after its collection, but also an additional examination of donors is carried out after 6 months in order to exclude the period of seroconversion at the time of blood donation. All this time, the prepared blood is in the blood bank of the transfusion stations and is issued only after re-checking.

In dental offices and clinics, in the surgical service, instruments, in addition to disinfection, are sterilized in dry-heat cabinets or in autoclaves. Therefore, the risk of infection with them in medical institutions is minimized.

The most relevant way of HIV transmission through the blood is for drug users by injection. Many of them try to calm themselves in the matter of HIV infection by using disposable syringes. However, when buying a dose from a drug distributor, they cannot be sure that a previously infected substance has not been drawn into the disposable syringe they brought.

Sometimes drug users use a common syringe, changing only needles, although intravenous injections of blood necessarily enter the syringe and infect it.

In everyday life, infection can occur when using someone else's or a common razor. Family members of an infected person can also become infected from him when providing assistance without rubber gloves in case of injury, cut.

vertical transmission of the virus from an infected mother to her child is called HIV infection. How is HIV transmitted in this case? Ways of HIV infection for a child can be different:

firstly, the virus is able to overcome the placental barrier and then the infection of the fetus occurs in utero;
secondly, infection can occur directly during childbirth;
thirdly, a mother can infect a child through breast milk.

It is possible to prevent infection of the baby with the help of free preventive treatment with antiviral drugs, if the woman applied to the antenatal clinic in a timely manner during pregnancy and passed all the necessary studies.

To reduce the risk of infection of the child in some cases, delivery by caesarean section is performed. The baby also receives free antiviral drugs for 28 days.

After the birth of a child, it is recommended to feed with milk mixtures. There are, however, cases when tests during pregnancy were negative, as there was a period of a seronegative window (seroconversion). In this case, the baby will get the virus through milk while breastfeeding.

When infection does not occur

Despite the fact that the virus is present in any body fluid, its concentration in them is different. So, tears, sweat, saliva, feces and urine do not play an epidemiological role, since they do not lead to infection of another person. Liters of tears or sweat would be needed, for example, so that when they get on the damaged skin of a healthy person, they could transmit the virus. True, infection is possible with kisses, if blood enters the saliva with bleeding gums.

Infection does not threaten in such cases:

Fortunately, HIV is not an airborne virus. Staying in the same room with an infected person is not dangerous.
It is not dangerous to use one toilet, bathroom, shared utensils or towels.
You can't get sick in the pool.
You can safely use one phone, not be afraid of shaking hands with the infected.
HIV is not transmitted by animals or insect bites.
Water and food routes of infection are also excluded.

Risk group

Given the possible ways of spreading the disease, doctors identify a risk group, which includes:

injecting drug users;
persons with non-traditional sexual orientation (homosexuals);
persons engaged in prostitution;
persons with promiscuity, practicing unprotected sex (without a condom);
patients with venereal diseases;
recipients of blood products;
children born from an HIV-positive mother;
healthcare workers caring for patients with HIV.

HIV infection is a special disease that may not have clinical manifestations for a number of years, but sooner or later leads to a state of immunodeficiency, that is, to AIDS. At this stage, it is quite difficult to fight the disease, a person can die from any banal infection. Therefore, everyone should clearly know how they become infected with HIV, and protect themselves as much as possible.