TASS-DOSSIER. From 15 to 21 May 2017, the All-Russian Stop HIV / AIDS campaign will be held in Russia for the third time. It is organized by the Fund for Social and Cultural Initiatives (the President of the Fund is the wife of the Prime Minister of the Russian Federation, Svetlana Medvedeva). The action is supported by the Ministry of Health, the Ministry of Education, the Ministry of Telecom and Mass Communications of the Russian Federation, Rosmolodezh, Rospotrebnadzor, as well as the Union of Rectors of Russia, leading state universities of the Russian Federation and the Russian Orthodox Church.

It is timed to coincide with World AIDS Day, which is held annually on the third Sunday in May. Its goal is to draw attention to this problem in Russia, to raise awareness of the population, especially young people, about the disease.

Action "Stop HIV / AIDS"

The all-Russian action "Stop HIV / AIDS" began in Russia in 2016. The key event of the first action, which took place in May, was an open student forum. The second event was timed to coincide with World AIDS Day (December 1) and took place at the end of November. It started at the II All-Russian Forum for Specialists in the Prevention and Treatment of Disease (November 28).

As part of the action in the senior classes of secondary schools, public lesson"Knowledge - Responsibility - Health", which showed a film about topical issues in the fight against HIV infection.

Disease HIV / AIDS

The Human Immunodeficiency Virus (HIV) attacks the immune system and weakens the body's defenses against a wide range of infections and diseases, including some types of cancer. HIV-infected people gradually develop immunodeficiency.

The last stage of the disease that develops when infected with the human immunodeficiency virus is AIDS (acquired immunodeficiency syndrome), when the human body loses its ability to defend itself against infections and tumors. Different people can develop AIDS 2-15 years after HIV infection.

There is no cure for HIV infection. However, treatment with antiretroviral drugs can control the virus and prevent transmission. This facilitates and prolongs the life of those infected with the infection.

Statistics for Russia

The epidemiological situation of HIV infection in Russia (the first case was detected in 1987) is unfavorable, cases of the disease were detected in all regions of the Russian Federation.

According to Rospotrebnadzor, as of December 31, 2016, since 1987, 1 million 114 thousand 815 cases of HIV infection have been registered among citizens of the Russian Federation, of which 243 thousand 863 people have died. Thus, at the beginning of 2017, 870 thousand 952 Russians lived with a diagnosis of HIV / AIDS in Russia, which is 0.59% of the total population of the country (146 million 804 thousand 372). The prevalence of HIV as of December 31, 2016 is an average of 594.3 people with an established diagnosis per 100 thousand of the country's population.

The number of newly diagnosed HIV cases in the country continues to grow. According to Rospotrebnadzor, in 2011-2016. annual growth averaged 10%. In 2016, the territorial centers for the prevention and control of AIDS registered 103,438 new cases of HIV infection (excluding those identified anonymously and foreign citizens), which is 5.3% more than in 2015 (95,475).

A high prevalence of HIV is observed in the 30 largest regions of the Russian Federation, where 45.3% of the country's population lives. The most disadvantaged regions, where the number of people living with HIV exceeds 1 thousand people per 100 thousand of the population, are Sverdlovsk (1648 per 100 thousand of the population), Irkutsk (1636), Kemerovo (1583), Samara (1477), Orenburg (1217) regions, Khanty-Mansi Autonomous Okrug (1202), Leningrad (1147), Tyumen (1085), Chelyabinsk (1079) and Novosibirsk (1022) regions.

A high incidence of HIV infection in the Russian Federation is observed in the age group from 30 to 39 years old. More than 1.1 thousand people with HIV infection are registered annually among young people (15-20 years old). Cases of infection of children continue to be detected with breastfeeding: In 2014, 41 children were infected, in 2015 - 47 children, in 2016 - 59.

In 2016, 675 thousand 403 patients (77.5% of all those living with HIV / AIDS diagnosis) were registered in specialized medical organizations. Of these, 285 thousand 920 patients received antiretroviral therapy (42.3% of those registered).

HIV / AIDS in the world

Some scientists believe that HIV was transmitted from monkeys to humans as early as the 1920s. The first victim of this disease may have been a man who died in 1959 in the Congo. This conclusion was reached by doctors who later analyzed his medical history.

For the first time, the symptoms of the disease characteristic of HIV / AIDS were described in 1981 when several men of non-traditional sexual orientation were examined in clinics in Los Angeles and New York. In 1983, researchers from the United States and France described a virus that is capable of causing HIV / AIDS. Since 1985, HIV blood tests have become available in clinical laboratories.

According to the World Health Organization, at the end of 2015, there were between 34 and 39.8 million (on average - 36.7 million) HIV-infected people in the world. The most affected region is sub-Saharan Africa, in 2015 there were about 25.6 million people living with HIV (about two thirds of all infected). More than 35 million people worldwide have become victims of HIV / AIDS. In 2015 alone, approximately 1.1 million people died. As of June 2016, 18.2 million patients, including 910 thousand children, had access to antiretroviral treatment.

The word "AIDS" is known to every person on earth and means a terrible disease, against the background of which there is an uncontrolled drop in the level of lymphocytes in a person's blood. The state of the disease is the final phase of the development of HIV infection in the body, leading to a lethal end. The first descriptions of the disease date back to the 80s, when physicians around the world were faced with its manifestations.

Statistics data

Currently, AIDS in Russia is spreading at a colossal rate. Statistics officially recorded the number of infected. Their number is shocking with its zeros, namely, there are about 1,000,000 patients with HIV infection. These data were voiced by V. Pokrovsky, the head of the Center for Epidemiology of the Russian Federation. Statistics claim that only during the Christmas holidays in 2015, the number of people who received HIV infection corresponds to the figure of 6,000. Pokrovsky noted this data as the highest figure in all previous years.

As a rule, the problem of AIDS becomes the most discussed twice a year. The AIDS Center has declared the beginning of winter (December 1) as the Day of Resistance to Disease. In the first days of May, the Day of Mourning for those who died from the "plague of the 20th century" is held. However, the topic of AIDS and HIV infection was raised outside of these two days. The UN statement sounded information that the Russian Federation has become the world center for the spread of HIV. Especially frequent cases of the disease were registered in the Irkutsk region. It has become the generalized center of the HIV epidemic.

This information once again confirms the growing process of the disease. V. Pokrovsky has repeatedly stated this, and UNAIDS documents have also reported this. Dmitry Medvedev, during a meeting of the Commission on Health Protection, confirmed the presence of cases in the country and an increase in the number of patients by 10% annually. The frightening facts were voiced by V. Skvortsova, who believes that in about 5 years AIDS in Russia could reach the 250% level. These facts speak of an all-encompassing epidemic.

Percentage of cases

Discussing the problem, V. Pokrovsky argues that sexual intercourse is a typical way of infecting women. The fact is that AIDS in Russia is recorded in more than 2% of the male population aged from 23 to 40 years. Of them:

• with drug use - about 53%;
• sexual contact - about 43%;
• homosexual relationships - about 1.5%;
• children born to mothers with HIV infection - 2.5%.

The statistics are truly shocking in their performance.

Reasons for AIDS Leadership

Experts note two main indicators of the deterioration of the situation in this area.

• AIDS in Russia is spreading at such a fast pace due to the lack of programs to combat it. The fact is that in the period 2000-2004, the Russian Federation received support to overcome this problem from an international fund. After the RF was recognized as a country with high incomes, international subsidies were suspended, and internal subsidies from the country's budget became insufficient to overcome the disease.
• The disease is advancing by such leaps and bounds due to the use of drugs through the use of injections. The AIDS Center confirmed that about 54% of citizens received the disease "through a syringe."

The statistics are shocking with the massiveness of the disease. The risk of becoming HIV-infected is increasing every year. The number of deaths from this disease has also increased.

According to V. Pokrovsky, there are 205,000 people in Russia. This figure covers only the surveyed population groups. This includes patients who are already registered as having received an infection. According to experts, this number should be added to potentially hidden carriers of HIV who do not receive treatment and are not registered with a doctor. In total, the figure can reach 1,500,000.

Most problematic area on AIDS

AIDS statistics in Russia show how widespread the problem is. On this moment the most critical is the situation covering the Irkutsk region. The chief physician of the region for the fight against the disease stated that almost every 2 people out of a hundred have an HIV test confirmation. This corresponds to 1.5% of the total population of the region.

Three out of four incidents occur through sexual contact between people under the age of 40. When clarifying the circumstances, it often turns out that the infected person did not even suspect that he had become a carrier of the infection and he needed intensive treatment.

V. Pokrovsky's report sounded the phrase: “If 1% of women carrying a fetus are diagnosed with HIV as a result of a blood test, then epidemiologists have the right to classify the disease as a generalized epidemic.” This indicator was confirmed by doctors in the Irkutsk region. center and negligence towards the problem of the regional governor.

Along with the Irkutsk Territory, a difficult situation is noted in 19 other regions. These include areas:

• Samara;
• Sverdlovsk;
• Kemerovo;
• Ulyanovsk;
• Tyumen;
• Perm Territory;
• Leningradskaya;
• Chelyabinsk;
• Orenburg;
• Tomsk;
• Altai region;
• Murmansk;
• Novosibirsk;
• Omsk;
• Ivanovskaya;
• Tverskaya;
• Kurgan;
• Khanty-Mansiysk district.

The first place in the black list is occupied by the Sverdlovsk and Irkutsk regions, followed by Perm, followed by the Khanty-Mansiysk district, the Kemerovo region concludes the list.

The regional leadership is far from encouraging. In these areas, you can take the test anonymously at any medical institution.

AIDS: cost of treatment

If anonymous testing is free in most cases, then the treatment itself will require significant investments. The pricing policy of pharmaceutical companies in the field of antiretroviral therapy in our country is quite tough. So, when comparing prices, it can be noted that the course of treatment in African countries is $ 100, in India it will be from $ 250 to $ 300, but in Russia about $ 2,000 should be paid for it. Such a sum for many residents of the country turns out to be unaffordable.

Statistics note that over the past year, only slightly more than 30% of the sick population were able to receive antiretroviral care. The reason for this fact is the inflated prices set by the suppliers of medicines.

If it turns out that the partner is HIV-infected, it is urgent to take a test. AIDS is a dangerous, fatal disease, so a delay in the examination can end in disaster for the patient.

1. For the first time, people of the planet learned about the disease only 3 decades ago.
2. The most insidious is the HIV 1 strain.
3. Compared to the original virus, today's HIV has become more adaptable and tough.
4. In the 1980s, the disease sounded like a death sentence.
5. The first case of infection was recorded by doctors in the Congo.
6. Many experts are of the opinion that it was the secondary use of syringes that led to such a rapid spread of the disease.
7. The first to open the list of people infected and died from AIDS was a teenager from It happened in 1969.
8. In America, Steward Dugas, a homosexual who died of HIV in 1984, is considered the first spread of the disease.
9. The list of famous people in the world who have died from the virus can be read with tears in their eyes. The disease claimed the lives of Arthur Ashe, Freddie Mercury, Magic Johnson and many others.
10. The case of Nushon Williams, who, knowing about his infection, specially infected his partners, for which he received a prison sentence, is considered an outrageous case.
11. Do not despair if our immune system is able to resist the disease. So, out of 300 people, the body of one independently copes with the disease. This means that our body includes a gene that can protect us from the virus, and it will be hoped that soon a terrible diagnosis will not mean a death sentence.

About two million people worldwide are infected with HIV every year. Global HIV statistics: by WHO country and region.

There were approximately 36.7 million people living with HIV worldwide in 2016, and 1.8 million acquired HIV in 2016.

Number of adults and children living with HIV

The most alarming situation is in the countries of Eastern Europe and Central Asia. For more information, see TheWorldOnly.

New HIV infections by region of the world for all ages, (1990-2016)

Source: http://www.unaids.org/sites/default/files/media_asset/20170720_Data_book_2017_en.pdf

The magnitude of HIV

Goals

In June 2016, the UN General Assembly agreed that ending the fight against AIDS by 2030 requires a quick response to achieve three main stages by 2020:

• reducing the number of new HIV infections to less than 500 thousand people by 2020;
• reducing AIDS-related deaths to less than 500,000 worldwide by 2020;
• End HIV-related stigma and discrimination by 2020.

Successes

The tremendous progress in the AIDS response over the past 15 years has inspired a global commitment to ending the epidemic by 2030. A significant increase in antiretroviral therapy has led to the worldwide achievement of the AIDS target. Intensive efforts to eliminate mother-to-child transmission of HIV have led to a sharp decline in the annual number of new HIV infections among children from 290,000 in 2010 to 150,000 in 2015.

Problems

However, HIV prevention challenges remain. The decline in new HIV infections among adults has slowed, threatening further progress in ending the AIDS epidemic. Since 2010, the annual number of new HIV infections among adults (15+) has remained unchanged at about 1.9 million.

Efforts to reach fewer than 500,000 new HIV infections by 2020 are lagging behind. Data from 146 countries show that some have achieved 50% or more reductions in new HIV infections among adults over the past 10 years, while many others have not made significant progress, says UNAIDS report (pdf) ...

Change in the growth rate of new HIV infections among adults (15 years and older) from 2005 to 2015

Source: Prevention gap report, UNAIDS, 2016

• HIV infection is often diagnosed with rapid tests that check for the presence or absence of antibodies to HIV. In most cases, test results can be obtained on the same day; it is important for diagnosis and early treatment;
• there is no cure for HIV infection. However, thanks to effective treatment antiretroviral drugs can control the virus and prevent its transmission, which allows people with HIV and those at significant risk to have healthy and productive lives, WHO said.

HIV statistics in the world

• Since the beginning of the epidemic, the virus has claimed more than 35 million lives. In 2016, 1 million people from AIDS-related illnesses;
• the most affected region is sub-Saharan Africa, with 25.6 million people living with HIV in 2015.

Estimated number of people living with HIV by WHO region, 2016

AIDS virus(abbreviation Hiv) was discovered in 1983 when studying the causes of AIDS - syndrome immunodeficiency. The first official publications about AIDS appeared back in 81, the new disease was associated with sarcoma. Kaposi and uncommon pneumonia in homosexuals. The designation AIDS (AIDS) was fixed as a term in the 82nd, when similar symptoms identified in drug addicts, homosexuals and patients with hemophilia were combined into a single acquired immune deficiency syndrome.

Modern definition of HIV infection: viral disease, which is based on immunodeficiency, which becomes the cause of the development of concomitant (opportunistic) infections and oncological processes.

AIDS is the last stage of HIV infection, whether congenital or acquired.

How can you get HIV?

The source of infection is an HIV-infected person, and at any stage of the disease and for life. Large amounts of the virus contain blood (including menstrual) and lymph, semen, saliva, vaginal discharge, breast milk, liquor- cerebrospinal fluid, tears. Endemic(with reference to the area) an HIV outbreak was detected in West Africa, monkeys were infected with a type 2 virus. The natural locus of type 1 virus has not been found. HIV is transmitted only from person to person.

With unprotected sex the possibility of contracting HIV increases if there is inflammation, microtrauma of the skin or mucous membranes of the genitals, anus. At the only one During intercourse, infection is rare, but with each subsequent intercourse, the likelihood increases. During any kind of intercourse receiving a sexual partner is at a higher risk of getting HIV (from 1 to 50 per 10,000 episodes of unprotected sex) than the transmitting partner (0.5 to 6.5). Therefore, the risk group includes prostitutes with their clients and "Barebackers"- gay men who knowingly do not use condoms.

HIV transmission routes

A baby can get HIV in utero from an infected mother, if there are defects in the placenta and the virus enters the blood of the fetus. In childbirth, infection occurs through the injured birth canal, and later through breast milk. Between 25 and 35% of children born to HIV-infected mothers can become carriers of the virus or develop AIDS.

For medical reasons: transfusion of whole blood and cell mass (platelets, erythrocytes), fresh or frozen plasma to patients. Among the medical staff, accidental injections with an infected needle account for 0.3-0.5% of all cases of HIV infection, so doctors are at risk.

With intravenous injections with a "public" needle or syringe, the risks of HIV infection are more than 95%, therefore at the moment the majority of carriers of the virus and an inexhaustible source of infection are drug addicts constituting the main risk group for HIV.

HIV CANNOT be contracted through everyday use, as well as through water in pools and saunas, insect bites, air.

Spread of HIV

Features - a variable incubation period, an unequal rate of onset and the severity of symptoms, which directly depend on the state of human health. People weakened(asocials, drug addicts, residents of poor countries) or with related chronic or acute STDs(, etc.), get sick more often and more severely, HIV symptoms appear faster, and life expectancy is 10-11 years from the moment of infection.

In a prosperous social environment, in practically healthy people, the incubation period can stretch for 10-20 years, the symptoms are erased and progress very slowly. With adequate treatment, such patients live long, and death occurs due to natural causes - due to age.

Statistics:

• At the beginning of 2014 in the world - 35 million people diagnosed with HIV;
• The increase in the number of infected in 2013 is 2.1 million, deaths from AIDS - 1.5 million;
• The number of registered HIV carriers among the entire population of the world is approaching 1%;
• In the Russian Federation in 2013, there were 800 thousand infected and sick, that is, about 0.6% of the population is affected by HIV;
• 90% of all AIDS cases in Europe are in Ukraine (70%) and the Russian Federation (20%).

HIV prevalence by country (percentage of adults with the virus)

Facts:

1. HIV is more common in men than in women;
2. In the last 5 years, cases of HIV detection in pregnant women have become more frequent;
3. Inhabitants of northern European countries are infected and get sick with AIDS much less frequently than southerners;
4. Africans are most susceptible to the immunodeficiency virus, about 2/3 of all sick and infected - it is in Africa;
5. Those infected with the virus over the age of 35 get AIDS 2 times faster than young people.

Characterization of the virus

HIV belongs to the group retroviruses HTLV group and genus lentiviruses("Slow" viruses). It has the form of spherical particles, 60 times smaller than an erythrocyte in size. It quickly dies in an acidic environment, under the influence of 70% ethanol, 3% hydrogen peroxide or 0.5% formaldehyde. Sensitive to heat treatment- becomes inactive after 10 minutes. already at + 560 ° C, at 1000 ° C - within a minute. Resistant to UV, radiation, freezing and drying.

Blood with HIV that gets on various objects remains infectious for up to 1-2 weeks.

HIV is constantly changing the genome, each subsequent virus differs from the previous one by one step of the RNA-nucleotide chain. The HIV genome is 104 nucleotides long, and the number of errors during reproduction is such that after about 5 years nothing remains of the original combinations: HIV mutates completely. Consequently, previously used drugs become ineffective, and new ones have to be invented.

Although in nature there are not even two absolutely identical HIV genomes, some groups of viruses have typical signs... On their basis, all HIV is classified into group, numbered from 1 to 4.

• HIV-1: Most common, this group was the first to be discovered (1983).
• HIV-2: less likely to contract than HIV-1. Infected species 2 have no immunity to 1 type of virus.
• HIV-3 and 4: rare variations, do not particularly affect the spread of HIV. In the formation of a pandemic (a general epidemic covering countries on different continents), HIV-1 and 2 are of primary importance, with HIV-2 being more common in West African countries.

Development of AIDS

Normally, the body is protected from the inside: the main role is played by cellular immunity, in particular lymphocytes. T-lymphocytes produces thymus (thymus gland), according to their functional duties, they are divided into T-helpers, T-killers and T-suppressors. Helpers“Recognize” tumor cells and cells damaged by viruses, and activate T-killers, which are involved in the destruction of atypical formations. T-suppressors regulate the direction of the immune response, preventing them from triggering a reaction against their own healthy tissues.

A virus-infected T-lymphocyte becomes atypical, the immune system reacts to it as a foreign formation and "sends to the aid" T-killers. They destroy the former T-helper, the capsids are released and take with them part of the lipid membrane of the lymphocyte, becoming unrecognizable for the immune system. Further, the capsids disintegrate, and new virions are introduced into other T-helpers.

Gradually, the number of helper cells decreases, and inside the human body the “friend or foe” recognition system ceases to function. In addition to this, HIV activates the mechanism of mass apoptosis(programmed death) of all types of T-lymphocytes. The result is active inflammatory reactions to resident (normal, permanent) and conditionally pathogenic microflora, and at the same time, an inadequate response of the immune system to really dangerous fungi and tumor cells. Immunodeficiency syndrome develops, characteristic symptoms of AIDS appear.

Clinical manifestations

Symptoms of HIV depend on the period and stage of the disease, as well as on the form in which the effect of the virus is predominantly manifested. Periods of HIV divided into incubation, when there are no antibodies to the virus in the blood, and clinical - antibodies are determined, the first signs of the disease appear. V clinical distinguish stages HIV:

1. Primary, including two shape- asymptomatic and acute infection without secondary manifestations, with concomitant diseases;
2. Latent;
3. AIDS with secondary diseases;
4. Terminal stage.

I. Incubation period, the time from the moment of HIV infection until the onset of symptoms is called the serological window. Serum reactions to the immunodeficiency virus are negative: specific antibodies have not yet been detected. The average incubation time is 12 weeks; terms can be reduced to 14 days with concomitant STDs, tuberculosis, general asthenia, or increase to 10-20 years. During the entire period, the patient dangerous as a source of HIV infection.

II. Stage of primary manifestations of HIV characterized by seroconversion- the appearance of specific antibodies, serological reactions become positive. The asymptomatic form is diagnosed only by a blood test. Acute HIV infection occurs 12 weeks after infection (50-90% of cases).

First signs are manifested by fever, various types of rash, lymphadenitis, sore throat (pharyngitis). Possible bowel disorder - diarrhea and pain in the abdomen, enlarged liver and spleen. Typical laboratory sign: mononuclear lymphocytes, which are found in the blood at this stage of HIV.

Secondary diseases appear in 10-15% of cases against the background of a transient decrease in the number of T-helper lymphocytes. The severity of the diseases is moderate and can be treated. The duration of the stage is on average 2-3 weeks, in most of the patients it becomes latent.

Forms acute HIV infections:

III. Latent stage of HIV, lasts up to 2-20 years or more. Immunodeficiency progresses slowly, HIV symptoms are expressed lymphadenitis- an increase in lymph nodes. They are elastic and painless, mobile, the skin retains its normal color. When diagnosing latent HIV infection, the number of enlarged nodes is taken into account - at least two, and their localization is at least 2 groups that are not connected by a common lymph flow (the exception is the inguinal nodes). Lymph moves in the same direction as venous blood, from the periphery to the heart. If 2 lymph nodes are enlarged in the head and neck area, then this is not considered a sign of the latent stage of HIV. The concomitant increase in the groups of nodes located in the upper and lower parts of the body, plus a progressive decrease in the number of T-lymphocytes (helpers) are in favor of HIV.

IV. Secondary diseases, with periods of progression and remission, depending on the severity of manifestations, is divided into stages (4 A-B). Persistent immunodeficiency develops against the background of massive death of T-helpers and depletion of lymphocytic populations. Manifestations - various visceral (internal) and cutaneous manifestations, Kaposi's sarcoma.

V. Terminal stage irreversible changes are inherent, treatment is ineffective. The number of T-helpers (CD4 cells) falls below 0.05x109 / L, patients die in weeks or months from the onset of the stage. In drug addicts who have been using psychoactive substances for several years, the CD4 level can remain almost within the normal range, but severe infectious complications (abscesses, pneumonia, etc.) develop very quickly and lead to death.

Kaposi's sarcoma

Sarcoma ( angiosarcoma) Kaposi is a tumor emanating from the connective tissue and affecting the skin, mucous membranes and internal organs. It is provoked by the herpes virus HHV-8; more common in men with HIV. The epidemic type is one of the reliable signs of AIDS. Kaposi's sarcoma develops in stages: it begins with the appearance stains 1-5 mm in size, irregular in shape, bright bluish-red or brown color, with a smooth surface. With AIDS, they are bright, localized on the tip of the nose, hands, mucous membranes and on the hard palate.

Then formed tubercles- papules, round or semicircular, up to 10 mm in diameter, elastic to the touch, can merge into plaques with a surface similar to an orange peel. Bumps and plaques transform into nodular tumors 1-5 cm in size, which merge with each other and are covered ulcers... At this stage, sarcoma can be confused with syphilitic gummas. Syphilis is often combined with the immunodeficiency virus, like hepatitis C, shortening the incubation period and provoking the rapid development of acute AIDS symptoms - lymphadenitis, lesion internal organs.

Kaposi's sarcoma is clinically divided into shape- acute, subacute and chronic. Each is characterized by the rate of tumor development, complications and prognosis regarding the duration of the disease. At acute form, the process spreads rapidly, intoxication and extreme exhaustion become the cause of death ( cachexia), the lifetime is from 2 months to a maximum of 2 years. At subacute the course of symptoms increases more slowly, the prognosis of life expectancy is 2-3 years; for a chronic form of sarcoma - 10 years, possibly more.

HIV in children

Incubation period lasts about a year if HIV is passed from mother to fetus. When infected through blood (parenteral) - up to 3.5 years; after transfusion of contaminated blood, the incubation is short, 2-4 weeks, and the symptoms are severe. HIV infection in children proceeds with a predominant lesion nervous system (up to 80% of cases); long, lasting up to 2-3 years, bacterial inflammation; with damage to the kidneys, liver and heart.

Very often develops pneumocystis or lymphocytic pneumonia, inflammation of the parotid salivary glands ( mumps, he's a pig). HIV manifests itself in congenital dysmorphic syndrome- impaired development of organs and systems, in particular microcephaly - reduced size of the head and brain. A decrease in the level of proteins of the gamma-globulin fraction in the blood is observed in half of those infected with HIV. Highly rare Kaposi's sarcoma and hepatitis C, B.

Dysmorphic syndrome or HIV embryopathy determined in children infected with early terms of pregnancy. Manifestations: microcephaly, a nose without membranes, the distance between the eyes is increased. The forehead is flat, upper lip split and protrudes forward. Strabismus, eyeballs pushed outward ( exophthalmos), bluish cornea. Growth retardation is observed, development does not correspond to the norms. Forecast for life is mostly negative, mortality is high during 4-9 months of life.

Manifestations of neuro-AIDS: chronic meningitis, encephalopathy(damage to brain tissue) with the development of dementia, damage to peripheral nerves with symmetric disorders of sensitivity and trophism in the arms and legs. Children significantly lag behind in development from their peers, are prone to seizures and muscle hypertonia, paralysis of the limbs may develop. Diagnosis of HIV neuro-symptoms is based on clinical signs, blood test data, and computed tomography. Layered images reveal atrophy(reduction) of the cerebral cortex, expansion of the cerebral ventricles. With HIV infection, calcium deposits are characteristic in the basal nerve nodes (ganglia) of the brain. The progression of encephalopathy is fatal within 12-15 months.

Pneumocystis pneumonia: in children of the 1st year of life, it is observed in 75% of cases, over a year - in 38%. Often, pneumonia develops by the age of six months, manifestations - high fever, rapid breathing, dry and constant cough. Excessive sweating, especially at night; weakness that only gets worse over time. Pneumonia is diagnosed after auscultation (according to the stages of development, first weakened breathing is heard, then small dry rales, in the stage of resolution - crepitus, the sound is heard at the end of inhalation); X-ray (enhancement of the pattern, infiltration of the pulmonary fields) and microscopy of biomaterial (detect pneumocysts).

Lymphocytic interstitial pneumonia: a unique disease associated specifically with childhood AIDS, no concomitant infections. Septa between the alveoli and the tissue around the bronchi are thickened, where lymphocytes and others are determined immune cells... Pneumonia begins imperceptibly, develops slowly, among initial symptoms a prolonged dry cough and dry mucous membranes are typical. Then shortness of breath appears and respiratory failure sharply increases. The x-ray shows the compaction of the pulmonary fields, enlarged lymph nodes in the mediastinum - the space between the lungs.

Laboratory tests for HIV

The most common method for diagnosing HIV is (ELISA or ELISA test), with the help of it, it is detected for the immunodeficiency virus. Antibodies to HIV are formed in the period from three weeks to 3 months after infection, are detected in 95% of cases. Six months later, HIV antibodies are found in 9% of patients, later - in only 0.5-1%.

As biomaterial use a blood serum taken from a vein. You can get a false-positive ELISA result if HIV infection is accompanied by autoimmune (lupus, rheumatoid arthritis), oncological or chronic infectious diseases (tuberculosis, syphilis). A false-negative answer occurs during the period of the so-called. seronegative window, when antibodies in the blood have not yet appeared. In this case, to control blood for HIV, you need to donate again, after a pause of 1 to 3 months.

If the ELISA is assessed positively, the HIV test is duplicated using a polymerase chain reaction, determining the presence of the RNA of the virus in the blood. The technique is highly sensitive and specific, does not depend on the presence of antibodies to the immunodeficiency virus. Immune blotting is also used to find antibodies to HIV protein particles with precise molecular weights (41, 120 and 160 thousand). Their identification gives the right to make a final diagnosis without confirmation by additional methods.

HIV test necessarily is done only during pregnancy, in other cases, a similar examination is voluntary. Doctors have no right to disclose the diagnosis, all information about patients and those infected with HIV is confidential. Patients have the same rights as healthy people. For the deliberate spread of HIV, criminal punishment is provided (Article 122 of the Criminal Code of the Russian Federation).

Treatment principles

HIV treatment is prescribed after clinical examination and laboratory confirmation of the diagnosis. The patient is constantly monitored, repeated blood tests are performed during antiviral therapy and after treatment of HIV manifestations.

A cure for HIV has not yet been invented, a vaccine does not exist. It is impossible to remove the virus from the body, and this is a fact at this time. However, one should not lose hope: active antiretroviral therapy (HAART) can reliably slow down and even practically stop the development of HIV infection and its complications.

The life expectancy of patients receiving modern treatment is 38 years (for men) and 41 years (women). An exception is the combination of HIV with hepatitis C, when the 5-year survival threshold reaches less than half of the patients.

HAART- a technique based on the use of several pharmaceuticals at once, which affect various mechanisms of the development of HIV symptoms. Therapy combines several goals at once.

1. Virological: block the multiplication of the virus in order to reduce the viral load (the number of HIV copies in 1 ml3 of blood plasma) and fix it at a low level.
2. Immunological: stabilize the immune system to raise the level of T-lymphocytes and restore the body's defenses against infections.
3. Clinical: to increase the life of HIV-infected people, to prevent the development of AIDS and its manifestations.

Virological treatment

The human immunodeficiency virus is exposed to drugs that prevent it from attaching to the T-lymphocyte and getting inside - this is inhibitors(suppressors) penetration... A drug Celsentri.

The second group of drugs is viral protease inhibitors, which is responsible for the formation of full-fledged viruses. When it is inactivated, new viruses are formed, but they cannot infect new lymphocytes. Drugs Kaletra, Viracept, Reataz and etc.

The third group - inhibitors of reverse transcriptase, an enzyme that helps the reproduction of viral RNA in the nucleus of a lymphocyte. Drugs Zinovudine, Didanosine There are also combination HIV medications that need to be taken only once a day - Trizivir, Combivir, Lamivudin, Abacavir.

With the simultaneous action of drugs, the virus cannot get inside the lymphocytes and "multiply". When appointing triple therapy the ability of HIV to mutate and develop insensitivity to drugs is taken into account: even if the virus becomes immune to one drug, the remaining two will act. Dosage are calculated for each patient, taking into account the state of health and possible side effects... A separate regimen is used for pregnant women, and after the use of HAART, the frequency of HIV transmission from mother to child decreases from 20-35% to 1-1.2%.

It is important to take your medications at the same time for the rest of your life.: in case of violation of the schedule or interruption of the course, treatment completely loses its meaning. Viruses quickly change the genome, becoming immune ( resistant) to therapy, and form numerous resistant strains. With such a development of the disease, it is very problematic to choose antiviral treatment, and sometimes it is simply impossible. Cases of development of resistance are more often observed among HIV-infected drug addicts and alcoholics, for whom strict adherence to the therapy schedule is unrealistic.

The drugs are effective, but the prices are high. For example, the cost of a year's treatment with "Fuzeon" (a group of penetration inhibitors) reaches $ 25 thousand, and the cost per month when using "Trisivir" is from $ 1000.

note that farm. funds almost always have two names - by the active substance and the commercial name of the drug, which the manufacturer gave it. The prescription should be written exactly by active substance, indicating its amount in a tablet (capsule, ampoule, etc.). Substances of the same action are often presented under different commercial names and can vary significantly in price. The pharmacist's job is to offer the patient a choice of several options and to provide guidance on cost. Generics- analogs of original developments are always much cheaper than “branded” drugs.

Immunological and clinical treatment

An immunostimulant drug is used Inosine pranobex, due to which the level of lymphocytes increases, the activity of some leukocyte fractions is stimulated. The anti-viral action indicated in the annotation does not apply to HIV. Indications relevant for HIV-infected: viral hepatitis C, B; immunodeficiency states; cytomegalovirus; herpes simplex virus type 1; mumps. Dosage: adults and children 3-4 times / day. at the rate of 50-100 mg / kg. Well 5-15 days, can be repeated many times, but only under the supervision of an infectious disease specialist. Contraindications: increased blood uric acid ( hyperuricemia), kidney stones, systemic diseases, pregnancy and breastfeeding.

Interferon group drug Viferon possesses antiviral and immunomodulatory activity. In the case of HIV (or AIDS), it is used for Kaposi's sarcoma, mycoses and hairy cell leukemia. The action of the drug is complex: interferon enhances the activity of T-helpers and increases the production of lymphocytes, blocks the multiplication of viruses in several ways. Additional components - vit. C, E - protect cells, and the effectiveness of interferon increases 12-15 times (synergistic effect). Viferon can be taken in long courses, its activity does not decrease over time. In addition to HIV, indications are any viral infections, mycoses (including internal organs), hepatitis C, B or D. When administered rectally the drug is used twice a day for a course of 5-10 days, ointment for HIV is not used. Pregnant women are prescribed from 14 weeks.

Treatment of pulmonary manifestations

The main early manifestation of HIV infection is inflammation of the lungs.to their caused by pneumocystis (Pneumocystis carina), unicellular organisms similar to fungi and protozoa at the same time. In patients with AIDS, untreated Pneumocystis pneumonia is fatal in 40%, and correct and timely prescribed therapeutic regimens help to reduce the mortality rate by up to 25%. With the development of relapse, the prognosis worsens, recurrent pneumonia is less sensitive to treatment, and the mortality rate reaches 60%.

Treatment: basic drugs - biseptol (bactrim) or pentamidine... They act in different directions, but ultimately lead to the death of pneumocysts. Biseptol is taken orally, pentamidine is injected into a muscle or vein. The course is from 14 to 30 days, with AIDS it is preferable to use pentamidine. Together, drugs are not prescribed, because their toxic effect increases without a noticeable increase in the therapeutic effect.

Low-toxic drug DFMO (alpha-difluoromethylornithine) acts on pneumocysts and at the same time blocks the reproduction of retro viruses, which include HIV, and also has a beneficial effect on lymphocytes. The course is 2 months, the daily dosage is calculated on the basis of 6 g per 1 sq. meter of body surface and break it into 3 steps.

With adequate treatment of pneumonia, the improvement is noticeable already 4-5 days from the start of therapy, after a month in a quarter of patients, pneumocysts are not detected at all.

Immunity to HIV

Proven HIV Resistance Statistics: among Europeans, 1% are completely immune to the immunodeficiency virus, up to 15% - partially... In both cases, the mechanisms are not clear. Scientists associate this phenomenon with the bubonic plague epidemics in Europe in the fourteenth and eighteenth centuries (Scandinavia), when, possibly, in some people, early genetic mutations were entrenched in heredity. There is also a group of so-called. “Non-progressors”, who make up about 10% of those infected with HIV, in whom AIDS symptoms do not appear for a long time. In general, there is no immunity to HIV.

A person is immune to the HIV-1 serotype if his body produces the TRIM5a protein, which is able to “recognize” the viral capsid and block HIV multiplication. CD317 protein can hold viruses on the surface of cells, preventing them from infecting healthy lymphocytes, and CAML makes it difficult for new viruses to be released into the blood. The useful activity of both proteins is violated by hepatitis C and simple viruses, therefore, with these concomitant diseases, the risks of HIV infection are higher.

Prophylaxis

The fight against the AIDS epidemic and its consequences is declared by WHO:

HIV prevention among drug addicts means raising awareness of the danger of infection through injection, providing disposable syringes and exchanging used for sterile ones. The latest measures seem strange and are associated with the spread of drug addiction, but in this case it is easier to at least partially stop the pathways of HIV infection than to wean a huge number of drug addicts.

HIV first aid kit is useful in everyday life for everyone, in the workplace - to doctors and rescuers, as well as people in contact with HIV infected. Medicines are available and elementary, but their use actually reduces the risk of infection with the immunodeficiency virus:

• Alcoholic solution of iodine 5%;
• Ethanol 70%;
• Dressing equipment (packaging of sterile gauze tampons, bandage, plaster) and scissors;
• Sterile distilled water - 500 ml;
• Crystals of potassium permanganate (potassium permanganate) or hydrogen peroxide 3%;
• Eye pipettes (sterile, packaged or in a case);
• Specific drugs are provided only for physicians working at blood sampling stations and in admission departments of hospitals.

Blood trapped on the skin from an HIV-infected person, you must immediately wash off with water and soap, then treat with a swab dipped in alcohol. In case of an injection or cut through gloves they need to be removed, blood squeezed out, hydrogen peroxide on the wound; then blot the foam, and cauterize the edges of the wound with iodine and, if necessary, apply a bandage. Hit in the eyes: rinsing first with water, then with potassium permanganate solution (slightly pink). Oral cavity: Rinse with poor pink potassium permanganate, then with 70% ethanol. After unprotected intercourse: if possible - shower, then treatment (douching, washing) of the genitals with a saturated pink solution of potassium permanganate.

AIDS prevention will be more effective if everyone becomes conscious about their health. It is much easier to use a condom during sexual intercourse and to avoid unwanted acquaintances (prostitutes, drug addicts), than then long and expensive treatment. To understand the picture of the danger of HIV, just compare the statistics: for a year from a fever Ebola about 8000 people died, and from HIV - more than 1.5 million! conclusions obvious and disappointing - in modern world the immunodeficiency virus has become a real threat to all of humanity.

Video: HIV educational film

Video: AIDS in the program “Life is great!”

According to UNAIDS, the United Nations Organization Against AIDS, we have compiled a list of countries where you should be especially careful not to contract the "plague of the 20th century."

The topic of the article is not the most pleasant, but "forewarned is forearmed", the problem exists and just turning a blind eye to it is an unforgivable carelessness. Travelers often risk their health, fortunately, with fewer consequences, but you shouldn't put yourself in danger anyway.

Although the country is the most developed on the African continent, the number of HIV-infected here is a record 5.6 million. This is despite the fact that there are 34 million patients in the world, and the population of South Africa is about 53 million, that is, more than 15% live with the virus.

What you need to know: most of those living with HIV are blacks from disadvantaged suburbs. It is this group that is in the worst social conditions with all the ensuing consequences: drug addiction, promiscuous sex, unsanitary conditions. Most of the patients were recorded in the provinces of KwaZulu-Natal (capital - Durban), Mpumalanga (Nelspreid), Freestate (Blomfontien), Northwest (Mafikeng) and Gauteng (Johannesburg).

Nigeria

Here, there are 3.3 million carriers of HIV infection, although this is less than 5% of the population: Nigeria recently ousted Russia, taking 7th place in the world - 173.5 million people. In large cities, the disease spreads due to asocial behavior, and in rural areas due to constant labor migration and "free" customs and traditions.

What you need to know: Nigeria is not the most hospitable country and the Nigerians themselves are well aware of this. Therefore, the receiving party will surely take care of safety and warn against dangerous contacts.

Kenya

The country accounts for 1.6 million infected, just over 6% of the population. At the same time, women are more likely to suffer from the disease - about 8% of Kenyans are infected. As in many African countries, the status of women, and hence the level of her safety and education, is still very low.

What you need to know: safari in national park or a beach and hotel vacation in Mombasa are quite safe activities, unless, of course, on purpose, you are not looking for illegal entertainment.

Tanzania

It is quite a tourist-friendly country with a bunch of interesting places, which is also dangerous in terms of HIV infection, although not like many other states in Africa. According to the latest research, the incidence of HIV / AIDS in Tanzania is 5.1%. There are fewer infected men, but the gap is not as significant as, for example, in Kenya.

What you need to know: Tanzania, by African standards, is a fairly prosperous country, therefore, if you follow the obvious rules, the threat of infection is minimal. A high, over 10, percentage of infected in the Njobe region and the capital Dar es Salaam. Fortunately, both of them are far from the tourist routes, unlike Kilimanjaro or the island of Zanzibar.

Mozambique

The country is deprived not only of sights, but also of basic infrastructure from hospitals to roads and water pipes. In addition, many consequences civil war still not resolved. Of course, an African country in this state could not avoid an epidemic: according to various estimates, from 1.6 to 5.7 people were infected - conditions simply do not allow an accurate study. Due to the wide spread of the immunodeficiency virus, foci of tuberculosis, malaria and cholera often break out.

What you need to know: a dysfunctional country, an outsider even in its own region. The chance of infection is higher here than in others, so you need to be especially careful about precautions.

Uganda

A country with good potential for classic safari tourism, which it is actively developing in recent times... Plus, Uganda has been and remains one of the most progressive countries in terms of HIV prevention and diagnosis in Africa. The first specialized clinic was opened here, and disease testing centers operate throughout the country.

What you need to know: risk groups are the same as everywhere else: drug addicts, ex-prisoners - it will not be difficult for a sane tourist not to intersect with them.

Zambia and Zimbabwe

These countries are very similar, even the main attraction, they have one for two: Victoria Falls is located right on the border - tourists can come to it from both sides. In terms of living standards and the incidence of AIDS, the countries are also not far from each other - in Zambia there are almost a million infected, in Zimbabwe - 1.2. This is the average for southern Africa - from 5% to 15% of the population.

What you need to know: there are problems with the provision of medicines, in addition, in rural areas, many self-medicate and practice useless rituals. Therefore, the disease, typical for cities, has reached remote areas.

India

There are 2.4 million HIV-infected here, although against the background of 1.2 billion of the population, this does not look so frightening - less than 1%. The main risk group is sex workers. 55% of Indians live in the four southern states - Andhra Pradesh, Maharashtra, Karnataka and Tamil Nadu. In Goa, the incidence rate is far from the highest for India - 0.6% for men and 0.4% for women.

What you need to know: Fortunately, HIV infection, unlike many other tropical ailments, is indirectly dependent on unsanitary conditions. Outright dirt and tightness is a normal condition in India. The main thing, as, by the way, in any country, is to try not to appear in public places if there are wounds and cuts on the body, not to wear open shoes in the city, and we are not even talking about dubious entertainment.

Ukraine

Eastern Europe, unfortunately, over the past decades has shown a positive trend in the incidence of HIV / AIDS, and Ukraine is consistently at the top of this sad list. Today, a little more than 1% of people in the country are HIV-infected.

What you need to know: a few years ago, unprotected sex became a way of spreading the disease, overtaking injections with dirty syringes. Dnepropetrovsk, Donetsk, Odessa and Nikolaev regions are unfavorable. There, per 100 thousand inhabitants, there are 600-700 infected. Kiev, where tourists most often come, has an average level, and the lowest rate in the country is in Transcarpathia.

America is in 9th place in the world in terms of the number of carriers of HIV infection - 1.2 million people. Such a high indicator in one of the most prosperous countries is due to the high level of drug addiction, unresolved social contradictions, and active migration. And the violent, loose 60s were not in vain for the health of the nation. Of course, the disease concentrates on specific groups of people who in the United States most often live not so much separately from everyone else, but localized, in "bad" areas.

What you need to know: Here are ten cities where the percentage of HIV-positive patients is highest (in descending order): Miami, Baton Rouge, Jacksonville, New York, Washington, Columbia, Memphis, Orlando, New Orleans, Baltimore.

HIV infection in the world is one of the most progressive sexually transmitted diseases. It is also worth noting that AIDS statistics in the world, as a rule, absolutely do not correspond to the true picture of the spread of the disease, since research methods are based only on patients who are served in medical institutions. At the same time, most carriers of the infection and patients are not even aware of their infection due to the reluctance or lack of opportunity to see a doctor.

Another factor contributing to the concealment of truthful information about the spread of AIDS in the world is the fear of politicians and doctors to be blamed for the inability to contain the avalanche of infection that is rapidly moving towards humanity.

The state of the spread of HIV in the world

The number of HIV-infected in the world is growing exponentially. This is primarily due to the fact that the problem of AIDS in the world does not lend itself to the basic rules for combating infectious diseases, which are based on the exclusion of one of the components of the epidemiological process:

1. The source of the disease.
2. Transmission path.
3. A receptive contingent.

In the countries of the world, HIV has long become the number one problem. For the spread of each infection, a source is needed, a route of transmission that ensures that the virus reaches a susceptible population. In the case of HIV, there is no way to act on any of the three components that contribute to the spread of the disease. A huge problem is the fact that most people become infected from carriers of the virus, who are in the so-called "serological window", when a person is already infected, but the tests are still negative. It has not been possible to exclude the latter factor for many decades, since the invention of a vaccine against immunodeficiency has been postponed indefinitely due to lack of knowledge, research and technical capabilities.

Considering the above, the statistics of HIV in the world will worsen every year, as many inhabitants of the planet underestimate the danger of the immunodeficiency virus. The current HIV epidemic situation in the world can only be influenced by the awareness of the population and support for the fight against AIDS at the state level.

Prevalence of HIV infection (AIDS) in the world

Only by the end of the eighties, the statistics of HIV-infected in the world reached indicators that shocked the world community. In 142 countries, the World Health Organization has detected more than 120 thousand people with AIDS and more than 100 thousand infected with a retrovirus. The real prevalence of HIV in the world is much higher than these data, since there is always a percentage of the population that is not registered with medical institutions and therefore cannot be taken into account in statistical indicators. There are also carriers who are not even aware of their infection. The AIDS epidemic in the world affects mainly people of reproductive age. This leads to a significant loss of the able-bodied population, a decrease in the birth rate of healthy children and, accordingly, a decrease in the health indicator of all layers of humanity.

How many HIV-infected are in the world?

The question that interests many is how many people are sick with AIDS in the world today? The countries of southern Africa, India, Russia, the USA and Latin America occupy the first place in terms of HIV in the world. In these states, infected people make up approximately 15% of the total population. Every year the number of HIV-infected in the countries of the world increases by 5-10 million. So, at the beginning of the XXI century, the number of AIDS patients in the world amounted to more than 60 million. The first place in AIDS in the world community is occupied by the countries of southern Africa. Due to the unstable economic situation, the ability to treat and identify HIV-infected is very difficult. This leads to the rapid and rapid spread of immunodeficiency among humans. The disease progresses very quickly to stage 4 - AIDS.

Epidemiological situation of HIV infection in the world

Countries in which the incidence of immunodeficiency is rapidly increasing:

1. Brazil.
2. countries of Central Africa.
3. Haiti.
4. Indonesia.
5. Bangladesh.
6. Pakistan.
7. Mexico.
8. United Kingdom.
9. Turkey.

The ways in which AIDS spreads around the world in some way depends on economic situation in the state and on its policy in relation to HIV-infected. There are such features:

1. The countries of the European Union, the USA, Australia and New Zealand are characterized by a high early detection of the disease among the population. This is due to compulsory health insurance and relatively frequent high-quality medical examinations. According to the results of the study, it can be concluded that 80% of the infected were identified among homosexual men and drug addicts who use intravenous drugs. In childhood, the incidence is practically not recorded. This is due to the timely and high-quality treatment of infected pregnant women, which prevents the vertical transmission of immunodeficiency (from a sick mother to a healthy fetus through the placenta, blood, breast milk). Non-sexual infections in these countries are practically not recorded.
2. For the states of Africa and the adjacent warm islands, as well as the states of the Caribbean, Indonesia, the rate of early detection of AIDS is very low. In these countries, most patients are heterosexual. Their age is 18-38 years old. Most of these people became infected through sexual contact with prostitutes. Studies show that more than 90% of them are infected with a retrovirus. In Africa, HIV transmission is often associated with sexual contact with a sick woman. More often, such intercourse additionally leads to diseases that are sexually transmitted. And genital ulcers that develop due to these pathologies lead to a higher probability of transmission of the pathogen. In such states, transfusion of blood and blood products from an infected donor to a healthy recipient is not uncommon.
3. Countries where HIV has been introduced relatively recently. These include Asia and Eastern Europe. Retrovirus infection here occurs mainly through sexual contact. The highest risk of infection in people who have multiple sexual partners does not neglect unprotected relationships with prostitutes.

HIV in Russia

The Ural Federal District ranks first in terms of HIV in the Russian Federation. It registered about 800 patients per 100 thousand of the population, which is a very high indicator. Over the past 15 years, cases of detection of immunodeficiency in pregnant women have increased by 15% in Russia. Moreover, such women will be registered in late dates, which leads to intrauterine infection of the fetus due to the lack of the necessary treatment in the early stages of embryo formation. Also, the Siberian Federal District claims the first place in AIDS in Russia, in which about 600 infected people are registered per 100 thousand of the population, of which most of them have the last stage of the development of the disease, that is, AIDS.

Medical news in the world of HIV

Nowadays, the task of creating a vaccine against a retrovirus in scientists is in the first place. There is a huge amount of research works in the field of molecular microbiology, which undoubtedly brings mankind closer to the creation of an AIDS vaccine. Despite this, there are a number of factors that impede the possibility of obtaining such a drug:

• The high ability of the virus to mutate.
• A variety of strains of HIV (currently 2 types are known).
• The need to fight not only the retrovirus, but also the infected cells of the body, as well as AIDS-associated infections.

Due to the fact that the spread of HIV in the world is growing every year, many patients simply do not have time to wait for a vaccine. Therefore, the main way in the fight against this disease should be directed towards preventive measures. All HIV-positive people in the world receive free treatment, which provides them with the most comfortable life. With adequate and competent therapy, patients can live a full and long life. HIV treatment in the world is carried out in regional AIDS centers according to uniform standards and provides an individual approach to any patient, selection of a scheme depending on the stage of pathology progression. The main principle of rendering medical care is the maximum confidentiality.

AIDS is constantly spreading among the world's population, while it is not yet possible to completely cure it. Therefore, it is worth directing maximum efforts to the prevention of such a dangerous pathology.

Last week it became known that every 50th inhabitant of Yekaterinburg is infected with HIV. Today, the Ministry of Health officially announced that an increased level of the spread of the disease is observed in 10 regions, including the Sverdlovsk region. Life found out which regions of the country are most likely to contract a deadly disease.

On November 2, Tatyana Savinova, First Deputy Head of the Health Department of the Yekaterinburg City Administration, announced the immunodeficiency virus pandemic in the Ural capital. According to her, the disease is firmly rooted in all segments of the city's population and the spread of the disease no longer depends on risk groups. In total, 26 693 cases of HIV infection were registered in Yekaterinburg, but this includes only officially known cases, so the real incidence is much higher.

Later, the city health department information about the epidemic, and the refutation was made by itself Savinova. According to her, on NS reporters asked her a question about the situation in Yekaterinburg at the ress-conference. And in response, she just " voiced the data broadcast in the media. "

Of course, for us, doctors, this has long been an HIV epidemic, since many people are sick in Yekaterinburg, ”the official said. “It didn't happen yesterday and nothing was officially announced.

Today, the head of the Ministry of Health of the Russian Federation, Veronika Skvortsova, that an increased level of HIV prevalence has been recorded in 10 regions Russia.

We have 57% of all sources of HIV infection - this is the injection route, as a rule, among heroin addicts, she added.

Meanwhile, according to experts, it is really high time to declare the epidemic officially, and on a national scale.

The epidemic is spreading throughout the country, and only one administrator (the administration of one region. - Approx. ed.) admit it. There is an unevenness: the population of cities is more affected. And where the urban population is higher than the rural population, the percentage of those affected is higher. This is the Volga region, the Urals, Siberia. These are signs of a general epidemic that we have, - told Life Director of the Federal Methodological Center for the Prevention and Control of AIDS, Deputy Director of the Central Institute of Epidemiology Vadim Pokrovsky.

To prove the above, the head of the center cited figures.

Now we have 1% of the population infected with HIV, and in the age group 30-40 years old - 2.5%. Every day we register a total of 270 new cases of HIV infection in the country, 50-60 people die from AIDS every day. What else do you need to talk about an epidemic? - asked Pokrovsky.

In Yekaterinburg, the situation with HIV is not even the worst. Every 50th inhabitant of the city (2% of the population) is infected there. But in Togliatti (Samara region), as told by r Head of the Federal Scientific and Methodological Center for the Prevention and Control of AIDS Vadim Pokrovsky,already 3% of the population are HIV-positive.

On the Life map, you can find your region and see how many cases are among your fellow countrymen.

The share of HIV-infected people in the total population of the region

As you can see, the epidemic covered Russia unevenly. Half of all those infected live in 20 of the 85 regions. The worst situation is in the Irkutsk and Samara regions (1.8% of residents are infected with HIV). In third place is the Sverdlovsk Region, the capital of which is Yekaterinburg (1.7% of residents are infected with HIV).

Slightly fewer infected people are in the Orenburg Region (1.4%), the Leningrad Region (1.3%), and the Khanty-Mansi Autonomous Okrug (1.3%).

And here are the statistics on the mortality of HIV-infected by region (data Federal Center AIDS, dated 2014, more recent statistics are not yet available).

As of December 31, 2014 in Russia 148,713 HIV-positive adults and 683 children died. In 2014, 24.4 thousand HIV-positive died.

Pokrovsky explained why HIV "chose" these particular regions:

These are the regions where drug trafficking took place, for example, the Orenburg region. As well as materially prosperous parts of the country where it was easier to sell drugs (Irkutsk and Sverdlovsk regions).

The mayor of Yekaterinburg, Yevgeny Roizman, also says that most HIV-positive people got infected because of drugs.

I started talking about this in 1999, - he noted. - Of those drug addicts who passed through my hands, the guys are heroin addicts, 40% of them were HIV-infected. Girls are heroin addicts, if without HIV infection - this was an event. Moreover, they were all, as a rule, also prostitutes. Then, when what was called a crocodile went, everyone was there with HIV. They could buy disposable syringes, but they collected from one bowl. Now there is a sexual spread. Indeed, we are ahead of all of Russia. The situation in the Sverdlovsk region is worse than in Yekaterinburg. Ahead of the whole of Russia - it was connected with drug addiction, - said Yevgeny Roizman.

Vadim Pokrovsky emphasized that among the main problems in this area is the lack of medicines.

Now it is necessary to treat a little more than 800 thousand HIV-infected people. 220 thousand have died, and, according to estimates, another 500 thousand have not yet been diagnosed in our country, '' Pokrovsky noted.

Earlier Pokrovsky, which is bad with prevention.

There are no strategic programs to combat AIDS in the regions, - says Vadim Pokrovsky. “As a result, they will print and post several posters and leaflets. This is where the prevention ends.

It turns out to be a vicious circle.

People do not even suspect how difficult the situation with HIV is in Russia, - says Vadim Pokrovsky. - Information is the main method of combating the spread of disease. In addition, this is also cost savings, because what less people gets infected, the less then you have to treat.

Online Q&A
November 2016

What is HIV?

The Human Immunodeficiency Virus (HIV) infects cells of the immune system, destroying or disrupting its function. Infection with the virus leads to progressive degradation of the immune system and, as a result, to "immunodeficiency". The immune system is considered defective when it can no longer fulfill its role in the fight against infection and disease. Infections associated with severe immunodeficiency are known as "opportunistic infections" because they "take advantage" of a weakened immune system.

What is AIDS?

Acquired Immunodeficiency Syndrome (AIDS) is a term applied to the very late stages of HIV infection. It is characterized by the occurrence of any of the more than 20 opportunistic infections or HIV-related cancers.

How is HIV transmitted?

HIV can be transmitted through unprotected sex (vaginal or anal) and oral sex with an infected person; with contaminated blood transfusion; and sharing contaminated needles, syringes, or other sharp instruments. It can also be passed from mother to child during pregnancy, childbirth and breastfeeding.

How many people in the world are infected with HIV?

According to WHO and UNAIDS estimates, at the end of 2015, there were 36.7 million people living with HIV worldwide. In the same year, about 2.1 million people became infected, and 1.1 million people died from HIV-related causes.

How quickly does an HIV-infected person develop AIDS?

This period of time varies widely from person to person. If untreated, most HIV-infected people develop signs of HIV-related illness within 5-10 years, and possibly sooner. After acquiring HIV infection, it usually takes 10-15 years before AIDS is diagnosed, and sometimes even more. Antiretroviral therapy (ART) can slow disease progression by preventing viral replication and therefore reducing the amount of viruses (known as “viral load”) in an infected person's blood.

What is the most common life-threatening opportunistic infection that affects people with HIV / AIDS?

In 2015, almost 390,000 people living with HIV died from tuberculosis. It is the leading cause of death among people living with HIV in Africa and one of the leading causes of death among this population worldwide. There are a number of key health strategies that are critical for the prevention and management of tuberculosis infection in people living with HIV.

• routine screening for tuberculosis symptoms at every doctor visit;
• management of latent tuberculosis infection (for example, preventive treatment with isoniazid);
• fight against tuberculosis infection;
• early initiation of antiretroviral therapy.

How can I reduce the risk of HIV transmission through sexual intercourse?

• correct use of male or female condoms at every sexual encounter;
• take antiretroviral drugs for pre-exposure prophylaxis of HIV (PrEP)
• engage in only non-penetrating sex;
• remain faithful in a relationship with an uninfected and equally loyal partner and avoid any other forms of risky behavior.

Does male circumcision prevent HIV transmission?

Male circumcision reduces the risk of acquiring HIV during sex between men and women by about 60%.

A one-time medical male circumcision procedure provides life-long partial protection against HIV as well as other sexually transmitted infections. Male circumcision should always be seen as part of an overall HIV prevention package and in no way replaces other known prevention methods such as male and female condoms.

How effective are condoms in HIV prevention?

When used correctly at every sexual encounter, condoms are a reliable way to prevent HIV infection in women and men. However, no method of protection other than abstinence is 100% effective.

What is a female condom?

The female condom is the only woman-controlled contraceptive barrier method currently available on the market. The female condom is a durable, soft, transparent polyurethane cap that is inserted into the vagina before sexual intercourse. When used correctly with every sexual intercourse, it completely wraps around the vagina and provides protection from both pregnancy and sexually transmitted infections, including HIV.

What are the benefits of an HIV test?

Knowing your HIV status has two important benefits:

• Once you know that you are HIV positive, you can take the necessary steps to access treatment, care and support before symptoms appear, and thereby potentially extend your life and prevent complications from developing over time. years.
• Once you know that you are infected, you can take precautions to prevent HIV transmission to others.

What are antiretroviral drugs?

Antiretroviral drugs are used to treat and prevent HIV infection. They fight HIV by stopping or inhibiting the reproduction of the virus and decreasing its amount in the body.

What is the current status of antiretroviral therapy (ART) provision?

As of mid-2016, 18.2 million people were on antiretroviral therapy (ART) worldwide. While this figure represents the impressive progress made over the past decade in scaling up HIV treatment coverage, it represents only 46% of patients requiring ART. Thus, more than half of people who need access to treatment still do not have it.

Is there a cure for HIV?

No, there is no cure for HIV. But with proper and continued adherence to antiretroviral therapy guidelines, the progression of HIV in the body can be slowed to near standstill. More and more people living with HIV, even in low-income countries, are able to feel well and be productive for long periods of time. WHO recommends treatment for all people living with HIV, as well as those at significant risk.

What other types of care do people living with HIV need?

In addition to antiretroviral therapy, people with HIV often need counseling and psychological support. Access of people living with HIV to adequate nutrition, safe water and basic hygiene products can also help maintain a high quality of life.

Many countries view HIV infection as the main problem in the formation of a healthy nation around the world. Depending on the economic state of the state, the possibility of quick and accurate detection of the infected, timely high-quality treatment of patients, as well as the awareness of the population about the danger of the disease and methods of prevention, the indicator depends on which country has the most HIV (AIDS) incidence.

The popularity of the state in the world community and economic growth depend on this indicator in the 21st century. Many highly developed countries do not allow entry into their territory without passing the appropriate analysis, which indicates the government's interest in the health of its population. V Russian Federation every working person is obliged to take an analysis to determine the retrovirus in the blood every year. This allows you to control the disease and take appropriate measures to prevent immunodeficiency. For example, in Belarus, when crossing a border point, you must document your HIV-negativity. But in Europe this document is not always required. In any case, when traveling to another country, you must have such data with you, which is valid for 3 months.

Countries by the number of HIV-infected are divided into 3 levels:

1. States in which the causative agent of AIDS is transmitted among men - homo- and bisexuals, drug addicts using potent intravenous substances. These include the USA, Brazil, Bangladesh, Pakistan, Mexico, Great Britain, Turkey. These countries have a high infection rate per 100 thousand population, which ranges from 53 to 246 patients, depending on the region.
2. The disease occurs among heterosexuals when the pathogen is transmitted sexually through contact with a prostitute. At the same time, a high degree of possibility of infection in people with many sexual partners. Often these patients are also exposed to sexually transmitted diseases. Such regions include the countries of Asia and Eastern Europe. They have a relatively low rate of retrovirus infected, which is from 20 to 50 patients per 100 thousand of the population.
3. In China, Japan, Nigeria, Egypt, the incidence of HIV infection is lower than in other countries of the world. Here the disease is considered imported and is observed most often in prostitutes and persons who use their services. These countries have a low rate of infected, which is from 6 to 16 patients per hundred thousand citizens.

Countries intensively infected with HIV pose a great danger to the population of the Globe. The statistics of such states show that the incidence of immunodeficiency is growing every year. This suggests that the country either does not fight AIDS, or the actions taken are not effective. There is a list of the most dangerous countries in terms of HIV transmission. The rating below shows the level of danger in them:

1. SOUTH AFRICA. Has the highest rate of retrovirus infection in the population. It is believed that about a quarter of the population is immunocompromised. There are 5.6 million AIDS patients. The state has an HIV mortality index of about 1 million people a year, infected people - 15% of the total number of citizens.
2. India. The AIDS disease has affected 2.4 million people here. In the country, the mortality rate from immunodeficiency varies from 1% to 2% per year, the number of HIV-infected is 10-12% of the population.
3. Kenya has lower HIV (AIDS) rates in Africa. Statistics say about 1.5 million patients. The country has a mortality rate from a retrovirus - 0.75 million people, 7.5% of the population are infected with this pathogen.
4. Tanzania, Mozambique. There are 0.99-0.34 million AIDS patients, depending on the region. These countries have an immunodeficiency mortality index of 0.2-0.5 million citizens per year, 8-12% of the population is infected.
5. USA, Uganda, Nigeria, Zambia, Zimbabwe. There are 1.2 million AIDS patients. These countries have a total HIV mortality rate of 0.3-0.4 million people per year, 5% of the population is infected.
6. Russia. There are 0.98 million people living with HIV in Russia. Mortality from AIDS reaches a level of slightly less than 3-4% of all cases. The most HIV-infected city in Russia is Yekaterinburg. It is believed that one in 50 residents of the city is infected with a retrovirus.
7. Uzbekistan. 32,743 people are affected by the infection in Uzbekistan. Of these, 57% are men.
8. Azerbaijan. The number of HIV (AIDS) patients in Azerbaijan is 131 people. Of these, 36 are women and 95 are men.
9. United Arab Emirates... Recently, the detection rate of HIV infection among Arabs has increased. According to the latest data, the incidence rate is 350-370 thousand per 367 million population.

HIV (AIDS) in Kazakhstan

According to the latest report, HIV-infected people in Kazakhstan account for 0.01%. At the end of 2016, 22,474 cases of infection were registered. 16 530 people were diagnosed with AIDS. Among the total number of infected men make up 69%, women - 31%. Although the female sex occupies a smaller proportion of the infected, their number is gradually increasing. The government is actively involved in HIV (AIDS) treatment in Kazakhstan. The effectiveness of the program is evidenced by:

an increase in the number of early detection of patients;

an increase in the number of patients who received antiretroviral therapy;

a decrease in the birth rate of infected children.

HIV in the USA

The number of HIV-infected in the United States is growing every year. The country has a high level of economy, which contributes to the early detection of infected and the appointment of adequate treatment at the initial stages of the disease. This helps to reduce the aggressiveness of the virus, prolong life and improve its quality.

How many HIV-infected are there in the US? To a greater extent in America, immunodeficiency is common among homosexuals. It is believed that there are about 2.6 million carriers of the infection in the United States. But the high level of medical care allows you to take good care of such patients, making their life the same as that of healthy people.

How common is HIV in Russia?

AIDS in Russia has not yet achieved the status of an epidemic, but growing rates indicate the possibility of a rapid progression of infection in people in the country. HIV infection in Russia is considered one of the most dangerous pathologies, because there is no vaccine for its prevention, and only the self-awareness of citizens can lead to a decrease in the incidence rate.

Where did AIDS come from in Russia? The first confirmed case of immunodeficiency was discovered in Moscow in the family of a seafarer. After a 9-month business trip to hot countries, he was already in his hometown was hospitalized in a hospital with pneumocystis pneumonia, which very often affects infected people due to a decrease in the barrier function of immunity. The examination revealed the human immunodeficiency virus. The man died a few months later, and his family had to move to the other end of the country, change their names so that ill-wishers would not find them.

Since this period, the level of HIV incidence in Russia has been gradually increasing, violating the standard indicators of the population's health and reducing its efficiency.

How many HIV-infected are in Russia? At the end of 2016, the quantitative index among those infected with the retrovirus was 0.98 million. This number is considered one of the lowest in the world, while the death rate from AIDS in the Russian Federation is stable at an average level. In the regions of Russia, the situation of HIV incidence is different. This is due to several factors:

1. Religiosity.
2. Population of the region.
3. Economic significance.
4. The quality of medical equipment and services.

How many people have HIV (AIDS) in Russia? The largest indicator is in the Ural Federal District. The incidence has the highest numerical indicator among other regions of the country. It is 757.2 infected per 100 thousand population.

The Siberian FD has an incidence rate of 532 infected people per 100 thousand citizens. Volga Federal District - 424 patients for the same number of the population.

Among all the federal districts of the country, the North Caucasian FD has the lowest indicator, here the level is 58 people per 100 thousand of the population.

The number of AIDS patients in Russia in the Far Eastern Federal District is 172 infected. How many people have HIV (AIDS) in Russia in the North-West region? The morbidity index in this district is 407 patients per 100 thousand of the population.

The number of HIV, AIDS-infected in Russia is progressing towards an increase every year, therefore, only measures that include prevention can reduce the incidence among citizens of the Russian Federation.

Thanks to the standards of treatment of immunodeficiency, the state program for detection and therapeutic care, the number of people with HIV infection (AIDS) in Russia has slightly decreased. The birth rate of infected children has decreased, which indicates the early detection of retrovirus in pregnant women and the appointment of correct and effective treatment for them.

Thanks to the simplification of retrovirus testing and continuous screening of the population, the dynamics of HIV disease in Russia tends to decrease in mortality rates. Some facts indicate that the number of carriers of the pathogen is increasing. But on closer examination, it turns out that the number of surveyed citizens is growing every year, and this leads to an overestimation of the absolute incidence rate.

Do not be afraid that there are a million HIV-infected in Russia. If you adhere to the basics of personal hygiene and prevention methods, the risk of infection approaches zero. You need to know that the best means protection against infection with a retrovirus are barrier contraceptives, sterile instruments.