The Impact of HIV

by Asawer Nihal, GCSOM, MBS 2019
Mentor, Christian Carbe, PhD

Human immunodeficiency virus (HIV) is a virus that impacts the lives of many individuals. It is an RNA virus that has the enzyme reverse transcriptase. The reverse transcriptase protein reverses the normal flow of genetic information, transcribing its own RNA and making complementary viral DNA in the host’s cells. This DNA is then incorporated into the host cell genome where it will be used to make new virus. The outside of the virus has spikes on it that allow the virus to latch on to other immune cells in the host’s body. After these cells attach, they gain entry into the cells, multiply and destroy immune cells that are required to fight off all routine infections. HIV can spread from human-to-human by way of bodily fluids (saliva, blood, semen). The main immune cells HIV targets are CD4+ T cells.

No effective cure has been found thus far, although, with proper treatment, HIV can be controlled. Specifically, it is seen that mothers infected with HIV can transmit the virus to their infants either while pregnant or post-delivery. It is shown to be transmitted either during pregnancy, birth, or through breastfeeding. There are however, multiple factors that are seen to play a role in the transmission of the infection from mother to child. One study showed that male partner involvement with infected mothers showed a decrease in transmission rates from mother to child. The infected mothers that did not have any male partner involvement showed not only higher signs of depression, but also showed higher rates of transmitting the virus to their infants at much earlier ages. Another factor that was studied was whether breastmilk or formula played a significant role in decreasing the transmission rates from mother to child. Various studies showed that infants that are strictly fed formula tend to show much lower rates of HIV-transmission. Whereas, children who are fed breastmilk from their HIV-infected mothers show high rates of early transmission of the virus. 
A successful way to control HIV is through the use of antiretroviral therapy. Antiretroviral therapy includes medications targeted to decrease levels of HIV replication within the host’s cells. There are six different classes of drugs, each targeting a required step in the process of viral replication. One medication targets both reverse transcriptase and other HIV protein enzymes which are essential in converting the viral RNA to DNA in the infected host cells. We know that inhibition of these viral enzymes decreases the number of human cells infected with HIV. Today, more than one combination of antiretroviral agents is often administered to infected patients and has proven to be more effective in controlling the virus, allowing the reconstitution of the immune system. 
I believe HIV is a life changing disease that deserves attention. There are people all over the world infected with HIV, but most infections are seen in developing countries including eastern and southern Africa containing more than half of all HIV cases. The goal should be to extend resources from developed countries and supply them to underdeveloped countries so individuals with HIV can have resources to control their infection or to decrease the rate of transmission through safer practices. For example, in underdeveloped countries there should be more resources to provide quality care of infected mothers with formula at either a lower cost or free of cost, so they don’t have to breastfeed their infants, increasing the risk of transmission. If HIV is controlled in all countries with proficiency, then there should be less transmission rates and more so, the virus should remain controlled in infected individuals.