The Use of Human Growth Hormone in the treatment of HIV / AIDS

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency syndrome). The HIV retrovirus may be passed from one person to another when infected blood, semen, vaginal secretions or other bodily fluids come in contact with an uninfected person's broken skin or mucous membranes. People with HIV have what is called HIV infection and are fit and well. Some of these people will develop AIDS as a result of their HIV infection.

Growth hormone is a popular bodybuilding and performance enhancing aid, and the use of recombinant human growth hormone (rHGH, or simply GH) to treat various conditions in HIV infection has been debated with excitement for years. Indeed it is licensed for the treatment of wasting syndrome in advanced stages of AIDS. GH is also a commonly used bodybuilding and performance enhancing drug, which can be purchased on the black market; used to help both muscle anabolism / strength and reduction in body fat levels. Both of these applications have possible significance in the treatment of HIV.

Other than in the treatment of wasting disease, results from the studies using rHGH to treat body changes associated with HIV and/or drugs used to treat HIV have been very favourable. One which has been studied extensively is the use of rHGH in reducing HIV-associated adipose redistribution syndrome (HARS). However, the positive effects of HGH treatment in HIV may be more direct. Several studies have proposed that rHGH may bolster the immune system in ways that might improve clinical outcomes in HIV.

Let's look at each of the possible treatment benefits of rHGH in HIV in turn:

HIV-associated adipose redistribution syndrome (HARS)
HARS is a type of lipodystrophy (abnormal distribution of body fat), where there is accumulation of excess truncal fat and visceral adipose tissue, as opposed to regular gynoid (glutes and hips) or android (abdomen) deposition. This is observed in HIV infected people, moreso as virus load increases. Although not a debilitating condition in itself (indeed extra body fat can prolong life if followed by wasting), HARS is unpleasant for the individual, giving reduced confidence in body image; another negative aspect of the disease.

rHGH therapy has been shown to significantly reduce HARS, leading to an improved body image, and significant improvement in psychological well-being. Numerous studies have demonstrated the benefits of this, leading to rHGH being licesenced for the treatment of HARS in some countries. It should also be noted that improvement in psychological well-being could also contribute to a positive clinical outcome, in that it reduces the effects of wasting.

Acute Infections
HIV patients are often more prone to acute infections which may take longer to clear up than in non-HIV individuals. Sometimes these can be associated with poor appetite and weight loss. rHGH therapy may curb rapid weight loss often associated with acute infections in HIV positive people and may also reduce length of infection. Far more research is needed here though.

Fasting lipid profile
HIV patients have been shown to have elevated serum lipids, and dyslipidaemia, i.e. high LDL (bad) cholesterol and low HDL (good) cholesterol with raised total cholesterol and triglycerides. This is associated with anti-HIV drug treatment especially later on in infection. This does increase risk of cardiovascular diseases, and rHGH treatment may improve lipid profiles.

Bone Building
HIV patients may have loss of bone density associated with wasting. Both treatment with rHGH and growth hormone releasing factor (GHRF) have indicated improved bone mass in HIV patients (Koutkia et al 2005).

Side effects of rHGH treatment
Although we have focused on the promising benefits for rHGH treatment in HIV infection, consideration of possible side effects is important in ensuring an informed decision can be made. Side effects of rHGH therapy include possible joint pain (arthralgia), abnormal growth of the body's extremities and impaired glucose intolerance, increasing the risk of type 2 diabetes.

Caution is also advised against using over-the-counter or faddy internet products that claim to contain human growth hormone. Some of them claim to contain plant-derived growth hormone, others claim to contain cow or goat growth hormone, and still others claim to contain substances that increase the body's production of GH. There is no evidence that any of these products contain either a relevant product or a dose needed to induce the types of effects seen in studies. Over-the-counter and internet sales of these 'growth hormone' products are a major source of health fraud.

Certainly rHGH has shown benefits in treating wasting syndrome in advanced stages of HIV disease or AIDS, and its approval as a treatment for body lipodystrophy is encouraging. However, it's important that larger studies confirm these early findings. They can tell us whether or not increases in thymus size and CD4+ cell numbers, associated with rHGH use, ultimately benefit people living with HIV and result in better quality of life and longer life. Treatment with GH in HIV is encouraging and exciting, but far more research is still required.

The Use of Human Growth Hormone in the treatment of HIV / AIDS

HIV (human immunodeficiency virus) is the virus that causes AIDS. The HIV retrovirus may be passed from one person to another when infected blood, semen, vaginal secretions or other bodily fluids come in contact with an uninfected person's broken skin or mucous membranes. People with HIV have what is called HIV infection and are fit and well. Some of these people will develop AIDS as a result of their HIV infection.

Growth hormone is a popular bodybuilding and performance enhancing aid, and the use of recombinant human growth hormone (HGH, or simply GH) to treat various conditions in HIV infection has been debated with excitement for years. Indeed it is licensed for the treatment of wasting syndrome in advanced stages of AIDS. GH is also a commonly used bodybuilding and performance enhancing drug, which can be purchased on the black market; used to help both muscle anabolism / strength and reduction in body fat levels. Both of these applications have possible significance in the treatment of HIV.

Other than in the treatment of wasting disease, results from the studies using HGH to treat body changes associated with HIV and/or drugs used to treat HIV have been very favourable. One which has been studied extensively is the use of HGH in reducing HIV-associated adipose redistribution syndrome (HARS). However, the positive effects of HGH treatment in HIV may be more direct. Several studies have proposed that HGH may bolster the immune system in ways that might improve clinical outcomes in HIV.

Let's look at each of the possible treatment benefits of HGH in HIV in turn:

Wasting
Like cancer cachexia, advanced stages of AIDS are characterised by severe muscle wasting and weakness. The reasons for this are because the patient often has a very poor appetite and food intake, as well as there being direct wasting effects from the HIV and some associated diseases which the patient may have, e.g. pneumonia. The patient then enters a downward cycle with diminished strength, poor food intake and further wasting, and it's often this which leads to eventual death.

Both anabolic steroids (AS) and HGH therapy are used clinically to both slow the effects of wasting and to help improve appetite. Both have been shown to prolong life significantly and improve quality of life in advanced stages of AIDS .

HIV-associated adipose redistribution syndrome (HARS)
HARS is a type of lipodystrophy (abnormal distribution of body fat), where there is accumulation of excess truncal fat and visceral adipose tissue, as opposed to regular gynoid (glutes and hips) or android (abdomen) deposition. This is observed in HIV infected people, moreso as virus load increases. Although not a debilitating condition in itself (indeed extra body fat can prolong life if followed by wasting), HARS is unpleasant for the individual, giving reduced confidence in body image; another negative aspect of the disease.
HGH therapy has been shown to significantly reduce HARS, leading to an improved body image, and significant improvement in psychological well-being. Numerous studies have demonstrated the benefits of this, leading to HGH being licesenced for the treatment of HARS in some countries. It should also be noted that improvement in psychological well-being could also contribute to a positive clinical outcome, in that it reduces the effects of wasting.

Immune system
Of most interest in HIV therapy are the possible benefits of HGH use on the immune system, since HIV's primary adverse effect is reduction in the immune system. It has been clearly demonstrated that HGH does benefit the immune system, but the method by which it helps is still under debate. One theory is that HGH may stimulate renewal of the thymus gland, an important organ in the immune system. This may, in turn, lead to improved immune health in people with HIV. Studies are now examining whether or not renewing thymus tissue leads to better health and longer survival.

The thymus is necessary for developing new T-lymphocytes, which are key immune cells in the defence against disease, and numbers of which steadily reduce in HIV as infection progresses. In particular the thymus gland is involved in the development of CD4+ and CD8+ cells, and it is the CD4+ level which is a very critical marker in HIV outcome. Without some thymus activity, immune reconstitution that produces a wide range of functional CD4+ cells is not believed to be possible. Thus, the state of the thymus in HIV disease and how therapies affect it are of great interest to those researching ways to restore the immune system.

Acute Infections
HIV patients are often more prone to acute infections which may take longer to clear up than in non-HIV individuals. Sometimes these can be associated with poor appetite and weight loss. HGH therapy may curb rapid weight loss often associated with acute infections in HIV positive people and may also reduce length of infection. Far more research is needed here though.

Fasting lipid profile
HIV patients have been shown to have elevated serum lipids, and dyslipidaemia, i.e. high LDL (bad) cholesterol and low HDL (good) cholesterol with raised total cholesterol and triglycerides. This is associated with anti-HIV drug treatment especially later on in infection. This does increase risk of cardiovascular diseases, and HGH treatment may improve lipid profiles.

Bone Building
HIV patients may have loss of bone density associated with wasting. Both treatment with HGH and growth hormone releasing factor (GHRF) have indicated improved bone mass in HIV patients (Koutkia et al 2005).

Side effects of HIV (human immunodeficiency virus) is the virus that causes AIDS. The HIV retrovirus may be passed from one person to another when infected blood, semen, vaginal secretions or other bodily fluids come in contact with an uninfected person's broken skin or mucous membranes. People with HIV have what is called HIV infection and are fit and well. Some of these people will develop AIDS as a result of their HIV infection.

Growth hormone is a popular bodybuilding and performance enhancing aid, and the use of recombinant human growth hormone (HGH, or simply GH) to treat various conditions in HIV infection has been debated with excitement for years. Indeed it is licensed for the treatment of wasting syndrome in advanced stages of AIDS. GH is also a commonly used bodybuilding and performance enhancing drug, which can be purchased on the black market; used to help both muscle anabolism / strength and reduction in body fat levels. Both of these applications have possible significance in the treatment of HIV.

Other than in the treatment of wasting disease, results from the studies using HGH to treat body changes associated with HIV and/or drugs used to treat HIV have been very favourable. One which has been studied extensively is the use of HGH in reducing HIV-associated adipose redistribution syndrome (HARS). However, the positive effects of HGH treatment in HIV may be more direct. Several studies have proposed that HGH may bolster the immune system in ways that might improve clinical outcomes in HIV.

Anabolic steroids help people with HIV put on weight and muscle mass

People with HIV who are treated with anabolic steroids to prevent AIDS wasting may realize modest gains in weight and muscle mass.

The review covered 13 studies of adults age 24 to 42 with HIV, 294 of whom received anabolic steroids for at least six weeks and 238 of whom received placebo. The average weight increase in those taking anabolic steroids was nearly three pounds.

The magnitude of weight gain observed may be considered clinically relevant. One hopes there would be greater weight gain with the long-term use of anabolic steroids; however, this has not been proven to date in clinical trials.

AIDS wasting, which leads to significant weight loss in people with HIV, causes severe loss of weight and muscle and can lead to muscle weakness, organ failure and shortened lifespan. Researchers have long sought to reverse this common, destructive effect of HIV with mixed success.

The wasting stems from loss of the body’s ability to grow muscle and from low levels of testosterone.

Anabolic steroids are synthetic substances similar to the male sex hormone testosterone that promote growth of skeletal muscle and the development of male sexual characteristics.

Although most recently in the news for their misuse by professional athletes, anabolic steroids have legitimate medical application for men with low testosterone and people with certain types of anemia. Two anabolic steroids available in the United States, nandrolone decanoate and oxandrolone, have been used to help increase weight and muscle mass in small studies of people with wasting.

Conversely, anabolic steroid use has been associated with increased rates of HIV in those who share needles or use nonsterile needles when they inject steroids.
In the review studies, anabolic steroids were administered to patients either orally or by injection. The main side effects were mild and included abnormal liver function tests; acne; mild increase in body hair; breast tenderness; increased libido, aggressiveness and irritability; and mood swings — all common side effect of anabolic steroid use.

The risks and side effects of taking anabolic steroids long-term are certainly of concern.

HIV/AIDS program director at the Group Health Cooperative in Seattle, suggests that clinicians should obtain blood testosterone levels, if an HIV-infected individual has had significant weight loss, significant fatigue or muscle wasting, and particularly if associated with a significant decrease in libido and erections. If testosterone is in the low or low-normal range then a trial of steroids could be tried. The individual and the clinician should decide what result would constitute a successful trial: weight gain of 15 pounds, a 30 percent improvement in sense of well-being or a successful erection once a week.

The reviews authors conclude that further studies are needed to determine if increase in weight leads to improved physical functioning and quality of life, and ultimately increased survival, as well as the potential for serious side effects, especially with prolonged use.

Anabolic Steroids Used for Weight Gain of HIV Patients

People with HIV suffer from a condition referred to as HIV wasting. This condition is characterized by involuntary loss of about 10% of the total body weight, often coupled with prolonged diarrhea, fever, or weakness. In HIV wasting, the weight loss is attributed to the loss of lean body mass or muscle mass.anabolic steroids

HIV wasting is caused by several factors, one of which is reduced food intake. HIV patients usually consume less food because they have low appetite. Furthermore, the medicines they take also have side effects that make them eat less.

Another factor that causes wasting in HIV patients is that their small intestine, affected by infections brought about by the disease, does not absorb nutrients effectively anymore. Finally, HIV patients experience wasting because their body?s metabolism is altered. The disease affects the way their body processes food and builds up protein.

A study conducted in 2005 showed that HIV patients have a chance to gain the weight they lost to wasting. This can be made possible by treating them with anabolic steroids.
The study involved HIV patients with ages ranging from 24 to 42. A total of 294 individuals were given anabolic steroids, which they took for 6 weeks, while 238 individuals were given the placebo. At the end of the study, those who took the anabolic steroids showed weight gain of almost three pounds.

According to medical experts, this amount of weight gained because of steroid intake is clinically relevant. This positive result has birthed the hope that more of the weight lost because of wasting can be regained by longer treatment of anabolic steroids.

Although more research is needed to establish this principle, the result of the study definitely brings good news to HIV patients. Scientists and medical experts have been trying for a long time to reverse the effect of HIV wasting, which can lead to extreme muscle loss and weakness. Wasting can even cause organs to fail and make the patient die more quickly. People with HIV or AIDS suffer from reduced testosterone levels, and their bodies are unable to build muscle mass.

So what are anabolic steroids? These are synthetic steroids that have the same characteristics as testosterone, which is the male sex hormone. They help the body to grow skeletal muscles.

Anabolic steroids have been made largely unpopular primarily because athletes misuse and abuse these products. However, they do have important medical applications and are being used to treat certain medical conditions like low testosterone level for men and anemia. Now this study involving the use of anabolic steroids for the treatment of HIV wasting proves once again that these substances have a significant role in the field of medicine.

In this study, the patients either took the anabolic steroids orally or through an injection. The side effects reported include acne, mood swings, slight increase in growth of body hair, aggressiveness, abnormal liver function tests, and irritability, which are all common manifestations of using anabolic steroids.

More study is needed to confirm if the weight gain caused by anabolic steroid intake will bring about an improvement in the patient?s quality of life. Experts also still need to determine how much gain weight translates to a successful result of treatment with anabolic steroids.

Steroids and HIV Infection

The connection between injection drug use and HIV infection is well known. Sharing injection equipment such as needles and syringes presents a real risk of transmitting HIV as well as Hepatitis C. However, the injection of steroids is often overlooked as a risk behaviour.

Unlike mood-altering drugs, steroids are not perceived as having any health risks and, therefore, the user does not think he/she is in any danger.
Who Uses Steroids?

The majority of users are high school students. Other users may include strip dancers, wrestlers, weight lifters, military personnel and prisoners. The use of anabolic steroids for cosmetic purposes far exceeds their use by athletes for competition. The preferred method of use is by injection rather than by mouth.

Steroid use is a short cut to self-esteem. It needs little investment in energy and its reinforcing results are almost immediate. In a society that places so much value on body image, steroids are seen as a quick and easy response to that pressure.
What Are The Risks?

Most of the negative effects of steroids are due to overuse or misuse. The side effects may include: liver damage, sexual difficulties, aggressive behaviour, depression, acne, muscle spasms and interference with normal growth. Some of the effects are reversible after discontinuing the steroid use. However, the very real health risks are from:

    sharing needles, syringes and vials
    improper injection site
    failure to clean injection site
    failure to ensure the needle is not in a vein or artery

Steroid users must be given the opportunity to decide for themselves the negative aspects of steroid use. Until they are ready to quit, it is essential to help our young people stay alive. Any discussion of HIV/AIDS should ensure that use of steroids is included as a risk behaviour. In addition, information on the proper use of injection equipment must be readily available.

10 Steps to Staying Healthy With HIV

If you have HIV, it's essential to maintain your health so your immune system stays strong. Use these tips to get started.

People who have been infected with the human immunodeficiency virus (HIV) need to be especially vigilant about keeping their immune systems strong and healthy. The HIV virus kills white blood cells of the immune system called CD4 lymphocytes, or T cells. In people who have HIV, the T-cell count can fall to dangerously low levels, which eventually leads to acquired immune deficiency syndrome (AIDS). Because of this, it’s challenging — yet essential — to stay healthy. Following smart lifestyle practices can help you maintain your health with HIV.

Eat a Healthy, Well-Balanced Diet

Maintaining a well-balanced, nutritious diet is crucial for people with HIV. A healthy diet can help keep the immune system strong, help prevent illness, and also help slow the progression of HIV. According to research from the Tufts University School of Medicine in Boston, a nutritious diet can make it easier for the body to process the many medications that people with HIV often take, and may even help ease common symptoms of HIV, such as diarrhea, nausea, and fatigue.

Avoid Alcohol and Drugs

Alcohol and recreational drugs can weaken the body’s immune system, which is particularly hazardous for people with HIV. Alcohol and drugs can also interfere or dangerously interact with the medications that are necessary to keep HIV in check. Substance abuse can also lead to poor nutrition and to forgetting to take HIV medications. Channel your energy into more positive ways of spending your time, such as visiting with friends or working on hobby.

Pay Attention to Oral Health

Dental health problems are common in people with HIV, affecting more than one-third of patients. A compromised immune system and HIV medications can lead to conditions such as oral warts, fever blisters, oral thrush, and canker sores. Many people with HIV and AIDS also experience dry mouth, which can increase the risk of cavities. They are also more likely to develop gum disease that can quickly worsen and lead to other problems, such as heart disease, according to the American Academy of Periodontology. HIV patients should brush and floss regularly and see their dentist at least every six months.

Find Ways to Reduce Stress

Reducing stress is an essential part of managing HIV. The chronic stress of living with HIV can take a toll on a person’s health. According to the University of California, San Francisco, research has shown a clear link between stress and reduced immune system function; stress can cause lack of appetite, interfere with sleep patterns, and cause other negative impacts on your health. Some effective ways to manage stress include yoga, meditation, exercise, and counseling. For best results, talk to your doctor before starting any exercise program.

Consider Acupuncture

Many HIV patients opt for complementary and alternative medicine (CAM) such as acupuncture to treat symptoms of the disease and the side effects of HIV medications, including fatigue and stomachaches. Acupuncture, the practice of inserting very thin needles into specific points in the body, has also been shown to boost immune function. One way acupuncture may do this is by reducing stress. In one study done at the Boston University School of Public Health, HIV patients who were treated with acupuncture reported feeling more relaxed, peaceful, and calm.

Travel With Caution

Because people with HIV have weakened immune systems, they have to be especially careful about the food and water they ingest when traveling. While food-borne illnesses can be unpleasant and even dangerous for people who don’t have HIV, they can lead to severe complications and even death in people with HIV or AIDS. It’s best to avoid visiting developing countries where food and water safety can be more difficult to ensure and rates of transmittable diseases are higher. And be sure to talk to your doctor before you travel anywhere to get extra supplies of your HIV medications as well as medical advice.

Watch Your Skin

Skin problems are often among the earliest signs of HIV infection — HIV patients frequently have simultaneous or persistent skin infections. According to the American Academy of Dermatology, common skin conditions in those with HIV include psoriasis, hives, shingles, and impetigo, to name just a few. Kaposi's sarcoma, a rare form of skin cancer, can also affect people with AIDS.

See Your Gynecologist Regularly

HIV raises a woman’s risk of developing cervical cancer, so women with HIV should have regular Pap smears to test for any signs of the condition. Currently, the American College of Obstetricians and Gynecologists suggests that women with HIV get two Pap smears in the year right after an HIV diagnosis and then one Pap smear every year after that. Women with HIV are also more likely to develop recurrent and more aggressive forms of yeast infections and pelvic inflammatory disease.

Take Your Medication on Time

Many studies have shown a link between adherence to antiretroviral therapy (ART) — taking prescribed HIV medications on schedule and as prescribed by a doctor — and an increase in T cells. Other studies have shown that adherence to ART is second only to T-cell count in predicting an HIV patient’s prognosis. Skipping doses of medication or not taking HIV medication on time has been shown to increase the likelihood of hospitalization, the progression of HIV to AIDS, and even death. Work with your doctor to come up with the right combination of medications for your current needs.

Learn All You Can About HIV

Empower yourself and take control of your condition by learning as much as you can about HIV and AIDS. There are many resources available: Start by talking to your doctor. Check out government Web sites such as the Centers for Disease Control and Prevention and the National Institutes of Health: AIDS Info. Your doctor may also be able to refer you to support groups to talk to other HIV patients in your area, and there are online HIV support groups as well. 

Human Immunodeficiency Virus (HIV) Infection - What Increases Your Risk

Most people get HIV by having unprotected sex with someone who has HIV. Another common way of getting the virus is by sharing needles with someone who is infected with HIV when injecting drugs.

You have an increased risk of becoming infected with HIV through sexual contact if you:

    Have unprotected sex (do not use condoms).
    Have multiple sex partners.
    Are a man who has sex with other men.
    Have high-risk partner(s) (partner has multiple sex partners, is a man who has sex with other men, or injects drugs).
    Have or have recently had a sexually transmitted infection, such as syphilis or active herpes.

People who inject drugs or steroids, especially if they share needles, syringes, cookers, or other equipment used to inject drugs, are at risk of being infected with HIV.

Babies who are born to mothers who are infected with HIV are also at risk of infection.
What to think about

HIV may be spread more easily in the early stage of infection, and again later, when symptoms of HIV-related illness develop.

The risk of getting HIV from a blood transfusion or organ transplant is extremely low because all donated blood and organs in the United States are screened for HIV.

Ways HIV cannot be spread

HIV does not survive well outside the body. So HIV cannot be spread through casual contact with an infected person, such as by sharing drinking glasses or by casual kissing. HIV is not transmitted through contact with an infected person's saliva, sweat, tears, urine, or feces, or through insect bites.
Contagious and incubation period

The incubation period—the time between when a person is first infected with HIV and when early symptoms develop—may be a few days to several weeks.

It can take as little as 2 weeks or as long as 6 months from the time you become infected with HIV for the antibodies to be detected in your blood. This is commonly called the "window period," or seroconversion period. During the window period, you are contagious and can spread the virus to others. If you think you have been infected with HIV but you test negative for it, you should be tested again. Tests at 6, 12, and 24 weeks can be done to be sure you are not infected.

After you become infected with HIV, your blood, semen, or vaginal fluids should always be considered infectious, even if you receive treatment for the HIV infection.

Management of HIV in Pregnancy

HIV infection in young children most commonly arises as a result of mother-to-child transmission (MTCT). It is thought that only 1.5-2% of MTCT occurs transplacentally during pregnancy. The vast majority occurs due to maternofetal transmission of blood during parturition or postnatal breast-feeding.

All pregnant women are recommended screening for HIV infection, syphilis, hepatitis B and rubella in every pregnancy at their booking antenatal visit. If a woman declines an HIV test, this should be documented in the maternity notes, her reasons should be sensitively explored and screening offered again at around 28 weeks.

A negative maternal HIV test at booking does not preclude neonatal infection - maternal infection and seroconversion can occur at any time during pregnancy and lactation. This is well-documented in countries with a high prevalence of HIV and has been seen in the UK.

Risk of mother-to-child transmission (MTCT)

This is increased with:

    Higher levels of maternal viraemia.
    HIV core antigens.
    Lower maternal CD4 count.
    Primary HIV Infection occurring during pregnancy.
    Chorioamnionitis.
    Co-existing other sexually transmitted disease (and malaria - possibly).
    Invasive intrapartum procedures, eg fetal scalp electrodes, forceps, ventouse.
    Rupture of membranes (especially if delivery is more than 4 hours after the membranes ruptured).
    Vaginal delivery.
    Preterm birth
    Female babies more likely to be infected early (transplacental/perinatal routes).
    Advanced maternal age.
    The firstborn of twins (born to an HIV-infected mother).

Factors that decrease risk of transmission are:

    Higher levels of neutralising HIV antibody.
    Elective Caesarean section.
    Zidovudine (ZDV)
    Less invasive monitoring and intrapartum procedures.

Management

Mother-to-child transmission (MTCT) of HIV infection can be greatly reduced through early diagnosis of maternal HIV infection.

    Pregnant women should be offered screening for HIV early in pregnancy because appropriate antenatal interventions can reduce MTCT of HIV infection.
    Interventions to reduce MTCT of HIV during the antenatal period include antiretroviral therapy, elective Caesarean section delivery and avoidance of breast-feeding after delivery.
    These interventions can reduce the risk of mother-to child HIV transmission from 25-30% to less than 1%.
    All pregnant women who are HIV-positive should be screened and appropriately treated for genital infections during pregnancy. This should be done as early as possible in pregnancy and repeated at about 28 weeks.
    Presentation with symptoms or signs of pre-eclampsia, cholestasis or other signs of liver dysfunction during pregnancy may indicate drug toxicity, and early liaison with HIV physicians is essential.

Drug therapy

Women who require HIV treatment for their own health should take highly active antiretroviral therapy (HAART) and continue treatment postpartum. They may also require prophylaxis against pneumocystic pneumonia (PCP), depending on their CD4 lymphocyte count.

Women already taking HAART and/or PCP prophylaxis before pregnancy should not discontinue their medication.

    Antiretroviral therapy is given to prevent MTCT and to prevent maternal disease progression. The optimal regimen is determined on a case-by-case basis.
    Zidovudine (ZDV) is indicated for use in pregnancy for prevention of MTCT of HIV but single-agent ZDV therapy which does not suppress plasma viraemia to undetectable levels may allow the emergence of resistant virus.
    Potent combinations of three or more antiretroviral drugs (HAART) have now become the standard of care. Women with advanced HIV should be treated with a HAART regimen. The start of treatment should be deferred until after the first trimester, if possible, and should be continued after delivery.
    For women who do not require HIV treatment for their own health, HAART should be initiated between 20 and 28 weeks and discontinued at delivery. If they have a plasma viral load of less than 10,000 copies/ml and are prepared to be delivered by elective Caesarean section, an acceptable alternative is ZDV monotherapy initiated between 20 and 28 weeks, given orally, 250 mg twice daily, and intravenously started four hours before beginning the Caesarean section, continuing until the umbilical cord has been clamped. ZDV is usually administered orally to the neonate for four to six weeks.
    Combination antiretroviral therapy maximises the chance of preventing transmission and represents optimal therapy for the mother but may increase the risk of drug toxicity to the fetus.
    The use of antiretrovirals to reduce MTCT has resulted in resistant mutations and, in the Paediatric AIDS Clinical Trials Group Protocol, 15% of the women developed nevirapine-resistant mutations by 6 weeks' postpartum.

In sub-Saharan Africa, access to services is improving. In 2008, 45% of HIV-infected pregnant women received antiretroviral treatment compared with 9% in 2004. 

The Spread Of HIV

Despite the significant progress made in the world in recent years in the diagnosis and treatment of HIV, the number of new cases detected among gay and bisexual men can not be cut. British scientists have found out how, from 2001 to 2010 in England and Wales diagnosed with HIV each year approximately 2,300 men who have sex with members of their sex. Researchers from Cambridge, it says that gays and bisexuals are returned to the practice of "risky sex" do not take precautions to properly during sexual act. The results of study published are in the journal Lancet Infectious Diseases.

In the whole country, according to a recent report by the UK Health Protection Agency, the rate of HIV infection in homosexual and bisexual British men increased from year to year. "Every day about seven gay and bisexual men infected with HIV in the UK" - says Yusef Azad, one of the leaders National Fund for AIDS.

In fact, according to the researchers, the exact number of people ill with HIV each year, it is extremely difficult, as many patients do not seek medical attention immediately, but after many months or even years after infection. Scientists from Cambridge based in the Department of Biostatistics, Medical Research Council were founded upon the immune system of the patient at the time of referral to a doctor to figure out exactly when it was positive. "We found that the number of new cases has remained stable over the decade, there is no signs of its decline, "- said in an interview with BBC, Dr. Daniela De Angelis.

At the same time, the number of gay and bisexual men, every passing HIV testing in clinics in England and Wales rose from 16 to 59,000, the period from infection to the detection of the disease decreased from four years to three, and the number of patients receiving antiretroviral drugs, increased from 69% to 80%. "Men who have sex with men should be tested for HIV and sexually transmitted diseases at least annually, and every three months, if they have unprotected sex with new or casual partners," - said the representative of the Health Protection Agency Dr. Valerie Delpesh.

Results of the study alarmed activists British organisations to prevent the spread of HIV. Sir Nick Partridge, the head of the charity Terrence Higgins Foundation said that spending on promotion of safe sex in the last 10 years in a strongly reduced. It is possible that this is one of the reasons for increase in the number of unprotected sex in gay media, as described in the study, researchers from Cambridge.