These guidelines provide guidance on the diagnosis of human immunodeficiency virus (HIV) infection, the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and the care of people living with HIV. They are structured along the continuum of HIV testing, prevention, treatment and care. This edition updates the 2013 consolidated guidelines on the use of antiretroviral drugs following an extensive review of evidence and consultations in mid-2015, shared at the end of 2015, and now published in full in 2016. It is being published in a changing global context for HIV and for health more broadly.
As a low-income country, Ethiopia has made impressive progress in improving health outcomes. This report examines how Ethiopia s Health Extension Program (HEP) has contributed to the country s move toward Univeral Health Coverage (UHC), and to shed light on how other countries may learn from Ethiopia s experiences of HEP when designing their own path to UHC. HEP is one of the government s UHC strategies introduced in a context of limited resources and low coverage of essential health services. The key aspects of the program include the capacity building and mobilization of more than 30, 000 Health Extension Workers (HEWs) targeting more than 12 million model families, and the mobilization of health development army ? to support the community-based health system. Using the HEP-UHC conceptual model and data from Demographic and Health Surveys, the study examines how the HEP has contributed to the country s move toward UHC. During the period that the HEP has been implemented, the country has experienced significant improvements in many dimensions: in terms of socioeconomic, psychological, behavioral, and biological dimensions of the beneficiaries; and in terms of the coverage of health care services. The study finds an accelerated rate of improvements among the rural, less-educated, and the poor population, which is leading to an overall reduction in equity gaps and improvements in the equity indicators including the concentration indices - that suggest a more equitable distribution of resources and health outcomes. The HEP in Ethiopia has demonstrated that an institutionalized community approach is effective in helping a country make progress toward UHC. The elements of success in the HEP include the emphasis on community mobilization which identifies community priorities, engages and empowers community members, and supports their ability to solve local problems. The other aspect of HEP is the emphasis on institutionalization of the activities, which addresses the sustainability of community programs through high level of political commitment, and effective coordination of national policies and leveraging of support from partners. These findings may offer useful lessons for other low income countries facing similar challenges in developing and implementing a sustainable UHC strategy.
The world continues to lose more than a million lives each year to the HIV epidemic, and nearly two million individuals were infected with HIV in 2017 alone. The new Sustainable Development Goals, adopted by countries of the United Nations in September 2015, include a commitment to end the AIDS epidemic by 2030. Considerable emphasis on prevention of new infections and treatment of those living with HIV will be needed to make this goal achievable. With nearly 37 million people now living with HIV, it is a communicable disease that behaves like a noncommunicable disease. Nutritional management is integral to comprehensive HIV care and treatment. Improved nutritional status and weight gain can increase recovery and strength of individuals living with HIV/AIDS, improve dietary diversity and caloric intake, and improve quality of life. This book highlights evidence-based research linking nutrition and HIV and identifies research gaps to inform the development of guidelines and policies for the United Nations’ Sustainable Development Goals. A comprehensive approach that includes nutritional interventions is likely to maximize the benefit of antiretroviral therapy in preventing HIV disease progression and other adverse outcomes in HIV-infected men and women. Modification of nutritional status has been shown to enhance the quality of life of those suffering HIV/AIDS, both physically in terms of improved body mass index and immunological markers, and psychologically, by improving symptoms of depression. While the primary focus for those infected should remain on antiretroviral treatment and increasing its availability and coverage, improvement of nutritional status plays a complementary role in the management of HIV infection.
Infection with the human immunodeficiency virus is characterized by the destruction of the host immune system as also reflected by a progressive loss of CD4-positive T-cells. This finally results in the host's incapacity to deal with opportunistic infections and the immune surveillance of tumors, a clinical status known as the Acquired Immunodeficiency Syndrome (AIDS). The book AIDS Pathogenesis provides the reader with a complete overview of the clinical course of HIV-1 infection. It describes the clinical aspects of primary infection, the different clinical outcomes of HIV-1 infection, and strategies for anti-viral treatment. In addition, more fundamental aspects of HIV-1 infection are reviewed. These include the biology of the virus and the novel insights in AIDS pathogenesis. Not only is the significance of an HIV-specific cellular and humoral immune response discussed, but also the possible incapacity of the adult human host to deal with T-cell destruction. Finally, the book discusses the currently used laboratory markers that allow for monitoring of the clinical course of infection.
Dr. Jose Luis Subiza is the founder and CEO of Inmunotek SL. The other Topic Editors declare no competing interests with regard to the Research Topic subject.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
While many volumes have been written about various aspects of antimicrobial resistance, this book is a comprehensive reference work. All manifestations of resistance are addressed: viral; bacterial, parasitical and fungal are given dedicated sections. The underlining molecular mechanisms, which depend not only on the microbe but on the specific drug (target), are highly diverse. This work discusses and compares the biological, biochemical and structural aspects of resistance and its evolution.
The COVID-19 pandemic has reminded the world that infectious diseases are still important. The last 40 years have experienced the emergence of new or resurging viral diseases such as AIDS, ebola, MERS, SARS, Zika, and others. These diseases display diverse epidemiologies ranging from sexual transmission to vector-borne transmission (or both, in the case of Zika). This book provides an overview of recent developments in the detection, monitoring, treatment, and control of several viral diseases that have caused recent epidemics or pandemics.
Extensively revised and updated, the new edition of AIDS and Other Manifestations of HIV Infection is an essential reference resource providing a comprehensive overview of the biological properties of this etiologic viral agent, its clinicopathological manifestations, the epidemiology of its infection, and present and future therapeutic options. - Expanded section on clinical manifestations includes new chapters on cardiovascular, renal and dermatologic manifestations of HIV infection - Additional chapters on molecular diagnostic techniques, the role of host genetic variation in HIV infection and its manifestations, the discovery and development of new HIV medicines, analysis of HIV dynamics using mathematical models, toxicities of antiretroviral therapy, HIV drug susceptibility testing, practical therapeutics and the global impact of HIV and AIDS
