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  • Patients with serologic evidence of infection with the human immunodeficiency virus (HIV) can be diagnosed as having acquired immunodeficiency syndrome (AIDS) based on AIDS-defining conditions (Table 52–1).

  • Patients with HIV are living longer in the era of highly active antiretroviral therapy (HAART).

  • The United Nations estimated that 38 million (range 32–45 million) people worldwide were living with HIV infection in 2019, with the majority being infected by heterosexual contact.



Human Immunodeficiency Virus 1

  • The primary cause of AIDS is infection with HIV-1.

  • HIV-1 is a member of the Lentivirinae subfamily of retroviruses.

    — Retroviruses are RNA viruses that induce a chronic cellular infection by converting their RNA genome into a DNA provirus that is integrated into the genome of the infected cell.

  • Infection by these lentiviruses is characterized by long periods of clinical latency followed by gradual onset of disease-related symptoms.

Transmission of HIV

  • The four main routes of HIV infection are:

    Sexual contact with an infected partner

    • The risk for HIV transmission through sexual contact may be increased in persons with other concurrent sexually transmitted diseases.

    Parenteral drug use

    • Sharing needles and syringes is the main mode of transmission.

    Exposure to infected blood or blood products

    • Ninety percent of those who ...

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