HIV AIDS

AIDS (acquired immune deficiency syndrome) was first recognized in North America in the early 1980s. It is caused by a virus known as HIV (human immunodeficiency virus).


HIV infection has become a worldwide epidemic. As of 2013, the World Health Organization (WHO) stated there were 35 million people currently infected with the virus.

HIV is more common among certain populations at risk, such as people who inject illicit drugs, and bisexual and gay men. HIV infections are also increasing among women, Aboriginal peoples, and African and Caribbean communities.



Causes of HIV/AIDS

The virus can be found in the blood, semen, vaginal fluid, and breast milk of infected people. HIV is also found in saliva, sweat, and tears, though not in high enough amounts to transmit the virus to another person. There are no known cases of anyone catching HIV through sneezing, shaking hands, or from toilet seats or mosquito bites.

The two most common ways to be infected with HIV in North America are through unprotected sex and sharing needles. HIV may be transmitted through unprotected heterosexual or homosexual, vaginal, anal, or oral sex.

Although the risk of infection is lower with oral sex, it is still important to use protection during oral sex, such as a dental dam (a piece of latex to cover the vagina during oral sex) or a condom. HIV can also be passed on through perinatal infection, where mothers who have HIV are at risk of giving the disease to the baby during birth. The risk of perinatal infection is declining with new treatments. Breast-feeding by an infected mother can also transmit HIV.

Once HIV enters the bloodstream, it takes over cells vital to the immune response, known as CD4+ lymphocytes. The virus then inserts its own genes into the cell, turning it into a miniature factory that produces more copies of the virus. Slowly, the amount of virus in the blood goes up and the number of healthy CD4+ cells goes down. The destruction of CD4+ cells interferes with the body's ability to fight off infections and other diseases.

Symptoms and Complications of HIV/AIDS

Symptoms of HIV infection appear 2 to 12 weeks after exposure. At this point the virus begins rapidly taking over immune cells in the blood. The symptoms of this phase are flu-like and include:

diarrhea
fatigue or weakness
fever
headache
joint pain
night sweats
rash
swollen glands
weight loss
yeast infections (of the mouth or vagina) that last a long time or occur frequently
When the symptoms begin to appear, the person with HIV is very infectious. The symptoms usually go away within a week to a month, and the person will feel fine again. However, the symptoms may return from time to time.


The symptoms of HIV are similar to symptoms of other diseases. The only way to know for sure whether you are HIV-positive is to be tested. After infection with HIV, it can take 3 months for antibodies to the virus to be detectable in the blood. On average, it takes about 22 days to develop antibodies. This is called seroconversion. After seroconversion occurs, the virus can be detected using a blood test.

After the initial symptoms go away, the body's immune system tries to control the virus. The immune system can keep the virus at bay for a while, but it can't completely get rid of it. Many people will feel fine for years before their immune system weakens and they develop AIDS. Without treatment, about half of HIV-positive people develop AIDS within 10 years of infection. Some people develop AIDS within a few years of infection. A few, called long-term non-progressors, do not develop AIDS until much later. Many factors affect the timeframe to develop AIDS, including medications and the person's general health and lifestyle.

AIDS is a term applied to advanced HIV disease. AIDS is defined as having HIV and an opportunistic infection (an infection by a microorganism that ordinarily does not cause disease unless the immune system is weakened) normally associated with AIDS. These infections can be bacterial, fungal, viral, or parasitic.

Examples of opportunistic infections include toxoplasmosis, pneumocystis pneumonia, cryptococcal meningitis, progressive multifocal leukoencephalopathy (PML), cryptosporidium, cytomegalovirus, and Mycobacterium avium complex (MAC). With the use of better medications to treat HIV, the risk of opportunistic infections has dropped over the years; however, people with AIDS will usually need to take medications (such as antibiotics) to prevent opportunistic infections.

People who have AIDS are also more likely to develop cancer, especially cancers of the immune system (lymphomas). Another cancer common for people with AIDS is Kaposi's sarcoma, a type of cancer that causes bluish red nodules on the legs and that spreads to the lymph system. Women with AIDS are prone to developing cancers of the cervix. Gay men with HIV have higher rates of infection by HPV, a virus linked to anal cancer, and precancerous HPV strains.

Children with AIDS tend to get common childhood infections like conjunctivitis, otitis media, and tonsillitis, but they experience symptoms much worse than the infection usually causes.

Excessive weight loss or "wasting syndrome" is a problem for approximately 20% of people who have HIV infection. It is associated with an unexplained loss of 10% or more of normal body weight, plus chronic diarrhea (30 days or more) or chronic weakness with fever (30 days or more).

Most people with AIDS die from the diseases that AIDS makes them more susceptible to. The virus occasionally infects the brain, causing dementia that gets worse over time.

Creative chocolates

Many of the old myths about chocolate and health and crumbling under the weight of scientific fact. The once-prevalent believe that something that tastes so good just can't be good for you has given way to a more balanced picture of chocolate and cocoa products and their relation to health and nutrition. Here are brief reviews of recent findings that correct common mis perceptions of the effects of chocolate on health.

Myth: Confectionery is a major cause of tooth decay.

Truth: Tooth decay is primarily the result of poor oral hygiene. Dental caries (another word for cavities) are caused by any foods containing ferment able carbohydrates that are left on the teeth for too long. In fact, there are ingredients found in chocolate products that may retard the tooth decaying process.

 

Myth: Chocolate is high in caffeine.

Truth: The amount of caffeine in a piece of chocolate candy is significantly lower than that in coffee, tea or cola drinks. For instance, a 5 oz cup of instant coffee has between 40 and 108 mg of caffeine, while a 1 oz milk chocolate bar contains only 6 mg and many confectionery items have no caffeine at all.

 

Myth: Confectionery has a high fat content and will lead to weight gain.

Truth: "Candy, in moderation, can be part of low-fat eating. In fact, an occasional sweet treat helps you stick to a healthy eating plan." - Annette B. Natow, Ph.D., R.D., author of The Fat Counter and The Fat Attack Plan.

 

Cholesterol

Q. What is the level of cholesterol in a 1.65 oz. bar of milk chocolate?

A. The American Heart Association recommends that daily cholesterol intake not exceed 300 mg. A chocolate bar is actually low in cholesterol. A 1.65 oz. bar contains only 12 mg! A one oz piece of cheddar cheese contains 30 mg of cholesterol — more than double the amount found in a chocolate bar.

 

Sodium

Q. What is the level of sodium in a one oz milk chocolate bar?

A. According to the National Research Council of the National Academy of Sciences, the maximum Recommended Daily Allowance (RDA) for sodium is 1,100 to 3,300 mg daily. A 1.5 oz milk chocolate bar contains 41 mg, while the same size dark chocolate bar contains only 5 mg On the other hand, a 1.5 oz serving of iced devil's food cake has a whopping 241 mg — many times more than chocolate bars.

 

Fat

Q. How much fat is there in a 1.5 oz. chocolate bar?

A. Health professionals and nutritionists suggest that calories from fat should account for no more than 30% of your daily caloric intake. A 1.5 oz. milk chocolate bar contains 13 grams of fat; a dark chocolate bar of the same weight contains 12.

 

Acne: No Link to Chocolate

Over the past two decades, clinical studies have exonerated chocolate as a cause or exacerbating factor in the development or persistence of acne. In fact, many dermatologists doubt that diet plays any significant role in acne.

 

At the University of Missouri, student volunteers with mild to moderate acne each consumed nearly 20 ounces of chocolate over a 48 hour period. Examination of lesions on the fifth day of the test and again on the seventh day showed no new lesions other than those that might be expected based upon the usual variations the subjects had exhibited during several weeks of observation prior to the test.

 

In a research study at the University of Pennsylvania School of Medicine, a group of 65 subjects were fed chocolate bars containing nearly ten times the amount of chocolate liquor as a normal 1.5 oz commercially available chocolate bar. A control group ate a bar that tasted like chocolate, but actually contained no chocolate liquor. At the conclusion of the test, the average acne condition of those eating the chocolate was virtually identical to that of the controls, who had eaten the imitation bars.

 

Chocolate and Allergy

It is possible for a person to be allergic to any food, including chocolate. But recent evidence suggests that allergy to chocolate may be relatively rare.

 

The actual incidence of allergic sensitivity to chocolate is far less common than positive reactions to skin scratch tests would seem to indicate. In at least one double-blind study to determine the correlation positive skin tests for chocolate allergy and the manifestation of clinically observable symptoms, researchers could find only one patient out of a possible 500 who showed both a positive response to the skin test and an objective clinical reaction after eating chocolate.

 

To confirm food allergy or food sensitivity, a "challenge" of the food in question is administered. To yield accurate results, the challenge should be conducted under double-blind conditions; that is, neither the investigator nor the patient knows in advance whether the food administered is the suspected substance or a placebo. This allows for objective evaluation of clinical symptoms.

 

According to S. Allan Bock, M.D., a researcher in food allergy at the National Jewish Center for Immunology and Respiratory Medicine, evaluation of hundreds of patients at that institution has shown no confirmed allergic reaction to chocolate during double-blind challenges.

 

Caffeine and Theobromine

Caffeine and theobromine belong to a group of substances known as methylxanthines. Caffeine occurs naturally in coffee, tea, cola and, to some degree, cocoa beans. It may also be added to cola drinks and is a component of certain over-the- counter and prescription medications. Theobromine is found in cocoa beans; tea contains trace amounts.

 

Caffeine

The amount of caffeine ingested when people eat chocolate in normal quantities is very small. One ounce of milk chocolate, for example, contains 6 mg of caffeine, little more than the amount found in a cup of decaffeinated coffee. Moreover, there have been no reports in the scientific literature of any health problems among children or adults as a result of the caffeine consumed in chocolate.

 

Theobromine

Although theobromine is chemically related to caffeine, it lacks caffeine's stimulant effect on the central nervous system (CNS). In fact, theobromine is virtually inert as a CNS stimulant.

 

Despite the weakness of theobromine's effect on the brain, many people have mistakenly assumed that it is effective in warding off fatigue and sleep, especially when it is consumed in combination with caffeine, as in chocolate.

 

To test this assumption, researchers compared the effect of caffeine, theobromine and a placebo in a clinical study. They found that theobromine administered in a dose of 500 mg (the amount of theobromine in approximately 11 oz of milk chocolate consumed in one sitting) did not increase pulse rate significantly more than the placebo. Caffeine, when compared to theobromine and the placebo, produced significant CNS stimulation.

 

In a double-blind clinical study, subjects ingested measured quantities of caffeine and theobromine, separately and together, at random. Caffeine altered the subjects' own estimates of the time it took to fall asleep, as well as the soundness of sleep, in a dose-dependent fashion. A dose of 300 mg. of theobromine, however, had no detectable effect on sleep. When administered in combination with caffeine, theobromine neither increased nor decreased the sleep effects of caffeine.

 

Dental Caries

Tooth decay has become less of a problem for American children over the last 25 years. Between 1960 and 1980 the incidence of cavities dropped by 50%. Today, one-third of all Americans of college age have never had a single cavity, thanks largely to fluoride delivered in water systems, toothpastes and professional fluoride treatments.

 

Fluoride, good oral hygiene, and professional check-ups and prophylactic treatments are keys to minimizing the incidence of tooth decay. Diet is another factor.

 

It is widely accepted that all foods containing "fermentable carbohydrate" have the potential to contribute to caries formation. Fermentable carbohydrate is present in most starches and all sugars, including those that occur naturally in foods and those added in processed foods. The frequency and duration of tooth exposure to fermentable carbohydrate have been identified as a factor in caries.

 

Although chocolate contains fermentable carbohydrates, a number of dental research studies suggest that chocolate may be less apt to promote tooth decay than has been traditionally believed.

 

Research at the Forsyth Dental Center in Boston has shown that chocolate has the ability to offset the acid-producing potential of the sugar it contains. Acid, produced by certain oral bacteria that digest, or "ferment", sugars, may damage tooth enamel and cause decay.

 

Other theories have been advanced to explain the fact that chocolate appears to be less cariogenic (cavity-producing) than its fermentable carbohydrate content would seem to indicate. In a study conducted at the Eastman Dental Center, certain chocolate products tested were found to be among the snack foods contributing least to tooth decay. The researchers reported that milk chocolate's protein, calcium and phosphate content may provide protective effects on tooth enamel. In addition, because of its natural fat content, chocolate clears the mouth relatively faster than other confections; this is important because the time fermentable carbohydrate remains n contact with tooth surfaces has a bearing on the food's cariogenic potential.

 

Weight Control

Contrary to popular stereotype, most overweight people do not eat excessive amounts of cake, cookies, confections or other foods containing sugar. Their sugar intake tends, in fact, to be below average.

 

More important in controlling weight is the total number of calories consumed each day and the amount of energy expended in physical activity. Overweight children, for example, are generally less active than those of normal weight; thus, they may remain obese even when their caloric intake is reasonable or even limited.

 

Moreover, many people overestimate the calories in chocolate. A 1.5 oz milk chocolate bar contains approximately 220 calories, low enough to incorporate into a weight control diet. The occasional chocolate confection may also reduce the possibility of severe bingeing, which can occur as a result of feeling deprived of highly satisfying foods such as chocolate.