Thursday, October 15, 2009

Acquired Immune Deficiency Syndrome (AIDS)

“AIDS is an epidemic disease, a potentially preventable, deadly infection for which there is no cure, no vaccine, and it is not under control.” (National Commission on AIDS, 1993).


Etiology

AIDS is the name given to the later stage of Human immunodeficiency virus (HIV) infection in which causes significant damage to the immune system. The course of AIDS is often grim and generally ends in total depletion of your immune system causing death from cancer or other over whelming infections.
HIV is transmitted through direct contact of body secretions, especially blood, semen, and vaginal secretions but also commonly enters the body via blood transfusions, blood-contaminated needles. AIDS can also be exchanged between Mother and Baby during pregnancy, childbirth or while breastfeeding. There are two versions of HIV, both of which can cause AIDS: HIV-1, which has spread throughout the world, and HIV-2, a far less common and not as harmful version that is largely restricted to West Africa.

Sandy Fritz describes AIDS as a group of symptoms caused by the transmission of a virus that causes a breakdown of the immune system. The AIDS syndrome causes a dysfunction in the bodies’ immune system, one of the body’s primary defenses against disease. (Fritz, 2000)



Pathogenesis

HIV affects nearly every organ system so opportunistic infections are common in people with AIDS.
Being HIV does not necessarily mean having full blown AIDS which only occurs after certain immune functions are completely destroyed after the HIV virus renders the immune system incompetent, thereby affecting the individuals capacity to ward off common infections. The time interval between exposure to the virus ranges from a few months to ten years, with appearance of symptoms depending on various factors like, treatment, immunity of the exposed person and Cell mediated Immunity.
The HIV virus infects the T-cells of the white blood cells of the immune system, these T-cells help clear disease causing substances from the body, as the HIV virus destroys more and more helper T-cells the immune system begins to break down and finally can no longer kill the HIV or any other invading germs therefore the diagnosis of AIDS is given.



Symptoms and Signs of HIV/AIDS

The symptoms of AIDS are usually due to the result of conditions that do not normally develop in healthy immune systems. Most of these are infections caused by everyday viruses and bacteria that are normally controlled by the immune system that HIV damages.

Signs and Symptoms of AIDS:

  • Flu-like symptoms 2-4 weeks after exposure.
  • Fevers.
  • Sweats, particularly at night.
  • Rash and swelling of lymph nodes in the groin, armpits and neck.
  • Chills.
  • Weakness.
  • Loss of appetite.
  • Fatigue.
  • Diarrhea- unexplained chronic diarrhea in infection has many possible causes including common bacterial and parasite infections, but can also be a side effect of several drugs used to prolong the HIV status.
  • Cancers- HIV patients have an increased chance of getting several cancers.
  • Kaposi’s sarcoma- cancer like condition of the blood vessels that leave purple lesions on the skin.
  • Pneumocystis Pneumonia- rare in healthy immune systems and is the first indication of AIDS in developing countries.

Prevention of AIDS

The spread of AIDS can be prevented by:

  • Avoiding unprotected sex by use of condoms.
  • Disposable Syringes.
  • HIV testing for blood transfusions.

Epidemiology

Prevalence: In 2007 it was estimated that 33.2 million people lived with the disease worldwide and killed approximately 2.1 million people.
Incidence: One in four new infections occurs in Asia every day.
1,500 people effected with AIDS die in Asia every day.




Treatment of HIV/AIDS

Currently there is no cure or vaccine for AIDS or HIV, although expensive antiretroviral treatments slow the progression of HIV infection reducing the mortality and morbidity.
Commonly used Medications for treating HIV/AIDS:

  • Abacavir,
  • Amantadine,
  • Indinavir,
  • Lamivudine,
  • Stavudine,
  • Zidovudine.

Massage Indications:

Massage therapy boosts immune system by:

  • Reducing stress and anxiety.
  • Increasing white blood cell counts.
  • Activating natural killer cells.

Massage can also help HIV/AIDS symptoms by decreasing pain by:

  • Relieve muscle spasms and cramps.
  • Reduce general body tension.
  • Improve Edema
  • Reduce inflammation.
  • Increases blood flow to aid removal of toxins and increase oxygen and nutrients to areas with symptoms.

Massage Contraindications:

If there is no exchange of bodily fluids, HIV/AIDS cannot be transmitted.

  • Infections that AIDS patients get in the later stage are contraindicated so get a thorough health status and check with physician.
  • Avoid massaging rashes, sores, lesions or swelling.
  • Use precautions. (Protective barriers disinfect linen with thorough washing; avoid contact if you have openings in the skin).
  • If your linen does come into contact with bodily fluids, use 10% bleach solution; wash immediately with antiviral agent.

Working with HIV/AIDS Clients:

  • Educate yourself about the etiology and pathology of AIDS.
  • Collect a thorough client history.
  • Survey the client and yourself for cuts, open wounds or bleeding.
  • Keep your fingernails short so you don’t accidentally scratch the client.
  • Wash your hands thoroughly with warm/hot water and soap.
  • Reschedule if you are sick, since their immune systems are vulnerable.



References

Cutler, N. (2006). Massage Therapy for HIV/AIDS. Retrieved on September 26th 2009 from www.integrative-healthcare.org/mt/archives/2006/.html

Gnanakkan, J. (2005). The Effects of Therapeutic Massage on HIV and AIDS Patients. Canada. Massage Today Magazine.

Goldman, B. (1999). A Healing Touch: Massage Therapy and HIV/ AIDS. Retrieved on September 26th 2009 from www.thebody.com.

Frtiz, S. (2004). Mosby’s Fundamentals of Therapeutic massage (3rd Ed.). Missouri: Mosby

Medindia Health Network. (1997-2009). Retrieved on September 29th 2009 from www.medindia.net/patients/aids.htm.

Pathology for Massage Therapists.(1999-2009). Retrieved on July 19th 2009 from http://www.thebodyworker.com/pathology-

Premkumar, K. (2000). Pathology A to Z- a Handbook for Massage Therapists. (2nd Edition). Canada; VanPub Books.

Salvo, S, G. (2008). Mosby’s Pathology for Massage Therapists (2nd Ed.). Elsevier Health Science.

Werner, R. (2005). A Massage Therapists Guide to Pathology (3rd Ed.). Philadelphia: Lippincott Williams & Wilkins.