Not done yet.

I've been confined at the hospital since Wednesday. It's Sunday. I've been transfused with three bags of blood as of Friday morning, and in afternoon I found out I still need one more. That means we have to do the entire process of blood transporting and crossmatching all over again. I guess that means I'd stay here a few more days than expected... And more movies and tv series.

The Big Bang Theory, anyone?

HPV exam.

What's more embarassing than a doctor examining your arse? It's when five of them start peeking and poking at your arse trying to look for signs of HPV.

I don't know how HPV got written on my chart, but one of the doctors referred me to derma on reports of HPV. I'm clueless because to know if one has genital warts, you actually have to see the warts. I don't remember any doctor examining my privates, so how did it get reported?

The report said I had peri-anal warts. So they tried and tried to look for warts in an area of my body so private not even I have seen. It didn't end there. They also examined my other private part. After a careful and thorough search, they gave up and said I probably have none because if I have it, I would definitely know. Genital warts are supposedly hard, cauliflower-like growths that can easily be felt when cleaning.

Not that I'm complaining, it was about time somebody examined my privates for signs of anything, but they sure did it with a bang! :)

(For more info on HPV, you can check this article out.)

Na naman.

It's 730am, and I'm back at my favorite place on earth: RITM. Yeah, you guessed it right, I'm getting another blood transfusion.

I had a checkup yesterday and from 84 last week, my hemoglobin dropped again to 68. I also had my first shot of erythropoietein yesterday, the glycoprotein hormone that controls red blood cell production. I'll have it thrice a week.

I'm waiting for the doctor who will process my admission. Stay tuned. :)

Meetup with a balikbayan friend.

I've been regularly meeting up with people I've become friends with online, pozzies and otherwise. Last friday, I've met up with a friend who was coming home from Abu Dhabi. He gave me pasalubongs: chocolates from the middle east, and a book entitled "Chicken Soup for the Unsinkable Soul".

Inside, I found a short hand-written message:

"Always strive to be happy."

Thank you very much, C. Having friends like you around me makes me happy. :)

Going down.

Yesterday I was back in RITM for a follow-up checkup. My CBC is down again to 84 from 97 post-BT.

I'll have another CBC next week. If the trend continues, I might need to see a hematologist, which RITM doesn't have.

Am I worried about my condition? No. S has gone through worse, and he's doing fine. I thank him for showing me that things will be ok. But what I am going through right now is very, very frustrating.

See you again next Monday, RITM.

How is HIV Transmitted? : Specific Sexual Practices: What are the Risks?

How is HIV Transmitted? : Specific Sexual Practices: What are the Risks?

Specific Sexual Practices: What are the Risks?

Studies have repeatedly demonstrated that certain sexual practices are associated with a higher risk of HIV transmission than others.

Vaginal Intercourse:

Unprotected vaginal intercourse is the most common mode of HIV infection worldwide. In the United States and many other developed nations, it is the second most common mode of sexual HIV transmission (after anal intercourse among MSM).

At least five European and American studies have consistently demonstrated that male-to-female HIV transmission during vaginal intercourse is significantly more likely than female-to-male HIV transmission. In other words, HIV-positive men are much more likely to transmit the virus to HIV-negative women through vaginal intercourse than HIV-positive women are to HIV-negative men.

There are a few reasons for this. First, there are more men than women in the United States infected with HIV, meaning that it's much more likely for a female to have sex with an HIV-positive male than for a male to have sex with an HIV-positive female. Second, women have a much larger surface area of mucosal tissue – the lining of the vagina and cervix that can chafe easily and are rich in immune system cells that can be infected by HIV – than men. For men, HIV must enter through a cut or abrasion on the penis, through the lining of the urethra inside the penis.

There has been some research suggesting that men who are uncircumcised have a higher risk of becoming infected with HIV or transmitting the virus if they are already HIV positive. However, it is important to stress that men who are circumcised can still be infected (or transmit the virus) if condoms are not used for vaginal sex.

Men or women who have ulcerative sexually transmitted infections (STIs), such as genital herpes or syphilis, are more likely to spread the virus if they are HIV positive or to become infected with the virus if they are HIV negative.

Anal Intercourse:

Being the receptive partner – the "bottom" – during unprotected anal intercourse is linked to a high risk of HIV infection. The reason for this is that HIV-infected semen can come into contact with mucosal tissues in the anus that can be damaged easily during anal intercourse. And the risk of HIV transmission isn't necessarily reduced if the "top" pulls out before ejaculation – studies have demonstrated that pre-ejaculate (pre-cum) can contain high amounts of HIV and can result in transmission during anal intercourse.

It's important to note that both MSM and heterosexuals have anal intercourse. Many heterosexuals report that it is a pleasurable form of intimacy that eliminates the risk of pregnancy. However, it is still associated with a high risk of HIV infection, if condoms are not used and the insertive partner's HIV status is either positive or not known.

Is the insertive partner (the "top") also at risk during unprotected anal intercourse? At least eight studies conducted over the years were unable to demonstrate a clear link between insertive anal sex and a risk for HIV infection among MSM. However, these studies should not be interpreted to mean that being the top during anal intercourse – and not using a condom – is without risk. We know that men can be infected with HIV through vaginal intercourse – an activity in which they are the insertive partner. Based on this knowledge, it is also believed that the insertive partner during unprotected anal intercourse can also be infected with HIV. Studies, using mathematical estimates, suggest that unprotected insertive anal sex is roughly four to 14 times less risky than unprotected receptive anal sex. However, experts still believe that the risk for transmission is noteworthy.

Penile-Oral Sex

Of the different sex acts, the one that often causes the greatest amount of confusion in terms of risk – and raises the greatest number of questions – is penile-oral sex. The fact is, most experts agree that fellatio, sometimes referred to as "blow jobs," is not an efficient route of HIV transmission. However, this does not mean that it cannot happen.

Research attempting to evaluate the risk of fellatio has often faced important limitations. For starters, very few people participating in studies only engaged in penile-oral sex. Many people also had unprotected vaginal or anal intercourse, making it very difficult to determine if unprotected fellatio is an "independent factor" associated with HIV transmission. There are also people who test positive for HIV and claim that unprotected fellatio was their only risky behavior. However, it's virtually impossible to know if these people are always reporting their sexual behavior accurately. (Study volunteers often have a difficult time admitting the truth about potentially embarrassing behavior to healthcare professionals conducting scientific studies.)

Because unprotected fellatio can mean that body fluids from one person can (and do) come into contact with the mucosal tissues or open cuts, sores, or breaks in the skin of another person, there is a "theoretical risk" of HIV transmission. "Theoretical risk" means that passing an infection from one person to another is considered possible, even though there haven't been any (or only a few) documented cases. This term can be used to differentiate from documented risks. Having unprotected receptive anal or vaginal intercourse with an HIV-positive partner is a documented risk, as they have been shown in numerous studies to be an independent risk factor for HIV infection. Having unprotected oral sex is a theoretical risk, as it is considered possible, but has never been shown to be an independent risk factor for HIV infection in studies.

Here's a good way to think about theoretical risk: In theory, it is possible that while walking down the street, a meteor will fall on your head and kill you instantly. This is because meteors do occasionally fall to earth. People live their lives above ground, so there is a theoretical risk of being hit be a meteor. In fact, there have been reports of a few people being hit by meteors. But because the risk is so small, given that few meteors fall to earth and the large number of inhabitants of this planet, the risk is purely theoretical. The same principle holds true with oral sex – millions of people all over the world are believed to engage in unprotected oral sex and there have only been a handful of documented cases of HIV transmission. In turn, fellatio, and other types of oral sex (see below), remains a theoretical risk for HIV infection.

There have been a number of studies that have closely followed MSM and heterosexual couples, in which one partner was HIV positive and the other partner was HIV negative. In all of the studies, couples that used condoms consistently and correctly during every experience of vaginal or anal sex – but didn't use condoms during oral sex – did not see HIV spread from the HIV positive partner to the HIV negative partner.

There have been three case reports and a few studies suggesting that some people have been infected with HIV as a result of unprotected oral sex. However, these case reports and studies all involved MSM – men who were the receptive partners (the person doing the "sucking") during unprotected oral sex with another HIV-positive man. There haven't been any case reports or studies documenting HIV infection among female receptive partners during unprotected oral sex. Even more importantly, there hasn't been a single documented case of HIV transmission to an insertive partner (the person being "sucked") during unprotected oral sex, either among MSM or heterosexuals.

Is insertive oral sex a possible route of HIV transmission? Yes. But is it a documented risk? Absolutely not.

Oral-Vaginal Sex

Like the study of fellatio, evaluating the risk of unprotected oral-vaginal sex (cunnilingus) is difficult, given that most people surveyed in studies did not avoid other types of unsafe sexual activity. However, there have been case reports highlighting one case of female-to-female transmission of HIV via cunnilingus and another case of female-to-male transmission of HIV via cunnilingus. Both of these cases involved transmission from receptive partner (the one receiving oral sex) to the insertive partner (the one performing oral sex). There haven't been any documented cases of HIV transmission from the insertive partner to the receptive partner.

Oral-Anal Sex

Oral-anal sex is often referred to as analingus. Analingus, or "rimming," is not considered to be an independent risk factor for HIV. However, it has been shown to be a route of transmission for hepatitis A and B, as well as parasitic infections like giardiasis and amebiasis.

Digital-Anal or Digital-Vaginal Sex

Digital-anal or digital-vaginal sex is the clinical term for "fingering" either the anus or the female genitals (including the vagina). While it is theoretically possible that someone who has an open cut or fresh abrasion on his or her finger or hand can be infected with HIV if coming into contact with blood in the anus or vagina or vaginal secretions, there has never been a documented case of HIV transmission via fingering.

Source: http://www.aidsmeds.com

Treatment News : Possible Cure in Protein That Starves HIV of Needed Building Blocks

Treatment News : Possible Cure in Protein That Starves HIV of Needed Building Blocks

Possible Cure in Protein That Starves HIV of Needed Building Blocks

Focusing on a protein called SAMHD1, a team of researchers believes it has stumbled upon the mechanism in which some immune system cells keep HIV from hijacking their cellular machinery to produce new virus. The findings, published online ahead of print by the journal Nature Immunology, pave the way for novel methods to treat—and potentially cure—HIV infection.

SAMHD1, the international team of scientists explains, is found in white blood cells known as macrophages and related cells known as dendritic cells. Building upon research published last year, demonstrating that SAMHD1 makes it difficult for HIV to infect macrophages, the scientists have helped close the knowledge gap with the discovery that the protein cuts off the supply line of deoxyribonucleotide triphosphate (dNTP)—the building blocks of DNA—which HIV needs to re-create its genetic contents.

When a virus, like HIV, infects a cell, it hijacks the cell’s dNTP. Once the virus replicates, the resulting DNA molecule contains all the genes of the virus and instructs the cell to make more virus.

SAMHD1, the researchers found, protects the cell from viruses by destroying the pool of dNTPs, leaving the virus without any building blocks to make its genetic information, a process known as nucleotide pool depletion.

“SAMHD1 essentially starves the virus,” explained Nathaniel Landau, PhD, a professor of microbiology at New York University School of Medicine and a lead author of the Nature Immunology paper in an accompanying news announcement. “The virus enters the cell, and then nothing happens. It has nothing to build and replicate with, so no DNA is made.”

As a result, the most common form of HIV—HIV-1—does not readily infect these cells. Instead, the virus has evolved to replicate mainly in CD4 cells, which do not contain SAMHD1 and therefore have a healthy pool of dNTPs.

The virus, the researchers suggest, may have evolved in such a way that it deliberately avoids trying to infect immune cells that have SAMHD1, in order to avoid alerting the greater immune system to activate a variety of antiviral mechanisms to attack the virus.

The team also discovered how a protein in the other form of HIV—HIV-2, which is found mainly in Africa—knocks out SAMHD1. They found that the protein Vpx destroys SAMHD1, clearing the way for HIV-2 to infect macrophages. While scientists have known that HIV-2 needs Vpx to infect macrophages, they hadn’t known precisely why.

Interestingly, while one might think that a virus that is able to replicate itself in crucial cells like macrophages might be more dangerous than one that cannot, that’s not the case with HIV. The researchers note that HIV-2 is generally actually less virulent than HIV-1.

One possible explanation for this is that, like a starving man who becomes increasingly desperate for food, HIV-2—when faced with a shortage of raw materials—puts its mutation capabilities into overdrive, creating the Vpx proteins necessary to circumvent the pathway blocked by SAMHD1.

“Viruses are remarkably clever about evading our immune defenses,” Landau said. “They can evolve quickly and have developed ways to get around the systems we naturally have in place to protect us. It’s a bit of evolutionary warfare, and the viruses, unfortunately, usually win. We want to understand how the enemy fights so that we can outsmart it in the end.”

Understanding the mechanism by which SAMHD1 protects cells may provide a new idea about how to stop or slow the virus’s ability to spread, the researchers explained. Potential future research efforts, for example, might focus on finding a way to increase the amount of SAMHD1 in cells where it does not exist, such as CD4 cells, or to reduce the amount of dNTPs in cells vulnerable to infection.

This could potentially force HIV to remain dormant in all immune system cell lines, unable to replicate—another functional cure strategy.

“Over the past few years, a number of these natural resistance mechanisms have been identified, specifically in HIV,” Landau sad. “This is a very exciting time in HIV research. Many of the virus’s secrets are being revealed through molecular biology, and we’re learning a tremendous amount about how our immune system works through the study of HIV.”

Source: http://www.poz.com