Monday, March 30, 2009

We know that gay men are at higher risk for HIV. What about lesbian women?

HIV is a virus without any preference of sexual orientation, gender, race, or class. It is important to remember that just because a couple is composed of two women, neither party is immune to HIV.
HIV can be transmitted when infected blood and/or vaginal secretions come into contact with a woman's genitals, mouth or with open cuts anywhere on the body. Hence, it is important that when making physical contact to cover the hand with a latex glove. Nothing should be inserted directly in the vagina or around the genital area or anus after it has been in a woman's vagina. This can spread vaginal infections and STDs.

Oral sex between lesbians may still pose a threat for HIV transmission. A dental dam, a split latex glove, or condom is recommended as safety precautions to be used during lesbian sex in order to protect both parties.

What does testing positive for HIV mean? What is meant by the window period? How does a false positive relate to it?

A window period is a recommended waiting period to receive an accurate HIV test result. Generally, it is a six-week to six-month period from the moment of your last unsafe sex encounter to the moment that you receive a HIV screening. This is the time your body uses to create antibodies in the blood stream, which signify exposure to HIV. This process is known as seroconversion.
It is important when receiving an HIV test to ask what kind of test is being used. Whenever someone is screened for HIV, two types of tests are used. They are, 1) a reactive test, and 2) a confirmatory test. A reactive HIV test indicates if HIV antibodies are in the blood (such as the Elisa Test). A reactive test may give a false positive reading to anyone with kidney or renal failure, to a woman that has had multiple pregnancies, anyone receiving the influenza vaccine, or to anyone that has received gamma globulin. When a reactive test has a negative result, that means no HIV antibodies were detected. But in order to receive an accurate reading, the CDC recommends you wait a specific window period: six weeks to six months and either abstain from all sexual activity, or practice safe sex in every sexual situation, and then get a confirmatory test, such as the Western Blot Test.
A confirmatory test (such as the Western Blot) provides the HIV status of a person. A positive test result on a confirmatory test means that the person has been infected with HIV, has HIV antibodies in his or her blood, and can infect others.

Can HIV be transmitted through semen during oral sex?

Yes, it can. HIV can be transmitted through the exchange of body fluids (e.g. blood, semen, saliva, and vaginal secretions). HIV is transmittable through all forms of sexual intercourse (oral, vaginal, and anal) when one or both partners are infected with HIV. Oral sex without a latex condom places you at risk of exposure to HIV. It should also be noted that pre-ejaculation fluid can carry HIV and it can be absorbed into the thin mucous linings of the mouth. The Center for Disease Control (CDC) recommends that during oral sex, a latex condom should be used to decrease risk of exposure.

If I'm pregnant and have HIV, will my baby have HIV too?

Most babies born to HIV-infected women escape the virus, but 1 in 4 do become infected before or during birth or through breast-feeding, although no one is certain when viral transmission occurs. Transmission may also be linked to the mother's health during the pregnancy or birth. There are more viruses during the earliest stages of AIDS than later, for example. Currently, physicians may prescribe drug Retrovir (AZT) for infected pregnant women to reduce rates of transmission; effectiveness of this therapy increases the earlier HIV is diagnosed during the course of infection or before or after pregnancy.

What research and advances have investigators made concerning HIV/AIDS and women?

Very few women with HIV were included in early studies of the epidemic, but in 1994, women accounted for 18% of adult participants in the AIDS Clinical Trials Group of the National Institute of Allergy and Infectious Disease. Studies are focusing on clinical signs of HIV infection in women and on the relationships between pregnancy and HIV. Researchers are investigating "female-controlled" methods of protection by developing creams or gels that women would apply before intercourse to protect themselves from HIV and other sexually transmitted diseases. There is no conclusive evidence on the effectiveness of contraceptive films as a HIV-transmission prevention tool.

Is there any treatment or a cure for HIV/AIDS?

Currently, there is no known cure for HIV/AIDS. The best treatment right now seems to be prescription "cocktails," or combinations of prescription drugs. These medications include those for antiviral treatment and other drugs, like oral antifungals to combat yeast infections, which fight diseases that take advantage of the weakened immune response of HIV-infected people. It is also important for HIV-infected women and their physicians to watch for pelvic inflammatory disease or other STDs through screening. Similarly, cervical cancer may be more common and progress more quickly in infected women; for this reason, women with HIV should have Pap Smears twice a year to make sure cancer is detected and treated early.

How can I reduce my chances of contracting the human immunodeficiency virus (HIV), the virus that causes AIDS?

Since women constitute the most rapidly growing segment of the HIV-infected population in the United States, AIDS prevention is particularly important for women's health. HIV is transmitted through bodily secretions, like blood and semen. Using injection drugs, having unprotected sex with someone who has used injection drugs, having unprotected sex with a man who has had sex with another man, and having multiple sex partners all increase the chances of acquiring HIV. According to the FDA, the best way to protect yourself against HIV is abstinence from sexual intercourse and illegal drug use. If you have intercourse, be sure it is with one uninfected partner or that you properly use barrier methods such as condoms and dental dams.

What are the symptoms of HIV/AIDS in women?

Symptoms that could serve as warning signals of HIV infection may go ignored because many women do not perceive themselves at risk. Symptoms include recurrent yeast infections (vaginal candidiasis), pelvic inflammatory disease, abnormal changes or dysplasia (growth and presence of precancerous cells) in cervical tissue, genital ulcers, genital warts, and severe mucosal herpes infections may also accompany HIV infection in women.
It is possible for a person infected with HIV to show no signs of infection. For women, the most common symptoms of exposure to the HIV virus are frequent or severe vaginal infections, abnormal PAP smears, or pelvic infections (PID) that are difficult to treat.
Within a few weeks of having been infected, many people have flu-like symptoms. However, in some cases, symptoms do not show for many years. As the infection progresses, some symptoms can include 1) swollen lymph glands in the neck, underarm, or groin area, 2) recurrent fever including "night sweats," 3) rapid weight loss for no apparent reason, 4) constant tiredness, 5) diarrhea and decreased appetite, 6) white spots or unusual blemishes in the mouth.

Saturday, March 28, 2009

Who provides HIV and AIDS care in the home? – Family and friends

Family members and friends provide the majority of home care for people with HIV and AIDS. Among this group, however, the provision of care falls disproportionately to women and older people. In one South African study, over two-thirds of family caregivers in households affected by HIV and AIDS were women or girls.14 It is estimated that half of all older people in areas severely affected by AIDS are involved in caring for older children with HIV and/or AIDS orphans.15 This burden of care assumed by women and the elderly has been recognised at the highest levels. The United Nations’ 2006 Political Declaration on HIV/AIDS advocates ‘providing support and rehabilitation to these children and their families, women and the elderly, particularly in their role as caregivers’.16 At an awareness raising concert former South African president, Nelson Mandela, specifically mentioned these carers as deserving of more attention:

What HIV care is needed at home?


Although people living with HIV can be healthy and strong and live perfectly ‘normal’ lives they can experience a range of symptoms that will affect their day-to-day life, and for which they will need care and assistance. In a survey of home-based care patients in Malawi just 15% were able to live as if they did not have the disease. More than one-third needed help with washing and walking, and 28% needed help going to the toilet.11 In a study in South Africa, around 16-17% of people could not control their bladders or bowels and needed help getting on and off the toilet. A similar proportion required help with washing themselves. Poor sanitation makes many of these tasks all the more difficult. In the South African survey less than half of the households had a tap and only 20% of rural homes had access to a flush toilet, with a quarter having no access to any form of toilet or latrine.1



Given the often debilitating effects of HIV, people living with the disease may need assistance performing simple tasks that most of us would take for granted. These could include washing, cooking, feeding, cleaning, purchasing household essentials, going to the toilet and other needs not necessarily specific to AIDS but essential in helping a person live a relatively stable life.

More HIV-related tasks could include purchasing, administering and supporting adherence to ARV drugs and pain relief medication if the infected person is receiving such treatment, as well as helping with nutrition, as the person’s diet may differ from other members of the household. Monitoring and recording progress, making notes of events such as toilet visits, fluid intake and symptom occurrence are also other tasks that can be undertaken by family and home-based care workers and volunteers.13 These very practical measures are in addition to seeing to the person’s social, psychological and emotional needs – often termed ‘psychosocial’ needs – which all of us have but which are often broader and more severe if living with HIV


Why HIV and AIDS care in the home?

The diminished capacity of many countries’ health sectors makes the prospect of having people with HIV treated at home all the more attractive to governments. One South African hospital reported patients’ average stay decreased from 14 days to 3.5 days when referred to a home-based care organisation.6

A potential benefit of being cared for at home is that sick people are continually surrounded by people they love and are familiar with, so they can also receive more flexible and nurturing care. They will also not be exposed to hospital-based infectious diseases. As people with terminal illness generally spend their final moments at home, strengthening the capacity to be cared for also removes the cost and distress of travelling to and from the hospital when they are weakest.

In the UK, the majority of people die in hospital despite between 56% and 74% of people preferring to die at home.7 One cancer patient stated his preferred location of care as:

“Here at home. It’s because I have got my family support here, because the kids are good. My stepson lives with us and my step daughter turns up every now and again.“8

Furthermore, in being cared for at home, a person with HIV may be in a more ready position to work or look after family members for short periods of time while the primary earners work. The family’s time that would otherwise be used travelling to and from hospital can instead be spent doing house work and looking after other family members. Expenditure on transport and hospital costs is also reduced.9

Despite the potential benefits of being cared for at home, often there is little choice as to where someone with HIV is cared for. As mentioned, health facilities may not be able to cope and furthermore, fear of stigma and discrimination from doctors and nurses directed towards people living with HIV could deter people from seeking care in a medical setting. So too could a lack of knowledge that effective treatment is available.10

Why HIV and AIDS care in the home?

t is estimated that up to 90 percent of illness care is provided in the home by untrained family and associates, and up to 80 percent of AIDS-related deaths occur in the home.1 This location of care is determined greatly by the scale of the epidemic.

In many African countries the adult prevalence rate is over 15%, with the number of infected people as high as 5.7 million in South Africa1.5 million in Mozambique and 2.6 million in Nigeria. Typically, countries with high prevalence have overstretched health systems, a lack of resources and among the lowest levels of hospital beds and health workers per person. The massive epidemic itself contributes to the overburdened health sector. In Kenya, for example, 50-60% of public hospital beds are occupied by HIV patients.2

Country Doctors per 1000 population3 Nurses per 1000 population4 Adult (15-49) HIV Prevalence5
Tanzania 0.02 0.37 6.2%
Namibia 0.30 3.06 15.3%
Botswana 0.40 2.65 23.9%
United States 2.56 9.37 0.6%
France 3.37 7.24 0.4%
Cuba 5.91 7.44 0.1%

There are relatively few health workers per person in many African countries making the home the likely location of HIV and AIDS care.


Friday, March 27, 2009

Women and children


An HIV positive woman and her baby with a co-blister pack of antiretroviral medication
Mother-to-child transmission (MTCT) is an issue that directly affects women and at the same time increases the spread of HIV. MTCT occurs when an HIV positive woman passes the virus to her baby during pregnancy, labour and delivery, or breastfeeding. UNAIDS say that at the end of 2007 there were an estimated 2 million children (under 15 years) living with HIV, most of whom were infected by their mothers19. A large number of these children will not live to adulthood.
Although there are drugs that can reduce the chances of a child acquiring HIV from its mother from about 40% to less than 2%, they are unavailable in many parts of the world. In recent years drugs companies have significantly reduced the price of drugs such as nevirapine and AZT, which help to prevent MTCT in developing countries. However, because of limited human resources and poor infrastructures, many women are still not receiving these drugs. See Preventing Mother-to-child Transmission Worldwide for more information

How is the HIV/AIDS epidemic affecting women?


A young woman with AIDS is comforted by her sister
In areas with few palliative carefacilities, when a person becomes ill from AIDS the care is usually a woman’s responsibility. In 2004 in Vietnam for example, 75 percent of all caregivers for persons living with HIV/AIDS were women16. This care giving is usually in addition to many other tasks that women perform within the household, such as cooking, cleaning, and caring for the children and the elderly
Caring for ill parents, children or husbands is unpaid and can increase a person’s workload by up to a third17. Women often struggle to bring in an income whilst providing care and therefore many families affected by AIDS suffer from increasing poverty. In some areas of sub-Saharan Africa where a family’s livelihood relies on growing and maintaining crops, the death of farmers can lead to famine18.
The HIV/AIDS epidemic also affects young girls and elderly women. Often households where both the husband and the wife are ill from AIDS, girls are usually the main carers, even if it means that they have to miss school. If both parents die then it tends to be the grandmothers, aunts or cousins who then look after the AIDS orphans

Women and HIV/AIDS - the global picture


The percentage of women living with HIV/AIDS varies significantly between different regions of the world. In areas such as Europe and Oceania, women account for a relatively low percentage of HIV infected people. However, in regions such as sub-Saharan Africa and the Caribbean, the percentage is significantly higher.
An HIV positive woman in Joza
In 1985 in sub-Saharan Africa there were as many HIV infected men as there were women. However as the infection rate has increased over the years, the number of women living with HIV/AIDS has overtaken and remained higher than the number of infected men. In 2007 there were around 12 million women living with HIV/AIDS, compared to about 8.3 million men. UNAIDS have estimated that around three quarters of all women with HIV live in sub-Saharan Africa4.
Sub-Saharan Africa is one region of the world where the majority of HIV transmission occurs during heterosexual contact. As women are twice as likely to acquire HIV from an infected partner during unprotected heterosexual intercourse than men5, women are disproportionately infected in this region.

Women, HIV and AIDS

At the end of 2007 it was estimated that out of the 30.8 million adults worldwide living with HIV and AIDS, around half are women1. It is suggested that 98 percent of these women live in developing countries2. The AIDS epidemic has had a unique impact on women, which has been exacerbated by their role within society and their biological vulnerability to HIV infection.
Generally women are at a greater risk of heterosexual transmission of HIV. Biologically women are twice more likely to become infected with HIV through unprotected heterosexual intercourse than men3. In many countries women are less likely to be able to negotiate condom use and are more likely to be subjected to non-consensual sex.
Additionally, millions of women have been indirectly affected by the HIV/AIDS epidemic. Women’s childbearing role means that they have to contend with issues such as mother-to-child transmission of HIV. The responsibility of caring for AIDS patients and orphans is also an issue that has a greater effect on women.
There are a number of things that can be done in order to reduce the burden of the epidemic among women. These include promoting and protecting women's human rights, increasing education and awareness among women and encouraging the development of new preventative technologies such as post-exposure prophylaxis and microbicides.

Tuesday, March 24, 2009

Other evidence

Even Koch recognized that in some cases not all of his conditions could be met, so other evidence should also be considered. This is particularly true when the germ is a virus rather than a bacterium.16 Modern scientists are willing to consider a wide range of evidence. In particular, we can ask five key questions:

  • Do surveillance statistics show a relationship between HIV and AIDS?
  • How well does HIV infection predict illness and death?
  • Do drugs designed to combat HIV benefit people with AIDS?
  • Are there any credible causes besides HIV?
  • What can we learn from Africa?

We'll address these questions after looking at Koch's Postulates.

How can we prove that HIV causes AIDS?

Koch's Postulates

In the nineteenth century, the German scientist Robert Koch developed a set of four "postulates" to guide people trying to prove that a germ causes a disease. Scientists agree that if HIV satisfies all of these conditions with regard to AIDS then it must be the cause of AIDS:15

  • Koch 1: The germ must be found in every person with the disease
  • Koch 2: The germ must be isolated from someone who has the disease and grown in pure culture
  • Koch 3: The germ must cause the disease when introduced into a healthy person
  • Koch 4: The germ must be re-isolated from the infected person

Problems with the definition?

The definition of AIDS usually requires a positive HIV test. This means that any connection between HIV and AIDS is artificially strengthened because any cases of "HIV-free AIDS" are discounted. In other words, the definition already assumes that HIV causes AIDS, so it can't be used to prove that theory. However, it is possible to redefine AIDS without reference to HIV or even to any other diseases.

The alternative definition of AIDS requires a CD4+ cell count consistently below 200 cells per cubic millimetre of blood, which cannot be explained by any factor other than HIV (such as cancer, malnutrition, radiation or chemotherapy). No HIV test is required.

It turns out that the vast majority of people diagnosed with AIDS fit these criteria. They form a population that barely existed before 1980, but which now numbers hundreds of thousands in the USA and Europe alone. People with such severe immune deficiency are at very high risk of developing serious illnesses and usually die within months (unless they take antiretroviral drugs).We can use this simple, unambiguous definition to test the association between HIV and AIDS.

What is AIDS?

Before we can begin to look for a cause, we must first work out exactly what type of illness we are talking about.

In early 1981, doctors in New York and California began to report some bizarre new disease outbreaks. In both places, previously healthy young men were showing up with rare illnesses including Kaposi's sarcoma (a kind of tumour) and PCP (a type of pneumonia), which until then had been virtually unheard of among such people. Within months, dozens of similar cases had been reported in 23 American states and in the UK, representing the start of a massive and unprecedented epidemic.5

Doctors soon discovered a distinctive feature of these cases. More than anything else, the men were lacking a specific type of white blood cell, which is essential to a healthy immune system. Normally, people have between 600 and 1,500 "CD4+ cells" (also called T helper cells) in each cubic millimetre of their blood. But the men with the strange new disease typically had very much lower levels. This immune deficiency explained why they were so vulnerable to disease.

The cases were clearly related in time and by population group (initially gay men and injecting drug users). No cause of immune deficiency could be found, but it was clearly not inherited. Scientists therefore grouped together all of these strange new cases under the heading "Acquired Immune Deficiency Syndrome" – or AIDS for short.

In 1982, no-one claimed to know the cause of AIDS, so the first definition was based on the diagnosis of one of 13 rare diseases known to be linked to immune deficiency (including Kaposi's sarcoma and PCP) "occurring in a person with no known cause for diminished resistance to that disease".6 Over the years, the US definition has been refined as hundreds of thousands of similar cases have been documented, sometimes involving other diseases, but always associated with the same distinctive immune deficiency.7 Other definitions have also been developed to suit different situations elsewhere in the world.8

The latest US AIDS definition was created in 1993. Under this definition, someone has AIDS if they have one of 26 specific diseases (28 in children) but no known cause of immune deficiency other than HIV (with some diseases, a positive HIV test is required); or if they have a CD4+ cell count below 200 cells per cubic millimetre of blood, or less than 14% of all lymphocytes, plus a positive HIV test.9

Europe and Canada have similar AIDS definitions to the US, but do not include low CD4+ cell counts.

Who doubts that HIV causes AIDS?

By far the most significant scientist to question the HIV/AIDS theory is Professor Peter Duesberg, a virologist at the University of California at Berkeley, who first wrote about this topic in 1987. Throughout the 1990s and into the new millennium, as HIV/AIDS researchers announced many new discoveries and amassed huge volumes of data, Dr Duesberg remained unconvinced. He admits that HIV exists, but he maintains that it is harmless, and that AIDS is caused by non-contagious factors including drug abuse, malnutrition, and even the very drugs used to combat HIV.2

Other dissidents (often called "denialists" by their opponents) include the Perth Group of medical scientists and physicians from Australia. The Perth Group (led by Eleni Papadopulos) claims that nobody has conclusively proven the existence of HIV, so any proof that HIV causes AIDS has no foundation.3

Dissident arguments have received attention from the popular media, as well as from scientific journals. And with the rise of the Internet, alternative views have found a much wider audience, so that scarcely anyone interested in AIDS can have failed to hear of them.

Some of their followers are intrigued by conspiracy theories involving sinister drug companies or government persecution of minority groups. But alternative explanations can also appeal to those diagnosed with HIV or AIDS, who read that their condition might not be fatal, that they shouldn't take toxic drugs, and that unprotected sex poses no risks. Even a few AIDS service organisations have adopted non-HIV viewpoints.4

However, the proportion of scientists who doubt that HIV causes AIDS is tiny, and shows no sign of increasing. Interest in dissident views appears to have dwindled after the excitement surrounding Thabo Mbeki's AIDS panel and the Durban Declaration in 2000. It seems likely that new and better evidence, including the obvious benefits of modern drug treatments, has caused many former-dissidents to change their minds.

Introduction

"AIDS is caused by infection with a virus called human immunodeficiency virus (HIV). This virus is passed from one person to another through blood-to-blood and sexual contact."1

That's the standard explanation of what causes AIDS. But what evidence do scientists have to support this theory? And why do some websites say that the world has got it terribly wrong – that HIV does not cause AIDS at all?

As an independent AIDS organisation founded in 1986, AVERT has taken a keen interest in the ongoing debate about what causes AIDS. As well as investigating the consensus position, we have followed and carefully considered the arguments of the dissident minority who claim that HIV is harmless or even that it might not exist. This topic is vitally relevant to how our organisation works to prevent people developing AIDS and to help those who are suffering.

It is AVERT's considered opinion that the evidence that HIV causes AIDS is abundant and conclusive. This page outlines some of that evidence, while also mentioning how some dissidents have interpreted things differently. In particular, we'll look for proofs of the following:

  • AIDS is a new epidemic disease
  • AIDS does not occur without HIV
  • HIV infection is the only factor that predicts who will develop AIDS
  • Surveillance statistics support the HIV theory
  • Modern antiretroviral treatment is highly beneficial.

Sunday, March 22, 2009

What are the implications for an AIDS vaccine?

The development of an AIDS vaccine is affected by the range of virus subtypes as well as by the wide variety of human populations who need protection and who differ, for example, in their genetic make-up and their routes of exposure to HIV. In particular, the occurrence of superinfection indicates that an immune response triggered by a vaccine to prevent infection by one strain of HIV may not protect against all other strains. The effectiveness of a vaccine is likely to vary in different populations unless some innovative method is developed which guards against many virus strains.

Inevitably, different types of candidate vaccines will have to be tested against various viral strains in multiple vaccine trials, conducted in both high-income and developing countries.

What are the treatment implications?

Although most current HIV-1 antiretroviral drugs were designed for use against subtype B, there is no compelling evidence that they are any less effective against other subtypes. Nevertheless, some subtypes may be more likely to develop resistance to certain drugs, and the types of mutations associated with resistance may vary. This is an important subject for future research.

The effectiveness of HIV-1 treatment is monitored using viral load tests. It has been demonstrated that some such tests are sensitive only to subtype B and can produce a significant underestimate of viral load if used to process other strains. The latest tests do claim to produce accurate results for most Group M subtypes, though not necessarily for Group O. It is important that health workers and patients are aware of the subtype/CRF they are testing for and of the limitations of the test they are applying.

Not all of the drugs used to treat HIV-1 infection are as effective against HIV-2. In particular, HIV-2 has a natural resistance to NNRTI antiretroviral drugs and they are therefore not recommended. As yet there is no FDA-licensed viral load test for HIV-2 and those designed for HIV-1 are not reliable for monitoring the other type. Instead, response to treatment may be monitored by following CD4+ T-cell counts and indicators of immune system deterioration. More research and clinical experience is needed to determine the most effective treatment for HIV-2.25

Do HIV antibody tests detect all types, groups and subtypes?

Initial tests for HIV are usually conducted using the EIA (or ELISA) antibody test or a rapid antibody test.

EIA tests which can detect either one or both types of HIV have been available for a number of years. According to the US Centers for Disease Control and Prevention, current HIV-1 EIAs "can accurately identify infections with nearly all non-B subtypes and many infections with group O HIV subtypes."22 However, because HIV-2 and group O infections are extremely rare in most countries, routine screening programs might not be designed to test for them. Anyone who believes they may have contracted HIV-2, HIV-1 group O or one of the rarer subtypes of group M should seek expert advice.

Rapid tests - which can produce a result in less than an hour - are becoming increasingly popular. Most modern rapid HIV-1 tests are capable of detecting all the major subtypes of group M.23 Rapid tests which can detect HIV-2 are also now available.24

Is it possible to be infected more than once?

Until about 1994, it was generally thought that individuals do not become infected with multiple distinct HIV-1 strains. Since then, many cases of people coinfected with two or more strains have been documented.

All cases of coinfection were once assumed to be the result of people being exposed to the different strains more or less simultaneously, before their immune systems had had a chance to react. However, it is now thought that "superinfection" is also occurring. In these cases, the second infection occurred several months after the first. It would appear that the body's immune response to the first virus is sometimes not enough to prevent infection with a second strain, especially with a virus belonging to a different subtype. It is not yet known how commonly superinfection occurs, or whether it can take place only in special circumstances.20 21

Are there differences in transmission?

It has been observed that certain subtypes/CRFs are predominantly associated with specific modes of transmission. In particular, subtype B is spread mostly by homosexual contact and intravenous drug use (essentially via blood), while subtype C and CRF A/E tend to fuel heterosexual epidemics (via a mucosal route).

Whether there are biological causes for the observed differences in transmission routes remains the subject of debate. Some scientists, such as Dr Max Essex of Harvard, believe such causes do exist. Among their claims are that subtype C and CRF A/E are transmitted much more efficiently during heterosexual sex than subtype B.9 10 However, this theory has not been conclusively proven.11 12

More recent studies have looked for variation between subtypes in rates of mother-to-child transmission. One of these found that such transmission is more common with subtype D than subtype A.13 Another reached the opposite conclusion (A worse than D), and also found that subtype C was more often transmitted that subtype D.14 A third study concluded that subtype C is more transmissible than either D or A.15 Other researchers have found no association between subtype and rates of mother-to-child transmission.16 17 18 19

The implications of variability

Does subtype affect disease progression?

A study presented in 2006 found that Ugandans infected with subtype D or recombinant strains incorporating subtype D developed AIDS sooner than those infected with subtype A, and also died sooner, if they did not receive antiretroviral treatment. The study's authors suggested that subtype D is more virulent because it is more effective at binding to immune cells.5 This result was supported by another study presented in 2007, which found that Kenyan women infected with subtype D had more than twice the risk of death over six years compared with those infected with subtype A.6 An earlier study of sex workers in Senegal, published in 1999, found that women infected with subtype C, D or G were more likely to develop AIDS within five years of infection than those infected with subtype A.7

Several studies conducted in Thailand suggest that people infected with CRF A/E progress faster to AIDS and death than those infected with subtype B, if they do not receive antiretroviral treatment.8

Are more subtypes likely to "appear"?

It is almost certain that new HIV genetic subtypes and CRFs will be discovered in the future, and indeed that new ones will develop as virus recombination and mutation continue to occur. The current subtypes and CRFs will also continue to spread to new areas as the global epidemic continues.

Where are the different subtypes and CRFs found?

The HIV-1 subtypes and CRFs are very unevenly distributed throughout the world, with the most widespread being subtypes A and C.

Subtype A and CRF A/G predominate in West and Central Africa, with subtype A possibly also causing much of the Russian epidemic.4

Historically, subtype B has been the most common subtype/CRF in Europe, the Americas, Japan and Australia. Although this remains the case, other subtypes are becoming more frequent and now account for at least 25% of new infections in Europe.

Subtype C is predominant in Southern and East Africa, India and Nepal. It has caused the world's worst HIV epidemics and is responsible for around half of all infections.

Subtype D is generally limited to East and Central Africa. CRF A/E is prevalent in South-East Asia, but originated in Central Africa. Subtype F has been found in Central Africa, South America and Eastern Europe. Subtype G and CRF A/G have been observed in West and East Africa and Central Europe.

Subtype H has only been found in Central Africa; J only in Central America; and K only in the Democratic Republic of Congo and Cameroon.

What about subtypes E and I?

One of the CRFs is called A/E because it is thought to have resulted from hybridization between subtype A and some other "parent" subtype E. However, no one has ever found a pure form of subtype E. Confusingly, many people still refer to the CRF A/E as "subtype E" (in fact it is most correctly called CRF01_AE).2

A virus isolated in Cyprus was originally placed in a new subtype I, before being reclassified as a recombinant form A/G/I. It is now thought that this virus represents an even more complex CRF comprised of subtypes A, G, H, K and unclassified regions. The designation "I" is no longer used.3

How many subtypes of HIV-1 are there?











The strains of HIV-1 can be classified into three groups: the "major" group M, the "outlier" group O and the "new" group N. These three groups may represent three separate introductions of simian immunodeficiency virus into humans.

Group O appears to be restricted to west-central Africa and group N - discovered in 1998 in Cameroon - is extremely rare. More than 90% of HIV-1 infections belong to HIV-1 group M and, unless specified, the rest of this page will relate to HIV-1 group M only.

Within group M there are known to be at least nine genetically distinct subtypes (or clades) of HIV-1. These are subtypes A, B, C, D, F, G, H, J and K.

Occasionally, two viruses of different subtypes can meet in the cell of an infected person and mix together their genetic material to create a new hybrid virus (a process similar to sexual reproduction, and sometimes called "viral sex").1 Many of these new strains do not survive for long, but those that infect more than one person are known as "circulating recombinant forms" or CRFs. For example, the CRF A/B is a mixture of subtypes A and B.

The classification of HIV strains into subtypes and CRFs is a complex issue and the definitions are subject to change as new discoveries are made. Some scientists talk about subtypes A1, A2, A3, F1 and F2 instead of A and F, though others regard the former as sub-subtypes.

What is the difference between HIV-1 and HIV-2?

There are two types of HIV: HIV-1 and HIV-2. Both types are transmitted by sexual contact, through blood, and from mother to child, and they appear to cause clinically indistinguishable AIDS. However, it seems that HIV-2 is less easily transmitted, and the period between initial infection and illness is longer in the case of HIV-2.

Worldwide, the predominant virus is HIV-1, and generally when people refer to HIV without specifying the type of virus they will be referring to HIV-1. The relatively uncommon HIV-2 type is concentrated in West Africa and is rarely found elsewhere.

Introduction to HIV types, groups and subtypes

HIV is a highly variable virus which mutates very readily. This means there are many different strains of HIV, even within the body of a single infected person.

Based on genetic similarities, the numerous virus strains may be classified into types, groups and subtypes

Friday, March 20, 2009

Red ribbons




Pills and treatment




HIV images



Assembly, Budding and Maturation

Among the strands of messenger RNA produced by the cell are complete copies of HIV genetic material. These gather together with newly made HIV proteins and enzymes to form new viral particles, which are then released from the cell. The enzyme protease plays a vital role at this stage of the HIV life cycle by chopping up long strands of protein into smaller pieces, which are used to construct mature viral cores.

The newly matured HIV particles are ready to infect another cell and begin the replication process all over again. In this way the virus quickly spreads through the human body. And once a person is infected, they can pass HIV on to others in their bodily fluids.

Transcription and Translation

HIV provirus may lie dormant within a cell for a long time. But when the cell becomes activated, it treats HIV genes in much the same way as human genes. First it converts them into messenger RNA (using human enzymes). Then the messenger RNA is transported outside the nucleus, and is used as a blueprint for producing new HIV proteins and enzymes.

Reverse Transcription and Integration

Once inside the cell, the HIV enzyme reverse transciptase converts the viral RNA into DNA, which is compatible with human genetic material. This DNA is transported to the cell's nucleus, where it is spliced into the human DNA by the HIV enzyme integrase. Once integrated, the HIV DNA is known as provirus.

HIV life cycle

HIV can only replicate (make new copies of itself) inside human cells. The process typically begins when a virus particle bumps into a cell that carries on its surface a special protein called CD4. The spikes on the surface of the virus particle stick to the CD4 and allow the viral envelope to fuse with the cell membrane. The contents of the HIV particle are then released into the cell, leaving the envelope behind.

How many genes does HIV have?

HIV has just nine genes (compared to more than 500 genes in a bacterium, and around 20,000-25,000 in a human). Three of the HIV genes, called gag, pol and env, contain information needed to make structural proteins for new virus particles. The other six genes, known as tat, rev, nef, vif, vpr and vpu, code for proteins that control the ability of HIV to infect a cell, produce new copies of virus, or cause disease.

At either end of each strand of RNA is a sequence called the long terminal repeat, which helps to control HIV replication.

What is RNA?



HIV belongs to a special class of viruses called retroviruses. Within this class, HIV is placed in the subgroup of lentiviruses. Other lentiviruses include SIV, FIV, Visna and CAEV, which cause diseases in monkeys, cats, sheep and goats. Almost all organisms, including most viruses, store their genetic material on long strands of DNA. Retroviruses are the exception because their genes are composed of RNA (Ribonucleic Acid).

RNA has a very similar structure to DNA. However, small differences between the two molecules mean that HIV's replication process is a bit more complicated than that of most other viruses.

What does HIV look like?


Unlike most bacteria, HIV particles are much too small to be seen through an ordinary microscope. However they can be seen clearly with an electron microscope.

HIV particles surround themselves with a coat of fatty material known as the viral envelope (or membrane). Projecting from this are around 72 little spikes, which are formed from the proteins gp120 and gp41. Just below the viral envelope is a layer called the matrix, which is made from the protein p17.

The viral core (or capsid) is usually bullet-shaped and is made from the protein p24. Inside the core are three enzymes required for HIV replication called reverse transcriptase, integrase and protease. Also held within the core is HIV's genetic material, which consists of two identical strands of RNA.

HIV stands for Human Immunodeficiency Virus. Like all viruses, HIV cannot grow or reproduce on its own. In order to make new copies of itself it must


What does HIV look like?

Outside of a human cell, HIV exists as roughly spherical particles (sometimes called virions). The surface of each particle is studded with lots of little spikes.

An HIV particle is around 100-150 billionths of a metre in diameter. That's about the same as:

  • 0.1 microns
  • 4 millionths of an inch
  • one twentieth of the length of an E. coli bacterium
  • one seventieth of the diameter of a human CD4+ white blood cell.

Thursday, March 19, 2009

Origin of HIV


Scientists identified a type of chimpanzee in West Africa as the source of HIV infection in humans. The virus most likely jumped to humans when humans hunted these chimpanzees for meat and came into contact with their infected blood. Over several years, the virus slowly spread across Africa and later into other parts of the world. For more information

AIDS










AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection. It can take years for a person infected with HIV, even without treatment, to reach this stage. Having AIDS means that the virus has weakened the immune system to the point at which the body has a difficult time fighting infection. When someone has one or more specific infections, certain cancers, or a very low number of T cells, he or she is considered to have AIDS.

HIV


HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. HIV is different from most other viruses because it attacks the immune system. The immune system gives our bodies the ability to fight infections. HIV finds and destroys a type of white blood cell (T cells or CD4 cells) that the immune system must have to fight disease.

HIV/AIDS and Women

HIV and AIDS were originally thought to affect mostly gay men. However, women have always been affected too. And even though more men than women have HIV, women are catching up. In fact, if new HIV infections continue at their current rate worldwide, women with HIV may soon outnumber men with HIV.

The good news is that many women with HIV are living longer and stronger lives. With proper care and treatment, many women can continue to take care of themselves and others.

In some respects HIV and AIDS affect women in almost the same way they affect men. For example,

  • Women of color (especially African American women) are the hardest hit.
  • Younger women are more likely than older women to get HIV.
  • AIDS is a common killer, second only to cancer and heart disease for women.

How are women getting HIV?

The most common ways are (in order)

  1. having sex with a man who has HIV
  2. sharing injection drug works (needles, syringes, etc.) used by someone with HIV

STATISTICS

HIV/AIDS in 2005
(The following bullets, except for the last one, are based on data from 33 states with long-term, confidential name-based HIV reporting.*)

  • HIV/AIDS was diagnosed for an estimated 9,708 women [3].
  • High-risk heterosexual contact was the source of 80% of these newly diagnosed infections [3].
  • Women accounted for 26% of the estimated 37,163 diagnoses for adults and adolescents [3].
  • Of the 126,964 women living with HIV/AIDS, 64% were black, 19% were white, 15% were Hispanic, 1% were Asian or Pacific Islander, and less than 1% were American Indian or Alaska Native [3].
  • The estimated number of HIV/AIDS in female adults or adolescents decreased from 11,941 in 2001 to 9,708 in 2005 [3].
  • According to a recent CDC study of more than 19,500 patients with HIV in 10 US cities, women were slightly less likely than men to receive prescriptions for the most effective treatments for HIV infection [4].

HIV/AIDS among Women

Early in the epidemic, HIV infection and AIDS were diagnosed for relatively few women and female adolescents (although we know now that many women were infected with HIV through injection drug use but that their infections were not diagnosed) [1]. Today, women account for more than one quarter of all new HIV/AIDS diagnoses. Women of color are especially affected by HIV infection and AIDS. In 2004 (the most recent year for which data are available), HIV infection was

  • the leading cause of death for black women (including African American women) aged 25–34 years.
  • the 3rd leading cause of death for black women aged 35–44 years.
  • the 4th leading cause of death for black women aged 45–54 years.
  • the 4th leading cause of death for Hispanic women aged 35–44 years.
In the same year, HIV infection was the 5th leading cause of death among all women aged 35–44 years and the 6th leading cause of death among all women aged 25–34 years. The only diseases causing more deaths of women were cancer and heart disease

Tuesday, March 17, 2009

Definition of brain tumor

The growth of abnormal cells in the tissues of the brain. Brain tumors can be benign (non-cancerous) or malignant (cancerous).Estimated new cases and deaths from brain and other nervous system tumors in the United States in 2008:
New cases: 21,810
Deaths: 13,070

Definition of bone cancer

Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).Estimated new cases and deaths from cancer of the bones and joints in the United States in 2008:
New cases: 2,380
Deaths: 1,470

Definition of bladder cancer

Cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.Estimated new cases and deaths from bladder cancer in the United States in 2008:
New cases: 68,810
Deaths: 14,100

Definition of extrahepatic bile duct cancer

A rare cancer that forms in the part of the bile duct that is outside the liver. The bile duct is the tube that collects bile from the liver and joins a duct from the gallbladder to form the common bile duct, which carries bile into the small intestine when food is being digested.

Definition of skin cancer

Cancer that forms in tissues of the skin. There are several types of skin cancer. Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma. Skin cancer that forms in basal cells (small, round cells in the base of the outer layer of skin) is called basal cell carcinoma. Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma. Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin. Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems.Estimated new cases and deaths from skin (nonmelanoma) cancer in the United States in 2008:
New cases: more than 1,000,000
Deaths: less than 1,000

Saturday, March 14, 2009

Radiation Therapy

Cancer treatment may vary depending upon the type of cancer, the stage of cancer, and the goal of treatment. Often, one or more treatment modalities may be used in order to provide the most complete treatment for the patient. Increasingly, it is common to use several treatment modalities concurrently (together) or in sequence. This is referred to as multi-modality treatment of the cancer and the modalities may include surgery, chemotherapy, biological therapy, and/or radiation therapy. For the majority of newly diagnosed cancer patients, the optimal treatment may be a multi-modality approach composed of standard therapies that have been established through extensive medical research. For other patients, the most appropriate therapy may still be under investigation and may be available only through a clinical trial.

Radiation therapy works by damaging the DNA in the cancer cell, thereby disabling the cancer cells from reproducing and growing. The cancer cells then die and the cancer shrinks. The objective of radiation therapy is to kill enough cancer cells to maximize the probability of cure and minimize the side effects. Under some circumstances, radiation therapy may also be used as palliation, or palliative care, which is aimed at reducing symptoms but not curing the underlying disease.
Radiation is usually administered in the form of high-energy beams that deposit the radiation dose in the body where cancer cells are located. Radiation therapy, unlike chemotherapy, is considered a local treatment. This means that cancer cells are only killed at the location in the body where the radiation is delivered, called the radiation field. If cancer exists outside the radiation field, those cancer cells are not destroyed by the radiation.

Chemotherapy

Chemotherapy is any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs, and can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment.

More than half of all people diagnosed with cancer receive chemotherapy. For millions of people who have cancers that respond well to chemotherapy, this approach helps treat their cancer effectively, enabling them to enjoy full, productive lives. Furthermore, many side effects once associated with chemotherapy are now easily prevented or controlled, allowing many people to work, travel, and participate in many of their other normal activities while receiving chemotherapy.

Being informed about chemotherapy and its potential side effects can help you to proactively manage your own care and optimize your treatment and outcome

Introduction to Cancer Treatment

Overview of Cancer Treatments

Choice of cancer treatment is influenced by several factors, including the specific characteristics of your cancer; your overall condition; and whether the goal of treatment is to cure your cancer, keep your cancer from spreading, or to relieve the symptoms caused by cancer. Depending on these factors, you may receive one or more of the following:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Hormonal therapy
  • Targeted therapy
  • Biological therapy

One or more treatment modalities may be used to provide you with the most effective treatment. Increasingly, it is common to use several treatment modalities together (concurrently) or in sequence with the goal of preventing recurrence. This is referred to as multi-modality treatment of the cancer.

Surgery

Surgery is used to diagnose cancer, determine its stage, and to treat cancer. One common type of surgery that may be used to help with diagnosing cancer is a biopsy. A biopsy involves taking a tissue sample from the suspected cancer for examination by a specialist in a laboratory. A biopsy is often performed in the physician’s office or in an outpatient surgery center. A positive biopsy indicates the presence of cancer; a negative biopsy may indicate that no cancer is present in the sample.

When surgery is used for treatment, the cancer and some tissue adjacent to the cancer are typically removed. In addition to providing local treatment of the cancer, information gained during surgery is useful in predicting the likelihood of cancer recurrence and whether other treatment modalities will be necessary.

Learn more about surgery.

Chemotherapy

Chemotherapy is any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs, and can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment.

More than half of all people diagnosed with cancer receive chemotherapy. For millions of people who have cancers that respond well to chemotherapy, this approach helps treat their cancer effectively, enabling them to enjoy full, productive lives. Furthermore, many side effects once associated with chemotherapy are now easily prevented or controlled, allowing many people to work, travel, and participate in many of their other normal activities while receiving chemotherapy.

Learn more about chemotherapy treatment and the management of side effects.

Radiation Therapy

Radiation therapy, or radiotherapy, uses high-energy rays to damage or kill cancer cells by preventing them from growing and dividing. Similar to surgery, radiation therapy is a local treatment used to eliminate or eradicate visible tumors. Radiation therapy is not typically useful in eradicating cancer cells that have already spread to other parts of the body. Radiation therapy may be externally or internally delivered. External radiation delivers high-energy rays directly to the tumor site from a machine outside the body. Internal radiation, or brachytherapy, involves the implantation of a small amount of radioactive material in or near the cancer. Radiation may be used to cure or control cancer, or to ease some of the symptoms caused by cancer. Sometimes radiation is used with other types of cancer treatment, such as chemotherapy and surgery, and sometimes it is used alone.

For more information, go to Radiation Therapy.

Hormonal Therapy

Hormones are naturally occurring substances in the body that stimulate the growth of hormone sensitive tissues, such as the breast or prostate gland. When cancer arises in breast or prostate tissue, its growth and spread may be caused by the body’s own hormones. Therefore, drugs that block hormone production or change the way hormones work, and/or removal of organs that secrete hormones, such as the ovaries or testicles, are ways of fighting cancer. Hormone therapy, similar to chemotherapy, is a systemic treatment in that it may affect cancer cells throughout the body.

Targeted Therapy

A targeted therapy is one that is designed to treat only the cancer cells and minimize damage to normal, healthy cells. Cancer treatments that “target” cancer cells may offer the advantage of reduced treatment-related side effects and improved outcomes.

Conventional cancer treatments, such as chemotherapy and radiation therapy, cannot distinguish between cancer cells and healthy cells. Consequently, healthy cells are commonly damaged in the process of treating the cancer, which results in side effects. Chemotherapy damages rapidly dividing cells, a hallmark trait of cancer cells. In the process, healthy cells that are also rapidly dividing, such as blood cells and the cells lining the mouth and GI tract are also damaged. Radiation therapy kills some healthy cells that are in the path of the radiation or near the cancer being treated. Newer radiation therapy techniques can reduce, but not eliminate this damage. Treatment-related damage to healthy cells leads to complications of treatment, or side effects. These side effects may be severe, reducing a patient's quality of life, compromising their ability to receive their full, prescribed treatment, and sometimes, limiting their chance for an optimal outcome from treatment.

Biological Therapy

Biological therapy is referred to by many terms, including immunologic therapy, immunotherapy, or biotherapy. Biological therapy is a type of treatment that uses the body’s immune system to facilitate the killing of cancer cells. Types of biological therapy include interferon, interleukin, monoclonal antibodies, colony stimulating factors (cytokines), and vaccines.

Personalized Cancer Care

There is no longer a “one-size-fits-all” approach to cancer treatment. Even among patients with the same type of cancer, the behavior of the cancer and its response to treatment can vary widely. By exploring the reasons for this variation, researchers have begun to pave the way for more personalized cancer treatment. It is becoming increasingly clear that specific characteristics of cancer cells and cancer patients can have a profound impact on prognosis and treatment outcome. Although factoring these characteristics into treatment decisions makes cancer care more complex, it also offers the promise of improved outcomes.

The idea of matching a particular treatment to a particular patient is not a new one. It has long been recognized, for example, that hormonal therapy for breast cancer is most likely to be effective when the breast cancer contains receptors for estrogen and/or progesterone. Testing for these receptors is part of the standard clinical work-up of breast cancer. What is new, however, is the pace at which researchers are identifying new tumor markers, new tests, and new and more targeted drugs that individualize cancer treatment. Tests now exist that can assess the likelihood of cancer recurrence, the likelihood of response to particular drugs, and the presence of specific cancer targets that can be attacked by new anti-cancer drugs that directly target individual cancer cells.

To learn more about personalized cancer care for two common types of cancer, visit the following:

Friday, March 13, 2009

What’s next?

Following your diagnosis of cancer, your reaction may be one of shock and disbelief. If you have been told that chemotherapy or radiation therapy are an important part of your treatment, many unpleasant images may come to mind. But as you move beyond that initial shock to begin the journey of surviving your cancer, you have many good reasons to be optimistic. Medicine has made—and continues to make—great strides in treating cancer and in making cancer treatment more tolerable, both physically and emotionally.

No one would call cancer a normal experience, but by proactively managing aspects of your treatment, you can maintain a sense of normalcy in your life. Fighting cancer is not a challenge you face alone. It's a team effort that involves family, friends, and your healthcare team. Don't overlook the strength that can come from having your support network by your side.

How did I get cancer?

Although every patient and family member wants to know the answer to this question, the reason people develop cancer is not well understood. There are some known carcinogens (materials that can cause cancer), but many are still undiscovered. We do not know why some people who are exposed to carcinogens get cancer and others do not. The length and amount of exposure are believed to affect the chances of developing a disease. For example, as exposure to cigarette smoking increases, the chance of developing lung cancer also increases. Genetics also plays an important role in whether an individual develops cancer. For example, certain types of breast cancer have a genetic component.

What is Cancer?

Cancer is not one disease, but many diseases that occur in different areas of the body. Each type of cancer is characterized by the uncontrolled growth of cells. Under normal conditions, cell reproduction is carefully controlled by the body. However, these controls can malfunction, resulting in abnormal cell growth and the development of a lump, mass, or tumor. Some cancers involving the blood and blood-forming organs do not form tumors but circulate through other tissues where they grow.

A tumor may be benign (non-cancerous) or malignant (cancerous). Cells from cancerous tumors can spread throughout the body. This process, called metastasis, occurs when cancer cells break away from the original tumor and travel in the circulatory or lymphatic systems until they are lodged in a small capillary network in another area of the body. Common locations of metastasis are the bones, lungs, liver, and central nervous system.

The type of cancer refers to the organ or area of the body where the cancer first occurred. Cancer that has metastasized to other areas of the body is named for the part of the body where it originated. For example, if breast cancer has spread to the bones, it is called "metastatic breast cancer" not bone cancer.

Newly Diagnosed

A new diagnosis of cancer can be a shock, making you feel out of control and overwhelmed. Getting informed can help alleviate these feelings. Remember, very few cancers require emergency treatment; you have time to learn about your diagnosis and treatment options, ask questions, and get a second opinion. This section is designed to help you address your initial questions before you move forward with your treatment.

Wednesday, March 11, 2009

How Stress Affects Your Health

Look around. One of ten people you see at work, at the store, and wherever you go in your daily life is over stressed at any given moment. Scientists agree that stress causes actual chemical changes in the brain, and these changes can influence the state of your health.

Suicide and Suicidal Behavior

Important information that provides an overview of suicide and suicidal behavior. Covers causes, symptoms, treatment, and prevention. Related links provide information about suicide in children and the elderly.

Depression and Women

More than 17 million Americans experience depression every year -- over half of them are women. In fact, women experience depression twice as often as men and they often experience it earlier, longer, and more severely.

Depression and Women (9) Women and Anxiety Disorders (3) Planning Stress Free Holidays

The Holiday season is often a time of stress. Learn how you can forget the holiday stress of past holiday seasons using these tips to keep yourself mentally healthy at this time of year.

Women's Mental Health

Learn about mental health issues including depression, anxiety, and suicide, among other psychiatric illnesses.Mental health issues often affect women differently than men. Learn the facts that women need to know about mental illnesses including ADD or ADHD, depression, anxiety, and suicide, as well as other relavent psychiatric conditions.

Tuesday, March 10, 2009

Definition of vulvar cancer

Cancer of the vulva (the external female genital organs, including the clitoris, vaginal lips, and the opening to the vagina).

Estimated new cases and deaths from vulvar cancer in the United States in 2008:


New cases: 3,460

Deaths: 870

Definition of vaginal cancer:

Cancer that forms in the tissues of the vagina (birth canal). The vagina leads from the cervix (the opening of the uterus) to the outside of the body. The most common type of vaginal cancer is squamous cell carcinoma, which starts in the thin, flat cells lining the vagina. Another type of vaginal cancer is adenocarcinoma, cancer that begins in glandular cells in the lining of the vagina.

Estimated new cases and deaths from vaginal (and other female genital) cancer in the United States in 2008:


New cases: 2,210

Deaths: 760

Definition of ovarian cancer:

Cancer that forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).

Estimated new cases and deaths from ovarian cancer in the United States in 2008:


New cases: 21,650

Deaths: 15,520