Genetic Considerations

Susceptibility to HIV infection and progression to full-blown AIDS varies among people. Investigators are finding genetic variants that increase or mitigate susceptibility to HIV infection. CCL3L1 is a protein that interacts with the CCR5 receptor that is used by HIV to infect cells. Persons with more copies of the gene that codes for CCL3L1 are less likely to contract HIV infection than others of the same ethnicity with fewer copies.

GENDER, ETHNIC/RACIAL, AND LIFE SPAN CONSIDERATIONS

The patterns of HIV-related deaths have changed during the past 5 years. In the late 1990s, HIV was the second leading cause of death in the United States in men ages 25 to 44 years and the third leading cause of death in women of the same age range. Recent statistics show that HIV-related deaths remain 1 of the top 10 causes of death in both men and women 20 to 54 years of age, with the highest number of deaths for men (approximately 4000/year) and women (approximately 1500) occurring during 35 to 44 years of age. Black/African Americans bear a disproportionate burden of HIV disease compared with other populations. In addition, 68% of women with newly diagnosed HIV disease are black/African American, and many of those women live in the southern parts of the United States.

Individuals can contract HIV at any time during their life span, including infancy. The average time between exposure and diagnosis in adults is from 8 to 10 years, although the incubation period varies among people. In children, the incubation period is approximately 18 months. Children are likely to have a history of repeated bacterial infections such as middle ear infections and pneumonia. Most of the AIDS cases in children are the result of maternal-child transmission.

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