From A to Z - A Glossary for People with HIV
Adapted from AIDS Care, Volume 1, Issue 6 - December 1997
A clear, concise, alphabetical list of all the names, terms and acronyms for HIV-positive patients, their families and their healthcare providers.
When your healthcare provider says "If your HIV RNA doesn’t drop below 400 by the time we run your next labs, I think we’d better consider adding a PI to your d4T and 3TC to boost your CD4 count and prevent OIs," that care provider knows exactly what he or she is saying. Do you? If you aren’t absolutely certain what all those letters and numbers mean, you aren’t in a position to make fully informed decisions about the care you are receiving. And you should be.
A
Accelerated Approval - The process by which the FDA (Food and Drug Administration) rapidly approves experimental drugs for the treatment of life-threatening conditions.
Acemannan - Ingredient in aloe-vera juice; that has shown anti-HIV activity in the test tube.
Acidophilus - Bacteria that when ingested helps restore the normal bacterial populations in the human digestive system. Found in yogurt, it may be helpful in preventing thrush.
ACTG - The AIDS Clinical Trails Group is a network of federally funded institutions that conducts AIDS research. It is coordinated by the National Institutes of Allergy and Infectious Diseases (NIAID).
Acute - Rapid and recent onset, usually involving intense symptoms.
Acyclovir (Zovirax): A drug used to treat herpes infections (herpes simplex and herpes zoster, or shingles).
ADC - see AIDS Dementia Complex.
Adherence - The extent to which a patient takes his/her medications according to the prescribed schedule (also called "compliance").
Adverse Event - An unwanted side effect of drug toxicity (see Side Effects).
AIDS (Acquired Immunodeficiency Syndrome) - A state of severe immune suppression brought about by infections with HIV. A diagnosis of AIDS is given to a person with HIV infection who experiences at least one condition from a list compiled by the Centers for Disease Control and Prevention; the condition may be an opportunistic infection like CMV or a cancer like Kaposi's sarcoma. In addition, anyone with HIV infection and a CD4 count less than 200 are given a diagnosis of AIDS.
AIDS Demnetia Complex (ADC) - Disturbance in brain function that is thought to be due to HIV infection in the brain. ADC may impair a person's ability to function in social or work settings.
AIDS-Related Complex - see ARC
Albendazole - A treatment approved for parasitic infection that has shown activity against microsporidiosis; may cause liver toxicity and low white-cell counts.
Alopecia - Hair loss.
Alpha Interferon - A natural substance produced by white blood cells in response to viral infections alpha interferon is now manufactured in the lab and used to treat Kaposi's sarcoma as well as other illnesses: other interferons (beta and gamma) are being studied.
Alternative Medicine - This phrase describes medical approaches that differ from Western, drug-based medicine. It includes Chinese medicine, Ayurveda, acupuncture, and homeopathy, among other treatments.
Amphotericin B (Fungizone) - A drug used to treat serious fungal infections. It is given intravenously (IV), but an oral version is now available for difficult to treat oral thrush. Side effects of IV Amphotericin include kidney damage in low white-cell counts as well as nausea, vomiting, chills. and fevers.
Anaphylaxis - A severe allergic reaction, usually to a drug. Symptoms include difficulty breathing, low blood pressure, and rash, sometime with blisters or hives. Persons experiencing anaphylaxis require immediate medical attention (injection with epinephrine) as this condition is potentially life threatening.
Anemia - A condition in which the blood is not able to deliver enough oxygen to the tissues. Too few red blood cells impaired red blood cells, or insufficient/ineffective hemoglobin may cause anemia.
Anergic - Term used to describe the inability of the immune system to mount a response against particles or substances that usually cause a reaction.
Anorexia - Loss of appetite; weight loss related to loss of appetite.
Antibiotic: A drug that slows bacterial growth or kills bacteria.
Antibody - A natural substance made by B cells (which are a type of white blood cell) that is specifically designed to neutralize an invading organism. HIV has a much smaller effect on the body's ability to produce antibodies compared to its other effects on the immune system.
Antigen - A portion of a foreign substance or organism against which B cell designs an antibody. Antibodies neutralize antigens
Antiretrovirals - Classes of drugs that inhibit retroviruses like HIV.
Aphasia - Partial or complete loss of the ability to speak or to understand spoken language.
Aphthous Ulcer - Very painful sore in the mouth or throat: Treated with steroids or thalidomide.
ARC (AIDS-Related Complex) - This is an old term that is used to describe a collection of symptoms in a person with HIV who does not have a diagnosis of AIDS. The term is rarely used today.
Arm - All of the study subjects taking a particular drug or drug dose are said to be in that "arm" (or "cohort") of the study.
Asymptomatic - Without symptoms clinically normal
Ataxia - Loss of motor coordination.
Atavoquone (Mepron) - A drug used to treat PCP and sometimes toxoplasmosis.
Atrophy - Tissue wasting and loss of body mass.
Azithromycin (Zithromax) - An antibiotic used to prevent Mycobacterium Arium Complex in HIV/AIDS patients with very low CD4 counts.
B
Bacteremia - Presence of bacteria in the bloodstream.
Bactrim (TMP/SMX) - An antibiotic used to prevent and treat PCP as well as many other infections.
B Cell - A type of white blood cell that produces antibodies.
Biaxin: "see Clarithromycin".
B.I.D. - Latin abbreviation meaning twice a day; refers to how often pills are to taken.
Bioavailabilty - The extent to which a drug taken by mouth is absorbed into the bloodstream.
Biopsy - Removal of a piece of tissue; for examination under the microscope for diagnostic purposed
Blinded - Participants do not know which arm of a clinical study they are in (i.e. they do not know what drug or drug dose they are getting).
Blood-Brain Barrier - A tight network of cells lining the vessels of the brain that makes it difficult for drugs to get into brain tissue.
Bronchitis - Infection of the airways (bronchi) leading to the lungs.
Bronchoscopy: A diagnostic procedure that involves passing a flexible tube with a camera attached into the airways.
C
Cachexia - Severe wasting/weigh loss.
Cancer - Unregulated cell growth that invades normal body structures.
Candida - A yeast-like organism that causes infection of the mucous membranes (mouth, gastrointestinal tract, and vagina). Symptoms include white patches on the affected areas (thrush) pain and itching. The condition of having a Candida infection is called Candidiasis several treatments are available
Candidiasis - see entry above.
Carbohydrate - A nutritional molecule that consists of carbon, oxygen and hydrogen atoms. Carbohydrates include sugars and starches.
Catheter - A tube that allows access to the bloodstream and is left in place for an extended period of time. Catheters are also used for other purposed, such as draining the bladder.
CDC - see Centers for Disease Control and Prevention.
CD8 Cell - A subtype of T lymphocytes that has traditionally been seen as a suppressor cell one that shuts off the immune system when an invading organism is eliminated. CD8 cell also performs active immunity functions such as killing certain infected cells.
CD4 Cell - Also known as T4 or helper T cell. The CD4 cell is the
primary target of HIV. It performs critical functions such as signaling other parts of the
immune system to respond to an infection. Treatment decision is often based on
CD4 count. Normal counts range from 500 to 1500.
CD4 Percent - The percent of all lymphocytes (including B cell s, CD4 cells. And CD8 cells) that are CD4 cells, The normal value is 35 to 40 percent.
CD4/CD8 Ratio - This number is a reflection of the health of the immune system. The normal ratio is two-to-one (i.e. twice as may CD4 as CD8 cells).
Cell-Mediated Immunity (CMI) - This term simply refers to the parts of immune function that are carried out by the body's CD4 and CD8 cells (as opposed to "humoral" immunity).
Centers for Disease Control and Prevention (CDC) - This federal agency is concerned with control of infectious diseases, such as HIV in the U.S.
Central Nervous System (CNS) - The part of the nervous system that consists of the brain an spinal cord, as opposed to the peripheral nerves that supply the tissues of the body.
Cerebrospinal Fluid (CSF) - Fluid produced by the CNS that protects the brain and spinal cord, When a spinal tap is done, CSF is removed for diagnostic purposes.
Cervical Dysplasia - Abnormal cells from the cervix that may indicate a pre-cancerous condition.
Cervix - The lower end of the uterus that protrudes into the vagina.
Chemotherapy - Use of chemicals to treat a disease; commonly used to refer to cancer treatments.
Chlamydia - A sexually transmitted disease caused by an organism called Chlamydia trachomatis; easily treated with antibiotics.
Chronic - Long-term symptoms or diseases that often require on-going suppressive treatment.
Cidofovir - A recently approved drug to treat CMV retinitis. Most severe side effect is kidney damage; must be given with intravenous hydration and probenecid.
Clarithrmycin (Cleocin) - An antibiotic that is used as an alternative treatment for PCP and toxoplasmosis. Commonly causes diarrhea and may cause growth of an organism called Clostridium difficile,
Clinical Trail - An experimental study in people to test the safety and efficacy of new drugs.
Clotrimazole (Lotrimin Mycelex) - A medication used to treat fungal infection of the skin and vagina; should be applied directly to affected area.
CMV (Cytomegalocirus) - A virus that is a member of the herpes virus family and is present as a silent infection in most people. CMV often becomes reactivated in people with advanced immunosuppression (CD4 counts under 50) and can cause disease in many parts of the body, especially the eye, throat and colon. Several treatments are available.
CNS - see "Central Nervous System."
Colitis - Inflammation of the colon.
Colposcopy: A diagnostic procedure to closely examine the cervix, involving use of a microscope. This is an accurate test to examine the cervix for abnormal cell growth.
Combination Therapy - Use of more than one drug to treat a disease or infection.
Complementary Medicine - This usually refers to treatment approaches other than traditional Western modalities. Synonymous with "Alternative Medicine."
Complete Blood Count (CBC) - This is a lab test that reports the number of white blood cells, red blood cells, platelets, hemoglobin, and hematocrit as well as other values that reflect the overall health of blood.
Compliance: The extent to which a patient takes medications according to the prescribed schedule; synonymous with "adherence."
Condyloma Acuminata - Genital warts, caused by a virus call human papillomavirus (HPV). Usually treated by destruction of the wart using various means (laser, acids and liquid nitrogen).
Contraindication - A situation that prevents use of a certain medication (for instance, using two drugs that have the same toxicity)
Control Group - Clinical trail participants who do not receive the experimental treatment.
Corticosteroid - A hormone that is produced in the outer part of the adrenal gland, known as the cortex. Corticosteriods are synthetically produced and used to treat many conditions; common ones include prednisone, decadron and hydrocortisone.
Crixivan - see "Indinavir."
Crossover - A clinical trail in which the experimental and control groups switch treatments.
Cross- Resistance - This refers to the development of resistance by a viral strain that makes it less susceptible to other medications in the same class.
Crytococcal Meningitis - A fungal infection of the membranes lining the central nervous system. These membranes are called "meninges." Diagnosis requires a spinal tap. Common symptoms are headache, fever, and sensitivity to light, confusion and blurry vision.
Cryptosporididsis - A para infection of the intestines that is associated with severe, chronic, non-bloody diarrhea. There are nonstandard treatments, but a number of medications are used experimentally.
CSF - see "Cerebrospinal Fluid."
Culture - A diagnostic procedure in which a sample of body fluid or tissue is exposed to conditions that would favor growth of an infecting organism.
Cytokine - A chemical messenger produced by white blood cells that help carry out Immune functions.
Cytomegalovirus - see "CMV."
Cytovene - see "Ganciclovir."
D
Dapsone - A drug used as an alternative medication for prevention of PCP and toxoplasmosis. May cause destruction of red blood cells. Patients who are taking ddI and Dapsone need to follow specific regimens to avoid unwanted interactions between these drugs.
Data Safety Monitoring Board (DSMB) - A group of independent researchers who review the data while a clinical trial is going on, to determine if one drug is markedly safer or more effective than another.
ddC (Hivid, zalcitabine) - Belongs to the nucleoside analog class. A drug that inhibits an enzyme used by HIV call "reverse transcriptase." Side effects include pancreatitis and peripheral neuropathy. This drug is almost never used alone. Not used in pediatrics due to side effects.
ddI (Videx, didanosine) - Belongs to the nucleoside analoge class. A drug that inhibits an enzyme used by HIV called "reverse transcriptase." Side effects includes pancreatitis, peripheral neuropathy and diarrhea. Should be taken on an empty stomach.
Deca Durabolin - see "Nandralone Decanoate."
Delavirdine (Rescriptor) - Belongs to the non-nucleoside reverse transcriptase inhibitors class. A drug that inhibits an enzyme used by HIV called "reverse transriptase," via a different mechanism than nucleoside analogs. Side effects include temporary skin rash.
Dementia - see "AIDS Dementia Complex (ADC)."
Depression - A state characterized by depressed mood, decreased energy, reduced interest in sex, suppressed appetite, and too much sleep or sleeplessness. Depression is common in people the HIV infection; it often responds well to treatment.
Dermatitis - Inflammation of the skin, which can be due to many caused, including unknown ones.
Desensitization - Process by which a person who has a history of allergic reaction to a drug has it slowly introduces into their bloodstream over time in such a way that the reaction does not occur.
D4T (Zerit, stavudine) - Belongs to the nucleoside analog class. A drug that acts on the enzyme used by HIV called "reverse transcriptase." The most common side effect is peripheral neuropathy.
DHEA (dihydroepiandosterone) - Produced by the adrenal glands, the hormone's function remains unclear. Some people with HIV infection believe that they drive benefit for taking DHEA, but its effects are unproven so far. It is available over the counter.
Didanosine - see "ddI."
Diflucan - see "Fluconazole."
Dihydroepiandostrone - see "DHEA."
Double-Blinded - Neither the clinical trial participant the researchers know who is receiving which drugs or drug dose.
Dyspepsia - Stomach or intestinal upset, including nausea, increased gas and vomiting.
Dysphagia - Difficulty swallowing.
Dysplasia - Abnormal tissue growth.
Dyspnea - Shortness of breath of othe difficulty in breathing.
E
EBV - see "Epstein-Barr Virus."
Echinacea - An herb used by many people with HIV infection, which is thought to combat weight loss, although there is no hard evidence of this effect to date.
Edema - Tissue swelling, usually in the extremities results from collection of fluid in the tissue.
Efficacy - The power of the drug or treatment to accomplish its intended goals; how well it works.
Encephalitis - Inflammation of the brain; can be due to many causes.
Enzyme - A molecule mad by cells that allows the body to speed up chemical reactions.
Eosinophilic Folliculitis - A bothersome skin condition, involving inflammation of the hair follicles (the base of the hair that is underneath the skin). The exact cause is unknown, but researchers have determined that a certain type of white blood cell is responsible for the inflammation. A number of treatment approaches are used, such as exposure to ultraviolet light, use of antihistamines, and topical steroids.
Epivir - see "3TC."
Epogen - see "Etythropoientin."
Epstien-Barr Virus (EBV) - A member of the herpesvirus family, EBV has been implicated in mononucleosis, certain kinds of lymphoma and oral hairy leukoplakia. Acuclovir, which is active aginst other herpes viruses, has little effect against EVB.
Erthropoientin (Epogen) - This is a hormone made by the kidneys that stimulates red blood cell production in the bone marrow. Synthetic versions are available by prescription to treat certain kinds of anemia, such as the anemia caused by ZDV.
Erythrocytes - Red blood cells.
Exclusion Criteria - Reasons why some prospective participants should not be included in a clinical study (e.g. a trial may not want people with CD4 counts above 500, or pregnant women, or patients who have previously used the drug being studied).
Expanded Access - The FDA allows early use of some umapproved medications for people in life threatening situations. A number of programs are in place to ensur "expanded access" such as Compassionat Use, Parallel Track and Treatment-IND programs.
Experimental Group - Clinical trial paritcipants who do receive the experimental treatment.
F
Famvir - see entry below.
Famciclovir (Famivir) - An alternative treatment for herpes simplex (oral and genital herpes ) and herpes zoster (shingles).
Floaters - Spots or other forms that drift across the field of vision; may be a symptom of CMV retinitis.
Fluconazole (Diflucan) - An antifungal drug used to treat thrush ("candidiasis"), cryptococcal meningitis and other fungal infections.
Fortovase - see Saquinavir."
Foscarnet (Foscavir) - a treatment for CMV infections; possible side effects include kidney toxicity, nausea, and anemia.
Foscavir - see entry above
Fungizone - see "Amphotericin-B."
Fungus - A type of infection caused by yeast and molds, Common fugal infections in people with HIV infection include candida (thrush), cryptococcus, aspergillus, and histoplasma.
G
Ganciclovir (Cytovene) - An antiviral drug used to treat CMV infections. Common side effects include low white blood cells counts (neutropenia and low platelet counts (thrombocytopenia).
G-CSF (Neupogen) - A naturally-occuring substance that stimulates production of neutrophils (e.g. ganciclovir and certain anti-tumor agents).
GM-CSF (Leukine, Prokine) - Similar to G-CSF, except that in addition to stimulating neutrophils, GM-CSF stimulates production of macrophages. Another type of white blood cell.
Gonorrhea - A sexually-transmitted disease that affects the genitals of both sexes, gonorrhea causes burning or difficulty with urrination, itching and a yellow or green discharge. It is easily treated with antibiotics.
H
HAART (Highly-Active Anti-Retroviral Therapy) - Combination anti-HIV therapy, usually involving a protease inhibitor. Combinations of drugs have been found to be highly suppressive of HIV, and this strategy helps delay or avoid the development of treatment resistant viral mutants.
Half life - The time it takes for half of a drug dose to be eliminated from the bloodstream (or to be inactivated).
Hematocrit - This is the percentage of blood that is taken up by red blood cells. Normal values for men are 45% to 55% for women the normal range is 37% to 47%.
Hemoglobin - The molecule in red blood cells that carries oxygen; normal values for men are 13 to 17 grams; for women, the normal range is 12 to 16 grams.
Hemorrhage - Loss of a large quantity of blood either internally or externally.
Heparin - A drug that decreases the blood's ability to clot.
Hepatitis - Inflammation of the liver, which can be caused by an infection, a chemical such as alcohol, or other causes. Hepatitis A is caused by a virus that is transmitted by food or sex; hepatitis B is caused by a virus transmitted by sex or blood exposure (e.g. needle-stick injury); hepatitis C is caused by a virus that is thought to be transmitted by blood products. There are vaccines for hepatitis A and B.
Herpes Virus - A family of viruses that includes herpes simplex one and two (HSV-1, HSV-2), cytomegalovirus (CMV), Epstien-Barr Virus (EBV), Varicella Zoster Virus (VZV) and other subtypes called Human Herpes Viruses (HHV-1, HSV-2, etc.). Some of these viruses are thought to accelerate the progression of HIV infection.
Herpes Zoster - see "Shingles."
HICKMAN® Catheter - A surgically implanted line that allows access to a major vein, it can be left in place for long periods. The advantages to these catheters is that people who require frequent intravenous treatments do not need to be struck with a needle each time. The major disadvantages are that they are cosmetically undesirable and they can become infected.
HICKMAN is a registered trademark of C. R. Bard, Inc. and its related company, BCR, Inc.
Histoplasmosos - A fungal infection that can cause problems in the lungs, on the skin and other sites. It is most prevalent in the Southwestern U.S., but people can have it in any part of the country.
HIV-1 (human Immunodeficiency Virus) - The causative agent of AIDS. Infection with HIV does not mean that a person has AIDS; see "AIDS" for more information. It is the predominant virus causing AIDS in the U.S. and Europe.
HIV-2 - Also a virus that causes AIDS, although it may be somewhat less potent than HIV-1. It is the predominant virus causing AIDS in Western Africa.
Hivid - see "ddC."
HPV (Human Papillomavirus) - Causative agent of warts, anywhere on the body. More than a hundred subtypes have been identified. Certain subtypes are associated with cervical cancer.
Human Growth Hormone - A chemical messenger in the body that stimulates tissue growth. A synthetic version is available by prescription for children with growth retardation and persons with significant wasting (weight loss).
Human Immunodeficiency Virus - see "HIV-1" and HIV-2."
Human Papillomavirus - see "HPV."
Hypericin (St John's Wort) - A compound derived from an herb that may have anti-HIV activity. It is widely used as a natural treatment for depression. The main side effects are increased sensitivity to sunlight.
Hyperthermia - An experimental treatment that involves heating the blood after removing it from the body, in an attempt to kill HIV. This is a dangerous and so far ineffective treatment.
I
Idiopathic Thronmbocytopenic Purpura - see "ITP."
Immune System - The network of white blood cells and the chemical products they produce to protect the body from foreign "invaders.: One major division is between the "celluar" portion, which involves T cells and he hrmoral portion, which involves B cells that make antibodies. The two parts work hand-in-hand.
Invirase - see Saquinavir.
ITP (idiopathic Thrombocytopenic Purpura) - A process that results in destruction of platelets by an unknown mechanism. ITP can lead to easy bruising and if severe, uncontrolled bleeding. Treatments include AZT and Immunoglobulin.
Immunization - Use of a vaccine to stimulate the immune system to war off particular infections (flu, measles, typhoid, etc.)
Immunocompromised, Immunsuppressed: The stat of having a damaged immune system and therefore, increased susceptibility to illness.
Immunoglobulin - A substance made by B cells that neutralizes specific disease causing substances and organisms; also known as an antibody.
Imclusion Criteria - List of things (clinical state, blood values, etc.) that are required of every participant in a clinical trail at time of entry.
Indication - Intended purpose for a drug or treatment as determined by the FDA.
Indinavir (Crixivan) - A protease inhibitor that must be taken three times a day on an empty stomach to aid absorption. May cause kidney stones and increased triglyceride levels.
Inflammation - An immune reaction characterized by redness, pain, heat, swelling, and sometimes, loss of function.
Informed Consent - The process by which a healthcare provider gives a patient information, including pros and cons about a potential new treatment; when a person is entering a clinical trial that person must sign a document with this information, thereby providing "informed consent."
INH - see "Isoniazid."
Interferon: see "Alpha Interferon."
Interleukin - A chemical messenger made naturally by cells; many subtyped have been discovered that turn on and off certain aspect of immunity. Synthetic versions of interlueukins are being tested as treatments that might boost the immune stem.
In Vitro - Latin for in glass refers to test-tube studies such as mixing HIV with a potential antiviral to see if the drug inhibits the virus.
In Vivo - Latin for in living organisms; refers to studies involving people.
Isoniazid (IND) - A drug used as part of a combination to treat TB. INH is also used to prvent TB in people who have been exposed. The chief toxic effect involves the liver; so people on this drug need to have their liver enzymes checked peroidically.
Itraconzole (Sporanox) - An antifungal drug used to treat fungal infections of the nails, histoplasmosis. And other fungal infections. It is also used for candida (thrush) that is resistant to standard teatments. Side effects include GI problems, rash and headache.
J
Jaundice - A yellowish tone to the skin or the whites of the eyes. Jaundice is caused by bilirubin, a breakdown product of hemoglobin, a molecule found in red blood cells. There are several reasons why bilirubin can be elevated in the bloodstream; classic causes include liver disease, gallbladder disease, use of certain drugs and increased destruction of red blood cells.
K
Kaposi's Sarcoma (KS) - A tumor that is probably caused by a virus, KS typically appears as a flat or raised purplish patch on the skin or mucous membranes (in the mouth, rectum or vagina). KS areas on the skin are usually not painful. Its appearance may be very subtle in dark-skinned people. KS may also spread to internal organs, like the esophagus, intestines, colon or lungs. Several treatments are availale, including chemotherapeutic agents injected into skin lesions as well as intravenous or imtramuscular injections. Radiation is also used, and many experimental treatments are being studied.
Karnofsky Index - A scale used to assess how well someone functions. It is not specific to AIDS. A score of 100 is given to a fully and normally functioning person. Scores decrease by 10; a score of 30 indicates that a person needs to be hospitalized.
Ketoconazole (Nizoral) - An anti fungal that is used for candidasis (thrush). It is available as a pill, cream or liquid. The most serious side effect is liver damage.
L
Lamivudine - see "3TC."
Latency - A period of little or no activity. In the HIV world, latency usually refers to a stretch of time during which the virus is quiet and not reproducing. However, even when people have no symptoms, their virus may be very active. The best way to judge if you are in a period of latency is to have a viral load test.
Lesion - A broad term used to describe any abnormality in or on the body. Scratches, bumps, wounds, scars, tumors, insect bites, rashes and flat patches are all called lesions.
Leukine - see "GM-CSF."
Long-Term Non-Progression - This phrase came into vogue in the late 1980's when it became clear that some people with HIV infection did not develop progressive disease. It is non-specific and it includes people who have responded very well to treatment, people who have mounted an effective long-term immunologic response to HIV and people who have a weak, non-disease-producing strain of the virus. There is no strict definition, but it usually implies that an individual has had HIV infection for a decade or longer and is clinically well, with normal or near-normal CD4 counts.
Lotrimin - see "Clotrimazole."
Lumbar Puncture (LP) - A spinal tap; the doctor inserts a needle in a space between the bones that form the spinal column (vertebrae) in order to obtain cerbrospinal fluid. If meningitis is suspected, an LP is usually required.
Lymph - This is the fluid that fills your lymphatic vessels and runs through lymph nodes. Eventually, lymph is circulated into the bloodstream. Although the lymphoid system is separate from the vessels that carry blood, lymph contains lots of white blood cells. The lymphoid system plays a major role in the immune reaction to infections. HIV is very active in the lymphoid system, especially lymph nodes.
Lymph Node - An out pocketing of the lymphoid system where immune reactions occur. They range in size from peas to kidney beans. Collections of lymph nodes are found in the neck, around the collarbone, in the armpit (the axilla) and in the groin. During a physical exam, doctors usually feel these places looking for swollen lymph nodes, which are a sign that active infection is present.
Lymphocyte - Another term for a type of white blood cell; it is a broad category that includes B lymphocytes and T lymphocytes. T lymphocytes are further divided into T4 (see "CD4") and T8 (see CD8").
Lymphoma - A cancer of the lymph nodes. Two major varieties are Hodgkin's and non-Hodgkin's lymphoma. The incidence of lymphomas is increased in people with HIV infection compared to the general population. They can occur at high CD4 counts, but are more common in people with low counts. Common symptoms are swollen lymph nodes, weight loss, fever and malaise. Treatment is with radiation and/or chemotherapy.
M
MAC (Mycobacterium Avium Complex) - Caused by one of a variety of organisms called mycobacteria (which are different from bacteria), this is an infection that is difficult to treat. However, more effective treatments have become available in the last few years. A combination of drugs, including several used to treat TB, is employed. Symptoms include weight loss, low-graded fevers that have a predictable daily pattern, night sweats and general malaise. MAC is uncommon in people with CD4 counts above 50. The risk of MAC is great enough that doctors routinely prescribe medication to prevent it in people with low CD4 counts.
Macrophage - A "scavenger" white blood cell that engulfs anything recognized as "non-self" (debris, particles, viruses, bacteria, etc.) and susceptible to HIV infection.
MAI - Another name for "MAC."
Maintenance Therapy - This refers to long-term (perhaps life-long) treatment of an infection, to make sure it does not come back. Usually, drug doses are lower than the levels used to treat an actual case of the infection. Examples of infection that require maintenance (or suppressive) therapy include PCP, MAC, CMV and TB.
Malaise - Feeling weak, low and generally unwell.
Malignant - Often used to describe cancers. This term implies aggressive invasion, to the point where surrounding structures are compromised or destroyed. Alternatively, is a tumor that begins in as malignant. More generally, a diseased process other than a tumor may be described as malignant, meaning that it is rapidly progressive and destructive.
MDR-TB (Multi-Drug-Resistant TB) - A form of tuberculosis (TB) that is resistant to most standard treatments. As the name implies, this is a very difficult disease to treat and requires combinations of anti-TB drugs. Sometimes, experimental agents must be used; MDR-TB develops when patients with TB do not take all of the drugs prescribed for as long as they are supposed to.
Meningitis - Infection of the membranes that surround the brain and spinal cord. These membranes are referred to as the meninges. It is a serious infection and can be due to bacteria, viruses, or fungi. Diagnosis requires a spinal tap (see Lumbar Puncture). Lumbar puncture is critical to identifying the cause of infection so that appropriate treatment can be started. Symptoms include a horrible headache, fever, malaise, confusion and pain when moving the neck. Several treatments are available, depending on what is causing the infection.
Mephron - see Atavoquone.
Microsporidiosis: This is an infection of the intestines caused by a parasite. It causes chronic, massive, watery diarrhea. It is difficult to diagnose and treat, but agents are available.
Molluscum Contagiosum - Caused by a virus. This skin infection produces small, pearly-white bumps, usually on the face and torso. The bumps often have a little indentation in the middle. They are not painful or itchy. The only effective treatment is to destroy the lesions by scooping them out, freezing them with liquid nitrogen or zapping them with a tiny electric needle. It is important to treat them as early as possible, because they usually get worse and spread. Typically, more than one session is needed to get rid of them all.
Myalgia - muscle pain.
Mycelex - see "Clotrimazole."
Mucobacterium avium complex - see "MAC."
Mycosis - A general term for fungal infection.
N
Nandralone Decannoate (deca Durabolin) - A male steroid hormone that is being used to treat wasting, given by injection into muscle.
Nelfinavir (Viracept) - A protease inhibitor that is taken two or three times daily with food; approved for children and adults. Most common side effect is diarrhea.
Neoplasia - A new tissue growth, which is abnormal, usually benign, but may be pre-cancerous.
Nephrplothiasis - Kidney stones.
Neupogen - see G-CSF.
Neuropathy - Damage to the peripheral nerves; usually manifests as pain, tingling or numbness in the feet or more rarely the hands. Drugs or HIV itself may cause neuropathy. Many treatments are used for this condition.
Neutropenia - Abnormally low count of the type of white blood cell called "neutrophils." Neutrophils are particularly important in fighting bacterial and fungal infections. There is an injectable drug called Neupogen that can boost neutrophil counts.
Neutrophil - see Neutropenia.
Nevirapine (Viramune) - A drug that inhibits an enzyme used by HIV called "reversed transcriptase." Nevirapine belongs to a class of drugs call NNRTI's (see entry below). Side effects may include fever, rash and increased liver enzymes.
Nizoral - see Ketoconazole.
NNRTI (Non-Nucleoside Reverse-Transcriptase Inhibitor) - A class of drugs that inhibits an enzyme used by HIV called reverse transcriptase. NNRTIs work by a different mechanism than ZDV and similar drugs. Which also attack reverse transcriptase. NNRTI's are more specifically targeted to HIV than ZDV, etc., so they have fewer side effects. However, resistance develops more quickly with these drugs and compliance should be stressed to prevent resistance. NNRTI's are always used in combination with other anti-HIV drugs.
Non-Hodgkin's Lymphoma (NHL) - A cancer characterized by uncontrolled proliferation of lymphocytes (usually B cells but sometimes T cells), NHL can cause tumors in lymph nodes or other organs such as the spleen, bone marrow, gastrointestinal tract and brain. It is more likely than Hodgkin's lymphoma to cause disease in sites that are distant from one another. There are several grades of NHL. Treatment is with chemotherapy, radiation, or bone marrow transplant.
Non-Nucleoside Reverse-Transcriptase Inhibitor - see NNRTI.
Norvir - see Ritonavir.
Nucleoside Analog - This is a class of drugs that fight HIV by interfering with the virus's ability to create viral DNA. ZDV was the first nucleoside analog licensed, and many others, such as ddI, ddC, d4t and 3TC have followed it. These drugs act at the DNA level.
O
Off-Label - The use of a drug for a purpose not originally allowed by the FDA when the drug was licensed. An example is use of Dapsone to prevent PCP (it is licensed to treat leprosy.) The label refers to a sheet of instructions included with drugs that is also called the package insert. It is legal for physicians to prescribe drugs for off-label uses, but insurance companies may not reimburse a patient for the drug in such circumstances.
OHL - see Oral Hairy Leukoplakia.
OI - see Opportunistic Infection.
Open-Label - A clinical trial in which everyone gets the experimental treatment.
Opportunistic Infection (OI) - Many organisms (virus, bacteria, fungi, etc.) are held in check by the immune system. They often "colonize" the body (i.e. they are present but not noticed) without causing disease. When someone becomes immuno- compromised for any reason (HIV infection, cancer, or treatment wit immuno-suppression drugs, such as certain kinds of chemotherapy), some of these organisms take advantage of the opportunity by growing out of control and causing disease. Common OI's in patients with AIDS include PCP, CMV, MAC and toxoplasmosis.
Oral Hairy Leukoplakia (OHL) - An infection that causes white patches on the sides of the tongue. Epstien Barr virus most likely causes it.
P
Pancreatitis - Inflammation of the pancreas from any cause. Usual symptoms are abdominal pain, nausea, vomiting, and intolerance of fatty foods. Pancreatic enzymes (amylase, lipase) are elevated. Anti HIV drugs associated with pancreatitis include ddI and ddC.
Papillomavirus (HPV) - A virus that causes warts on many parts of the body; there are more than one hundred strains of HPV and few are associated with cancer. Rate of HPV causing cancer increases when HIV infection is present.
Pathogen - Anything capable of causing disease; usually a pathogen is a bug, like a virus or bacteria. But it also refers to substances like asbestos.
PCP (pneumocystis carinii Pneumonia) - This pneumonia is caused by an organism that most people have in their lungs. The immune system normally prevents the organism from causing disease, but PCP becomes a problem when T cells are below 200. PCP can be prevented in most people by starting medication when T cells are low. The first line of treatment is Bactrim or Septra (the same drug with different names). It is essential that people with low counts regularly take medication to prevent PCP, even if they feel perfectly well; the chances of getting PCP are high in the absence of preventive medicine. Symptoms of PCP include low grade fever, cough (without bringing up sputum), fatigue, and shortness of breath (for example, when walking up stairs.) If you have these symptoms and your T cells are below 300, go to an emergency room.
PCR (Polymerase Chain Reaction) - This is a laboratory test that works at the genetic level. With PCR, tiny amounts of DNA are found and amplified millions of times. PCR is also used to judge how much virus is present in a given blood sample. Viral load measurements are done with PCR techniques.
PID (Pelvic Inflammatory Disease) - A nonspecific infection of the female genital tract, PID may be caused by on or multiple organisms. Symptoms include fever, pain, and vaginal discharge. It is important that PID is treated as soon as possible; it is associated with infertility (inability to get pregnant).
Pentamidine (Pentam, Nebupent) - A drug used to treat and prevent PCP. Side effects when given by vein include kidney and pancreas damage as well as low blood sugar. Pentamidine can also be inhaled through a special machine to prevent PCP, although this is not a first line therapy.
Peripheral Neuropathy - Damage to nerves outside of the central nervous system; neuropathy commonly affects the feet, although the hands can be involved as well. Symptoms include tingling and pain in the extremities, as well as numbness. Usually, both sides are affected. Neuropathy can be caused by HIV itself, or by drugs such as ddC.
Peripherally Inserted Central Catheter - see entry at top of next column.
Pharmacokinetics - The study of how the body metabolizes a drug, which tissues the drug penetrates, its half-life and other variables.
PICC Line (Peripherally Inserted Central Catheter) - A piece of tubing that is inserted into a vein in the arm, to allow easy delivery of medication without frequent needle sticks. PICC lines can be left in place for up to three months. It must be remembered that they are a potential source of infection.
Placebo - A look a like dummy pills that does not contain drug; placebos are often used in clinical trials.
Platelet - Also called a thrombocyte. A fragment of a larger type of blood cell that helps promotes clotting. Normal Values are 100,000 to 300,000. When counts drop below 10,000, bleeding becomes a serious concern.
PML (Progressive Multifocal Leukoencephalopathy) - An infection of the brain tat caused b a virus; symptoms of PML include difficulty in speaking or in understanding language, unusual movements, or loss of ability to move an extremity, as well as defects in vision.
Pneumocystis carinii Pneumonia - see PCP.
PPD (Purified Protein Derivative) - A test for exposure to TB. A small piece of the bug that causes TB injected into the skin. There is no way that the test can cause TB. People who have been exposed to TB develop a reaction at the site of injection. People with HIV may have a false negative result (meaning that the test is negative, but they were exposed to TB). HIV patients with positive PPD test need to take medication to prevent TB, even though they feel well.
Progressive Multifocal Leukoencephalopathy - see PML.
Prokine - see GM-CSF.
Protocol - The overall design, or blueprint of a clinical study.
PRN - A Latin term used in medicine, meaning that treatment should be given as necessary,"
Prophylaxis - Preventive therapy; primary prophylaxis is given to at risk individuals to prevent a first infection by say PCP; secondary prophylaxis is given to prevent recurrent infections.
Protease - An enzyme used by HIV to process new copies of virus after it has reproduced; drugs specifically aimed at this enzyme are called protease inhibitors. Human cells also use protease enzymes but they are different from the HIV protease.
Pruritic - Itchy.
Purified Protein Derivative - see PPD.
R
Randomized - Distributed by chance.
Regimen - Refers to the specific doses and the specified times to take medications.
Remission - Time during which a disease is inactive.
Renal - Related to the kidney.
Rescriptor - see Delavirdine.
Resistance - Ability of an organism such as HIV to overcome the inhibitory effects of a drug. Such as AZT or a protease inhibitor, Resistance has been seen with every anti HIV drug. If someone has laboratory evidence of resistance to a drug. It does not mean that every strain of HIV in the person's body is resistant so there might still be some merit to taking the drug. Especially if there are no other treatment options. Drugs are used in combinations discourage resistance.
Retina - The portion of the eye onto which images are projected; CMV affects tins part of the eye, and it can become detached from the rest of the eyeball. Inflammation of the retina is called retinitis.
Retinitis - see entry above.
Retrovir - see AZT.
Retrovirus - A type of virus (like HIV) that encodes its genes as RNA, rather that DNA. Human cells use DNA to encode their genetic information for retroviruses to incorporate their genes into human genes. They must be able to convert RNA into DNA. The enzyme reverse transcriptase accomplished this conversion.
Ritonavir (Norvir) - A protease inhibitor that needs to be taken with food. It must be kept refrigerated. Ritonavir interacts with several drugs; so be sure the doctor who prescribes it knows everything you are taking. Main side effects are nausea and diarrhea.
S
Saquinavir (Invirase and Fortovase) - A protease inhibitor; the original for of Saquinavir (Invirase) is poorly absorbed, but a new version (Fortovase) now in pharmacies, delivers 300% more drug to the blood stream. Both forms are often taken with Ritonavir, which increases the amount of Saquinavir that is absorbed.
Sepsis - Overwhelming bacterial infection in the blood. Symptoms include fever and low blood pressure. Sepsis can be life threatening if not treated promptly.
Serostatus - A generic term that refers to the presence/absence of antibodies in the blood. Often the term refers to HIV antibodies.
Shingles (Herpes Zoster) - This is the adult form of chicken pox. Caused by the Varicell zoster virus, it result in a skin eruption of oozing vesicles on a reddened base, along the distribution of a nerve (an area called a dermatome). In the bast majority of cases, only one side of the body is affected. Usually the condition is very painful; pain often proceeds the skin lesions. Several treatments are available.
Side Effect - Any unwanted effect of a drug or treatment (also call an "adverse event" see entry). Some side effects are minor; others can be life threatening.
Sinusitis - Inflammation of the sinuses, headache and cold symptoms is usually present.
Spinal Tap - see Lumbar puncture.
Sporanox - see Itraconazole.
Sputum Analysis - A test don on fluid coughed up for the lungs; often used to diagnose PCP and TB. Sputum can be induced with a saline mist that causes deep coughing.
Stavudine - see d4T.
STD - An sexually transmitted disease, like gonorrhea, syphilis, HIV, etc.
Steroid - A class of molecules that contain a similar chemical core. The natural function of steroids is as hormonal messengers in the body. Synthetic versions are administered as drugs because of their ability to reduce inflammation.
St. John's Wort - See Hypericin.
Subcutaneous - Beneath the skin, an area that is rich in fat and blood vessels. Some drugs are injected into this area to aid their absorption.
Surrogate marker - Something that indirectly reflects the patients' current clinical condition. For example, the number of T cells tells us something about how much damage HIV has don but it is not a direct measure of how much virus is present.
T
Taxol (paclitaxel) - A cheotherpeutic drug used for the treatment of solid tumors. Taxol is an experimental treatment for Kaposi sarcoma. It works by inhibiting cell division and has a long list of side effects in particular bone marrow suppression (resulting in neutropenia).
TB - see Tuberculosis.
Testosterone - A male hormone (also present in females, in low concentrations) that affects muscle mass; it can be used therapeutically in people with HIV infection to promote weight gain and improve sex drive.
Therapeutic Vaccine - An injected therapy consisting of synthetic HIV antigen that is administered to people who already have HIV. It is supposed to heighten and broaden the immune response to HIV, helping to halt disease progression.
Testosterone - A naturally occurring male hormone. When administered as a drug it can cause gain in lean body mass, increased sex drive an possibly aggressive behavior. Many men with HIV have low testosterone levels.
Thalidomide - A drug that reduces levels of TNF it is being studied as a treatment for wasting and other complications of HIV as well as a number of other diseases where TNF levels are a problem.potential side effects include sedation, constipation, peripheral neuropathy and severe birth defects in the infants born to women who take the drug during pregnancy.
Thrombocyte - see Platelets.
Thymic Hormone - One of the hormones produced by the thymus that is believed to play a role in the maturation of T-lymphocytes and overall modulation of the immune system.
Thymus - A lymphoid organ in the chest that is the site of lymphocyte formation and maturation as well as the secretion of thymic hormones. An important function of the thymus is to weed out lymphocytes that react to proteins produced by the body (self-antigens) thus preventing autoimmune disease. The thymus is a large organ during childhood, but shrinks with adolescence.
Topoisomerase - An enzyme that uncoils the tightly wound DNA in cells nuclei so that cell division and application can take place.
Topotecan - An experimental anticancer chemotherapy that inhibits Topoisomerase I a block cell division. It is a possible therapy for HIV, having been found to inhibit the HIV long terminal repeat in the lab, and PML (progressive Multifocal leukoencephalopathy), an opportunistic virus infection of the brain.
Topical - Applied directly to the skin.
Total Parenteral Nutrition - see TPN
TNF (Total Necrosis Factor Alpha TNF) - A Cytokine produced by macrophages that help activate T-cells. It also may stimulate HIV activity. TNF levels are very high in people with HIV and the molecule is suspected to play a part in HIV related wasting, neuropathy and dementia.
TPN (Total Parenteral Nutrition) - A liquid food substitute infused directly into the blood designed to meet a person's nutritional needs. TPN provides an alternate nutritional route in cases of severe gastrointestinal distress in which nutrient absorption is poor. It strengthens the body and relieves the digestive tract while therapy for the underlying condition progresses. TPN's high cost precludes its use as long term therapy.
Toxicity - The harmful effects of a given drug that occur during therapy. The term is similar to side effect and adverse reaction.
Toxoplasmosis - A disease caused by the protozoa toxoplasma gondii. Toxoplasmosis can affect a number of organs. But it most commonly causes encephalitis (brain Inflammation).
Treatment IND - An FDA approved program that allow a physician to procure an experimental drug for seriously ill patients who have no other treatment options of exchanger for date on the safety and perhaps the effectiveness of the drug.
Trimetrexate (Neitrexin) - An antibiotic approved as an alternative treatment for moderate to severe PCP. Trimentrexate causes severe bon marrow. Liver, Kidney, gastrointestinal toxicities. It must be administered along with leucovorin (floinic acid) to ameliorate these adverse effects.
Tuberculosis (TB) - A disease caused by the bacterium mycobacterium tuberculosis. TB primarily infects the lungs, but it may attack almost any tissue or organ of the body. TB generally has a long latency period. And only about ten percent of infected people with normal immunity ever experience active TB. For people with immune deficiencies, however, active TB is much more common. TB is transmitted in close quarters when a person with active TN coughs the microbe into the environment.
V
Varicella Zoster Virus (VZV) - The cause of chicken pox in children. Its reactivation in adults causes shingles.
Vertical Transmission - Transmission of a pathogen such as HIV from mother to fetus or bay during pregnancy or birth.
Viremia - The presence of virus in blood or blood plasma. Plasma Viremia is a quantitative measurement of HIV levels similar to viral load but is accomplished by seeing how much of a patients plasma is required to start an HIV infection in a laboratory cell culture.
Virology - the study of viruses and viral diseases.
Virus - Disease causing parasites much smaller than bacteria. A virus is a non-cellular entity composed merely of genetic material (DNA or RNA) surrounded by a protein envelope. Viruses can reproduce only within living cells into which they inject their genetic material. The viral genes then subvert an infected cell's usually killing the cell in he process .
Viral Load - The number of viral particles (usually HIV) in a sample of blood plasma. HIV viral load is increasingly employed as a surrogate marker for disease progression. It is measured by PCR tests and is expressed in number of HIV copies per milliliter of plasma. The goal is to have viral loads of less than 50 copies per milliliter.
Virion - A complete virus particle existing outside a cell.
Vitamins - Organic molecules essential in small amount for normal metabolism. Growth and development of the body.
Vitreous Humor - The gel like substance that fills the eyeball between the lens and the retina.
W
Wasting syndrome - A condition characterized by loss of ten percent of normal weight obvious cause. The weight loss is largely the result of depletion of the protein in lean body mass and represents a metabolic derangement frequent during AIDS.
Western Blot - A test for detecting the specific antibodies to HIV in a person's blood. "It's commonly is used to double check positive ELISA test. A western blot test is more reliable than the ELISA is, but it is harder to do and costs more money.
White Blood Cell - see Leukocyte.
Y
Yeast Infection - see Candidiasis.
Z
Zidovudine - see AZT.
Zinc - An essential mineral often depleted in person with HIV. Zinc is a component of many enzymes. It is important in protection cells against excess oxidation and helps immune cells mature and function. Ingesting high doses of zinc can be harmful because it interferes with the absorption of copper, another essential micronutrient.
