A Public Health Concern Biology Essay

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Acquired immune deficiency syndrome is a disease which affects the immune system and is caused by infection with the human immunodeficiency virus (HIV). To be infected with HIV is to be HIV-positive, but this only occurs when the virus seriously damages the immune system, does one have AIDS (Sepkowitz 2001). This condition progressively reduces the operations of the body's immune system and leaves individuals susceptible to opportunistic infections and tumors. HIV transmission occurs through direct contact of a mucous membrane or within the bloodstream with a bodily fluid containing HIV, such as blood, vaginal fluid, semen, pre-seminal fluid, and breast milk. Transmission involves anal, vaginal or oral sexual intercourse, blood transfusions, contaminated hypodermic needles, biological exchange between mother and baby during pregnancy, childbirth, breastfeeding or other exposure to one of the above bodily fluids (Steven 2007). Although treatments for AIDS and HIV can slow the course of the disease, there is currently no vaccine or cure. Antiretroviral treatment can successfully reduce both the mortality and the morbidity of HIV/AIDS infection, although these drugs can be expensive and routine access to antiretroviral medication may not be available in all countries. AIDS was first recognized by the U.S. Centers for Disease Control and Prevention in 1981 and its cause, HIV, identified in the early 1980s (Schneider 2008). In 1981, the first cases of AIDS were identified among gay men in the United States, acquiring the designation, GRID (Gay-Related Immune Deficiency). However, scientists has uncovered evidence that the disease has existed in the world for some years prior, i.e., subsequent analysis of blood samples of a Congolese man, who died of an unknown disease in 1959, made him the first confirmed case of an HIV infection (The History of AIDS 2012). As of 2010 approximately 34 million people are been infected HIV worldwide. Approximately 16.8 million of these are female and 3.4 million are under 15 years of age. There 1.8 million recorded deaths in 2010, which is down from 3.1 million in 2001. (UNAIDS 2011)

Cancer is another serious health issue that, like HIV/AIDS, is major concern in terms of public health. Cancer is not a single disease, but a larger group of approximately 100 diseases (Medical Dictionary 2012). While normal cells in the body follow a normal process of growth, division and death, cancer cells grow irrepressibly and do not die. Programmed death of normal cells is termed apoptosis, and when this process is disrupted, cancer begins to form. In contrast to normal cells, cancerous cells do not undergo programmatic death but continue to grow and divide. This can result in the formation of a mass of abnormal cells that grows rampantly. Cancer becomes a danger to the body when damaged cells divide in this uncontrollable way to form masses of tissue called tumors (except for leukemia where cancer inhibits normal blood functions by irregular cell division in the blood stream) (What is Cancer? What Causes Cancer? 2012). Tumors grow and interfere with the nervous, digestive and circulatory biological systems, and can release hormones that alter some of the body's functions (Medical Terminology List 2012). The more malignant, tumors form when two things happen: a cancerous cell travels throughout the body via the lymph or blood systems and destroys healthy cells in a process called invasion and when the cell divides and grows, making new blood vessels to feed itself in a process called angiogenesis. Symptoms of cancer can vary and is depend on where the cancer is located, where it has spread, and the size of the mass or tumor is. There are some cancers can be felt or seen such a lump on the breast or testicle which can be an indicator of cancer in those locations. Skin cancer is often observed by a change in a wart or mole on the skin. Some oral cancers are discovered by the white patches inside the mouth or white spots on the tongue. Other cancers have symptoms that are less obvious physically. Some brain tumors tend to present symptoms in the early stages of the disease as they affect important cognitive functions. Symptoms also can be created when the tumor grows and presses against organs and blood vessels. Colon cancers, for example, are indicated by constipation, diarrhea, and changes in stool size (Jackse 2011). Recent reports have indicated that in 2007, cancer claimed the lives of over 7 million people in the world. In 2008 more than 12 million cancers were diagnosed and 7.6 million people died of cancer globally (Jemal et al 2011).

The Relationship

HIV does play a role in cancerous growths in people who are HIV-positive. This is because HIV attacks the immune system, which protects the body from infections and disease so that. a weaker immune system is less able to fight off diseases, like cancer (HIV and Cancer: What is the Link? 2012 Department of Health). People with HIV have a high risk of developing certain cancers, such as Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer. For persons living with HIV, these cancers are often called "AIDS-defining conditions," which means that if a HIV infected person has one of these cancers it can signify the development of AIDS. This relationship between AIDS and Cancer has been termed "AIDS-Related Cancers". It should be emphasized that AIDS related cancer is not directly caused by the AIDS virus, but a combination of factors. The connection between HIV/AIDS and certain cancers is still an obscure area, but the link likely depends on a weakened immune system. Certain high-risk factors like smoking and genetics that affect those without AIDS may be increased in those with HIV/AIDS (Cancer.net 2012).

Kaposi sarcoma is a form of skin cancer that has traditionally occurred in older men of Jewish or Mediterranean descent, young native African males, or people who have had organ transplants. This cancer can grow into reddish-purple patches on the skin but may be benign. It can, however, be deadly if it spreads to the throat or lungs. Today, Kaposi sarcoma is found most often in homosexual men with HIV/AIDS and is related to an infection with the human herpes virus 8 (HHV-8). Kaposi sarcoma in people with HIV is often called epidemic Kaposi sarcoma. HIV/AIDS-related Kaposi sarcoma cases may cause lesions to arise in multiple areas of the body, including the skin, lymph nodes, and organs such as the liver, lungs, and colon.

Non-Hodgkin lymphoma (NHL) is a cancer which affects the lymph system. This cancer usually starts in the lymph glands, which are integral to the immune system to help fight off diseases. Lymph glands are located mainly in the neck, arms pits, in the groin, and inside the belly. The Epstein-Barr virus is a risk factor for this cancer. The lymph system consists of thin tubes that branch out to all parts of the body and its job is to fight infection. The lymph system carries lymph, a transparent fluid that contains white blood cells called lymphocytes which are vital for fighting germs in the body. Groups of tiny, bean-shaped organs or lymph nodes are located throughout the body at different sites in the lymph system. These are found in clusters in the abdomen, groin, pelvis, underarms, and neck. Other components of the lymph system include the spleen, which produces lymphocytes and filters blood; the thymus, an organ under the breastbone; and the tonsils, located in the upper throat. There are many different subtypes of NHL. The most typical subtypes of NHL in people with HIV/AIDS are primary central nervous system lymphoma which affects the brain and spinal fluid, primary effusion lymphoma, which causes fluid to build up around the lungs or in the abdomen, or intermediate and high-grade lymphoma (Cancer.net 2012).

Cervical cancer begins in a woman's cervix, the lower, narrow part of the uterus which holds the growing fetus during pregnancy. The cervix connects the lower part of the uterus to the vagina and together they form the birth canal. Females with HIV/AIDS have a higher risk of developing cervical intraepithelial neoplasia (CIN), a pre-cancerous growth in the cervix that is usually associated with the human papillomavirus (HPV) infection. High-grade CIN can turn into invasive cervical cancer (Cancer.net 2012).

Other, more uncommon types of cancer that may develop specifically in people with HIV/AIDS are Hodgkin lymphoma, angiosarcoma which is a type of cancer that affects the lining of the blood vessels, anal cancer, liver cancer, mouth and throat cancer, lung cancer, testicular cancer, colo-rectal cancer, and other types of skin cancer including basal cell carcinoma and squamous cell carcinoma (Cancer.net 2012).

Impact on Public Health

Both Cancer and HIV/AIDS are constantly tossed about when discussing public health. There have been myriad initiatives to dress early detection, prevention, and control of these two health diseases. Institutions from both governmental and non-profit social and humanitarian have been quite active in trying to mitigate the diseases and its far reaching effects. These effects range from economic to social and even political. The epidemics have already had negative impacts on various population subsets and it is compromising successes achieved in public health. HIV/AIDS is seen as the most preventable and as such is more aggressively approached in the public health arena. Aside from the cost of prevention programmes such as those that market abstinence and safe sex, there is also the huge cost of anti-retroviral drugs. Additionally, social and humanitarian groups are abundant and usually dedicate their resources to provide therapeutic and other forms of counseling as well as fighting stigmatization against persons living with HIV/AIDS. Cancer research is also a hugely expensive endeavor and treatment is typically exorbitant: chemotherapy and other forms of treatment including various scans and tests. Quite often these costs are borne by the Government and other state or state-assisted agencies. As such it can be apparently discerned that this is a heavy burden on public health systems. It increases the need for health services while at the same time eroding the capacity for delivering health services in other areas. It creates gaps in major areas such as the loss of skill, social investment and national security. Additional expenses are incurred by orphan care. The business sector also incurs high costs of training, insurance, payments of benefits, and loss of production and productivity by absenteeism due to sick leave caused by the diseases. A disquieting example of the cost to public health can be seen in HIV /AIDS expenditure in regions such as Sub-Saharan Africa which consumes about half of total health coverage. This comes at a severe opportunity cost to spending in other critical public health areas such as health and nutrition, safe water supplies, combating infant mortality rates among countless others. Similarly the financial costs of cancer are high for both the person with cancer and for society as a whole. The National Institutes of Health (NIH) estimated the 2007 overall annual costs of cancer were as follows: direct medical costs and indirect mortality costs cost of lost productivity due to premature death is $123.0 billion