POSITIVELY AWARE SEPTEMBER/OCTOBER 2011
Coming to Terms - An HIV Glossary
ONLINE EXCLUSIVE
A1C: blood test to determine average blood glucose level over a three-month period. Used to help in the control of diabetes.
active: refers to the effectiveness of drug therapy. For example, “His medications remain active [effective] against his HIV.”
ACTG: see “AIDS Clinical Trials Group”
ACT UP: AIDS Coalition to Unleash Power, an activist group formed in 1987.
acute HIV infection: recent infection (within the previous six months)
acute retroviral syndrome: symptoms that may be experienced during acute HIV infection, such as fever (including night sweats), diarrhea, nausea and vomiting, and headache.
ADAP: AIDS Drug Assistance Program, a program to provide HIV medications to patients who are unable to pay for them, funded by both the federal and state governments.
adherence: taking medications as they should be taken (with or without food, on time, etc.).
adverse event (AE): In a clinical trial, an unwanted effect detected in participants. A serious AE is one that is rated Grade 3–4, with 3 being “severe” and 4 being “life-threatening.”
adverse reaction: a negative drug side effect.
AIDS: Acquired Immune Deficiency Syndrome. HIV advances to AIDS.
AIDS Clinical Trials Group (ACTG): the largest and most prestigious network of HIV-related studies in the U.S. There is a pediatric ACTG as well as one for adults.
anemia: a lower than normal red blood cell count
antibody: a protein that the immune system forms to fight germs and other unwanted elements entering the body. Hence, the immune system forms HIV antibodies when the virus enters the body.
antiretroviral: a drug that treats a retrovirus, like HIV.
arm: in research studies, one of the groups being studied. For example, “Participants in one arm were given once-daily doses of the drug.”
assay: a test
ASO: AIDS service organization
asymptomatic: without symptoms. In relation to HIV, a person who has tested positive for HIV, but who shows no clinical symptoms of the disease.
backbone: refers to the drugs someone is taking along with the medication considered to be the “star” of their treatment combination. For example, “He takes a backbone of two NRTIs with Sustiva.”
Bactrim: an antibiotic used to prevent a pneumonia (PCP) seen in people with AIDS
baseline: information gathered at the beginning of a study, or by your doctor, which are used to track variations such as viral load before and after a medication is taken.
bioavailability: rate and extent to which a substance is absorbed and circulated in the body
blind, double-blind: when study participants don’t know what they’re receiving. “Double-blind” means that neither the researcher nor the participant knows what the participant is being given. Participants do, however, know what they may possibly be receiving. Blinding helps eliminate bias.
blip: refers to a temporary increase in viral load (usually within 50 to 400 copies /mL) that then goes back down
boosted protease inhibitor: a protease inhibitor for which blood levels are increased with a small booster dose of the HIV drug Norvir (ritonavir), the only medication currently used for this purpose, though there are others in development.
CA-MRSA: Community Acquired Methicillin-Resistant Staphylococcus Aureus. Also see “MRSA”
CCR5 co-receptor: one of two co-receptors on the surface of T-cells that
HIV uses to enter the cell
CCR5 inhibitor, CCR5 antagonist: a drug that blocks HIV’s use of the CCR5 co-receptor
CDC: abbreviation for the U.S. Centers for Disease Control and Prevention
CD4+ T-cell: a T-cell with a CD4 receptor on it, HIV’s favorite source for infection and spreading through the body. Often referred to simply as “T-cells.”
Clade: a subtype or variant of HIV—different clades exist in various regions of the world. HIV variants are currently grouped into clades A, B, C, D, E, F and O.
Clinical trial: a research study or experiment done with humans (as opposed to animals), usually designed to answer specific questions.
cocktail: refers to a drug combination
cognitive: refers to the working of the mind
co-factor: substances, microorganisms, or characteristics of individuals that might influence the progression of a disease or the likelihood of becoming ill
cohort: in research studies, a group of individuals with certain characteristics in common.
contraindication: refers to things that should not be combined, such as medications that can not be taken together, or food or supplements that can’t be taken with medications.
control: in research study, something is tested against a “control.” For example, a placebo-controlled study compares an experimental treatment to a placebo.
co-morbidity: another illness besides HIV
compassionate use: the availability of an experimental drug or treatment for people who are seriously ill
CROI: Conference on Retroviruses and Opportunistic Infections, the largest HIV scientific/medical conference in the country
Cytomegalovirus (CMV): a herpes virus considered an opportunistic infection. In AIDS, most commonly known for infecting the eyes, potentially leading to blindness, but can invade other organs.
Data Safety Monitoring Board (DSMB): an independent group of medical providers and community representatives that oversees a research study.
discordant couple: when one person in a couple has HIV and the other doesn’t. Also called “sero-discordant.”
discordant response: when T-cells rise but viral load does not drop, or vice-versa (viral load drops but T-cells don’t rise), while on therapy
double-blind: see “blind”
drug interaction: an effect that one drug has on another; an interaction could be positive or negative
dysplasia: abnormal development in skin, bone, and other tissues. If left untreated, may lead to cancer.
ELISA: Enzyme-Linked Immunosorbent Assay. A type of lab test to determine the presence of antibodies to HIV in the blood.
elite controller: an HIV-positive person whose body is able to control the virus without HIV drugs, also called long-term non-progressors (LTNPs).
etiology: the cause of a disease
expanded access program (EAP): drug made available before final FDA approval to persons in great need of it
false positive: when an HIV test mistakenly shows that someone is positive for the virus.
FDA: U.S. Food and Drug Administration, which approves all medicines and medical devices on the market in this country
genotype resistance test: looks at the genetic make-up of person’s HIV to help determine what medications would work. Also see “phenotype resistance test.”
half-life: The time required for half the amount of a drug to be eliminated from the body.
HAART: highly active antiretroviral therapy, a combination of powerful anti-HIV drugs.
hepatitis: An inflammation of the liver caused by certain viruses and other factors. Hepatitis B (HVB) and/or C (HVC) are frequent co-infections in HIV-positive people—HIV, HVB, and HVC are all spread through sexual contact or by sharing needles
hepatotoxicity: toxicity in the liver
HIV: human immunodeficiency virus.
holistic: looking at physical, mental, emotional, and spiritual aspects of an individual (the “whole” person)
host: the person with a disease. For example, “A variety of host factors can influence the progression of HIV.”
HPTN: HIV Prevention Trials Network
Human Papilloma Virus (HPV): a virus that causes of warts of the hands and feet, as well as lesions of the mucous membranes of the oral, anal and genital cavities and can lead to cervical or anal cancer.
HVTN: HIV Vaccine Trials Network
immune reconstitution inflammatory syndrome (IRIS): illness occurring when the immune system becomes stronger with therapy and begins to activate underlying pathogens in order to fight them
immunologic: refers to the immune system, such as “immunologic response,” “immunologic progression,” etc. In HIV therapy, “immunologic response” refers to CD4+ T-cells, while “virologic response” refers to viral load.
inactivated vaccine: a vaccine made from a whole virus or bacterium whose ability to grow or replicate has been eliminated.
in vitro: in the test tube
in vivo: in the body
IRB: Institutional Review Board—each research institution has an IRB that reviews studies to make sure they’re scientifically and ethically acceptable to participants.
Kaposi’s sarcoma (KS): a systemic cancer which can present with reddish or purplish skin lesions. May also affect the lining of the mouth, nose, and throat, or other organs. While a common AIDS-defining illness in the early days of the epidemic, it is rarely seen today.
late breaker: refers to medical reports or presentations accepted late at a conference
leukocytes: white blood cells
lipoatrophy: loss of fat. HIV medications have been associated with loss of fat in the arms, legs, buttocks, and face (facial wasting).
lipodystrophy: a potential side effect of HIV therapy that may include increased blood levels of cholesterol and triglycerides; loss of fat in the arms, legs, buttocks, and face (see “lipoatrophy”); and increased fat in the stomach and upper back (buffalo hump)
live attenuated vaccine: a type of vaccine that uses a weakened version of the organism of infection.
long-term non-progressors (LTNPs): see “elite controllers.”
Lymphocytes: white blood cells present in the blood, lymph, and lymphoid tissue and essential to the immune system, such as T and B cells
Meta-analysis: quantitative statistical analysis that is applied to separate but similar experiments run by different researchers, that involves pooling, or combining, the data of all the studies and using the pooled data to test the effectiveness of the results
MRSA: methicillin-resistant staphylococcus aureus—drug-resistant staph Pronounced “mersa.” Also see CA-MRSA.
MSM: a term commonly used in social work or clinical settings which stands for “men who have sex with men,” a category that includes men who may or may not consider themselves to be gay.
mutation: in HIV, refers to the virus changing itself in order to get around the effects of medications.
myelin: a substance that sheathes nerve cells, acting as an electric insulator that facilitates the conduction of nerve impulses. Neuropathy is caused when myelin is damaged or destroyed.
neuropathy: any abnormal, degenerative, or inflammatory state of the peripheral nervous system; symptoms include numbness, tingling, or pain in the extremities (hands and feet).
non-inferiority study: an FDA-required standard; tries to show that the experimental treatment is not less effective than standard-of-care
nurse practitioner: a nurse who can prescribe medicine
off-label: refers to the use of a medication for which it is not approved, but for which there is evidence of effectiveness.
open-label: a drug study in which researchers and participants know what drugs or treatments, including experimental, are being given
opportunistic infection (OI): An illness caused by an organism that usually does not cause disease in a person with a normal immune system.
optimized background therapy (OBT): usually used in clinical studies; refers to studies where a person’s current therapy is improved with available medications (“optimized”). A person may or may not receive the experimental drug being tested in the study (on top of their OBT).
p24 antigen: a protein fragment of HIV
P450 pathway: the pathway through which many drugs, herbs, and supplements are metabolized in the liver; often the reason certain herbs/supplements can’t be taken with drugs
pandemic: a disease prevalent throughout an entire country, continent, or the world.
Pap smear: a test that collects cells from the cervix or anus to check for cancer or pre-cancerous changes. Named for Papanicolaou, the doctor who invented the test.
pathogen: a microorganism that can cause disease. Pathogens include viruses, bacteria, fungi, and parasites.
pathogenesis: origin and development of disease.
pelvic inflammatory disease (PID): inflammation of the pelvic area, which may lead to infertility, ectopic pregnancy (outside the uterus), or scarring of the fallopian tubes. PID is usually caused by untreated sexually transmitted infections, such as chlamydia or gonorrhea.
peripheral neuropathy: a disorder of the nerves, usually involving the hands, feet, arms, and legs. A potential side effect of some HIV medications.
Phase 1, 2, 3, and 4: the four stages of a clinical study. “Pre-clinical” generally refers to test tube measurements or testing in animals.
phenotype resistance test: a test tube measurement that puts an HIV blood sample against each of the HIV drugs to see which ones are effective against that particular individual’s virus. Also see “genotype resistance test.”
placebo: a dummy pill used in studies. Placebos are used to see if the experimental treatment makes a difference. See “control.”
Polymerase chain reaction (PCR): a laboratory process that selects a DNA segment from a mixture of DNA chains and rapidly replicates it; used to create a large, readily analyzed sample of a piece of DNA. This technology is used in most viral load tests.
post-exposure prophylaxis (PEP): HIV medications taken after exposure to the virus in an attempt to avoid infection.
pre-exposure prophylaxis (PrEP): HIV medications taken before exposure to the virus in an attempt to avoid infection.
Principal investigator: the scientist in charge of a research team conducting a clinical trial.
prophylaxis: something used as prevention. For example, condoms are a prophylaxis against disease.
protease inhibitor: a type of HIV drug that interferes with the phase of the HIV life cycle that requires the enzyme protease.
protocol: In medicine, refers to the plan for a study or course of treatment.
providers: health care workers, may refer to other services, such as those of social workers
PLWA: people (or person) living with AIDS
PLWH/A: people (or person) living with HIV/AIDS
randomized: in a research study, the process of placing people into different categories in a way that avoids skewing the results.
rapid HIV testing: an HIV test that gives results in 20 minutes.
recombinant vaccine: vaccine that uses genetic material from a disease-carrying organism to produce an immune response.
regimen: combination of drugs used to treat a disease
reservoirs: areas in the body where latent HIV can “hide” undetected
resistance: the ability of microbes, including HIV, to adapt to and/or change their structure so that certain drugs can no longer affect them
retrovirus: a virus that works “backwards,” differently from most viruses. Most viruses use their DNA to change a person’s RNA. A retrovirus uses its RNA to insert itself into a person’s DNA.
reverse transcriptase: an enzyme of the HIV virus necessary to convert the single-stranded viral RNA into DNA, the form in which the cell carries its genes. Two types of HIV drugs—nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors—work by interfering with this stage of the viral life
Ryan White CARE Act: named after Ryan White, a boy who contracted HIV through a blood transfusion and was the first child HIV activist until his death at age 18, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990 was the first significant funding act by Congress specifically "to improve the quality and availability of care for individuals and families with HIV disease."
salvage therapy: advanced therapy; the second or third, etc round; for people with advanced disease
second generation: refers to a new drug that works differently from the older medications in its drug class. Usually refers to an improved resistance pattern (harder for HIV to develop resistance to).
serconversion: the point at which a person becomes HIV-positive
sero-discordant: generally refers to a couple where one person is HIV-positive and the other is not
serostatus: refers to whether a person is HIV-positive or negative
serum: the clear, thin, and sticky fluid that separates from blood when it clots. Serum, not whole blood, is the actual fluid used for measuring T-cells and viral load.
sexually transmitted infection (STI): exactly what it says. “STD” stands for sexually transmitted disease
suppressed: “suppressed virus” is one of the goals of HIV therapy, simply, keeping the viral load down as low as possible, ideally at undetectable levels
susceptibility: when HIV has not developed drug resistance to a medication and that medication can still effectively fight it
T-cell: T lymphocyte, thymus-derived (hence the “T”) white blood cell that participates in a variety of immune reactions. T lymphocytes are CD3+ and can be separated into the CD4+ T helper cells and the CD8+ cytotoxic/suppresssor cells. Also see “CD4+ T-cell.”
thrush: Sore patches in the mouth caused by the fungus Candida albicans. Thrush is one of the most frequent early symptoms of an immune disorder.
transmission: the spread of HIV from one person to another. Transmission occurs through the exchange of the following bodily fluids: blood, semen, vaginal fluid, breast milk, and spinal fluid. HIV is not transmitted through saliva, tears, or sweat.
treatment-experienced: a person who has experience with antiretroviral therapy
treatment failure: generally refers to a detectable viral load, or a rising one, while on treatment
treatment-naïve: someone who has never taken HIV medicine.
trial: another word for a research study
tropism: the type of co-receptor that HIV can use to enter a cell. A person’s HIV can be “CCR5-tropic,” “CXCR4-tropic,” “dual tropic” (the virus uses both co-receptors), or “mixed tropic” (the virus is partially CCR5-tropic and partially X4-tropic).
ultrasensitive assay: in viral loads, a test that measures as low as 20 copies/mL viral load
undetectable: a viral load below the limit of a test’s detection, generally 50 copies/mL. Virus is still in the person’s blood, but not at a level that can be picked up by the test.
vertical transmission: HIV infection passed on from a mother to infant during or around the time of pregnancy, or during breastfeeding
viral load: the quantity of virus measured in blood (serum), other fluid, or tissue
viremia: the presence of virus in the bloodstream.
wild-type virus: virus that has not developed resistance. Often the type of virus with which a person is infected, although people can be infected with resistant virus.
ZFN: Zinc finger nuclease technology-used to knock out CCR5 receptors on CD4+ T-cells, making them resistant to CCR5-tropic HIV.
Sources include AIDSInfo at the National Institutes of Health, the Project Inform HIV Drug Book, and the HIV/AIDS Treatment Information Service
