Everything About HIV And AIDS | Causes, Symptoms & Treatment
What Is HIV?
Everything About HIV And AIDS – HIV is a virus that damages the immune system. Untreated HIV infects and destroys CD4 cells, a type of immune cell called T cells. Over time, as HIV destroys more CD4 cells, the body is more likely to develop a variety of conditions and cancer.
HIV is transmitted through body fluids including:
- Vaginal And Rectal Fluids
- Breast Milk
The virus is not transmitted through air or water, or by casual contact. Because HIV enters the DNA of cells, it is a lifelong condition, and there is currently no drug that can eradicate HIV from the body, although many scientists are trying to find it.
However, it is possible with medical care, called antiretroviral therapy, which includes managing HIV and staying with the virus for many years.
Without treatment, a person infected with HIV is more likely to develop a serious condition called acquired immunodeficiency syndrome, also known as AIDS. At this time, the immune system is too weak to respond successfully to other diseases, infections, and conditions.
In the absence of treatment, the final age with AIDS is 3 years of reliable confidence. With antiretroviral therapy, HIV can be better controlled and life expectancy can be similar to that of those who have not contracted it.
An estimated 1.2 million Americans are currently living with HIV. Of these, 1 in 7 do not know they have the virus. HIV can cause changes throughout the body.
What Is AIDS?
AIDS is a disease that can develop in people living with HIV. This is the last stage of HIV. But just because someone has HIV does not mean that they will develop AIDS.
HIV kills CD4 cells. Healthy adults typically have a CD4 count of 500 to 1600 per cubic millimeter. A person with HIV whose CD4 count is less than 200 per cubic millimeter will be diagnosed with AIDS. A person can also be diagnosed with AIDS if they have HIV and develop an infection or cancer that occurs in people who do not have HIV.
Pneumocystis is one of the opportunistic infections, such as Pneumocystis jiroveci pneumonia, that occurs only in a severely immunosuppressed person, such as a person with advanced HIV infection (AIDS).
Without treatment, HIV can turn into AIDS in a decade. There is currently no cure for AIDS and without treatment, life expectancy after diagnosis is approximately 3 years.
This person may be small if they develop a serious opportunistic disease. However, treatment with antiretroviral drugs can prevent the spread of AIDS.
If AIDS develops, it means that the immune system is severely compromised, meaning it becomes so weak that it cannot respond successfully to most diseases and infections.
This can lead to a variety of illnesses for people living with AIDS, including:
- Fungal infections of the mouth, mouth, or throat.
- Cytomegalovirus (CMV) is a type of herpes virus.
- cryptococcal meningitis, a fungal disease of the brain
- Toxoplasmosis, a brain condition caused by a parasite
- Cryptosporidiosis, a condition caused by intestinal parasites.
- Cancers, including Kaposi’s sarcoma (KS) and lymphoma.
The shortened life expectancy associated with treated AIDS is not a direct result of the syndrome itself. Rather, it is the result of diseases and complications caused by the weakening of the immune system through AIDS.
HIV And AIDS: What’s the Relationship?
For AIDS to develop, a person must contract HIV. But having HIV does not necessarily mean that someone will spread AIDS. HIV cases go through three stages.
- Stage 1: Intense phase, in the first weeks of transmission
- Stage 2: Medical delay or chronic phase
- Step 3: AIDS
Because HIV reduces CD4 cell counts, the immune system is weakened. The average adult CD4 count is 500 to 1,500 per cubic millimeter. A person under the age of 200 is considered AIDS.
How fast a case of HIV progresses in the chronic phase varies from person to person. Without treatment, it can last up to a decade before it turns into AIDS. With treatment, it can last indefinitely.
There is currently no cure for HIV, but it can be controlled. People living with HIV are expected to return to normal with early treatment with antiretroviral therapy.
With these letters, there is no technically cure for AIDS today. However, treatment can increase a person’s CD4 count to the point where it is no longer considered AIDS. (This point counts for 200 or more). Also, treatment is usually helpful in controlling opportunistic infections. HIV and AIDS are related, but they are not the same.
HIV Transmission: Know The Facts
Anyone can get HIV. The virus spreads to body fluids, including:
- Vaginal and rectal fluid
- Breast Milk
Some of the ways HIV is transmitted from one person to another include:
- Vaginal or anal sex – the most common way of transmission
- Sharing needles, syringes, and other injectable drug paraphernalia
- Distribute sterile tattoo products between uses
- During pregnancy, labor, or delivery by a pregnant woman to her baby
- During breastfeeding
- By “premature” or by chewing before feeding a baby
- Blood, semen, vaginal and rectal fluid, and breast milk from someone living with HIV, such as through a needle stick
The virus can also be spread through blood transfusions or organ and tissue transplants. However, rigorous testing for HIV among blood, organ and tissue donors ensures that it is rare in the United States.
This is theoretically possible, but is considered extremely rare, as HIV transmission:
- Oral sex (only if the person has bleeding gums or open sores in the mouth)
- From the bite of a person with HIV (only if the saliva is bloody or the person has open wounds in the mouth)
- Contact between broken skin, wounds or mucous membranes and blood of someone living with HIV
HIV is not transmitted through:
- Skin-to-Skin Contact
- Hug, shake hands or kiss
- Air or water
- Sharing food or beverages, including fountains
- Saliva, tears, or sweat (unless mixed with HIV)
- Distribute bathroom, towels, or bedding
- Mosquitoes or other insects
It is important to note that if an HIV-infected person undergoes treatment and continues to carry an unrecognizable sparse burden, it is virtually impossible to spread the virus to another person.
Causes Of HIV
HIV is a variant of the virus that can be transmitted to African chimpanzees. Scientists suspect that the Simian immunodeficiency virus (SIV) jumped from chimpanzees to humans when people ate chimpanzee meat that contained the virus. Once inside the human population, the virus turned into what we now know as HIV. This probably happened in the early 1920s.
HIV has been transmitted from person to person in Africa for decades. Eventually, the virus spread to other parts of the world. Scientists first discovered HIV in a human blood sample in 1959. HIV is thought to have been present in the United States since the 1970s, but it did not begin to affect public awareness until the 1980s.
Causes Of AIDS
AIDS is caused by HIV. If a person does not contract HIV, they cannot get AIDS. Healthy people have a CD4 count of 500 to 1500 per cubic millimeter. Without treatment, HIV multiplies and destroys CD4 cells. If a person’s CD4 count falls below 200, they get AIDS.
Also, if an HIV-infected person develops an opportunistic HIV-related infection, he or she can still be diagnosed with AIDS, even if his or her CD4 count is over 200.
What Tests Are Used To Diagnose HIV?
Many different tests can be used to diagnose HIV. Healthcare providers decide which test is best for each person.
Antibody / Antigen Test (Everything About HIV And AIDS)
Antibody / antigen tests are the most commonly used. They can usually show positive results within 18 to 45 days after someone first gets HIV. This test tests the blood for antibodies and antigens. An antibody is a type of protein that the body makes to respond to an infection. Antigen, on the other hand, is the part of the virus that activates the immune system.
Antibodies Test (Everything About HIV And AIDS)
These tests only look at the blood for antibodies. Between 23 and 90 days after transmission, most people will develop a detectable HIV antibody, which can be found in the blood or saliva. These tests are done by blood test or buckle swabs and no preparation is required. Some tests give results in 30 minutes or less and can be done at a healthcare provider’s office or clinic.
Other antibody tests can also be done at home:
- OraQuick HIV test: Oral broom provides results in less than 20 minutes.
- Home Access HIV-1 Test System: After licking the person’s finger, they send blood samples to a licensed laboratory. They can remain anonymous and request results the next business day.
If anyone suspects that they are at risk of HIV but have been tested negatively at home, repeat the test in 3 months. If they have a positive result, they should follow up with their own healthcare provider to confirm it.
Nucleic Acid Test (NAT) | Everything About HIV And AIDS
This expensive test is not used for general exams. This is for people who have early signs of HIV or have a risk factor. This test does not detect antibodies. Self-detecting viruses.
It takes 5 to 21 days for HIV to be detected in the blood. This test is usually accompanied by an antibody test.
What Is The Window Period For HIV?
As soon as someone contracts HIV, it begins to regenerate in their body. The person’s immune system responds by producing antibodies (cells that fight against the virus) to antibodies (parts of the virus). The time between exposure to HIV and when it is detected in the blood is called the HIV window period. Most people develop HIV antibodies that detect within 23 to 90 days of transmission.
If a person tests for HIV during the window period, it is likely to have a negative result. However, they can transmit the virus to other people during this time. If someone thinks they have been diagnosed with HIV but have been tested negatively in the meantime, they should repeat the test in a few months to confirm it (the time used depends on the test). Is). And during this time, they need to use condoms or other barrier methods to prevent the possible spread of HIV.
Anyone who has a negative experience during the window may benefit from later exposure prophylaxis (PEP). Expos to prevent HIV is a medicine that is taken after exposure. PEP should be taken as soon as possible after exposure. It should not be taken 72 hours after exposure, but ideally soon.
Another way to prevent the spread of HIV is pre-exposure prophylaxis (PEPP). A combination of anti-HIV drugs taken before possible exposure to HIV can reduce the risk of getting or transmitting HIV when taken permanently. Timing is important when testing for HIV.
Early Symptoms Of HIV
The first few weeks after contracting HIV are called acute stages of infection. During this time, the virus regenerates rapidly. The person’s immune system responds by producing antibodies to HIV, which are proteins that act to respond to infection.
During this stage, some people have no symptoms at first. However, many people experience symptoms after contracting the virus in the first month, but often do not realize that HIV causes these symptoms. This is because the symptoms of the acute phase may be similar to the flu or other seasonal viruses, such as:
- Can be mild to severe
- They can come and go
- It can last from a few days to several weeks
The first symptoms of HIV may include:
- Swollen lymph nodes
- Common aches and pains
- Sore throat
- Stomach pain
Because these symptoms are similar to common illnesses such as the flu, the sufferer may think they do not need to see a health care provider. And even if they do, your healthcare provider may suspect flu or mononucleosis and may not even consider HIV.
Whether a person has symptoms or not, their viral load is very high during this period. Viral load is the amount of HIV that is in the bloodstream. A higher viral load means that HIV can be easily transmitted to another person during this time.
Early symptoms of HIV usually resolve within a few months when the person enters the chronic or clinical latency phase of HIV. With treatment, this stage can last for many years or decades. The symptoms of HIV can vary from person to person.
What Are The Symptoms Of HIV?
In the first month or so, HIV enters a clinical delay. This phase can last from a few years to a few decades. Some people have no symptoms at this time, while others may have minor or insignificant symptoms. A special symptom is a symptom that is not related to any particular disease or condition.
These may include prominent symptoms:
- Headaches and other aches and pains
- Swollen lymph nodes
- Recurrent fever
- Night sweats
- Weight loss
- Skin rub
- Recurrent oral or vaginal yeast infections
As with the early stages, HIV can be transmitted during this time, even through symptoms, and can be transmitted to another person.
However, no one will know they have HIV unless they are tested. If someone has these symptoms and thinks they have HIV, it is important to get tested. Symptoms of HIV can come and go at this stage, or they can progress rapidly. This progression can be significantly reduced with treatment.
With continued use of this antiretroviral therapy, chronic HIV can persist for decades and may not progress to AIDS if treatment is started as soon as possible.
Is Rash A Sign Of HIV?
Many people change their skin when they experience HIV. Itching is often one of the first symptoms of HIV infection. In general, HIV rash appears as more than one small red lesion that is flat and raised.
HIV causes skin problems in a person because the virus kills the cells of the immune system that fight the infection. Leprosy infections include:
- Molluscum contagiosum
Determines the cause of the rash:
- What does it look like?
- How long does it last?
- How it can be treated depends on the cause?
Rashes Related To Medication (Everything About HIV And AIDS)
Although it can be caused by an early co-infection with HIV, it can also be caused by medication. Some medications used to treat HIV or other conditions can cause premature ejaculation. Such rashes usually appear within a week to 2 weeks after starting a new medication.
Sometimes the rash goes away on its own. If not, you may need to change your medication. Allergic reactions to a medicine can cause severe itching. Other symptoms of an allergic reaction include:
- Difficulty breathing or swallowing
Stevens-Johnson Syndrome (SJS) is an unusual allergic reaction to HIV drugs. Symptoms include fever and swelling of the face and tongue. A peeling rash appears, which can affect the skin and mucous membranes, which spreads rapidly.
When 30% of a reliable source of skin is affected, it is called toxic epidermal necrolysis, which is life threatening. If this happens, emergency medical help is needed.
Although rash may be related to HIV or HIV medications, it is important to note that rash is common and can have many other causes.
Symptoms of HIV in Men: Is There a Difference?
The symptoms of HIV vary from person to person, but are the same for men and women. These symptoms can come and go or get worse over time. If a person is infected with HIV, they can also get other sexually transmitted infections (STIs). These include:
Men, and people with erectile dysfunction, are more likely than women to have symptoms of STIs, such as genital lesions. However, men often do not seek medical help like women.
Symptoms Of HIV In Women: What’s The Difference?
For the most part, the symptoms of HIV are the same in men and women. However, the symptoms they usually experience can vary depending on the different risks that cause HIV in both men and women.
Both men and women living with HIV have an increased risk of STIs. However, women and men with vaginitis are less likely than men to notice small spots or other changes in their genitals.
In addition, HIV-infected women are at increased risk:
- Recurrent vaginal yeast infections
- Other vaginal infections, including bacterial vaginosis
- Pelvic inflammatory disease (PID)
- Menstrual changes
- Human papilloma virus (HPV), which can cause genital warts and cervical cancer
Although not related to the symptoms of HIV, another risk for HIV-infected women is that the virus can be passed on to a baby during pregnancy. However, antiretroviral therapy is considered safe during pregnancy.
Women receiving antiretroviral therapy have a much lower risk of transmitting HIV to their baby during pregnancy and delivery. Breastfeeding also affects HIV-infected women. The virus can be transmitted to a baby through breast milk.
In the United States and other settings where the formula is accessible and safe, it is recommended that HIV-infected women not breastfeed their babies. For these women, the use of formula is recommended.
Other options besides formula include stored pasteurized breast milk. For women who have had HIV, it is important to know what symptoms to look for.
What Are The Symptoms Of AIDS?
AIDS refers to immunodeficiency syndrome. With this condition, HIV weakens the immune system, which is usually not treated for many years. If HIV is detected and treated early with antiretroviral therapy, the person will not usually develop AIDS.
People living with HIV can get AIDS if they are not diagnosed late or if they know they have HIV but do not take antiretroviral therapy permanently. They can also develop AIDS if they have the type of HIV that is resistant (not reacting) to antiretroviral therapy.
Without proper and permanent treatment, people living with HIV can develop AIDS first. By this time, the immune system has deteriorated considerably and more difficult times are needed to respond to infections and diseases. With the use of antiretroviral therapy, a person can maintain a chronic diagnosis of HIV for decades without developing AIDS.
Symptoms of AIDS may include:
- Frequent fever
- Chronic swollen lymph nodes, especially in the armpits, neck and room
- Chronic fatigue
- Night sweats
- Dark spots under the skin or inside the mouth, nose, or eyelids
- Due to sores, spots, or lesions of the mouth and tongue, genitals, or anus
- Spots, sores, or blemishes on the skin
- Chronic or recurrent diarrhea
- Rapid weight loss
- Neurological problems such as difficulty concentrating, memory loss, and confusion
- Anxiety and depression
Antiretroviral therapy controls the virus and prevents the progression of AIDS in general. Other AIDS infections and complications can also be treated. This behavior should be tailored to the individual’s needs.
HIV Treatment Options
Treatment should begin as soon as possible after being diagnosed with HIV, regardless of the viral load. The primary treatment for HIV is antiretroviral therapy, a combination of daily medications that prevent the virus from recurring. This helps protect CD4 cells, and strengthens the immune system to fight disease.
Antiretroviral therapy helps prevent HIV from getting AIDS. It also helps reduce the risk of transmitting HIV to other people. When the treatment proves effective, the viral burden will be “unrecognizable.” This person still has HIV, but the virus does not show up in the test results.
However, the virus is still present in the body. And if that person stops antiretroviral therapy, the viral load will increase again and HIV can start attacking CD4 cells again.
Many antiretroviral therapy drugs are approved to treat HIV. They work to prevent HDV from regenerating and destroying CD4 cells, which help the immune system to respond to infection. This helps reduce the risk of developing HIV-related complications as well as spreading the virus to other people.
These antiretroviral drugs are divided into six classes:
- Nucleoside analog reverse transcriptase inhibitors (NRTI)
- Non nucleoside reverse transcriptase inhibitors (NNRTI)
- Stopping proteases
- Fusion inhibitors
- Opponents of CCR5, also known as entry inhibitors
- Integration of chain transfer inhibitors
Treatment Regimens (Everything About HIV And AIDS)
The US Department of Health and Human Services (HHS) generally recommends the first three HIV-style drugs in at least two of these categories. This combination helps prevent HIV from becoming drug resistant. (Resistance means that medicine no longer works to treat the virus.)
Many antiretroviral drugs are combined with others, so a person with HIV usually takes only one or two pills a day. The healthcare provider will help the person living with HIV choose a course of action based on their general health and personal circumstances.
These medicines must be taken every day, just like that. If not taken properly, viral resistance can develop and a new approach may be required.
Blood tests will help determine if the regimen is working to reduce the viral load and increase CD4 counts. If the antiretroviral therapy method does not work, the person’s health care provider will turn the person into a different practice that is more effective.
Side Effects And Costs (Everything About HIV And AIDS)
The side effects of antiretroviral therapy vary and include nausea, headache, and dizziness. These symptoms are usually temporary and disappear over time. Serious side effects can include swelling of the mouth and tongue and damage to the liver or kidneys. If the side effects are severe, the medication can be adjusted.
The cost of antiretroviral therapy depends on the geographical location and the type of insurance coverage. Some pharmaceutical companies have programs to help reduce costs.
Although many researchers are working to develop one, there is currently no vaccine available to prevent HIV transmission. However, taking some steps can help prevent HIV transmission.
Safe Sex (Everything About HIV And AIDS)
The most common way to transmit HIV is to have anal or vaginal sex without a condom or any other barrier procedure. This risk cannot be completely eliminated unless sexual intercourse is completely avoided, but some precautions can be taken to greatly reduce this risk.
Someone should be concerned about their risk of contracting HIV:
- Get Tested For HIV: It is important that they know your status and that of your partner.
- Get tested for other sexually transmitted infections (STIs): If they test positive, they should be treated, as having an STI increases the risk of contracting HIV.
- Use Condom: They must learn the right way to use condoms and use them every time they have sex, whether through vaginal or anal intercourse. It is important to note that pre-seminal fluid (which comes out before male ejaculation) can contain HIV.
- Take your medication as directed if you have HIV: This reduces the risk of the virus being transmitted to your sexual partner.
Other Methods Of Prevention (Everything About HIV And AIDS)
Other measures to help prevent the spread of HIV include:
- Avoid handling needles or other items: HIV is spread through the blood and can be contracted through the use of substances that have come into contact with the blood of someone with HIV.
- Consider PEP: A person who has been exposed to HIV should contact Postpaid Prophylaxis (PEP) after contacting their healthcare provider. PEP can reduce the risk of getting HIV. It contains three antiretroviral drugs that are given for 28 days. PEP should be started as soon as possible after the show, but 36 to 72 hours have already passed before that.
- Consider the prep: A person who is more likely to have HIV should talk to their healthcare provider about pre-exposure prophylaxis (PREP). If you take it regularly, it can reduce your risk of getting HIV. A combination of two drugs in pill form.
Healthcare providers can offer more information about these and other methods that can prevent the spread of HIV.
Living With HIV: What To Expect And Tips To Coping
More than 1.2 million people in the United States are living with HIV. It’s different for everyone, but with treatment, many people can expect a long and productive life.
The most important thing is to start antiretroviral treatment as soon as possible. With the right medications, people living with HIV can reduce their viral load and strengthen their immune systems.
It is also important to follow up with a healthcare provider regularly.
Other ways for people living with HIV to improve their health include:
- Make your health your top priority: Steps to help people with HIV feel better include:
- Providing your body with a balanced diet
- Exercise regularly
- Get enough rest
- Avoiding tobacco and other drugs
- Report any new symptoms to your healthcare provider immediately
- Focus on your mental health: They may consider seeing a licensed therapist who has experience dealing with people living with HIV.
- Use safe sex: Talk to their sexual partners. Get tested for other STIs. And use condoms and other barrier methods whenever you have vaginal or anal sex.
- Talk to your healthcare provider about PREP and PEP: When used permanently by someone other than HIV, pre-exposure prophylaxis (PEPP) and post-exposure prophylaxis (PEP) can reduce the chances of transmission. PEPP is often recommended in relationships with people living with HIV, but it can also be used in other situations.
- Surround yourself with your loved ones: When they first tell people about their diagnosis, they can start slowly by telling someone who can maintain their confidence. They want to choose someone who is unjustified and will support them in their health care.
- Get Help: They can join an HIV support group in person or online, so they can meet other people who have similar concerns. Your healthcare provider can also direct you to a number of resources in your area.
There are many ways to make the most of your life with HIV.
Life Expectancy For HIV: Get The Facts
In the 1990s, a 20-year-old man living with HIV was 19 years old. By 2011, at age 20, HIV can be expected to live another 53 years. This is a dramatic improvement, largely due to antiretroviral therapy. With proper treatment, many people with HIV can expect normal or near normal.
Of course, many things affect a person’s life expectancy. Among them are:
- CD4 cell count
- Viral load
- Serious HIV-related illnesses, including hepatitis
- Drug Misusing
- Of smoking
- Responses to access, restrictions and treatment
- Other health conditions
Where a person lives is also important. People in the United States and other developed countries are more likely to have access to antiretroviral therapy. Regular use of these drugs helps prevent HIV from spreading to AIDS. When HIV develops in AIDS, life expectancy without treatment is about 3 years.
In 2017, approximately 20.9 million people living with HIV were using antiretroviral therapy. Life expectancy statistics are just general guidelines. People living with HIV should talk to their healthcare provider to find out more about what to expect.
Is There A Vaccine For HIV?
Currently, there is no vaccine to prevent or treat HIV. Experimental vaccines are being researched and tested, but no one is close to being approved for general use. HIV is a complex virus. It (changes) change rapidly and often manages to defend itself against the immune system’s response. Only a small number of people with HIV develop a wide range of neutral antibodies, the type that can respond to different strains of HIV.
The efficacy of the first HIV vaccine in 7 years was studied in 2016 in South Africa. The latest version of the experimental vaccine was developed in Thailand in a 2009 trial. A 3.5-year follow-up after vaccination showed that the vaccine was 31.2% effective in preventing HIV transmission.
The study included 5,400 South African men and women. In South Africa in 2016, about 270,000 people were infected with HIV. The results of the study are expected in 2021. Other multinational clinical trials of the phase vaccine are also currently underway.
Another study is being done on the HIV vaccine. Although there is no vaccine to prevent HIV, people living with HIV can benefit from other vaccines to prevent HIV-related illnesses. Here are the CDC’s recommendations.
- Pneumonia: Reliable source recommended for children under 2 years of age and all children 65 years and older
- Influenza: Reliable source is recommended every year for people over 6 months with rare exceptions.
- Hepatitis A and B: Ask your doctor if you should be vaccinated against hepatitis A and B, especially if you are in a high-risk group.
- Meningitis: The meningococcal conjugate vaccine is recommended for all poor and adolescents aged 11-10 years with a booster dose of 16 or more at risk. The meningococcal serogroup B vaccine is recommended for everyone 10 years of age and older at increased risk.
- Shingles: Reliable source recommended for people aged 50 and over
These are today’s HIV numbers:
- In 2019, approximately 38 million people worldwide were living with HIV. Of those, 1.8 million were children under the age of 15.
- At the end of 2019, 25.4 million people living with HIV were using antiretroviral therapy.
- Since the onset of the epidemic, 75.7 million people have been infected with HIV and AIDS-related complications have claimed 32.7 million lives.
- In 2019, 690,000 people died of AIDS-related diseases. This is a decrease of 1.9 million in 2005.
- East and South Africa are the hardest hit. In 2019, 20.7 million people in these areas were living with HIV and 730,000 more were infected. The region has more than half the world’s population living with HIV.
- In the United States in 2018, the proportion of adult women and adolescents in the new HIV diagnosis was 19%. About half of all new cases are found in African Americans.
- If left untreated, an HIV-infected woman has a 15 to 45 percent chance of transmitting HIV to her baby during pregnancy or breastfeeding. With antiretroviral therapy and avoidance of breastfeeding during pregnancy, the risk is less than 5%.
- In the 1990s, a 20-year-old man living with HIV was 19 years old. By 2011, he had improved to 53 years. If antiretroviral therapy is started immediately after contracting HIV, life expectancy is almost normal.
As access to antiretroviral therapy is improving around the world, these figures are expected to change.