HIV/AIDS
HIV (Human Immunodeficiency Virus) is a virus that causes
AIDS (Acquired Immunodeficiency Syndrome), a condition that breaks down a
person’s immune system leading to a series of diseases. HIV does not instantly
lead to AIDS. An HIV infected individual can lead a healthy life for several
years before developing AIDS. HIV may be passed to another person when infected
blood, semen or vaginal fluids come in contact with skin tears or mucus
membranes of an uninfected individual.
According to the Mayo Clinic, an estimated 38.6 million
people are living with HIV. Nearly half of them are women and girls between the
ages of 15 and 24. In 2005, more than 4 million people were diagnosed with new
cases of HIV. Twenty-five million people have died of AIDS (advanced stage of
HIV) since the epidemic began about 25 years ago.
What are the symptoms
of HIV?
The first symptoms of HIV can resemble symptoms of other
conditions, such as a cold or flu virus, other sexually transmitted diseases,
other infections such as mononucleosis or hepatitis. Stress and anxiety can
also produce symptoms that are similar to HIV in some individuals.
The intensity of the symptoms can also vary from person to
person. Some may experience very strong symptoms while others experience none
at all. General symptoms can occur within days or weeks of initial exposure to
the virus and may include:
Fever
Fatigue
Rash
Headache
Swollen lymph nodes
Sore throat
These symptoms usually appear during a period called primary
or acute HIV infection.
The following may be
warning signs of advanced HIV infection:
Rapid weight loss
Dry cough
Recurring fever or profuse night sweats
Profound and unexplained fatigue
Swollen lymph glands in the armpits, groin or neck
(lymphadenopathy)
Diarrhea that lasts for more than a week
White spots or unusual blemishes on the tongue, in the
mouth, or in the throat
Pneumonia
Red, brown, pink or purple blotches on or under the skin or
inside the mouth, nose or eyelids
Memory loss, depression and other neurological disorders
No one should assume they are infected with HIV just because
of these symptoms. Each of these symptoms can be related to other medical
conditions. Because these symptoms are similar to other diseases, a person may
not realize they are infected with HIV. The only way to determine if a person
is infected with HIV is to be tested.
Even if someone doesn’t have symptoms it is still possible
to transmit the virus to others. Once the virus has entered the body it begins
to attack the immune system. The virus multiplies in the lymph nodes and begins
to destroy the T-cells, which are the white blood cells that coordinate the
entire immune system.
A person may be symptom free for nine years or more. During
this time the virus continues to multiply and destroy immune cells.
Can having HIV lead
to other problems?
The advanced stages of HIV have been identified by the term
AIDS (Acquired Immunodeficiency Syndrome). According to the definition provided
by the Centers for Disease Control & Prevention (CDC), AIDS includes all
HIV-infected people who have less than 200 CD4+ T cells per cubic millimeter of
blood. This definition also includes 26 clinical conditions that affect people
with advanced HIV disease. In people with AIDS, these infections are often
severe and fatal because the immune system has been so damaged by HIV that the
body cannot reject certain bacteria, viruses, fungi, parasites and other
microbes.
How is HIV
transmitted?
The most common ways that HIV is spread include:
Vaginal, oral or anal sex with someone who is infected with
HIV
Sharing needles or syringes with someone infected with HIV
Infected blood, semen or vaginal fluid (including menstrual
blood) can enter the body through the vagina, rectum or mouth and surrounding
tissue. The risk of becoming infected increases if there are sores (caused by
herpes, syphilis and chancroid) on the genitals (vagina, vulva, penis). Sharing
personal devices can be risky if they have been in contact with another
person’s blood, semen or vaginal fluid.
HIV is not spread through every day activities or casual
contact. Activities such as hugging, kissing, cuddling, touching or massaging
do not spread HIV unless there is contact with the person’s blood, semen,
vaginal fluid or breast milk.
HIV cannot be
contracted from:
Food
Handshakes
Coughs or sneezes
Being around an infected person
Insect bites
Using swimming pools or hot tubs
Toilet seats
Phones or computers
Drinking fountains
Straws, spoons or cups
How is HIV diagnosed?
Because this disease has nonspecific symptoms, they are not
a reliable way to diagnose HIV infection. The only way to know whether a person
has been infected is through HIV testing.
HIV tests do not test for the actual HIV virus. One test
detects HIV proteins while the other two detect HIV antibodies in the
bloodstream.
Elisa is the first portion of the HIV test. This test
detects the presence of HIV antibodies in the blood. Negative results determine
a person is not HIV infected. Positive results lead to the second portion of
the test to confirm results.
Western Blot is used to confirm a positive Elisa test
result. The Western Blot test detects specific protein bands that are present
with HIV infections. A positive Elisa test with a positive Western Blot test
gives 99.9% accuracy in identifying HIV infection.
PCR detects specific DNA and RNA sequences that indicate the
presence of HIV in the genetic structure of anyone HIV infected. DNA and RNA
from the HIV virus circulate in the blood. The presence of these “particles”
indicates the HIV virus.
Testing for HIV antibodies is the only way to know if a
person is infected. However, this test for HIV antibodies is effective only
after the infected person’s immune system produces antibodies to HIV. There is
a time period between the initial infection and when the HIV antibodies are
detectable which can be from 2 weeks to 6 months with an average length of 3
months. During this time period standard HIV testing is ineffective.
What is the treatment
for HIV?
When the HIV/AIDS epidemic began in the early 1980s, AIDS
patients were not expected to live more than a few years. Since then, the
development of safe and effective drugs is enabling people with HIV to live
longer and healthier lives.
At the present time there are 26 antiretroviral drugs that
have been approved by the U.S. Food and Drug Administration (FDA) for the
treatment of HIV patients. These drugs can be classified into three major
groups:
Reverse transcriptase (RT) inhibitors – interfere with the
conversion of reverse transcriptase (an HIV enzyme) into HIV RNA to HIV DNA.
Protease inhibitors (PI) – interfere with the protease
enzyme that HIV uses to produce infectious viral particles.
Fusion inhibitors – interfere with the HIV virus’ ability to
fuse with the cellular membrane, thus blocking entry into the host cell.
Current drugs can suppress the HIV virus, even to
undetectable levels, but are not able to completely remove HIV from the body.
These drugs help to manage HIV but are not able to cure it. It is important
that infected patients continue to take antiretroviral drugs.
Because HIV reproduces itself, new strains of the virus
continue to emerge which can be resistant to antiretroviral drugs. Most health
care providers recommend that HIV infected patients take a combination of
antiretroviral drugs known as HAART. This combination of drugs successfully
suppresses the virus and decreases the rate of opportunistic infections by
strengthening the immune system.
While the use of HAART can suppress the virus and has
greatly reduced the number of deaths due to HIV/AIDS, the virus may still be
transmitted. People infected with HIV who are taking antiretroviral drugs can
still transmit HIV to others through unprotected sex and needle sharing.
The Pharmaceutical Research and Manufacturers Association of
America maintains a database of new drugs in development to treat HIV
infection. Scientists are also studying how immune modulators can help to
increase the immune response to the HIV virus and make existing HIV drugs more
effective. Therapeutic vaccines are being examined for this purpose.
Can HIV be prevented?
Not having sex is the only sure way to avoid the
transmission of HIV.
If you decide to engage in sexual activity, in order to
reduce the risk of infection you should:
Have sex with only one partner who is not infected with HIV,
who does not share needles or syringes and who has sex only with you. These
things may be difficult to know about another person.
Avoid contact with your partner’s blood, semen or vaginal
fluid.
The correct use of a latex condom when having sex greatly
reduces your risk of HIV infection.
Use a water-based lubricant with the latex condom to reduce
risk of breakage when engaging in vaginal or anal sex.
Use a male condom without spermicide or a lubricant for oral
sex.
Further research is needed to determine the effectiveness of
the female condom or dental dams in preventing HIV transmission.
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