HIV is a virus that attacks and changes the immune system and increases the risk and effect of certain infections and diseases. Without treatment, the infection can progress to an advanced stage of disease called AIDS.
Nevertheless, recent developments in treatment suggest that people living with HIV in countries with strong access to health care seldom develop AIDS until they undergo medication.
The life expectancy of a person who carries the HIV virus is now approaching that of a person that tests negative for the virus, as long as they adhere to a combination of medications called antiretroviral therapy (ART) on an ongoing basis.
A Kaiser Permanent study in 2016 suggested that between 1996 and 2016, the gap in life expectancy between people who are HIV positive and HIV negative closed from 44 years to 12 years.
The World Health Organization (WHO) also advises that a person living with HIV can resume a high quality of life with treatment, and that 20.9 million people worldwide were receiving ART as of mid-2017.
In this post, we clarify the symptoms, causes and treatment of HIV and AIDS.
WHAT IS HIV?
Human Immunodeficiency Virus (HIV) is a virus that targets immune cells called CD4 cells that are a type of T cell.
They are white blood cells that travel across the body, identifying cell defects and abnormalities as well as infections. As HIV enters and infiltrates these cells, it reduces the capacity of the body to fight certain diseases.
This raises the risk and effect of opportunistic infections and cancer. However, a person can bear HIV for a long time without symptoms.
HIV is a life-long virus. However, successful care and disease control will prevent HIV from reaching a severe level and reduce the likelihood of a person spreading the virus.
What Is AIDS?
AIDS is the most advanced level of infection with HIV. When HIV infection progresses into AIDS, there is a greater risk of infection and cancer.
Without diagnosis, HIV infection is likely to develop into AIDS as the immune system slowly fades away. However, developments in ART mean that ever-decreasing numbers of people are making progress to this level.
Around 1,122,900 people were HIV-positive by the end of 2015. To comparison, estimates from 2016 indicate that an estimated 18,160 people have been diagnosed with AIDS by medical professionals.
Common ways People can transmit HIV in bodily fluids, this includes:
- Vaginal secretions
- Anal fluids
- Breast milk
In the United States, the main causes of this transfer of fluids are:
- Anal or vaginal sex with a person who has HIV while not using a condom or PrEP, a preventive HIV treatment for people at high risk of infection.
- Sharing facilities for injectable prescription drugs, hormones, and steroids with a person who has HIV
A woman living with HIV who is pregnant or has recently given birth may be able to transfer the disease to her child during pregnancy, childbirth or breast-feeding.
The risk of HIV transmission by blood transfusions is extremely low in countries with successful blood donation screening procedures in place.
Undetectable = untransmittable
To transmit HIV, these fluids must contain enough of the virus. If a person has ‘undetectable’ HIV, they will not transmit HIV to another person, even if after a transfer of fluids.
Undetectable HIV happens when the level of HIV in the body is so small that it can not be identified by a blood test. Individuals may be able to reach undetectable rates of HIV by following the recommended course of treatment closely.
It is necessary to confirm and frequently check the undetectable status with a blood test, because this does not indicate that a person no longer has HIV. Undetectable HIV relies on the individual who adheres to their care, as well as on the efficacy of the care itself.
Progression Towards AIDS
The risk of HIV progressing towards AIDS varies widely between individuals and depends on several factors, including:
- The age of the individual
- The body’s ability to defend against HIV
- Access to high-quality, sanitary healthcare
- The presence of other infections
- The individual’s genetic inheritance resistance to certain strains of HIV
- Drug-resistant strains of HIV
Most of the infections caused by certain bacteria, viruses, fungi or parasites cause more severe symptoms of HIV.
Such disorders appear to develop faster in people living with HIV than in people with stable immune systems. A well-functioning immune system would protect the body from the more advanced effects of pathogens, and HIV would interrupt this cycle.
Early Symptoms Of HIV Infection
Some people with HIV have no signs until months or even years after they have contracted the virus.
However, around 80 per cent of people may experience a series of flu-like symptoms known as acute retroviral syndrome about 2–6 weeks after the virus enters the body.
The early symptoms of HIV infection may include:
- Joint pain
- muscle aches
- Sore throat
- Sweats. particularly at night
- Enlarged glands
- A red rash
- Unintentional weight loss
Such effects can also be caused by the immune system that battles other forms of viruses.
Nonetheless, people who have encountered any of these symptoms and know of some cause that they might have been at risk of HIV infection in the last 6 weeks should take a test.
In many cases, signs of acute retroviral syndrome may not appear for many years.
At this time, the virus begins to evolve and inflict damage to the immune system and organs. Without drugs that inhibit the replication of the virus, this slow cycle will continue for an average of around 10 years.
A person living with HIV sometimes has no signs, feels fine and looks well.
Complying rigidly with the ART pathway will interrupt this process and fully suppress the virus. Taking effective antiretroviral medications for life can avoid damage to the immune system.
Late-stage HIV Infection
Without medications, HIV weakens the ability to fight infection. The person is vulnerable to serious illness. This stage is known as AIDS or HIV Phase 3.
Symptoms of late-stage HIV infection can include:
- Blurred vision
- Diarrhea, which is usually persistent or chronic
- Dry cough
- A fever of over 100 °F (37 °C) lasting for weeks
- Night sweats
- Permanent tiredness
- Shortness of breath, or dyspnea
- Swollen glands lasting for weeks
- Unintentional weight loss
- White spots on the tongue or mouth
The risk of developing a life-threatening illness rises dramatically during late-stage HIV infection. A individual with late-stage HIV can monitor, prevent and treat serious conditions by taking other drugs in addition to HIV treatment.
HIV care is nowadays also effective enough to keep many infections at bay.
In decreasing the function of the immune system, late-stage HIV decreases the body’s ability to combat a wide variety of pathogens, diseases and cancers. Infections that caused little to no health problems prior to the development of AIDS that pose a serious health risk once the infection has weakened the immune system.
Medical professionals refer to them as opportunistic infections (OIs). The doctor will treat AIDS after any of these diseases have occurred.
These include the following:
Bronchial candidiasis, trachea, esophagus, and lungs: as a fungal infection that usually occurs in the skin and hair, it also causes severe complications in the esophagus and lower respiratory tract in people with AIDS.
Invasive cervical cancer: this form of cancer starts in the cervix and spreads to other parts of the body. Daily visits with a cancer care team may help prevent cancer or reduce the spread of cancer.
Coccidioidomycosis: People often refer to the self-limited version of this disease as valley fever in healthy individuals. Inhalation of the fungus Coccidioides immitis triggers the infection.
Cryptococcus: Cryptococcus neoformans is a fungus that can invade any part of the body, but most commonly enters the lungs to cause pneumonia or swelling in the brain.
Cryptosporidiosis: Cryptosporidium protozoan parasite triggers this infection, which leads to extreme abdominal cramping and watery diarrhea.
Cytomegalovirus disease (CMV): CMV can cause a broad range of diseases in the body, including pneumonia, gastroenteritis, and encephalitis. However, CMV retinitis is of particular concern in people with late-stage HIV infection and may affect the retina at the back of the eye, permanently destroying the sight. Retinitis CMV is a medical emergency.
HIV-related encephalopathy: acute or chronic HIV infection may cause this brain condition. Physicians do not completely understand the cause, but find it connected to post-infection inflammation in the brain.
Herpes simplex (HSV): This virus, which is typically sexually transmitted or transmitted during childbirth, is extremely common and rarely causes health problems or causes self-limiting recurrence in people with healthy immune systems. Nevertheless, it can reactivate in HIV-positive individuals, causing painful cold sores around the mouth and ulcers on the genitals and anus that are not resolved. Sores, rather than a diagnosis of hiv, are an symptom of AIDS. HSV can also infect the breathing tube, the lungs.
Histoplasmosis: The fungus Histoplasma capsulatum causes very debilitating, pneumonia-like symptoms in people with advanced HIV. This disease may become increasingly disseminated histoplasmosis and may have an effect on organs outside the respiratory system.
Chronic intestinal isosporiasis: Isospora belli parasite can infect the body through contaminated food and water, causing diarrhea, fever, vomiting, weight loss, headache and abdominal pain.
Kaposi’s sarcoma (KS): Kaposi’s sarcoma herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8), induces cancer that induces irregular blood vessels to expand anywhere throughout the body. If KS enters tissues, such as the intestines or the lymph no.
Lymphoma: People refer to cancer of the lymph nodes and lymphoid tissues as lymphoma, and many different forms may occur. However, Hodgkin and non-Hodgkin lymphoma have close ties to HIV infection.
Tuberculosis (TB): The bacteria Mycobacterium tuberculosis causes this disease and may spread to the droplets if a person with an active form of the bacteria sneezes, coughs or talks. TB causes serious lung infection as well as weight loss, fever, and tiredness, and can also affect the brain, lymph nodes, bones, or kidneys.
Mycobacteria, including Mycobacterium avium and Mycobacterium kansasii: these bacteria exist naturally in the atmosphere and present few problems for people with full-fun.
Pneumocystis jirovecii pneumonia (PJP): a infection called Pneumocystis jirovecii causes shortness of breath, dry cough and high fever in people with weakened immune systems, including those with HIV.
Recurrent pneumonia: several different infections can cause pneumonia, but Streptococcus pneumoniae is one of the most dangerous causes of pneumonia in people with HIV. Vaccines are available for this bacteria and Streptococcus pneumoniae should be vaccinated for any person who has HIV.
Progressive Multifocal Encephalopathy (PML): John Cunningham (JC) virus occurs in a significant number of individuals, typically lying dormant in their kidneys. However, in people with weakened immune systems, either due to HIV or to drugs such as multiple sclerosis (MS), the JC virus affects the brain, leading to a severe conditon called progressive multifocal leukoencephalopathy (PML). PML can be life-, causing paralysis and cognitive difficulties.
Recurrent Salmonella septicemia: This type of bacteria frequently enters the body in infected food and water, circulates throughout the body and overpowers the immune system, causing nausea, diarrhea and vomiting.
Toxoplasmosis (toxo): Toxoplasma gondii is a parasite that inhabits warm-blooded animals, including cats and rodents, and leaves the body in its feces. Humans contract diseases by inhaling infected dust or consuming polluted food, but they may also occur in commercial meats. T. Gondii causes severe infection in the lungs, the eye, the heart, the liver, the pancreas, the brain, the testes and the colon. Take sure to wear protective gloves when changing cat litter and wash your hands thoroughly afterwards.
Wasting Syndrome: This happens when a person involuntarily loses 10% of his or her muscle mass through diarrhea, fatigue, or fever. Part of the weight loss can also be a loss of fat.
Preventing OIs is essential to increasing life expectancy with late-stage HIV. In addition to controlling HIV viral load with drugs, the person living with the disease must take precautions, including the following steps:
- Wear condoms to prevent other STIs from occurring.
- Get vaccines for future OIs. Discuss this with your primary care physician.
- Understand the germs in your surroundings that could contribute to an OI. For example, a pet cat may be a source of toxoplasmosis. Limit exposure and take precautions, such as wearing protective gloves when changing litter Avoid food that is at risk of contamination, such as undercooked eggs, unpasteurized milk and fruit juice, or raw seed sprouts.
- Do not drink water directly from a lake or river or tap water in certain foreign countries. Drink bottled water or using a water filter.
- Ask your doctor about job, home, and holiday behaviors to minimize exposure.
Antibiotic, antifungal or antiparasitic drugs that aid in the treatment of OI.
Myths and Reality of HIV and AIDS
Some assumptions exist about HIV that are negative and stigmatizing to people with the virus.
The virus can not be transmitted as follows:
- Rubbing unbroken skin
- Using the same toilet
- Sharing towels
- Exchanging mouth-to-mouth resuscitation or other forms of “casual contact” with the saliva, blood, feces and urine of a person with HIV
The Centers for Disease Control and Prevention (CDC) reports that about 1 out of every 7 HIV-positive Americans do not know their HIV status.
Being conscious of the HIV status is important for beginning care and avoiding more serious immune difficulties and subsequent infections from occurring.
HIV Blood Tests and Results
A doctor can take a particular blood test to check for HIV. A positive result means they found HIV antibodies in the bloodstream. Until a positive result is provided the blood is retested.
Prompt detection and diagnosis is critical following possible exposure to the virus, and significantly increases the likelihood of successful treatment. There are also customized test kits available.
It may take 3 – 6 months for HIV to appear in the test and re-testing may be required for a definitive diagnosis. People at risk of infection can get an immediate test within the last 6 months. Normally, the test provider will prescribe a further check within a few weeks.
Currently there is no treatment for HIV or AIDS.
Treatments, however, will avoid the progression of the disease and give most people living with HIV a chance to live a long and fairly safe life.
It is important to start ART early on as the virus progresses. According to the WHO guidelines from June 2013, this increases quality of life, extends life expectancy and reduces the transmission risk.
More efficient and better tolerated therapies have developed that, by taking as little as one pill a day, can improve general health and quality of life.
A individual living with HIV can reduce his or her viral load to such an extent that it can no longer be detected in a blood test. After reviewing a number of broad trials, the CDC concluded that individuals without detectable viral load “currently have no chance of sexually transmitting the virus to an HIV-negative partner.” Medical professionals refer to this as undetectable = untransmittable (U = U).
Emergency HIV pills, or post-exposure prophylaxis
If an person suspects that they have been exposed to the virus within the last 3 days, anti-HIV medicines, called post-exposure prophylaxis (PEP), may be able to avoid the infection. Take PEP at the earliest possible time following potential viral contact.
PEP is a 28-day cumulative procedure and doctors can continue to check for HIV until the procedure is complete.
HIV therapy includes antiretroviral medicines that counter the HIV infection and slow down the body’s spread of the virus. People living with HIV typically take a combination of drugs called highly active antiretroviral therapy (HAART), or antiretroviral combination therapy (cART).
A number of antiretroviral subgroups exist, such as:
Protease is an enzyme which must be repeated by HIV. These medicines bind to, and inhibit, the enzyme, preventing HIV from producing copies of itself.
- atazanavir/cobicistat (Evotaz)
- lopinavir/ritonavir (Kaletra)
- darunavir/cobicistat (Prezcobix)
In order to infect T cells, HIV requires integrase, another enzyme, Integrase blocks this drug. Those are also the first line of treatment for many people due to their effectiveness and minimal side effects.
Integrase inhibitors include:
- elvitegravir (Vitekta)
- dolutegravir (Tivicay)
- raltegravir (Isentress)
Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)
These medications, also known as “nukes,” interact with HIV when trying to replicate it.
- abacavir (Ziagen)
- lamivudine/zidovudine (Combivir)
- emtricitabine (Emtriva)
- tenofovir disproxil (Viread)
Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
NNRTIs work in a similar way to NRTIs, making it more difficult for HIV to replicate.
Chemokine co-receptor antagonists
Those drugs block the entry of HIV into cells. Physicians in the U.S., though, still don’t recommend these because other medications are more efficient.
Entry inhibitors hinder the entry of HIV into T cells. HIV can’t replicate without exposure to those cells. As with antagonists of chemokine co-receptors, they aren’t normal in the US.
People use a mixture of these medications sometimes to suppress HIV.
A medical team must customize each patient to the exact combination of drugs. HIV diagnosis is typically lifelong, effective and dependent on daily dose. A person living with HIV will regularly take pills. — ARV class has different side effects, but may have common side effects including:
- skin rashes
Complementary or alternative medicine
Although many people with HIV seek complementary, alternative, or herbal solutions, such as herbal remedies, there is no evidence to prove that they are successful.
Mineral or vitamin supplements can offer some benefits in overall health, according to some limited studies. Discussing these options with a health care provider is important because some of those options, including vitamin supplements, can interact with ARVs.
Healthcare practitioners suggest measures on the following to avoid contracting HIV.
Sex using a condom or PrEP: having sex without a condom or other prevention measures such as PrEP will raise the risk of transmitting HIV and other sexually transmitted infections (STIs) significantly.
Using condoms or PrEPs during any sexual act with a person outside of a trustworthy relationship in which there is no HIV in either partner.
In its 2019 Recommendations, the U.S. Preventive Services Task Force recommends that physicians should suggest Training only for people with recent negative HIV test results. They advise people with a high HIV risk who are appropriate for PrEP should take it once a day.
The Task Force accepts only one PrEP formulation in the Recommendations, which is a mixture of tenofovir disoproxil fumarate and emtricitabine.
Drug injection and needle sharing: A key factor for HIV transmission in developing countries is intravenous drug use. Users may be exposed to HIV and other viruses such as hepatitis C while exchanging needles and other drug equipment.
Many social interventions may help to minimize infections as a result of substance misuse, such as needle-exchange programmes. Recovering from a drug use disorder will for many reasons improve health quality of life, but it can significantly reduce future HIV exposure.
People who take drugs using a needle will use a new, unused, unshared needle.
Body fluid exposure: By taking precautions to reduce the risk of exposure to contaminated blood, a person can restrict their potential exposure to HIV;
In cases where exposure to body fluids is a possibility, health care staff will use boots, goggles, protective eyewear, helmets and gowns.
The risk of infection can be minimized by regular and thorough washing of the skin immediately following contact with blood or other body fluids. Healthcare works should follow a series of protocols for avoiding transmission known as universal safeguards.
Pregnancy: Many antiretrovirals during pregnancy can cause harm to an unborn fetus.
Nonetheless, an successful, well-managed treatment program will prevent transmission of HIV from mother to fetus. Delivery may be possible by Caesarean section.
Women who are pregnant but suffer from HIV can also transmit the virus by breast milk. However, taking the right drug schedule on a daily basis significantly decreases the risk of virus transmission.
Chat with a health care professional about all choices.
Education: It is important to educate people about recognized risk factors so they can be prepared with the resources to prevent HIV.
Living with HIV
Regardless of the increased risk of certain illnesses and diseases, people living with HIV must make changes to the lifestyle to manage their decreased immunity.
Adherence: It is completely necessary to take the HIV drug as prescribed for successful treatment. Missing just a few doses could put the treatment in jeopardy.
Model a regular, methodical routine for every current lifestyle and schedule to suit the treatment plan. Treatment arrangements can differ between persons. People often refer to “enforcement”
Model a regular, methodical routine for every current lifestyle and schedule to suit the treatment plan. Treatment arrangements can differ between persons. People often refer to “enforcement”
HIV medicines may cause especially severe side effects which often discourage adherence by people. Click here to read more about the negative effects of HIV drugs.
When side effects get too serious, talk to the care team instead of just stopping the drug. They can switch the diet to a more acceptable drug.
General health: It is important to take measures to prevent disease and other infections. People living with HIV should strive to improve overall health through physical exercise, a healthy, nutritious diet, and all medications, including tobacco, should cease.
Additional precautions: People living with AIDS should take extra precautions, particularly around animals, to avoid any exposure to infection. Evite interaction with animal waste and litter for dogs.
Doctors also prescribe thorough and frequent hand washing. Antiretrovirals minimize certain precautions that are required.
Daily contact with doctors: HIV is a lifelong disease, so it is vital to have frequent contact with a health care provider to monitor treatment in line with advancing age and conditions. The healthcare staff must monitor treatment periodically and change it accordingly.
Psychological effects: Common myths about AIDS and HIV are decreasing with growing awareness of the disease.
But in many parts of the world, stigma regarding the disorder remains. HIV-patients can feel excluded, persecuted and lonely.
A diagnosis of HIV can be very distressing and anxiety or depression is common. If you feel nervous, or have depression symptoms, seek urgent medical assistance.
HIV is a poorly-understood and potentially dangerous disease which reduces the immune system’s effectiveness in fighting other infections.
Modern medicine advances in people living with HIV may have an almost average life expectancy and an active lifestyle. For the most successful results, a person undergoing antiretroviral therapy must stick strictly to his / her regime.
HIV transmits during sex, or blood, in corporal fluids such as semen or vaginal secretions. In the U.S., HIV most often transmits without a condom or PrEP by sexual intercourse, and shares needles when injecting drugs.
However, if a person has a viral load that can not be identified by HIV tests, they can’t pass the virus on to another person.
When HIV progresses, for example in cases where a person is unaware of their HIV status or is not receiving medication, it may progress to a late stage known as AIDS.
AIDS can open the door to a variety of infections known as opportunistic infections which pose a serious health risk. Some are severe or prolonged presentations of infections that, in a person with healthy immune function, will normally resolve quickly.
Others that occur because of the microbes that exist naturally in the atmosphere and would not usually cause any infection.
By adhering to medication, a person living with AIDS will revert the condition to HIV.
If you think you have recently been exposed to the virus, click here to locate your nearest screening facility.