Introduction:
The virus that causes acquired immunodeficiency syndrome is called human immunodeficiency virus (HIV) (AIDS). HIV depletes your T-cell population, weakening your immune system to the point where you are unable to combat even minor diseases. HIV can exist without any visible signs. The best chance of living a long life is to get diagnosed and start treatment as soon as possible.
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| What is HIV/AIDS? |
OVERVIEW
What is HIV?
Human immunodeficiency virus is referred to as HIV. Your immune system's ability to fight off other illnesses is hampered by HIV infection and cellular apoptosis. HIV can cause acquired immunodeficiency syndrome by impairing your immune system (AIDS).
HIV is referred to as a retrovirus because it inserts its instructions backward into your DNA.
What is AIDS?
The last and most severe stage of HIV infection is AIDS. People with AIDS have compromised immune systems and low levels of certain white blood cells. They can have more conditions that show they have developed AIDS.
HIV infections can escalate to AIDS without therapy in around 10 years.
What sets HIV and AIDS apart from one another?
HIV and AIDS are distinct in that HIV is a virus that compromises your immune system. When your immune system is compromised as a result of an HIV infection, AIDS can develop.
If you don't have HIV, you cannot develop AIDS. Not everyone with HIV develops AIDS because of medication that reduces the virus's effects. But all HIV-positive individuals will develop AIDS in the absence of treatment.
What affects a person who has HIV?
Your immune system's CD4 cells, also known as helper T cells, are infected by HIV. Your white blood cell count will decline as a result of it destroying CD4 cells. Due to this, even infections that wouldn't cause you to become ill are no longer able to be fought off by your immune system.
HIV makes you feel ill with symptoms resembling the flu. After that, it can remain undetected in your body for a long time without showing any signs. Your T-cells are destroyed throughout that period. HIV has advanced to AIDS when your T-cell count drops or you start to contract infections that people with healthy immune systems don't get.
AIDS can result in a quick loss of weight, intense exhaustion, mouth or genital sores,
A Retrovirus is what?
A virus known as a retrovirus functions the opposite of how human cells operate. Human cells include DNA instructions that communicate with RNA to create the structural components of your body (proteins).
RNA is where the instructions for retroviruses are written. When a retrovirus enters your cells, it modifies its RNA to resemble the instructions on your cells (DNA). The DNA of your cells is then cut, and it inserts its own instructions. Then, your cell responds as though the virus' commands are it's own.
A retrovirus is HIV. All viruses enter your cells and use the "machinery" of those cells to replicate additional copies of themselves. In addition to using your cells to reproduce itself, HIV also inserts its genetic code into your DNA.
Who is affected by HIV?
The idea that HIV exclusively affects a few people is untrue. If they are exposed to the virus, anyone can get HIV. The two most typical methods of HIV transmission are having sex without using a condom and sharing needles when injecting drugs.
According to statistics, HIV affects some populations more than others. HIV affects the following groups:
- Homosexuals, bisexuals, and men who have sex with other men (MSM).
- Certain racial groups, such as Black or Hispanic individuals.
- HIV infection is also quite likely to occur in those who trade sexual favors for money or other commodities.
Even while they aren't the only groups affected by HIV. It's crucial to remember that they have particular difficulties getting access to testing, preventative care, and thorough treatment. Social stigmas associated with HIV, racism, poverty, and homophobia continue to fuel inequalities and prevent people from receiving high-quality medical care.
How common is HIV?
The number of new HIV infections has decreased. 1.2 million Americans with HIV as of 2019. Routine HIV testing is crucial because 13% of those people are unaware that they have the disease.
How does HIV spread in the body? What are the stages of HIV?
- Acute HIV infection: This stage occurs within the first few weeks after infection and may present flu-like symptoms such as fever, headache, fatigue, rash, and swollen lymph nodes.
- Clinical latency: During this stage, the virus is still actively replicating in the body, but the person may not experience any symptoms. It can last for several years.
- AIDS: Acquired Immunodeficiency Syndrome is the most severe stage of HIV infection. At this point, the immune system is severely weakened, and the person is at risk of developing life-threatening opportunistic infections and cancers.
CAUSES AND SYMPTOMS
What are the symptoms of HIV and when do they appear after infection?
HIV, or human immunodeficiency virus, is a virus that attacks the immune system and can lead to acquired immunodeficiency syndrome (AIDS) if left untreated. The symptoms of HIV can vary from person to person and may not appear immediately after infection. Some people may not experience any symptoms at all in the early stages of infection.
The early symptoms of HIV, which typically appear within 2 to 4 weeks after infection, are similar to those of the flu and may include the:
- Fever
- Headache
- Fatigue
- Swollen lymph nodes
- Sore throat
- Rash
- Muscle and joint aches
These symptoms may last for a few days to several weeks and can be mild or severe.
After the initial stage, many people with HIV may not experience any symptoms for several years, even though the virus is actively replicating in their bodies. This is why it is important to get tested regularly for HIV, especially if you engage in activities that put you at risk for infection, such as unprotected sex or sharing needles.
As the virus continues to attack the immune system, more severe symptoms may develop, including:
- Persistent fever
- Chronic diarrhea
- Rapid weight loss
- Night sweats
- Persistent cough
- Shortness of breath
- Skin rashes or bumps
- Memory loss, confusion, or neurological disorders
If left untreated, HIV can progress to AIDS, which is characterized by a severely weakened immune system and a high risk of developing life-threatening infections and cancers. It is important to seek medical care and begin treatment as soon as possible if you suspect you may have been infected with HIV.
Stages:
What are the HIV stages?
HIV has three Stages:
Stage 1: Acute HIV
A month or two after becoming HIV positive, some patients have flu-like symptoms. Within a week to a month, these symptoms frequently subside.
Stage 2: Chronic stage/clinical delay
You can have HIV for a long time after the acute stage without getting sick. It's crucial to understand that even if you feel fine, you can still distribute HIV to others.
Stage 3: AIDS
The most severe HIV infection stage is AIDS. Your immune system has been compromised by HIV at this point, making opportunistic infections much more likely to make you ill.
People with strong immune systems are usually able to resist opportunistic illnesses. When HIV has developed into AIDS, these diseases prey on your compromised immune system.
When you have AIDS, you run a higher risk of developing certain cancers. The combination of these cancers and opportunistic infections is referred to as an AIDS-defining illness.
HIV infection and at least one of the following are required for an AIDS diagnosis:
- 200 cells or fewer per milliliter of blood (CD4 cells/mm3).
- A disease associated with AIDS.
What conditions are AIDS-defining?
Opportunistic infections, some malignancies (often brought on by viruses), and a few neurological problems are diseases that define AIDS. They consist of:
- Lymphoma of Burkitt.
- Candidiasis of the lungs, esophagus, bronchi, or trachea.
- Intestinal cystoisosporiasis is a chronic condition lasting longer than a month.
- Coccidioidomycosis that has spread (disseminated/extrapulmonary) outside of the lungs.
- Intestinal cryptosporidiosis that persists (lasting more than a month).
- Other than the liver, spleen, or lymph nodes, cytomegalovirus illness manifests at a later age than one month.
- Retinal cytomegalovirus infection (with loss of vision).
- Encephalopathy is linked to the virus.
- Cryptococcosis extrapulmonary.
- Ulcers from herpes simplex (lasting more than a month).
- Herpes simplex pneumonia, esophagitis, or bronchitis (onset at an age older than one month).
- Histoplasmosis (disseminated/extrapulmonary) spread outside the lungs.
- HIV wasting illness.
- Invasive cervical cancer.
- Autoimmune lymphoma.
- The Kaposi sarcoma.
- Multiple or recurrent bacterial infections.
- Mycobacterium avium complex (MAC), spread outside the lungs (disseminated/extrapulmonary).
- Mycobacterium kansasii, spread outside the lungs (disseminated/extrapulmonary).
- Mycobacterium tuberculosis of any site.
- Mycobacterium, other species, or unidentified species, spread outside the lungs (disseminated/extrapulmonary).
- Pneumocystis jirovecii pneumonia.
- Primary lymphoma of the brain.
- Progressive multifocal leukoencephalopathy.
- Recurrent pneumonia.
- Recurrent Salmonella septicemia (nontyphoid).
- Toxoplasmosis of the brain (onset at an age older than one month).
What signs and symptoms do AIDS have?
AIDS symptoms can be brought on by HIV infection, but many are also brought on by diseases that prey on your compromised immune system.
What causes HIV/AIDS?
The human immunodeficiency virus is what causes HIV. Your immune system becomes compromised as a result of the virus's attack on its helper T-cells.
Having insufficient immune cells to combat other infections leads to AIDS.
How is HIV transmitted?
HIV can be transmitted through a person's blood, semen, vaginal fluids, breast milk, and rectal fluids. The HIV virus can infect and spread among people of all sexes and sexual orientations.
The mouth, anus, penis, vagina, or broken skin are all possible entry points for the virus. If you don't have a cut or wound, it can't penetrate your skin. HIV can be passed on to unborn children by pregnant people.
The two main methods for HIV transmission are having sex without using a condom and sharing needles when using drugs. If you feel fine, you can still transmit HIV to someone else.
Can you contract HIV with a kiss?
HIV is not contracted through kissing since it cannot be transmitted through spittle. Deep, open-mouthed kissing can transmit HIV in some circumstances where other body fluids are exchanged, such as when both partners have open sores in their mouths or bleeding gums.
Additionally, HIV cannot be contracted from:
- Hugging or touching a person who has HIV or AIDS
- Pool areas or restrooms in public places
- Sharing dishes, utensils, or phones with an HIV/AIDS patient
- Virus bites
- Blood donation
How do I determine if I have HIV?
You can't determine if someone has HIV by glancing at them, and HIV infection may leave you symptom-free. Getting tested for HIV is the only way to find out if you are infected.
The U.S. Centers for Disease Control & Prevention advises screening persons between the ages of 13 and 64 at least once as part of routine healthcare because approximately 1 in 7 people with HIV are unaware of their condition. This examination is optional and private.
DIAGNOSTIC AND TESTS
HIV testing methods:
A blood or spit test can be used to determine if you have HIV (saliva). A test can be completed at home, in a medical professional's office, or at a testing facility in your neighborhood.
If your test is negative, no more testing is necessary if:
Before testing with any type of test, you haven't had a possible exposure in the last three months.
The window of time for a test including a blood draw has not passed since you may have been exposed. If you are uncertain about the window period for a test you recently took, ask your healthcare practitioner.
You ought to think about retesting if you may have been exposed within three months of your test.
What procedures identify HIV?
Antigen/antibody tests, antibody tests, and nucleic acid tests (NATs) are the three types of HIV tests available.
Antigen/antibody assays:
Antigen assays check for p24 markers on the HIV surface. When your body reacts to such indicators, antibodies are made to detect those substances. Tests for HIV antigen/antibody look for both.
A little amount of blood will be drawn with a needle from your arm by a medical professional. In a lab, the blood is examined for p24 and antibodies to it. HIV can be found in an antigen/antibody test 18 to 45 days after exposure.
It is also possible to perform a quick antigen/antibody test by poking your finger and drawing blood. For this kind of test to be able to identify HIV, you must wait at least 18 days following exposure. For reliable results, you would need to take the test up to 90 days following exposure. (The term "rapid" refers to the time it takes to receive test results, not the time it takes to find the virus after exposure.
Antibody Tests
In your blood or saliva, these tests search for HIV antibodies. A blood sample from your arm, a finger prick, or saliva can be collected in this way by rubbing a stick on your gums.
It can take up to 90 days for an antibody test to show HIV following exposure. More than saliva or blood from a finger prick, antibody testing using blood can identify HIV.
Nucleic acid tests (NATs)
NATs search for the HIV virus in your blood. A little blood sample will be drawn using a needle from your arm by a medical professional. The blood is sent to a lab for an HIV test.
10 to 33 days after exposure, a NAT can identify HIV. It should be noted that unless you have experienced a high-risk exposure, this test is rarely done.
Your healthcare professional may suggest more tests to evaluate your health if your test results are positive. A complete blood count (CBC), as well as:
- Viral hepatitis screening
- Chest X-ray
- Pap smear
- CD4 count
- Tuberculosis
Is there HIV at-home testing available?
There are, in fact, at-home HIV test kits. Some of these tests are quick, requiring you to rub your gums with a stick having a flexible, soft tip. To get your results, you then place the stick in a tube containing a unique solution. In 15 to 20 minutes, results become visible.
A device that pricks your finger with a tiny needle is used in other at-home examinations. You apply a drop of blood to a card, then ship the test kit to a lab to receive your findings.
If the outcome of your at-home test is positive, you should speak with your healthcare physician to arrange for additional testing to verify your findings.
MANAGEMENT AND TREATMENT
Is there an HIV cure?
Although there is no cure for HIV, there are many treatments that can decrease the virus's development.
How is HIV handled?
A variety of oral medications (pills) are taken daily to treat HIV. Antiretroviral therapy is the name given to this regimen of medications (ART).
The best method to prevent HIV from spreading and killing your cells is to take a variety of different medications rather than one. Additionally, there exist combination pills that include many drugs in a single capsule. A mixture tailored for you will be chosen by your healthcare professional.
The purpose of ART is to lower the level of HIV in the blood (viral load) to undetectable levels.
HIV-treating medications
Every tablet type is distinctly used in ARTworks to prevent HIV from multiplying or infecting your cells. The same kind of ART medication may go under several distinct brand names.
ART medication types include:
- Nucleoside reverse transcriptase inhibitors (NRTIs)
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- Protease inhibitors (PIs)
- Fusion inhibitors
- CCR5 antagonists
- Integrase strand transfer inhibitors (INSTIs)
- Attachment inhibitors
- Post-attachment inhibitors
- Pharmacokinetic enhancers
- Combination of HIV medicines
How can I maintain my health while having HIV?
It's crucial to follow the directions on your prescription medication and to keep your appointments. The term for this is treatment adherence.
HIV can alter how it infects your cells (mutate) if you forget to take your meds, even. This could result in your treatments losing their effectiveness. Speak with your healthcare practitioner if your schedule makes it difficult for you to remember to take your prescription or arrive on time for appointments.
PREVENTION
What can I do to lessen my chance of getting HIV?
The greatest method to lower your chance of contracting HIV is to understand how it spreads and takes precautions when engaging in particular behaviors. The most typical means of HIV transmission are unprotected sexual activity and sharing needles for drug use.
Here are some strategies to lower your risk:
- When having any kind of sex, always use latex condoms (rubbers) (vaginal, anal, or oral).
- Use only non-animal product condoms (like lambskin).
- Use lubricants with a water basis (lotion).
- Never share a needle while using a drug.
- For more STDs, get examined and treated. Your chance of contracting HIV may increase if you have several STDs.
- Avert getting inebriated or high. Drunk people may be less willing to defend themselves.
- Ask your doctor if you need to take pre-exposure prophylaxis if you have a high risk of contracting HIV (PrEP).
- Contact your healthcare provider as soon as you suspect an HIV exposure to find out if post-exposure prophylaxis is necessary for you.
- Think about getting evaluated
To protect oneself from HIV, it's crucial to use a condom. For every sex act that involves your penis, use a male condom.
Dental dams or internal condoms can also be used to protect the genital area or the anus. If you're having oral sex, you can cover your vagina or anus with a flat piece of polyurethane or latex known as a dental dam. You can use an internal condom, often known as a female condom, by inserting it into your vagina or anus.
One condom type should always be used at a time. Do not use an internal condom in addition to a male condom.
Can drugs stop HIV from spreading?
HIV prevention drugs are available for those who have been exposed to it or are at high risk of doing so. Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis are some of them (PEP).
Pre-exposure medication (PrEP)
If you don't have HIV but are at a high risk of contracting it, you should take PrEP every day.
You should take PrEP if you don't have HIV if you had anal or vaginal sex during the previous six months and if at least one of the following is true:
- You have an HIV-positive sexual partner
- You don't frequently use condoms
- You were given a transmitted disease diagnosis during the previous six months (STD)
PrEP is also advised if you inject drugs, don't have HIV, and at least one of the following applies:
- You inject drugs with an HIV-positive partner.
- To inject narcotics, you exchange needles or other supplies.
Other preventative actions should still be used in addition to PrEP. While using PrEP, you should continue to use condoms and stay away from sharing needles for drug injections.
Post-exposure prophylaxis (PEP) PEP
Employs HIV drugs to attempt to stave off infection as soon as possible after being exposed. PEP is for those who don't have HIV or who are unsure whether they do and believe they were exposed through sexual assault, consenting sex, sharing needles (or other items of equipment), or at work.
PROGNOSIS
What should I expect if I have HIV?
If you've been diagnosed with HIV, it's vital to understand that those who follow treatment recommendations can live full lives for almost as long as those who do not have the virus.
According to research, you'll likely see the best results if you reach a high CD4 count and an undetectable viral load within a year of beginning treatment—as long as you stick with your prescribed course of action.
PEP must be started and taken daily for 28 days beginning no later than 72 hours after exposure. Only used in emergencies, PEP does not take the place of other safety measures like using condoms.
You can alter your perspective by:
- Get testing as part of standard medical care or if you suspect exposure.
- starting ART as soon as the diagnosis is made.
- daily taking of your medication.
- keeping the times set out for meetings with the medical staff
While ART can keep blood levels undetectable, it cannot completely get rid of the virus from your body (which remains inactive in your cells). If you don't take your prescription daily, the virus may mutate and begin to replicate once more, which could make your drugs ineffective.
It might take up to 10 years for HIV to progress to AIDS if untreated. Expect to live more than three years if you develop AIDS and it is left untreated.
For individuals who are receiving treatment, you can expect to live about as long as someone who is HIV-free if they have a high CD4 count and an undetectable viral load within a year of commencing treatment. If within a year you have a detectable viral load or a low CD4 level.
Does HIV ever go away?
HIV does not vanish by itself. For your cells to believe that it is a part of you, it inserts themselves into your DNA. Even if you don't feel ill, HIV can still be harming your immune system for many years after the first infection.
There may be times when the infection is undetectable by an HIV test while taking treatment. HIV may be residing in your body in certain situations. It might "wake up" and begin mutilating your cells once more.
It is crucial to keep taking HIV medicine even if you feel fine or the infection is undetectable for this reason. HIV will deteriorate your immune system without therapy.
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