Human Immunodeficiency Virus (HIV)

Acquired Immune Deficiency Syndrome (AIDS)
Acquired Immune Deficiency Syndrome (AIDS)

Overview Of Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome). There is currently no effective cure. Once people get HIV, they have it for life. But with proper medical care, HIV can be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and protect their partners.

Human immunodeficiency virus (HIV) is a virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases. It is spread by contact with certain bodily fluids of a person with HIV, most commonly during unprotected sex (sex without a condom or HIV medicine to prevent or treat HIV), or through sharing injection drug equipment.

AIDS

AIDS is a set of symptoms (or syndrome) caused by the HIV virus. A person is said to have AIDS when their immune system is too weak to fight off infection, and they develop certain symptoms and illnesses. This is the last stage of HIV when the infection is very advanced, and if left untreated will lead to death. HIV is an infection that can lead to AIDS.

The human body can’t get rid of HIV and no effective HIV cure exists. So, once you have HIV, you have it for life.

However, by taking HIV medicine (called antiretroviral therapy or ART), people with HIV can live long and healthy lives and prevent transmitting HIV to their sexual partners. Besides, there are effective methods to prevent getting HIV through sex or drug use, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

What’s the difference between HIV and AIDS?

Human immunodeficiency virus (HIV) is the virus that causes AIDS. AIDS stands for Acquired Immune Deficiency Syndrome. HIV and AIDS are not the same things. And people with HIV do not always have AIDS.

HIV is a virus that’s passed from person to person. Over time, HIV destroys an important kind of cell in the immune system (called CD4 cells or T cells) that helps protect you from infections. When you don’t have enough of these CD4 cells, the body can’t fight off infections the way it normally can.

AIDS is a disease caused by the damage that HIV does to the immune system. You have AIDS when you get dangerous infections or have a super low number of CD4 cells. AIDS is the most serious stage of HIV, and it leads to death over time.

Without treatment, it usually takes about 10 years for someone with HIV to develop AIDS. Treatment slows down the damage the virus causes and can help people stay healthy for several decades.

Causes Of Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus is spread (transmitted) person-to-person through certain body fluids:

• Blood

• Semen and preseminal fluid

• Rectal fluids

Vaginal fluids

• Breast milk

HIV can be spread if these fluids come in contact with:

Mucous membranes (inside of the mouth, penis, vagina, rectum)

• Damaged tissue (tissue that has been cut or scraped)

• Injection into the bloodstream

HIV cannot be spread through sweat, saliva, or urine.

In the United States, HIV is mainly spread:

• Through vaginal or anal sex with someone who has HIV without using a condom or is not taking medicines to prevent or treat HIV

• Through needle sharing or other equipment used to inject drugs with someone who has HIV

Less often, HIV is spread:

• From mother to child. A pregnant woman can spread the virus to her fetus through their shared blood circulation, or a nursing mother can pass it to her baby through her breast milk. Testing and treatment of HIV-positive mothers has helped lower the number of babies getting HIV.

• Through needle sticks or other sharp objects that are contaminated with human immunodeficiency virus (mainly health care workers).

The virus is NOT spread by:

• Casual contact, such as hugging or closed-mouth kissing

• Mosquitoes or pets

• Participating in sports

• Touching items that were touched by a person infected with the virus

• Eating food handled by a person with HIV

HIV and blood or organ donation:

• HIV is not spread to a person who donates blood or organs. People who donate organs are never in direct contact with the people who receive them. Likewise, a person who donates blood is never in contact with the person receiving it. In all of these procedures, sterile needles and instruments are used.

• While very rare, in the past HIV has been spread to a person receiving blood or organs from an infected donor. However, this risk is very small because blood banks and organ donor programs thoroughly check (screen) donors, blood, and tissues.

Risk factors for getting HIV include:

• Having unprotected anal or vaginal sex. Receptive anal sex is the riskiest. Having multiple partners also increases the risk. Using a new condom correctly every time you have sex greatly helps lower this risk.

• Using drugs and sharing needles or syringes.

• Having a sexual partner with HIV who is not taking HIV medicines.

• Having a sexually transmitted disease (STD).

Symptoms Of Human Immunodeficiency Virus (HIV)

People with HIV don’t usually have symptoms right away, so they may not know they have it. It can be years before HIV makes you feel sick.

Early HIV symptoms

People usually look and feel healthy for a long time after they’re infected. It can take 10 years or more for HIV to show any symptoms — or much, much longer than that for people who take HIV medicines. That’s why it’s really important to get tested for HIV regularly, especially if you’ve had unprotected sex or shared needles. HIV treatment can help you stay healthy. Treatment can also lower or even stop the chances of spreading HIV to other people during sex.

The first 2-4 weeks after being infected with HIV, you may feel feverish, achy, and sick. These flu-like symptoms are the body’s first reaction to the HIV infection. During this time, there’s a lot of the virus in the system, so it’s really easy to spread HIV to other people. The symptoms only last for a few weeks, and then you usually don’t have symptoms again for years. But HIV can be spread to other people — whether or not you have symptoms or feel sick.

Later HIV/AIDS symptoms

HIV destroys cells in the immune system called CD4 cells or T cells. Without CD4 cells, The body has a hard time fighting off diseases. This makes you more likely to get sick from infections that usually wouldn’t hurt you. Over time, the damage HIV does to the immune system leads to AIDS.

You have AIDS when you get rare infections (called opportunistic infections) or types of cancer, or if you’ve lost a certain number of CD4 cells. This usually happens about 10 years after getting HIV if you don’t get treatment. Treatment can delay or even prevent you from ever developing AIDS.

The signs of AIDS include:

Thrush (a thick, white coating on tongue or mouth)

Sore throat

● Bad yeast infections

● Chronic pelvic inflammatory disease

● Getting bad infections a lot

● Feeling tired, dizzy, and lightheaded

● Headaches

● Losing lots of weight quickly

● Bruising more easily than normal

● Having diarrhea, fevers, or night sweats for a long time

Swollen or firm glands in throat, armpit, or groin

● Deep, dry coughing spells

● Feeling short of breath

● Purplish growths on the skin or inside the mouth

● Bleeding from the mouth, nose, anus, or vagina

Skin rashes

● Feeling very numb in hands or feet, losing control of muscles and reflexes, not being able to move, and losing strength in muscles

How Do You Get or Transmit HIV?

You can only get HIV by coming into direct contact with certain body fluids from a person with HIV who has a detectable viral load. These fluids are:

● Blood

● Semen (cum) and pre-seminal fluid

● Rectal fluids

● Vaginal fluids

● Breast milk

For transmission to occur, the HIV in these fluids must get into the bloodstream of an HIV-negative person through a mucous membrane (found in the rectum, vagina, mouth, or tip of the penis); open cuts or sores; or by direct injection.

People with HIV who take HIV medicine daily as prescribed and get and keep an undetectable viral load have effectively no risk of sexually transmitting HIV to their HIV-negative partners.

How Is HIV Spread from Person to Person?

HIV can only be spread through specific activities. The most common ways are:

● Having vaginal or anal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV. Anal sex is riskier than vaginal sex.

● Sharing injection drug equipment (“works”), such as needles, with someone who has HIV.

Less common ways are:

● From mother to child during pregnancy, birth, or breastfeeding. However, the use of HIV medicines and other strategies have helped lower the risk of mother-to-child transmission of HIV to 1% or less.

● Getting stuck with an HIV-contaminated needle or other sharp objects. This is a risk mainly for health care workers. The risk is very low.

HIV is spread only in extremely rare cases by:

● Having oral sex. But in general, the chance that an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low.

● Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. The risk is extremely small these days because of rigorous testing of the blood supply and donated organs and tissues.

● Being bitten by a person with HIV. Each of the very small numbers of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.

● Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids.

● Deep, open-mouth kissing if both partners have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva.

● Eating food that has been pre-chewed by a person with HIV. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. The only known cases are among infants.

Treatment

While there’s no cure for HIV, there are very effective treatments that enable most people with the virus to live a long and healthy life.

HIV treatment involves taking medicines that slow the progression of the virus in the body. HIV is a type of virus called a retrovirus, and the combination of drugs used to treat it is called antiretroviral therapy (ART).

Although a cure for HIV does not yet exist, ART can keep you healthy for many years, ART reduces the amount of virus (or viral load) in the blood and body fluids. ART is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are. ART also reduces the chance of transmitting HIV to others if taken as prescribed.

ART is usually taken as a combination of 3 or more drugs to have the greatest chance of lowering the amount of HIV in the body. Ask the health care provider about the availability of multiple drugs combined into 1 pill.

If the HIV medicines you are taking are not working as well as they should, the health care provider may change the prescription. A change is not unusual because the same treatment does not affect everyone in the same way.

Let the health care provider and pharmacist know about any medical conditions you may have and any other medicines you are taking.

Stages of HIV

When people with HIV don’t get treatment, they typically progress through three stages. But HIV medicine can slow or prevent the progression of the disease. With the advancements in treatment, progression to Stage 3 is less common today than in the early days of HIV.

Stage 1: Acute HIV Infection

● People have a large amount of HIV in their blood. They are very contagious.

● Some people have flu-like symptoms. This is the body’s natural response to infection.

● But some people may not feel sick right away or at all.

● If you have flu-like symptoms and think you may have been exposed to HIV, seek medical care, and ask for a test to diagnose acute infection.

● Only antigen/antibody tests or nucleic acid tests (NATs) can diagnose acute infection.

Stage 2: Chronic HIV Infection

● This stage is also called asymptomatic HIV infection or clinical latency.

● HIV is still active but reproduces at very low levels.

● People may not have any symptoms or get sick during this phase.

● Without taking HIV medicine, this period may last a decade or longer, but some may progress faster.

● People can transmit HIV in this phase.

● At the end of this phase, the amount of HIV in the blood (called viral load) goes up and the CD4 cell count goes down. The person may have symptoms as the virus levels increase in the body, and the person moves into Stage 3.

● People who take HIV medicine as prescribed may never move into Stage 3.

Stage 3: Acquired Immunodeficiency Syndrome (AIDS)

● The most severe phase of HIV infection.

● People with AIDS have such badly damaged immune systems that they get an increasing number of severe illnesses, called opportunistic infections.

● People receive an AIDS diagnosis when their CD4 cell count drops below 200 cells/mm, or if they develop certain opportunistic infections.

● People with AIDS can have a high viral load and be very infectious.

● Without treatment, people with AIDS typically survive for about three years.

What are opportunistic infections?

Opportunistic infections (OIs) are infections that occur more frequently and are more severe in people with weakened immune systems, including people with HIV. OIs are less common now than they were in the early days of HIV because better treatments reduce the amount of HIV in a person’s body and keep a person’s immune system stronger. However, many people with HIV still develop OIs because they may not know they have HIV, they may not be on treatment, or their treatment may not be keeping their HIV levels low enough for their immune system to fight off infections.

For those reasons, people with HIV need to be familiar with the most common OIs so that they can work with their healthcare provider to prevent them or to obtain treatment for them as early as possible.

Other

What’s the difference between HIV and AIDS?

HIV is the virus that causes AIDS. AIDS stands for Acquired Immune Deficiency Syndrome. HIV and AIDS are not the same things. And people with HIV do not always have AIDS.

HIV is a virus that’s passed from person to person. Over time, HIV destroys an important kind of cell in the immune system (called CD4 cells or T cells) that helps protect you from infections. When you don’t have enough of these CD4 cells, the body can’t fight off infections the way it normally can.

AIDS is a disease caused by the damage that HIV does to the immune system. You have AIDS when you get dangerous infections or have a super low number of CD4 cells. AIDS is the most serious stage of HIV, and it leads to death overtime.

Without treatment, it usually takes about 10 years for someone with HIV to develop AIDS. Treatment slows down the damage the virus causes and can help people stay healthy for several decades.