HIV/AIDS

What is HIV/AIDS?

AIDS (acquired immunodeficiency syndrome) is a chronic illness caused by the human immunodeficiency virus (HIV). HIV is a virus that destroys the body's ability to defend itself against disease by damaging the cells in your immune system. Because of this weakness in the immune system, the body becomes less able to fight off viruses, bacteria, and fungi that cause disease. As a result, certain cancers and infections take hold that would normally be resisted. Pneumonia and meningitis are two common illnesses that affect HIV sufferers.

AIDS describes the later stages of the HIV infection. When AIDS was first identified and recorded about 25 years ago, it was thought to affect only certain members of the population, such as homosexuals and intravenous drug users. This perspective turned out to be untrue, and celebrities like Magic Johnson brought AIDS to the forefront of public consciousness, showing the public that AIDS can affect anyone.

HIV (AIDS) Symptoms

Often, people infected with HIV will experience flu-like symptoms between 2 and 6 weeks after becoming infected. Even if a person does not experience any symptoms, he or she can still transmit the virus to others. Some people do not recognize any symptoms for 10 years or more, but as the virus continues to break down the immune system, infections as well as chronic symptoms may result. Some examples of commonly acquired symptoms are:

• Swollen lymph nodes—often one of the first signs of HIV infection
• Diarrhea
• Weight loss
• Fever
• Cough and shortness of breath

In the final phase of HIV infection, which usually occurs about 10 or more years after the initial infection, symptoms will likely worsen. The official definition of full-blown AIDS was developed in 1993 by the Centers for Disease Control and Prevention (CDC): the HIV infection must be present, an HIV-antibody test must be positive, and at least one of the following must be true:

• The development of an opportunistic infection—an infection that occurs when the immune system is impaired—such as Pneumocystis carinii pneumonia (PCP)
• A CD4 lymphocyte count of 200 or less (a normal count ranges from 600 to 1000)

By the time AIDS has developed, the immune system will have been severely damaged, making one susceptible to a number of infections that cause such symptoms as:

• Soaking night sweats, requiring sheets to be changed
• Shaking chills or fever higher than 100° F. for several weeks
• Dry cough and shortness of breath
• Chronic diarrhea
• Persistent white spots or unusual lesions on the tongue or in the mouth
• Blurred or distorted vision
• Weight loss
• Persistent, unexplained fatigue
• Swelling of lymph nodes for more than 3 months
• Persistent headaches

A positive HIV status also puts a person more at risk for certain cancers including cervical cancer, lymphoma, and Kaposi's sarcoma.

What causes HIV/AIDS?

CD4 lymphocyte cells, called T-cells, are white blood cells that coordinate with other immune cells to protect the body from infection. These lymphocytes are also the main targets of the HIV infection. HIV attaches to and enters the lymphocytes, then inserts its own genetic material into the lymphocytes and duplicates itself.

When the new copies of the virus leave the host cells, they enter the bloodstream and search for new cells to attack. At the same time, the old host cells and other CD4 cells die from the effects of the virus. The cycle continues to repeat itself. Over time, the number of vital CD4 cells in the body decreases. This leads to severe immune deficiency.

How is HIV transmitted?

Sexually: HIV is a sexually transmitted disease. This means that HIV is transmitted via vaginal, anal, or oral sex with an infected person if his/her blood, semen, or vaginal secretions enter another person’s body. The virus is present in semen and vaginal secretions of infected people. It can enter the body through tiny tears in the rectum, vagina, or mouth. If a person already has another sexually transmitted disease (STD), he or she is at a higher risk of developing HIV. Also, women who use the spermicide nonoxynol-9 also may be at heightened risk because the spermicide irritates the lining of the vagina and may cause tears that allow the virus to enter the bloodstream.

Blood transfusion: HIV may be transmitted through blood and blood products that are received during blood transfusions. This includes whole blood, packed red cells, fresh-frozen plasma, and platelets. American hospitals started screening blood supplies for HIV in 1985. This screening process has reduced the risk of acquiring HIV thorugh a blood transfusion.

Needles: HIV is readily transmitted by sharing needles with people who have infected blood. The best way to decrease this risk is to avoid the use of injected drugs. If this is not possible, injection paraphernalia should always be sterilized with household bleach; participation in a needle-exchange program is another option. Healthcare workers are also at risk, should they get a needlestick. However, the risk of contracting HIV in this manner depends on multiple factors. It is generally a good idea to wear gloves and use universal precautions as a healthcare worker.

Mother-to-Child: Each year, almost 600,000 infants are infected with HIV by their mothers during gestation, delivery, or breast-feeding. However, if women receive HIV treatment while they are pregnant, this likelihood is significantly reduced.

Medications

• Antiretrovirals used in combination with protease inhibitors — help slow the infection; be sure to take as directed to avoid a stronger viral strain; significant serious side effects.
• Antibiotics — for complication of pneumonia; various side effects.
• Prednisone — for complication of pneumonia; various side effects.
• Amphotericin B with flucytosine — for complication of meningitis; various side effects.
• Clotrimazole — for complication of oral candidiasis; various side effects.

Research continues into new drugs and vaccines against HIV.

Diet

Maintain good nutrition. Malabsorption, altered metabolism and weight loss are common among patients.

Avoid raw eggs, unpasteurized milk or other potentially contaminated foods.

Last updated 4 April 2018