In this article, we will discuss HIV/AIDS. The human immunodeficiency viruses (HIV) can cause a life-threatening, chronic condition called acquired immunodeficiency syndrome (AIDS). HIV can damage your immune system and interfere with your body’s ability to fight disease and infection.
HIV is a sexually transmitted disease (STI). HIV can also spread through contact with infected blood, or mother-to-child transmission during pregnancy, childbirth, or breastfeeding. It can take many years for HIV to weaken your immune system enough that you develop AIDS.
Although there is no cure for HIV/AIDS or any other form of the disease, medications can significantly slow down the process. Many developed countries have seen a reduction in AIDS-related deaths.
Signs of HIV/AIDS
Depending on the stage of the infection, symptoms of HIV/AIDS can vary.
Primary Infection (Acute HIV)
Some HIV-infected people develop flu-like symptoms within two to four days of the virus entering the body. This is called primary (acute HIV infection) and can last for several weeks. These are possible signs and symptoms:
- Muscle pain and joint pain
- Sore throat or painful sores in the mouth
- Swollen lymph glands, especially on the neck
- Weight loss
- Night sweats
You might not notice these symptoms. The viral load (or amount of virus in the bloodstream) can be quite high during this stage. The infection spreads faster during primary infection than in the subsequent stages.
Clinical latent infection (Chronic HIV)
HIV can still be found in the body at this stage. During this stage, some people may not experience any symptoms of infection.
If you don’t receive antiretroviral treatment (ART), this stage can be very long. Some people develop more severe diseases much sooner.
You may experience mild to chronic infections as the virus continues its growth and destruction of your immune cells, the cells that protect you from germs.
- Swelling of the lymph nodes is often the first sign of HIV infection.
- Weight loss
- Oral yeast infection (thrush).
- Shingles (herpes zoster)
Progression to AIDS
AIDS is not a common occurrence in America today, thanks to improved antiviral treatment. HIV usually develops into AIDS if left untreated.
Your immune system is severely compromised when AIDS strikes. Your immune system will be affected more easily and you may develop opportunistic diseases or opportunistic carcinomas. These are rare conditions that can cause serious illness in someone with a healthy immune system.
These infections can be characterized by the following symptoms:
- Recurring fever
- Chronic diarrhea
- Swollen lymph glands
- White spots on your tongue, or other unusual lesions in your mouth.
- Fatigue that persists and is not explained
- Weight loss
- Skin rashes and bumps
When should you see a doctor?
Seek medical attention immediately if you suspect you have an HIV infection or that you are at risk.
Causes of HIV/AIDS
HIV is a virus. HIV can be spread via sexual contact, blood, or mother-to-child transmission during pregnancy, childbirth, or breast-feeding.
What are HIV and AIDS?
HIV can destroy CD4 T cells, white blood cells that are essential for fighting disease. Your immune system will weaken if you have fewer CD4-T cells.
An HIV infection can be present without any symptoms or signs for many years before it becomes AIDS. AIDS is diagnosed when your CD4 T cells count drops below 200, or if you have an AIDS-defining complication such as a serious infection.
Infected blood, vaginal or semen must be ingested by your body to become HIV-infected. There are many ways this can occur:
- You have sex. If you are involved in vaginal, oral, or anal sex with someone infected, your body may be infected. You can get the virus through small tears or mouth sores that may form in your rectum or vaginal area during sexual activity.
- You can share needles. You are at risk for HIV and other infections if you share IV drug paraphernalia (needles or syringes).
- Transfusions of blood. Some cases may allow the virus to be transmitted by blood transfusions. American hospitals and blood banks screen the blood supply for HIV antibodies. This risk is low.
- During pregnancy, delivery, or breastfeeding. Mothers infected with the virus can transmit it to their children. HIV-positive mothers who seek treatment during pregnancy for the disease can reduce the risk to their baby.
How HIV isn’t spreading
HIV can only be contracted through close contact. This means that you cannot get HIV/AIDS from touching, hugging, dancing, or kissing someone with HIV.
HIV can’t be spread by air, water, or bites.
HIV/AIDS can infect anyone of any race, age, sex, or sexual orientation. You are at the highest risk for HIV/AIDS if:
- Unprotected sex is allowed. Every time you have sex, use a new condom made of latex or polyurethane. Vaginal sex is less risky than anal sex. If you have multiple partners, your risk of contracting HIV is higher.
- Get an STI. Open sores can be caused by many STIs. These sores can be a gateway for HIV to enter your body.
- IV drugs. People who take IV drugs frequently share needles and syringes. They are exposed to blood droplets from other people.
HIV infection can weaken your immune system and make you more susceptible to developing certain types of cancers.
HIV/AIDS-related infections are common
- Pneumocystis pneumocystis (PCP). This fungal infection can lead to severe illness. Despite the fact that it has declined in severity with the current HIV/AIDS treatments, pneumonia is still a major cause of death in HIV-infected people.
- Candidiasis (thrush). The most common HIV-related infection is Candidiasis. It is characterized by inflammation and thick, white, sticky coatings on the tongue, mouth, esophagus, and vagina.
- Tuberculosis (TB). Tuberculosis (TB) is the most prevalent opportunistic HIV infection in resource-limited countries. It is a leading cause of death in people living with AIDS.
- Cytomegalovirus. The common herpes virus is transmitted through body fluids like saliva, blood, urine, and breast milk. The virus is inactivated by a healthy immune system, so it stays dormant in your body. The virus can resurface if your immune system is weak, causing damage to your eyes and other organs.
- Meningitis is caused by cryptococcal bacteria. Meningitis refers to inflammation of the membranes, fluid, and blood vessels surrounding your brain and spinal cord (meningitis). A fungus that is found in the soil causes cryptococcal meningitis, a common infection of the central nervous system.
- Toxoplasmosis. Toxoplasma goes dim, a parasite that is primarily transmitted to cats can cause this potentially fatal infection. Parasites can be transmitted to humans from infected cats by their stool. Toxoplasmosis may cause seizures and heart disease.
Common cancers with HIV/AIDS
- Lymphoma. A lymphoma is a form of cancer that affects white blood cells. Painless swelling of lymph nodes in the neck, armpit, or groin is the most obvious sign.
- Kaposi’s Sarcoma. Kaposi’s Sarcoma is a tumor of the blood vessel walls. It usually manifests as pink, purple, or red lesions on the skin. The lesions can appear dark brown or black in people with darker skin. Kaposi’s Sarcoma can also cause damage to the internal organs including the digestive tract, lungs, and heart.
- Wasting syndrome. If HIV/AIDS is not treated, it can lead to significant weight loss. This can often be accompanied by chronic weakness, fever, and diarrhea.
- Neurological complications. HIV can lead to neurological symptoms like confusion, forgetfulness, and anxiety. HIV-associated neurocognitive conditions (HAND), which can include mild symptoms such as behavioral changes and decreased mental functioning, to severe dementia that causes weakness and inability for the patient to function, may be caused by HIV.
- Kidney disease. HIV-associated kidney disease (HIVAN), also known as kidney disease, is an inflammation of tiny filters in the kidneys that remove excess fluid from your blood and allow them to pass it to your urine. This condition is most common in black and Hispanic individuals.
- Liver disease. Hepatitis B and hepatitis C can also cause liver disease.
There is no cure or vaccine for HIV infection. You can take steps to protect yourself and your loved ones from HIV infection.
To prevent HIV spread:
- Treat as Prevention (TasP). HIV medication is a way to prevent your partner from contracting the virus if you are living with HIV. You can prevent your partner from contracting the virus by making sure that your viral load is not detected (a blood test does not show any virus). TasP is a way to make sure you are following the instructions and getting regular checkups.
- If you have been exposed to HIV, use post-exposure protocol (PEP). If you suspect you have been exposed to HIV through sex, needles, or at work, you should contact your doctor immediately. You can reduce your chances of contracting HIV by taking PEP within 72 hours. For 28 days, you will need to be on medication.
- Every time you have sex, use a new condom. Every time you have anal or vaginal sexual activity, use a new condom. A female condom is available for women. Make sure that the lubricant you use is water-based. Oil-based lubricants may cause condoms to become weaker and break. A non-lubricated, cut-open condom is not recommended for oral sex.
- Preexposure prophylaxis (PrEP) is worth considering. Combinations of emtricitabine and tenofovir -Truvada – can lower the risk of getting sexually transmitted HIV infection among people at high risk. According to the Centers for Disease Control and Prevention, PrEP can lower your risk of contracting HIV through sex by more than 90% and injection drug use by more than 70%. Descovy has not been tested in women who have had receptive vaginal sexual contact. Your doctor will only prescribe these drugs to prevent HIV infection if you aren’t already diagnosed. Before you begin PrEP, you will need to have an HIV test. This test is repeated every three months for as long as you are taking PrEP. Before prescribing Truvada, your doctor will test your kidney function. This test is repeated every six months.
The drug must be taken every day. You can’t use them to prevent any other STIs. However, you will still need safe sex. Before you start treatment for hepatitis, it is important to be assessed by a liver specialist or infectious disease specialist.
- Inform your partners that you have HIV. Tell all of your sexual partners, past and present, that you are HIV-positive. They will need to be tested.
- Make sure you use a clean needle. Use a clean needle when injecting drugs. Make use of the needle-exchange programs available in your area. Consider seeking help for your drug use.
- If you’re pregnant, get medical care right away. HIV-positive people can pass the virus to their babies. You can reduce your baby’s chances of getting HIV-positive during pregnancy by receiving treatment.
- Consider male circumcision. Evidence suggests that male circumcision may reduce your risk of contracting HIV.
HIV can be detected by saliva or blood testing. The following tests are available:
- Antigen/antibody tests. These tests involve drawing blood from a vein. Antigens, which are substances that are associated with the HIV virus, are often detected in blood within a few days of exposure.
Your immune system produces antibodies when you are exposed to HIV. Antibodies can become detectable in weeks or months. It can take up to six weeks for antibodies to be detected in combination antigen/antibody testing.
- Antibody tests. These tests are used to detect antibodies to HIV in blood and saliva. Antibody tests are used for most rapid HIV tests. It can take up to 12 weeks to get an antibody test after being exposed.
- Nucleic acid testing (NATs). These tests are used to determine the virus load in your blood. These tests also draw blood from a vein. Your doctor might recommend NAT if you have been exposed to HIV in the last few weeks. After HIV exposure, NAT is the first test that will confirm you’re positive.
Talk to your doctor about the right HIV test for you. You may need to repeat the test if any of these tests come back negative.
To determine the stage of disease and to provide treatment options, tests are performed
It is important to seek out a specialist who has been trained to diagnose and treat HIV if you have been diagnosed.
- Consider whether additional testing is necessary
- Find the HIV antiretroviral treatment (ART) that is best for you
- Keep track of your health and work with your doctor to improve your overall health.
If HIV/AIDS is diagnosed, there are several tests that can be done to help your doctor determine which stage you are in and what treatment will work best.
- CD4 T cells count. CD4 T cells, which are white blood cells that are targeted and destroyed by HIV, are known as CD4 T cells. Even if there are no symptoms, HIV infection can progress to AIDS if your CD4 T cells count drops below 200.
- Viral load (HIV RNA). This test determines the level of virus in your blood. The goal of HIV treatment is to achieve an undetectable viral load. This will significantly lower your risk of getting opportunistic HIV infection or other HIV-related complications.
- Drug resistance. Some HIV strains are resistant to medication. This test allows your doctor to determine if you have resistance to the virus and guide treatment decisions.
Examen for possible complications
To check for any other complications or infections, your doctor may order laboratory tests.
- Hepatitis B and hepatitis C virus infections
- Kidney damage or liver failure
- Infections of the urinary tract
- Anal and cervical cancer
Treatment for HIV/AIDS
HIV/AIDS is currently incurable. Your body cannot get rid of HIV/AIDS once it has been infected. There are many medications that can help control HIV and prevent complications. These medications are known as antiretroviral treatment (ART). ART should be initiated for everyone with HIV, regardless of stage or complications.
ART usually includes a combination of several drugs from different drug classes. This combination has the highest chance of lowering HIV levels in the blood. Many ART options combine three HIV medications in one pill that is taken daily.
Different drugs block the virus differently. Combinations of drugs from a different classes to treat the virus include:
- Take into account individual drug resistance (viral genotype).
- Do not create new HIV strains that are resistant to drugs
- Maximize the suppression of viruses in the blood
Two drugs from the same class and a third from another class are commonly used.
These are the anti-HIV drug classes:
- Non-nucleoside retrotranscriptase inhibitors, or NNRTIs, turn off the ability of HIV to make duplicates of itself. Examples of these include Sativa, rilpivirine, and Pifeltro.
- Nucleoside and nucleotide-reverse transcriptase inhibitors are defective versions of the building blocks HIV uses to create copies of itself. Abacavir (Ziagen), Tenofovir (Viread), Emtricitabine, Emtriva, lamivudine and Zidovudine are all examples. Combination drugs also are available, such as emtricitabine/tenofovir (Truvada) and emtricitabine/tenofovir alafenamide (Descovy).
- HIV protease is an additional protein HIV requires to make copies of itself. Protease inhibitors (PIs), inactivate it. Atazanavir, darunavir and lopinavir/ritonavir are some examples.
- Integrase inhibitors disable a protein called integratase that HIV uses to insert genetic material into CD4 cells. Examples include bictegravir sodium/emtricitabine/tenofovir alafenamide fumar (Biktarvy), raltegravir (Isentress), and dolutegravir (Tivicay).
- Entry and fusion inhibitors stop HIV from entering CD4 T cells. Maraviroc (Selzentry) and enfuvirtide, (Fuzeon), are two examples.
Treatments: Starting and continuing
Antiviral medication should be given to everyone with HIV infection regardless of CD4 T cells count or other symptoms.
You can stay healthy by continuing to receive effective ART with a low HIV viral load.
It is important to follow the prescribed medication. You should not miss any doses. It is important to continue taking ART with an undetectable viral load.
- Keep your immune system strong
- You can reduce your chance of contracting an infection
- You can reduce your chances of getting treatment-resistant HIV
- Reduce your risk of passing HIV to others
It can be difficult to stay on HIV treatment. Talking to your doctor about side effects, difficulties taking medication, mental health issues, or any substance abuse problems that could make it difficult to continue ART can be very helpful.
Regular follow-up visits with your doctor are important to ensure your health and treatment response. Tell your doctor immediately if you have any problems with HIV treatment so you can work together to resolve them.
Treatment side effects
Side effects of treatment can include:
- Nausea, vomiting, or diarrhea
- Heart disease
- Liver and kidney damage
- Bone weakness or loss
- Normal cholesterol levels
- Higher blood sugar
- Sleep problems and cognitive and emotional problems are also problems
Age-related diseases can be treated
HIV can make it more difficult to manage certain health problems that are part of normal aging. Anti-HIV medication may not be compatible with certain medications that are commonly used for age-related metabolic, heart, or bone conditions. Talk to your doctor about any other conditions you may have and the medications that you are taking.
It is important to inform your doctor if you are being prescribed medication by another doctor. This will enable the doctor to ensure that there are no interactions.
Response to treatment
To determine how well you respond to HIV treatment, your doctor will check your HIV load and CD4 T cells counts. They will first be checked every two to four weeks. Then, they will be checked every three to six months.
Your viral load should be reduced so it is not detected in the blood. However, this does not mean that your HIV has disappeared. HIV can still be found in your bloodstream, but it is not in your blood.
Lifestyle and home remedies
It’s important to be involved in your own health care, as well as receiving medical treatment. These suggestions can help you live longer and stay healthy.
- Healthy foods are important. Get enough nutrition. You can stay strong by eating fresh fruits and vegetables, whole grains, and lean proteins. They also support your immune system and give you more energy.
- Avoid eating raw meats, eggs, and other animal products. HIV-infected people can experience severe foodborne illnesses. Cook meat until it’s well done. Avoid raw dairy products, unpasteurized eggs, and raw seafood like oysters, sushi, or sashimi.
- Make sure you get the correct vaccinations. These vaccinations can prevent common infections like influenza and pneumonia. Other vaccinations may be recommended by your doctors, such as for HPV and hepatitis B. However, vaccines containing live viruses are usually not safe due to your weak immune system.
- Companion animals should be taken care of. People who are HIV-positive may be infected by parasites from some animals. Toxoplasmosis can be caused by cat feces, salmonella can be transmitted to reptiles, and cryptococcus can be transmitted to birds. After handling pets or emptying their litter boxes, wash your hands well.
Some people with HIV may try supplements to improve their immune system or reduce side effects from anti-HIV medications. There is no scientific evidence to support the claims that nutritional supplements increase immunity. Some may also interact with other medications. To ensure that there are no medication interactions, it is important to consult your doctor before you take any supplements or other therapies.
Supplements that might be useful
- Acetyl-L-carnitine. Acetyl-L carnitine has been used by researchers to treat nerve pain, weakness, or numbness (neuropathy), in patients with diabetes. If you are deficient in this substance, it may help to ease the neuropathy caused by HIV.
- Whey protein and some amino acids. Early evidence suggests that whey proteins, a cheese product, may help HIV-positive people gain weight. Whey protein may also reduce diarrhea and increase CD4 cell count. The amino acids L-glutamine, L-arginine, and hydroxymethylbutyrate (HMB) may also help with weight gain.
- Probiotics. Probiotics. There are some indications that Saccharomyces boulardii, a probiotic, may be helpful in HIV-related diarrhea. However, you should only use it as directed by your doctor. Bovine colostrum has also been studied as a treatment for diarrhea.
- Vitamins and minerals If you are low in vitamins A, D, E, C, and B, as well as the minerals iron, zinc, and selenium, they may be beneficial.
Supplements that could be dangerous
- St. John’s Wort. St. John’s Wort is a common anti-HIV drug treatment. It can decrease the effectiveness of many anti-HIV medications by up to half.
- Garlic supplements. Garlic supplements. Although garlic may be beneficial for the immune system, it can interact with anti-HIV drugs. This could make them less effective. Sometimes eating garlic in food seems to be safe.
- Red yeast rice extract. This is used by some people to lower their cholesterol. However, it should be avoided if you are taking a statin or a protease inhibitor.
Yoga, meditation, and tai-chi have been proven to reduce stress and improve blood pressure, quality of life, and overall health. These practices are still being studied, but they may prove to be beneficial if you have HIV/AIDS.
Coping and Support
It is devastating to be diagnosed with any life-threatening illness. HIV/AIDS can have devastating financial, emotional, and social consequences. This illness can make it difficult to cope with.
Today, people living with HIV have many resources and services available. Many HIV/AIDS clinics offer social workers, counselors, and nurses that can assist you or connect you with others who can.
They may offer the following services:
- Organize transportation to and from doctor’s appointments
- Housing and child care assistance
- Assist with legal and employment issues
- Provide support during financial emergencies
A support system is essential. Talking to someone who understands HIV/AIDS is a comfort for many.
Prepare for your appointment
You should see your family doctor if you suspect you may have an HIV infection. An infectious disease specialist, who specializes in HIV/AIDS treatment, may refer you.
What you can do
These questions can be answered before you make an appointment.
- What do you think happened to you when you were first exposed to HIV?
- Which symptoms are you experiencing?
- Are you at risk of being exposed to unprotected sex?
- What prescription drugs and supplements are you taking?
What to expect from your doctor
Your doctor will ask questions about your lifestyle and health. Your doctor will conduct a thorough physical exam to check for the following:
- Swollen lymph nodes
- You may have lesions on your skin and in your mouth
- Nervous system problems
- You hear strange sounds in your lungs
- Your abdomen is swollen
What you can do while you wait
You should take precautions if you suspect you may have HIV. Do not have unprotected sexual relations. If you use injectable drugs, always use a fresh, clean needle. Do not share needles.