HIV (Human Immunodeficiency Virus) is a virus that causes AIDS (Acquired Immunodeficiency Syndrome), a condition that breaks down a person’s immune system leading to a series of diseases. HIV does not instantly lead to AIDS. An HIV infected individual can lead a healthy life for several years before developing AIDS. HIV may be passed to another person when infected blood, semen, or vaginal fluids come in contact with skin tears or mucus membranes of an uninfected individual.
According to the Mayo Clinic, an estimated 38.6 million people are living with HIV. Nearly half of them are women and girls between the ages of 15 and 24. In 2005, more than 4 million people were diagnosed with new cases of HIV. Twenty-five million people have died of AIDS (advanced stage of HIV) since the epidemic began about 25 years ago.
What are the symptoms of HIV?
The first symptoms of HIV can resemble symptoms of other conditions, such as a cold or flu virus, other sexually transmitted diseases, other infections such as mononucleosis or hepatitis. Stress and anxiety can also produce symptoms that are similar to HIV in some individuals.
The intensity of the symptoms can also vary from person to person. Some may experience very strong symptoms while others experience none at all.
General symptoms can occur within days or weeks of initial exposure to the virus and may include:
These symptoms usually appear during a period called primary or acute HIV infection.
The following may be warning signs of advanced HIV infection:
- Rapid weight loss
- Dry cough
- Recurring fever or profuse night sweats
- Profound and unexplained fatigue
- Swollen lymph glands in the armpits, groin or neck (lymphadenopathy)
- Diarrhea that lasts for more than a week
- White spots or unusual blemishes on the tongue, in the mouth, or in the throat
- Red, brown, pink or purple blotches on or under the skin or inside the mouth, nose or eyelids
- Memory loss, depression, and other neurological disorders
No one should assume they are infected with HIV just because of these symptoms. Each of these symptoms can be related to other medical conditions. Because these symptoms are similar to other diseases, a person may not realize they are infected with HIV. The only way to determine if a person is infected is to be tested.
Even if someone doesn’t have symptoms it is still possible to transmit the virus to others. Once the virus has entered the body it begins to attack the immune system. The virus multiplies in the lymph nodes and begins to destroy the T-cells, which are the white blood cells that coordinate the entire immune system.
A person may be symptom free for nine years or more. During this time the virus continues to multiply and destroy immune cells.
Can having HIV lead to other problems?
The advanced stages of HIV have been identified by the term AIDS (Acquired Immunodeficiency Syndrome). According to the definition provided by the Centers for Disease Control & Prevention (CDC), AIDS includes all HIV-infected people who have less than 200 CD4+ T cells per cubic millimeter of blood. This definition also includes 26 clinical conditions that affect people with advanced HIV disease. In people with AIDS, these infections are often severe and fatal because the immune system has been so damaged by HIV that the body cannot reject certain bacteria, viruses, fungi, parasites and other microbes.
How is HIV transmitted?
The most common ways that HIV is spread include:
- Vaginal, oral, or anal sex with someone who is infected with HIV
- Sharing needles or syringes with someone infected with HIV
Infected blood, semen or vaginal fluid (including menstrual blood) can enter the body through the vagina, rectum or mouth and surrounding tissue. The risk of becoming infected increases if there are sores (caused by herpes, syphilis and chancroid) on the genitals (vagina, vulva, penis). Sharing personal items can be risky if they have been in contact with another person’s blood, semen or vaginal fluid.
HIV is not spread through every day activities or casual contact. Activities such as hugging, kissing, cuddling, touching, or massaging do not spread HIV unless there is contact with the person’s blood, semen, vaginal fluid or breast milk.
HIV cannot be contracted from:
- Coughs or sneezes
- Being around an infected person
- Insect bites
- Using swimming pools or hot tubs
- Toilet seats
- Phones or computers
- Drinking fountains
- Straws, spoons, or cups
How is HIV diagnosed?
Because this disease has nonspecific symptoms, they are not a reliable way to diagnose HIV infection. The only way to know whether a person has been infected is through HIV testing.
HIV tests do not test for the actual HIV virus. One test detects HIV proteins while the other two detect HIV antibodies in the bloodstream.
- Elisa is the first portion of the HIV test. This test detects the presence of HIV antibodies in the blood. Negative results determine a person is not HIV infected. Positive results lead to the second portion of the test to confirm results.
- Western Blot is used to confirm a positive Elisa test result. The Western Blot test detects specific protein bands that are present with HIV infections. A positive Elisa test with a positive Western Blot test gives 99.9% accuracy in identifying HIV infection.
- PCR detects specific DNA and RNA sequences that indicate the presence of HIV in the genetic structure of anyone HIV infected. DNA and RNA from the HIV virus circulate in the blood. The presence of these “particles” indicates the HIV virus.
Testing for HIV antibodies is the only way to know if a person is infected. However, this test for HIV antibodies is effective only after the infected person’s immune system produces antibodies to HIV. There is a time period between the initial infection and when the HIV antibodies are detectable which can be from 2 weeks to 6 months with an average length of 3 months. During this time period standard HIV testing is ineffective.
What is the treatment for HIV?
When the HIV/AIDS epidemic began in the early 1980s, AIDS patients were not expected to live more than a few years. Since then, the development of safe and effective drugs is enabling people with HIV to live longer and healthier lives.
At the present time there are 26 antiretroviral drugs that have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of HIV patients.
These drugs can be classified into three major groups:
- Reverse transcriptase (RT) inhibitors – interfere with the conversion of reverse transcriptase (an HIV enzyme) into HIV RNA to HIV DNA.
- Protease inhibitors (PI) – interfere with the protease enzyme that HIV uses to produce infectious viral particles.
- Fusion inhibitors – interfere with the HIV virus’ ability to fuse with the cellular membrane, thus blocking entry into the host cell.
Current drugs can suppress the HIV virus, even to undetectable levels, but are not able to completely remove HIV from the body. These drugs help to manage HIV but are not able to cure it. It is important that infected patients continue to take antiretroviral drugs.
Because HIV reproduces itself, new strains of the virus continue to emerge which can be resistant to antiretroviral drugs. Most health care providers recommend that HIV infected patients take a combination of antiretroviral drugs known as HAART. This combination of drugs successfully suppresses the virus and decreases the rate of opportunistic infections by strengthening the immune system.
While the use of HAART can suppress the virus and has greatly reduced the number of deaths due to HIV/AIDS, the virus may still be transmitted. People infected with HIV who are taking antiretroviral drugs can still transmit HIV to others through unprotected sex and needle sharing.
The Pharmaceutical Research and Manufacturers Association of America maintains a database of new drugs in development to treat HIV infection. Scientists are also studying how immune modulators can help to increase the immune response to the HIV virus and make existing HIV drugs more effective. Therapeutic vaccines are being examined for this purpose.
Can HIV be prevented?
Not having sex is the only sure way to avoid the transmission of HIV.
If you decide to engage in sexual activity, in order to reduce the risk of infection you should:
- Have sex with only one partner who is not infected with HIV, who does not share needles or syringes and who has sex only with you. These things may be difficult to know about another person.
- Avoid contact with your partner’s blood, semen, or vaginal fluid.
- The correct use of a latex condom when having sex greatly reduces your risk of HIV infection.
- Use a water-based lubricant with the latex condom to reduce risk of breakage when engaging in vaginal or anal sex.
- Use a male condom without spermicide or a lubricant for oral sex.
- Further research is needed to determine the effectiveness of the female condom or dental dams in preventing HIV transmission.
For additional information:
Food and Drug Administration http://www.fda.gov
Centers for Disease Control and Prevention http://www.cdc.gov
Compiled using information from the following sources:
About Aids, http://aids.about.com
Centers for Disease Control and Prevention, http://www.cdc.gov
HIV Insite, http://hivinsite.ucsf.edu
Mayo Clinic, http://www.mayoclinic.com
Medline Plus, http://www.nlm.nih.gov/medlineplus
National Institute of Allergy and Infectious Diseases, http://www.niaid.nih.gov
Women and HIV, American Red Cross, 1999.