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HIV/AIDS

HIV and AIDS:

Overview

Human immunodeficiency virus (HIV), is the virus that causes AIDS. It weakens an individual’s ability to fight infections. It is mostly contracted through unsafe sex or needle sharing. Signs may include headache, fever, and swollen lymph nodes. An HIV test confirms the diagnosis.
Medications repress the virus to help you stay healthy, prevent the spread, and delay or prevent the onset of AIDS. With treatment, HIV-positive individuals can live normal, healthy lives.

HIV

What Are the Symptoms of HIV? 

This infection occurs in three stages. Without treatment, it gets worse over time and eventually overwhelms your immune system. Symptoms are stage dependent.

First Stage: Acute HIV Infection Symptoms

Most people do not know right away when they have been infected with it. But they may have symptoms within 2-6 weeks after they have gotten the virus. This is when your body’s immune system puts up a fight. It is called primary HIV infection or acute retroviral syndrome.

The symptoms are similar to those of other viral illnesses, and they are often flu-like. They typically last 1-2 weeks and then go away.

Early signs of HIV include:

  • Headache
  • Fever
  • Fatigue
  • Sore throat
  • Muscle ache
  • Swollen lymph nodes
  • A rash that does not itch, usually on your trunk

If you have symptoms like these and might have come into contact with someone with HIV in the past two to 6 weeks, go to a doctor and ask that you get a test for the virus. If you do not have symptoms but still think you might have come into contact with the virus, get tested.

Early testing is important for two reasons. First, at this stage, levels of the virus in your blood and body fluids are at the peak. This makes it infectious. Second, commencing treatment as soon as possible might help boost your immune system and ease your symptoms.

A combination of medicines (called HIV drugs, antiretroviral therapy/ART) can help fight the virus, keep your immune system healthy, and keep you from spreading the virus. If you take these medications and have healthy habits, your infection probably will not get worse.

Second Stage: Clinical Latency Symptoms

 

After your immune system has been overwhelmed by the virus, the flu-like symptoms will go away. But a lot is going on inside your body. Doctors call this the asymptomatic period or chronic HIV infection.

In your body, cells called CD4 T-cells coordinate the response of your immune system. During this stage, untreated HIV will kill CD4 cells and destroy your immune system. Your doctor can check how many of these cells you have with blood tests. Without treatment, the number of CD4 cells will drop, and you will be more likely to get other infections.

Most people do not have symptoms they can see or feel. You may not realise that you are infected and can spread the virus on to others.

If you are taking ART, you might stay at this stage for decades. You can spread the virus to other people, but it is extremely rare if you take your medicines.

Third Stage: AIDS Symptoms

Acquired Immune deficiency syndrome (AIDS) is the advanced stage of HIV infection. This is usually when your CD4 T-cell number drops below 200 and your immune system is badly damaged. Due to your weak immune system, you become predisposed to other infections.

If you did not know earlier that you were infected with HIV, you may realize it after you have some of these symptoms:

  • Being tired all the time
  • Swollen lymph nodes in your neck or groin
  • Fever that lasts more than 10 days
  • Night sweats
  • Unexplained weight loss
  • Purplish spots on your skin that do not go away
  • Difficulty breathing
  • Severe, long-lasting diarrhoea
  • Yeast infections in your mouth, throat, or vagina
  • Unexplained bleeding or bruises.

People with AIDS who do not take medication live about 3 years, or less if they get another infection. But HIV can still be treated at this stage. If you start on antiretroviral drugs, stay on them, follow your doctor’s advice, and keep healthy habits, you can live a long time.

HIV can spread when bodily fluids containing the virus come into contact with a permeable barrier in the body or small breaks in moist tissues of areas such as the genitals. Mostly through unsafe sex, sharing needles with an infected person. 

How HIV spreads

It can also be transmitted from a mother to her child during pregnancy and delivery. Individuals cannot become infected through ordinary day-to-day contacts such as kissing, hugging, shaking hands, or sharing personal objects, food or water. 

Do I have HIV?

The only way you can know for sure if you have HIV is to get tested. Although the virus can cause symptoms, they are not a reliable way to tell if you are infected. Some people may not present with symptoms at all. So even if you do not have any of the typical signs of an infection, you should always get tested if you think you are at risk.

Am I at Risk for HIV?

You get it through direct contact with certain kinds of body fluids such as blood, semen, pre-seminal fluid (also called pre-cum), vaginal fluids, rectal fluids, and breast milk

The biggest risks are having vaginal or anal sex without a condom, sharing needles with someone who has HIV or having an STI. 

Complications

HIV infection weakens your immune system, making you more likely to develop opportunistic infections and some cancers.

Infections common to HIV/AIDS include; Pneumocystis pneumonia, Candidiasis (thrush), Tuberculosis (TB), Cytomegalovirus, Cryptococcal meningitis and Toxoplasmosis.

Cancers common to HIV/AIDS are Lymphoma and Kaposi sarcoma.

Other complications

Wasting syndrome– Untreated HIV/AIDS can cause significant weight loss, often in the course of diarrhoea, chronic weakness and fever.

Neurological complications– It can cause neurological symptoms like confusion, forgetfulness, depression, anxiety and difficulty walking. HIV-associated neurocognitive disorders (HAND) can range from mild symptoms of behavioural changes and reduced mental functioning to severe dementia causing weakness and inability to function.

Kidney disease– HIV-associated nephropathy (HIVAN) is an inflammation of the little filters in your kidneys that remove excess fluid and wastes from your blood and pass them to your urine. It most frequently affects black or Hispanic people.

Liver disease– especially in those that have hepatitis B or viral hepatitis.

Diagnosing HIV

It is diagnosed through blood or saliva testing. Available tests include:

-Antigen/antibody tests

-Nucleic acid tests (NATs)

-Antibody tests

Discuss with your doctor about which HIV test is right for you. If any of these tests are negative, you may still need follow-up test weeks to months later to confirm the results.

How do you treat HIV?

There is no cure for HIV, but treatment options are much better than they were a few decades ago. Because of medical advancements, people can now live long, active lives with HIV.

HIV medications can help lower your viral load, fight infections, and improve your quality of life. They can lower your chances of spreading HIV, but if you take them incorrectly, you can still spread the virus to others. They are not a cure for HIV.

The aims for these medicines are to:

  • Control the growth of the virus
  • Improve how well your immune system works
  • Slow or stop symptoms
  • Prevent the spread of HIV to others

ART (Antiretroviral Therapy)

The medicines that treat HIV are called antiretroviral drugs. There are more than two dozen of them, and they fall into six main types. Each drug fights the virus in your body in a slightly different way.

Research shows that a combination, or “cocktail,” of drugs is the best way to control HIV and lower the chances that the virus will become resistant to treatment. Your doctor will probably recommend that you take three different medicines from two of the groups.

Which specific ones your doctor prescribes depends on what other medical conditions you have, what medications you take, how well your immune system is working, and even how many pills you want to take each day.

Medication Side Effects

The ART drugs can have side effects, they might include:

  • Nausea
  • Vomiting
  • Diarrhoea
  • Dizziness
  • Fatigue
  • Rashes on the skin
  • Insomnia

Often, side effects will go away as your body adjusts to the medication.

If a side effect is inconveniencing, your doctor might prescribe something to help or change your treatment regimen to lessen the effect.

Do not stop taking your ART. That could give HIV a chance to get stronger and do more damage.

Prevention

1.    Practice safe sex: Condoms are the best way to prevent HIV because the virus cannot pass through the barrier. It must be used correctly every time you have sex. Latex condoms give you the best protection. 

2.    Avoid sharing needles: The virus is spread through blood and can be contracted by using materials that have come in contact with the blood of an infected person.

3.    Consider Post-Exposure Prophylaxis (PEP): A person who has been exposed to HIV should contact their doctor about obtaining PEP. PEP can reduce the risk of contracting it. It consists of three antiretroviral medications given for 28 days. PEP should be taken 36 to 72 hours possible after exposure.

4.    Consider Pre-exposure Prophylaxis (PrEP). A person who has a higher chance of contracting HIV should talk to their doctor about PrEP. If taken consistently, it can reduce the risk of getting HIV. It is a combination of two drugs available in pill form.

HIV/AIDS can be prevented by practising safe sex. People living with it are humans too and should be treated as one. And for those living with it, strict adherence to your medications reduces the risk of infection. Never be ashamed of your medical status or health condition. It doesn’t define you and it is not a death sentence.

I. O. Eriyo, MB.BS in view, certified content creator at PoliMed, licensed google writer and contributing writer at Wikimedia Foundation.

F.O. Adagbonyin, MB.BS in view, certified content creator at Medblog180 and MedicWord, licensed google writer and contributing writer at Wikimedia Foundation.

REFERENCES

  • https://www.who.int/news-room/fact-sheets/detail/hiv-aids
  • https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes
  • https://www.webmd.com/hiv-aids/do-i-have-hiv
  • https://www.medicalnewstoday.com/articles/17131
  • https://www.healthline.com/health/hiv-aids#prevention

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