X
Table of contents

HIV and AIDS

Feel like sharing?

What are HIV and AIDS?

Human immunodeficiency virus (HIV) is a virus that can lead to acquired immunodeficiency syndrome (AIDS). It attacks specific cells of a person's immune system, called T-lymphocytes, which then impairs the immune system function. When the person's immune system is sufficiently weakened, they develop AIDS. People with AIDS become susceptible to opportunistic infections.

There are tens of millions of people living around the world with HIV/AIDS. Without a cure or vaccine, the number of people with HIV/AIDS has increased in recent years. However, with appropriate public awareness, further spread of this condition can be limited.

Signs, symptoms and stages

The early stages of HIV infection trigger flu-like symptoms such as fevers, swollen lymph nodes, a sore throat, rash, fatigue, headache, and muscle and joint pains. Given how common these symptoms are, it can be difficult to initially know if you have HIV. This initial period is referred to as acute retroviral syndrome. If you are sexually active, or experience any of the above symptoms after a sexual encounter and think they might be related, a sexual health check-up is a good idea. This is because the only accurate method with which to diagnose HIV is a blood test.

After early-stage infection, the disease progresses to a stage with little or no physical symptoms. However, during this stage the HIV infection is still replicating, usually at low levels, which makes the individual still infectious. It typically takes about 10 years for HIV infection to progress to AIDS. Antiretroviral medication helps to reduce replication of the virus and can delay the development of AIDS for up to several decades.

When HIV progresses to AIDS, symptoms include rapid weight loss, recurring fevers, chronic fatigue, prolonged lymph node swelling, diarrhea that lasts more than a week, pneumonia, sores on the mouth and genitals and neurological disorders such as depression and memory loss.

Causes

HIV is caused by a type of virus known as a retrovirus. It is mainly transmitted through sexual activity, but can also be spread through contact with other body fluids including blood and breastmilk. It cannot be spread by contact with saliva, such as from kissing or sharing cutlery. Once in the body, HIV invades a specific group of T-lymphocytes in the immune system, called CD4+ cells, or T-helper cells. The HIV replicates within these T-helper cells, ultimately destroying them and weakening the immune system. T-helper cells play a major role in protecting the body from infections. They send signals to other cells in the immune system to detect 'intruders' such as viruses and bacteria.

Risk factors

Risk factors for HIV infection include:

  • A sexual partner with HIV;
  • Unprotected vaginal or anal sex;
  • Multiple sexual partners;
  • Engaging the services of a sex worker;
  • Injecting drugs and using shared needles;
  • Tattoos from an unregistered tattooist and;
  • Being accidentally jabbed with a HIV-contaminated needle in a health clinic.

Types

There are two main types of viruses that cause HIV infections - HIV-1 and HIV-2. HIV-1 is the most common globally, while HIV-2 is largely limited to West Africa. There are currently no vaccines for either type of virus; however, there is ongoing research to develop a vaccine.

Methods for diagnosis and monitoring

HIV diagnosis

Blood tests are performed to check for HIV infection. There are two main ways to be tested - a rapid test or a conventional test. The rapid test uses a finger prick of blood, which an automated machine can quickly process, producing a result in 10-20 minutes. The conventional test uses a sample of blood taken from a vein, which is sent off to a laboratory for testing and can take up to a week for a result. Both tests commonly assess for:

There can be a period of time between becoming infected with HIV and the above tests showing positive results. This is known as the window period. This period can be between six weeks to three months, from the time when you might have been exposed to the virus. Often, if the test result is negative within this period, further testing may be recommended at the six-week or three-month mark (depending on the laboratory) to more confidently rule out the chance of an infection.

If the first test is positive, a second blood test is often performed to confirm the diagnosis. The following tests can be performed:

HIV monitoring

The following are used to monitor a HIV infection and check how well you are responding to treatment:

Types of treatment

HIV infection

There is no cure for HIV. However, HIV can be effectively managed to ensure a long and healthy life.

If you have HIV, treatment will focus on reducing the number of viruses in the body, which helps maintain a high CD4+ cell count and slow down the disease's progression to AIDS. Medications used to treat HIV infection are known as antiretroviral medicines. These include:

The decision about the type of medications to use and when to use them is often complex. Often you will be referred to a medical specialist in this area to supervise your treatment and provide guidance with making decisions.

Post-exposure prophylaxis

Post-exposure prophylaxis (PEP) is a course of antiretroviral medication that is taken immediately after a possible exposure to HIV. If you believe you have been exposed to HIV, PEP can help prevent the establishment of an infection. However, it must be taken within 72 hours of exposure. If you suspect that you may be at risk, it is important to see a doctor immediately for testing and possible PEP.

Treatment for AIDS-related infections

AIDS is defined as having a CD4+ cell count that is below 200 cells/microL. AIDS puts you at risk of opportunistic infections, so you will need preventative treatment for the following conditions:

Pneumocystis pneumonia

Pneumocystis pneumonia can occur if you have a CD4+ cell count of less than 200 cells/microL. An infection of the lungs is the most common cause of AIDS-related pneumonia death. The preferred preventative treatment for pneumocystis is an antibiotic known as trimethoprim-sulfamethoxazole.

Histoplasmosis

Histoplasma is a type of fungus found in soil or bird and bat droppings. Preventative antifungal treatment is recommended when the CD4+ cell count is less than 150 cells/microL.

Toxoplasmosis

Toxoplasmosis is an infection found worldwide that is caused by a parasite called Toxoplasma gondii. Healthy people typically do not have any symptoms. In people with AIDS, however, it can be a life-threatening infection.

Reducing the risk of exposure to toxoplasmosis is generally advised. This includes avoiding meat that is undercooked, washing fruit and vegetables properly, avoiding stray cats (and changing cat litter), avoiding gardening and washing your hands before food preparation.

A blood test is usually performed to assess if individuals have been previously exposed to this common parasite (most people have been). If there has been prior exposure and a person's CD4+ cell count is less than 100 cells/microL, medications (such as trimethoprim-sulfamethoxazole) can be used to further reduce the risk. If there was no prior exposure, such medications are generally not needed. However, regular retesting for this infection when the CD4+ cell counts are less than 100 cells/microL is recommended, as it is common for the person to easily pick up the infection.

Mycobacteria

Preventative treatment for mycobacterium avian complex, a type of bacteria, includes antibiotics when your CD4+ cell count is less than 50 cells/microL.

Candidiasis

Candidiasis (or thrush) is an infection with a yeast typically found in the mouth and groin areas. Preventative treatment for candidiasis is not recommended unless repeat infections occur, in which case antifungals can be used.

Cryptococcus

Cryptococcus is a yeast-like fungus found in soil. It can cause infection in the lungs (cryptococcosis) or the brain (cryptococcus meningitis). Preventative treatments are not commonly recommended for this type of infection because they have not been shown to improve survival. When used, treatment includes antifungals.

Coccidioides

Coccidioides is a type of fungus that causes coccidioidomycosis, which most commonly manifests as pneumonia, but can spread throughout the entire body. Preventative treatments are not commonly recommended for this type of infection. You can reduce your risk of acquiring this infection by avoiding activities that expose you to dust or soil. If you have a coccidiodes infection, treatment will include antifungals.

Cytomegalovirus

Cytomegalovirus is a common virus that in healthy people causes a mild illness, but can cause serious complications in people with AIDS. These include diseases of the digestive system, eyes and spinal cord.

Preventative treatment for cytomegalovirus is not commonly recommended. When used, preventative treatment includes antiviral medications.

Cryptosporidium

Cryptosporidium is a type of parasite found in contaminated water. It can also spread through contact with human or animal feces. The infection causes diarrhea in healthy individuals, which is generally mild. In people with AIDS, an infection with the parasite can result in severe and prolonged bouts of diarrhea. Practicing good hygiene can limit your risk of acquiring the infection, but there are no proven medications to prevent cryptosporidium infections.

Alternative treatments

Some people diagnosed with HIV seek out complementary and alternative therapies. None of these alternative therapies cure HIV, but some can help people feel better when used together with conventional medical treatment. However, it is important to discuss any treatments with your doctor before starting them, as they can interact with conventional medications.

Potential complications

The main complication of HIV infection is the development of AIDS. There are numerous complications associated with AIDS, including opportunistic infections mentioned above. Other complications of HIV/AIDS are:

Bone fracture

HIV is associated with a small increase in the risk of bone fractures.

Neurological complications

AIDS dementia complex

AIDS dementia complex (ADC), also called HIV-associated dementia (HAD), occurs in people with an advanced HIV infection. Symptoms include inflammation of the brain (encephalitis), decreased memory and thinking capacity, behavioral changes and difficulty concentrating, as well as progressive loss of motor function and coordination. ADC can lead to complete dependence and even early death; however, the condition can be effectively treated with antiretroviral medications and also antipsychotic, antidepressant or anticonvulsant medications to relieve specific symptoms. Also, it may be prevented or delayed through the use of antiretroviral medications in people with an HIV infection.

Vacuolar myeopathy

Vacuolar myeopathy is when small holes, called vacuoles, form in the outer layers of nerves. These holes interrupt the electrical messages sent by nerves, disrupting normal bodily functions. This damage is believed to be caused by specific white blood cells, called macrophages. Symptoms of vacuolar myeopathy include stiff and weak legs and instability while walking. In some people it can progress to AIDS dementia.

Progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is caused by a specific virus that destroys the outer layer of nerves. Symptoms include impaired vision and vision loss, speech problems, paralysis, brain lesions and coma. The condition occurs exclusively in individuals who are immunosuppressed and although there is no specific treatment, improving the immune system of HIV patients through use of antiretroviral medications may improve survival.

Neurosyphillis

Neurosyphillis is caused by the syphilis infection. It is recommended to adequately treat syphilis with antibiotics before it causes neurosyphilis.

Cancer

Kaposi's sarcoma

Kaposi's sarcoma is the second-most common HIV-related cancer, occurring in more than half of people with HIV in the late stages of infection. It is caused by Kaposi-sarcoma-associated herpes virus (KSHV). The relationship between HIV and KSHV infection is not fully understood.

Central nervous system lymphomas

Central nervous system lymphomas are a type of cancer that develops in the brain and, rarely, in the spinal cord. This type of cancer is associated with the Epstein-Barr virus. Symptoms include seizures, headache, impaired vision, dizziness, paralysis and speech problems.

Non-Hodgkin lymphoma

HIV increases the risk of developing non-Hodgkin lymphoma.

Invasive cervical carcinoma

Studies have found an elevated incidence of cervical cancer in HIV-infected women. Although not yet understood, there is believed to be a complex link between HIV and the human papillomavirus that causes cervical cancer.

Pulmonary arterial hypertension

Pulmonary arterial hypertension is when the pressure in the arteries to the lungs is abnormally high. It is not well understood how HIV causes it, but it only occurs in a small number of people with HIV.

Treatment side effects

The range of side effects of HIV medications is as broad as the range of medications itself. For more information, please discuss with your doctor the potential side effects of the specific medications that you are on.

HIV and pregnancy

HIV can be spread to your baby during the pregnancy, while in labor, during birth, or through breastfeeding. However, having HIV does not have to prevent you from having children. Seeing your doctor before you become pregnant can allow you to discuss choices about reducing the risk of passing the infection on to your child.

Prognosis

HIV is no longer the death sentence it once was. The development of antiretroviral therapies means if you are diagnosed with HIV early and comply with your treatment, you can expect a long and healthy life.

Prevention

It is possible to reduce your risk of getting HIV by:

References

  1. link here
  2. link here
  3. file:///C:/Users/jonathan.meddings/Downloads/varghese2002-29-1.pdf
  4. link here
  5. link here
  6. link here
  7. link here
  8. link here
  9. link here
  10. link here
  11. link here
  12. link here
  13. link here
  14. link here
  15. link here
  16. link here
  17. link here
  18. link here
  19. link here
  20. link here
  21. link here
  22. link here
  23. link here
  24. link here
  25. link here
  26. link here
  27. link here
  28. link here
  29. link here
  30. link here
  31. link here
  32. link here
  33. link here
  34. link here

11 Most frequently asked questions (FAQs)

What is HIV?
HIV stands for Human Immunodeficiency Virus. It is a type of virus that infects specific cells of the immune system, resulting in their destruction. This weakens the immune system.
What is AIDS?
AIDS stands for Acquired Immunodeficiency Syndrome. It is caused by the Human Immunodeficiency Virus (HIV), which destroys specific cells of the immune system, called CD4 T-cells. When the number of these cells in the blood drops below a certain level, a person is said to have AIDS. AIDS causes the body to be prone to infections and tumors that normally don't cause disease in healthy people.
What is the difference between HIV and AIDS?
HIV is the virus, AIDS is the disease: Human Immunodeficiency Virus (HIV) is the virus that causes Acquired Immunodeficiency Syndrome (AIDS). HIV invades and destroys cells of the immune system. This results in immunosuppression and, if it is sufficiently weakened, the person develops AIDS. People with AIDS are susceptible to opportunistic infections.
How long does it take for HIV to cause AIDS?
It can take 8 to 11 years for HIV to cause AIDS, but this varies greatly between individuals. Treatment with antiretroviral medications can delay the development of AIDS for several decades, meaning that most people diagnosed with AIDS today can have a normal life expectancy if they are diagnosed early and maintain their treatment regime.
What are the symptoms of HIV/AIDS?
The symptoms of HIV/AIDS vary depending on the stage of infection. In the early stages, flu-like symptoms appear. Regular sexual health check-ups are a good idea, because it is impossible to tell if you have HIV based on your symptoms alone.
Can I get HIV from kissing someone?
You cannot get HIV from kissing someone because HIV is not transmitted by saliva.
Can I get HIV from oral sex?
There is a lot of debate about the risk of getting HIV from unprotected oral sex. There is no doubt that the risk is much less than vaginal and anal sex. However, there is a theoretical risk of getting HIV from oral sex.
What are antiretrovirals?
Antiretrovirals are a group of medications that block the replication of retroviruses such as HIV.
How do antiretrovirals work?
Antiretroviral medications work in several different ways to disrupt the replication of HIV. Some of these medications work by blocking enzymes crucial to the replication process, such as protease, integrase, and nucleoside and non-nucleoside reverse transcriptase inhibitors; fusion inhibitors work by blocking the virus from entering cells.
How do people get HIV?
HIV is transmitted through unsafe sex with a HIV-infected person, sharing a needle with a HIV-infected person, from an HIV-infected mother to their baby in the womb and from breastfeeding after birth. It cannot be caught from kissing someone, shaking their hands or sharing food or cutlery.
Can HIV/AIDS be cured?
There currently is no cure for HIV/AIDS, but it can be controlled with antiretroviral medications. Researchers are working to find a cure or vaccine for the condition.

Related topics

Chlamydia

Chlamydia is a common sexually-transmitted infection (STI). Most people with chlamydia will not have symptoms, but others may experience pain when urinating, during intercourse, or have an abnormal discharge. If sexually active, it is important to get regular check-ups so it can be detected early and treated.

Genital herpes

Genital herpes is a common sexually-transmitted infection that is caused by a virus. Some people with the condition will not experience any symptoms, while others will develop small blisters or ulcers on or around their genitals. Following some advice can help reduce symptoms and help prevent spreading the virus.

Genital warts

Genital warts are a common sexually-transmitted infection that cause small, painless lumps to grow near the genitals. They are contagious through skin contact. Genital warts can be removed with medication, or by simple procedures performed by a doctor.

Gonorrhea

Gonorrhoea is a common sexually-transmitted infection. It may not have any symptoms, but if it’s untreated, it can lead to complications. If sexually active, it is important to get regular check-ups so it can be detected early and treated.

About this article

Title: HIV and AIDS

Author: Jonathan Meddings BMedLabSc (Hons)

First Published: 22 Sep 2014

Last reviewed: 17 Jan 2022

Category: Information on HIV and AIDS

Average rating: 4.9 out of 5 (1554 votes)

Processing your vote now...

Sorry your vote failed to process.

Rate this report below.

Feel like sharing?

X

Your privacy

We use cookies to improve our website and service. By continuing to browse this website you accept the use of cookies by us and our partners. If you require more information please read our privacy policy and terms and conditions before proceeding.