What Is HIV?

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People commonly mistake Human Immunodeficiency Virus (HIV) for Acquired Immunodeficiency Syndrome (AIDS) Even  though there is a correlation between the two, they are distinct conditions. HIV  is a virus that attacks the immune system, specifically the CD4+ cells , which play a crucial role in helping the body fight off infections and diseases. Over time, the virus destroys a significant number of these cells, making the body unequipped to fend off infections and diseases. When it reaches this stage, it leads to the development of AIDS.1

HIV is most commonly spread through sexual contact, sharing of needles or other injection equipment, or from mother to child during pregnancy, childbirth, or breastfeeding. Hence, people who have unprotected sex and share needles when using drugs are at high risk of acquiring the virus. This article will discuss the causes, symptoms, and treatment of HIV. It will also highlight the prevalence of HIV globally and how we can prevent its spread. 

Overview

HIV infection affects the immune system, and may eventually lead to  AIDS. HIV can be transmitted through contact with infected bodily fluids, most commonly through sexual contact, sharing of  injection equipment, or from a mother to a child during pregnancy, birth, or breastfeeding. The virus targets and destroys CD4+ cells , which play a crucial role in defending the body against infections and diseases.2   

There are three stages of HIV, namely: 

  • acute HIV infection
  • chronic HIV infection
  • AIDS

During the early stage of infection, some people may not experience any symptoms, while others may experience flu-like symptoms. In the later stages, if left untreated, HIV can lead to severe illnesses, especially from opportunistic infections that take advantage of the weakened immune system.

The Diagnosis of HIV can be done through a blood test. Early diagnosis and treatment are critical in managing the virus. There are now antiretroviral therapies (ARTs) available that can slow the progression of HIV and help people living with the virus live longer, and healthier lives. ARTs work by blocking the virus's ability to multiply and spread, helping to preserve the immune system.4

HIV/AIDS continues to be a major public health challenge worldwide, with millions of people living with the virus. However, through increased education and access to testing, prevention, and treatment, it is possible to control the spread of HIV and improve the lives of those affected by the virus.

Causes of HIV

HIV is caused by being infected with  human immunodeficiency virus. HIV destroys CD4+, which weakens the immune system. The virus can spread in the following ways:

  • Sexual contact: HIV can be contracted through vaginal, anal, and oral sex. The virus can enter the body through the mucous membranes of the anus, vagina, penis, or mouth
  • Sharing of needles or other injection equipment: People who share needles or other injection equipment, such as syringes, when using drugs, are at high risk of getting infected with HIV
  • Mother-to-child transmission: An infected mother can pass the virus to her baby when the child comes in contact with infected body fluids during pregnancy, childbirth, or breastfeeding
  • Blood transfusions: In the past, before blood was screened for HIV, people could get infected with the virus through transfusions of contaminated blood. This is now rare in countries with modern blood screening methods
  • Occupational exposure: Healthcare workers who are accidentally poked with a needle contaminated with HIV-positive blood are at risk of infection

It's important to note that HIV cannot be transmitted through casual contact such as shaking hands, hugging, or sharing food or drinks.

Signs and symptoms of HIV

People often present with HIV symptoms following the exposure between 2-4 weeks. However, the early stages of HIV infection may not cause any symptoms or only produce mild symptoms that are often mistaken for another illness.5 Some people may experience flu-like symptoms within two to four weeks after being infected with HIV. These include but are not limited to:

  • Fever 
  • Fatigue
  • Sore throat 
  • Skin rash 
  • Muscle aches and joint pain
  • Swollen glands
  • Nausea 
  • Headache 
  • Night sweats
  • Diarrhea

Although, some people may not experience any symptoms during this stage,  others may experience severe symptoms. These symptoms usually go away on their own within a few weeks, but the virus continues to multiply and damage the immune system.

As the virus progresses, the immune system becomes weaker, making the body more susceptible to other  infections and other illnesses. Later-stage symptoms of HIV may include:5

  • Persistent fatigue
  • Weight loss
  • Recurring fever and night sweats
  • Persistent or frequent bacterial infections
  • Dry cough
  • Shortness of breath
  •  Liver and Kidney diseases
  •  Pneumonia
  •  Cryptococcal meningitis
  • Toxoplasmosis

It is crucial to undergo an HIV test if there is a possibility of exposure to the virus or if symptoms are present. Prompt diagnosis and treatment can slow the progression of the virus and enhance overall health outcomes. Without treatment, a person with AIDS can expect to live around 1 to 2 years after the onset of the first opportunistic infection5

Management and treatment for HIV

Currently, there is no cure available for HIV, but with the help of ART, the progression of the virus can be slowed down. ART works by blocking the virus's ability to multiply and spread, helping to preserve the immune system. The goal of ART is to lower the amount of virus, better known as the viral load,in the blood to undetectable levels. When the viral load is undetectable, the risk of transmitting the virus to others is greatly reduced. Most people who are on HIV treatment often reach an undetectable viral load within 6 months after commencing treatment. Antiretroviral treatment typically consists of a combination of medications because HIV can quickly adapt and form resistance to treatment7

In addition to ART, there are other treatments and management strategies for HIV, including:

  • Opportunistic infection prophylaxis: To prevent infections, people with HIV may take preventive medications, such as antibiotics, antifungals, and antivirals
  • Vaccinations: People with HIV should also get vaccinated against infections, such as pneumococcal disease, hepatitis A and B, and the flu
  • Healthy lifestyle: Eating a balanced diet, exercising regularly, and getting enough sleep can help improve overall health and reduce the risk of illnesses
  • Mental health support: Living with HIV can be stressful and can affect mental health. Seeking support from friends, family, or mental health professionals can help
  • Adherence to medication: It's important to take ART as prescribed and attend regular appointments with a healthcare provider to monitor the effectiveness of treatment and manage side effects

With early diagnosis and appropriate treatment, people living with HIV can have a normal lifespan and lead healthy lives. However, it's important to continue ART for life and to attend regular appointments with a healthcare provider to monitor the effectiveness of treatment and manage any potential side effects.

FAQs

What are the stages of HIV?

There are three stages of HIV3

  • Acute HIV infection: This stage occurs within the first few weeks after being infected with the virus and can produce flu-like symptoms
  • Chronic HIV infection: During this stage, the virus continues to damage the immune system, and the person may not have any symptoms. However, they can still spread the virus to others
  • AIDS: This is the most advanced stage of HIV and is diagnosed when the immune system is severely damaged and the person develops serious illnesses or infections

It's important to note that not all people with HIV progress to AIDS, and early diagnosis and treatment can slow the progression of the virus.

How is HIV diagnosed?

HIV is diagnosed through a blood test. There are three types of HIV tests: antibody, antigen/antibody, and nucleic acid tests4

  • Antibody tests: checks for HIV antibodies in blood or oral fluid, but can take up to 90 days to detect the virus. It takes 23-90 days to detect HIV after exposure
  • Antigen/antibody tests: checks for both antibodies and antigens and is commonly done in labs. It takes 18-45 days to detect after exposure
  • Nucleic acid tests: detects the actual virus in blood and is recommended for those who have recently been exposed to HIV or have symptoms and negative results from other tests. These tests can usually detect HIV 10 to 33 days after exposure

How can I prevent HIV?

There are several ways to reduce the risk of getting infected with HIV, including:

  • Use condoms during sexual activities to reduce the risk of sexual transmission
  • Avoid sharing needles, syringes, and other injection equipment
  • Getting tested before having sex with a new partner
  • Avoiding contact with the blood or bodily fluids of someone who is infected with HIV
  • Taking pre-exposure prophylaxis (PrEP) if you are at high risk of getting infected with HIV
  •  Limiting the number of sexual partners you may have
  • If pregnant, get tested for HIV and receive appropriate medical care to reduce the risk of mother-to-child transmission

Who are at risks of HIV?

Anyone can get infected with HIV, but some groups are at higher risk, including:

  • People who engage in unprotected sexual activity with an HIV-positive partner and those who have multiple partners or engage in high-risk sexual practices
  • People who inject drugs and share needles or other injection equipment with other people
  • Babies born to mothers who have HIV
  • Healthcare workers with exposure to contaminated needles or other medical equipment

How common is HIV?

The prevalence of HIV changes based on geographical location and demographic groups. The World Health Organization highlighted that, as of 2021, there were an estimated 38.4 million people living with HIV globally. Of those, 1.5 million new cases were diagnosed and 650,000 deaths caused by HIV related illness. HIV is particularly prevalent in Africa regions with 1 in 25 people living with HIV . Consequently, HIV continues to pose a significant global health concern and challenge. 

When should I see a doctor?

If you suspect you may have been exposed to HIV or are experiencing symptoms, it's important to see a doctor as soon as possible. Early diagnosis and treatment can slow the progression of the virus and improve health outcomes.

Additionally, if you are at high risk of getting infected with HIV, it's important to get tested regularly. Similarly, if you are diagnosed with HIV, it's important to attend regular appointments with a healthcare provider to monitor the effectiveness of treatment and manage any potential side effects.

Summary

HIV is a virus that attacks the immune system and can lead to AIDS, a serious and potentially life-threatening illness. There are three stages of HIV: acute infection, chronic infection, and AIDS. Early diagnosis and treatment can slow the progression of the virus and improve health outcomes. HIV can be diagnosed through a blood test, and there are several ways to reduce the risk of getting infected, such as using condoms, not sharing needles, getting tested before having sex, and taking pre-exposure prophylaxis (PrEP). If you suspect you may have been exposed to HIV or are experiencing symptoms, it's important to see a doctor as soon as possible.

References

  1. Brenchley JM, Hill BJ, Ambrozak DR, Price DA, Guenaga FJ, Casazza JP, et al. T-cell subsets that harbor Human Immunodeficiency Virus (HIV) in vivo: implications for hiv pathogenesis. J Virol [Internet]. 2004 Feb [cited 2023 Feb 3];78(3):1160–8. Available from: https://journals.asm.org/doi/10.1128/JVI.78.3.1160-1168.2004
  2. Rainer S. Human Immunodeficiency Virus (HIV). Transfus Med Hemother [Internet]. 2016 [cited 2023 Feb 3];43(3):203–22. Available from: https://www.karger.com/Article/FullText/445852
  3. HIVinfo.NIH. The stages of HIV infection | NIH [Internet]. [cited 2023 Feb 3]. Available from: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection
  4. Centre for Disease Control and Prevention. Hiv testing | hiv/aids | cdc [Internet]. 2022 [cited 2023 Feb 3]. Available from: https://www.cdc.gov/hiv/testing/index.html
  5. Justiz Vaillant AA, Gulick PG. Hiv disease current practice. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2023 Feb 3]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK534860/
  6. World Health Organization. HIV [Internet]. [cited 2023 Feb 3]. Available from: https://www.who.int/data/gho/data/themes/hiv-aids
  7. NHS. HIV and AIDS - treatment [Internet]. nhs.uk. 2017 [cited 2023 Feb 3]. Available from: https://www.nhs.uk/conditions/hiv-and-aids/treatment/

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Aisha Mohamed

BSc (Hons) Nursing Studies (Adult), Nursing, Glasgow Caledonian University

Aisha Mohamed is a Registered Nurse (RN) with a Bachelor of Science degree in Nursing. With a strong academic background, Aisha has developed a comprehensive understanding of the medical field and has a deep commitment to providing quality patient care. Aisha currently works in clinical research specialty as she is passionate about improving community health through scientific medical research. These skills translate to her writing, as she is able to convey important medical information in a way that is easy for readers to understand.

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