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The Human Immunodeficiency Virus attacks the immune system and weakens a human’s body defense and the mechanisms that work against infections, as well as against certain types of cancer. This virus damages the immune cell functions and eventually destroys them. Thus, each infected person becomes immunodeficient, which means that the immunity system of a person is highly affected. When immunodeficiency is present, the patient is particularly sensitive to a large number of infections (which are usually caused by harmless germs that are normally easy to get rid of). Mild immune deficiencies are common, but when they are caused by HIV or AIDS they become definitive and much worse.
HIV denotes two related viruses that can be found in the retroviruses category. A retrovirus can never be removed from the human body because it enters its genetic code into the host’s one. HIV attacks the white cells which are called CD4 T lymphocytes, which protect the body against the apparition of infections. The attacked cells become malignant and after a while they are destroyed, and they disappear. The virus, however, will look for other cells to damage, making the body lack lymphocytes severely, leaving it unprotected. In a healthy person, the CD4 T lymphocyte healthy value should be between 600 and 1200. In a person who is HIV positive, the number may decrease to less than 200.
The HIV-1 type is divided into three different groups: M, N and O, respectively. The M subtype virus is the most widespread one, and this is the reason why it is divided in another ten categories: A-J. The latter one is particularly present in several parts of Europe and North America.
The HIV-2 type is divided into five different viruses: A-E. These subtypes are often encountered in West Africa. Lately, many cases of HIV-2 have been discovered in Europe as well.
The incubation period of HIV can extend up to several years or even decades. HIV is responsible for the onset of AIDS. When the number of CD4 T lymphocytes decreases that much, the body can no longer defend itself from viruses, fungi and bacteria. This means that the HIV infection evolves to the stage of AIDS (Acquired Immune Deficiency Syndrome). Yet, AIDS is not a unidirectional disease. It implies suffering from a complex combination of different diseases contracted because of the apparition of immunodeficiency. A normal organism can fight against such diseases without any help, while HIV-infected people cannot. Thus, AIDS is a syndrome, a set of signs and symptoms that people who are infected with HIV can encounter when the virus activates.
AIDS cannot be literally transmitted from one person to another, being a complex of diseases. The one that can be contracted is HIV, present in the body of an infected person in different kinds of concentrations. Biological fluids like blood, sperm, discharges, breast milk, feces, urine, saliva, tears or other are the ones that carry the virus and eventually transmit it. The most common way of contracting HIV is by sexual intercourse. Unprotected sex, whether vaginal, anal or oral can be the potential cause of contracting HIV. The most important precaution method would be using a condom. For proper transmission, HIV requires a gateway to the unaffected host which is usually represented by open wounds, lesions in the mouth, lesions in the genital area etc. The risk of getting HIV-infected increases in the case of multiple sexual partners and an inappropriate behavior.
HIV can be contracted by:
If one is accidentally infected with HIV and knows with certainty the time and date of the possible infection, there are methods of preventing the installation of the virus, 28 days post-exposure. The prophylaxis can begin as soon as 2 hours after contact. The first dose of prevention medication should be administered in the first 24h post-contact.
HIV is not transmitted through simple physical contact like hugs, cheek kisses or other kinds of contact where the concentration of infected fluids is too small for contracting the disease. Though, the situation changes the moment when blood is present in any of the fluids exchanged. Therefore, the mere presence of an infected person in the community when no fluid exchange in large quantities involved won’t represent any danger. The virus is not transmitted by insect bites or pets either, because it cannot transmit from a species to another. Needless to say, personal hygiene items shouldn’t be shared, for minimizing the risk of contracting the disease.
After HIV reaches the host cells, the viral replication (the rapid multiplication of the virus inside the human body) can occur either immediately after the infection either in time, inside the mononuclear cells. However, the preferred location for HIV replication is inside the lymphoid tissues (the lymph nodes, the spleen, the liver, the spinal cord). HIV can also be found in intestines or epithelial cells in the genital tract.
The HIV test reveals the stage of the infection by detecting the presence or absence of HIV antibodies in the blood. Antibodies are the “product” of the immune system and have the purpose of fighting against foreign pathogens. In the window period, HIV antibodies are produced continuously without being detectable. This early stage is the most contagious period, but transmission may take place throughout the entire course of the disease. It is recommended to repeat the test three months after the initial one, which is considered sufficient for the production and detection of antibodies. The occurrence of a positive test three months after the last exposure to risk of infection confirms the initial diagnosis.
The outcome of the HIV test is confidential. People tested, with a positive result, are infected and receive counseling, specialist medical assessment and appropriate treatment. In addition, they are being told what measures they must take to prevent spreading the infection.
HIV infection can be asymptomatic for up to 10 years. The infected person may or may not experience symptoms during the whole incubation period of the virus, starting to notice differences when AIDS occurs. Flu-like reactions are extremely common 1-5 weeks immediately after contracting the virus (fever, rashes, axillary adenopathy, headaches, fatigue etc.) This phase is called by specialists the acute phase of HIV infection. These flu-like symptoms disappear after maximum one month, making the infected person feeling alright again. In this phase, the virus is present and transmissible.
After several years, the virus will reactivate and begin to multiply rapidly. At this moment, AIDS occurs. Because the initial infection doesn’t have specific symptoms that can easily be differentiated, the presence of absence of signs is not a relevant way to decide either a person is infected or not. Blood testing is the only certain way to determine if a person is infected with HIV. Even so, the antibodies won’t be visible in blood immediately after the infection occurs. There is a period that can extend up to 6 months, called window period (or immunological period) when testing for HIV results can end up being negative even though the person is already infected.
Once suffering from AIDS, the disease will continuously evolve and expand. An AIDS patient will have the immune system so affected that that suffering from mild infections such as pneumonia, a simple cold or a rash can lead to death. Developing skin cancer, tuberculosis and losing a lot of weight in a short period of time are associated with patients dealing with AIDS. The WHO (World Health Organization) considers AIDS a pandemic disease. WHO claims that approximately 5 million people are annually infected with HIV.
Mycotic, viral, bacterial infections can all be triggered by AIDS. More specifically, a patient who developed AIDS can present the following affections:
As soon as 2 to 5 weeks after the initial infection, the patient will start experiencing the aforementioned flu-like symptoms (high fever, nocturnal sweating, nausea, headaches, muscle pain etc.). Unfortunately, these symptoms can be easily compared with many other diseases, meaning that diagnosing HIV infection just by the signs appeared is not possible.
This phase usually lasts for a few years and it includes the rapid multiplication of HIV. People who are diagnosed and soon treated for HIV infection experience no physical or clinical symptoms. Even though no physical symptoms are involved, people who are in this situation should consider seeing a psychologist regularly to help them cope with having AIDS. A patient is going to experience different emotional states which might be difficult to overcome.
When the symptoms that the patient experienced in the very first phase of HIV infection return, it means that the chronic phase begun. The difference between the acute phase and this one is that the symptoms will persist in time, becoming permanent and resistant to every kind of treatment administered. This is the moment when the immune system is entirely compromised, and the installation of AIDS will start.
This is the moment when AIDS is triggered and can be diagnosed. These are called opportunistic infections. In a healthy, non-HIV-infected person, all these infections can be treated, and they do not represent any danger due to the immune system that works at its full capacity. In AIDS, because of the damage to the immune system, opportunistic infections are out of control and their treatment is severely hampered. CD4 T lymphocytes are the ones that indicate the degree of damage caused to the immune system. Lowering them below 200-400 cells / mL requires starting an antiretroviral therapy.
AIDS was initially perceived as a death sentence because of the lack of treatment available in the 90s. Yet, once technology evolved, so did the treatment. HIV-infected patients are now promised to reach old age without any trouble if following certain treatments, even this disease has a very low estimated life expectancy. The HIV/AIDS treatment method is extremely complex and needs to be administered rigorously.
HIV-infected people are strongly advised to adopt a very strict lifestyle that doesn’t imply tobacco or alcohol. Plenty of rest is also recommended, besides following the treatment scheme provide. Fortunately, the treatment for AIDS is free of charge in most of the countries, so everyone can reach out and ask for help. If all these conditions are met, the life expectancy will grow exponentially, and the patient will be able to lead a normal life.
HIV can be kept under control by using antiretroviral therapy. More than 10 million HIV / AIDS infected people who are living in low to middle income countries receive the treatment scheme as they are supposed to. According to the statistics at the end of the year 2011, almost 1 million of these people are children. 60% of the people suffering from AIDS are receiving proper treatment.
Last updated on March 2nd, 2018