HIV (Human Immunodeficiency Virus)

What is HIV?

HIV is the virus that causes c. HIV infects cells of the human immune system specifically white cells (CD4 positive T cells) which are key building blocks of the immune system. The virus destroys or damages the cells ability to function. Infection with HIV results in the progressive deterioration of the immune system leading to 'immune deficiency'.

Transmission of HIV/AIDS

The virus can be passed from person to person through the exchange of body fluids such as blood, semen or vaginal secretions through broken skin or the mucus membranes. A mucus membrane is a thin, wet tissue found in many of the openings in the human body, these include the mouth, eyes, nose, rectum, vagina and the opening of the penis. Women can pass on the infection to their unborn children during the pregnancy and/or during delivery or through breast feeding.

HIV is a fragile virus. It cannot live for very long outside the body, therefore the virus is not transmitted through activities such as a casual kiss. You cannot become infected from contact with a toilet seat, you cannot even catch HIV mosquitoes. HIV is mainly found in the blood, semen, or vaginal fluid of an infected person. HIV is transmitted in 3 main ways:

• Having sex (anal, vaginal, or oral) with someone infected with HIV
• Sharing needles and syringes with someone infected with HIV
• Being exposed (foetus or infant) to HIV before or during birth or through breast feeding

HIV also can be transmitted through blood infected with HIV. Now all donated blood is tested for HIV and therefore, the risk of HIV infection through the transfusion of blood or blood products is extremely low.

Symptoms of HIV/AIDS

Most people infected with HIV are unaware that they have become infected, because they do not feel ill immediately after infection. However, some people develop “Acute retroviral syndrome (ARS)” when the body develops antibodies to the infection, usually this happens 1 to 6 weeks after infection. ARS is a glandular fever-like illness with fever, joint pains, a rash and enlarged lymph nodes. An HIV-infected person is highly infectious during this initial period. The only way to determine whether HIV is present in a person's body is by testing for HIV antibodies or for HIV itself.

Symptoms of advanced HIV Infection

There is only one way to know whether you are infected HIV and that is to be tested for HIV. You are not likely to have any symptoms for many years. Someone can look and feel healthy but can still be infected.

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
• diarrhoea that lasts for more than a week
• white spots or unusual blemishes on the tongue, in the mouth, or in the throat
• pneumonia
• red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
• memory loss, depression, and other neurological disorders

However, no one should assume they are infected if they have any of these symptoms. Each of these symptoms can be related to other illnesses. Again, the only way to determine whether you are infected is to be tested for HIV infection.

How the different HIV stages can be recognised.

HIV is staged on the basis of certain signs, symptoms, infections, and cancers grouped by the World Health Organization (WHO).

• Primary HIV infection – there maybe no symptoms or is experienced as Acute Retroviral Syndrome
• Clinical stage 1 – none symptomatic or generalized swelling of the lymph nodes
• Clinical stage 2 - includes minor weight loss, minor problems with mucus membrains, and recurrent upper respiratory tract infections
• Clinical stage 3 - includes unexplained chronic diarrhoea, unexplained persistent fever, oral candidiasis (an infection of yeast fungi of the mucus membrain) or leukoplakia, severe bacterial infections, pulmonary tuberculosis, and acute necrotizing (unnatural death of cells and living tissue) inflammation in the mouth. Some people with clinical stage 3 have AIDS.
• Clinical stage 4 - includes 22 opportunistic infections or cancers related to HIV. All persons with clinical stage 4 have AIDS. Most of these conditions are opportunistic infections that can be treated easily in healthy people.

Treatments

HIV is an uncommon type of virus called a retrovirus, and drugs developed to disrupt the action of HIV are known as antiretrovirals or ARV's. These ARV's come in a variety of formulas designed to act at different stages within the life-cycle of HIV.

The AIDS virus mutates rapidly, which makes it quick at developing drug resistance. To minimize this risk of this, people with HIV are treated with a combination of ARV's that attack the virus on from many directions at once.

When ARV's were introduced in 1996 they transformed the treatment of HIV and AIDS, improving the quality and greatly prolonging the lives of many infected people in places where the drugs are available. However, ARV's are not a cure. If treatment is discontinued the virus becomes active again, so a person on ARV's must take them for life.

Consequences

Eventually most HIV-infected individuals develop AIDS. These individuals mostly die from opportunistic infections or cancers which tens to be related with the progressive failure of the immune system. Close to 9 out of every 10 people with HIV will progress to AIDS after 10-15 years. Without antiretroviral therapy, death normally occurs within a year.

How quickly do people infected with HIV develop AIDS?

The length of time can vary widely between people. Most people infected with HIV, if not treated, will develop signs of HIV-related illness within 5-10 years. The time between infection with HIV and being diagnosed with AIDS can be 10–15 years, or longer. Antiretroviral therapy can slow down disease progression to AIDS.

Prevention

Don't become complacent. You may think that HIV infection is no longer a problem because all the hype of a few years ago has gone away. Be warned there are an estimated 6,800 new infections every day, over 5,700 people dying from AIDS every day. (June 2008)

The UK has a relatively low prevalence of HIV and AIDS. In their latest annual report the Health Protection Agency estimated that there were 73,000 persons living with HIV in the UK in 2006 (both diagnosed and undiagnosed), amounting to 121 persons living with HIV per 100,000 population in the UK (167 among men and 76 among women).

There's no vaccine to prevent HIV infection and no cure for AIDS. It is possible however to protect yourself and others from infection. That means educating yourself about HIV and avoiding any behaviour that allows HIV-infected fluids — blood, semen, vaginal secretions and breast milk — into your body.

The following measures can help keep you from being infected with HIV:

• Learn about HIV and AIDS and spread the word. Be sure you understand what HIV is and how the virus is transmitted.
• Know the HIV status of any sexual partner. Don't be shy about asking, it is the responsible thing to do!
• Don't engage in unprotected sex unless you're absolutely certain your partner isn't infected with HIV.
• Use a latex or polyurethane condom every time you have sex. If you're allergic to latex, use a plastic (polyurethane) condom, however avoid lambskin condoms — they do not protect you from HIV since the virus has small enough molecules to pass through the lambskin condom. Beware - Oil-based lubricants can weaken latex condoms and cause them to break. During oral sex use a condom or dental dam — a piece of medical-grade latex —or plastic wrap. Remember that although condoms can reduce your risk of contracting HIV, they don't eliminate the risk entirely.
• If you use a needle to inject drugs always use a clean needle one and make sure it's sterile, and don't share it. Take advantage of needle exchange programs in your community.
• Be careful about blood products in certain countries. If an emergency requires that you receive blood or blood products in another country, get tested for HIV as soon as you return home.
• Get regular screening tests, and keep them up. If you are a woman, have a yearly Pap test. Men and women who engage in anal sex should also have regular tests for anal cancer.
• HIV/AIDS is still a terminal illness for which there is no vaccine and no cure. Right now, the only way to stay healthy is to protect yourself and others from infection.