HIV/AIDS
Definition:
AIDS is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight the organisms that cause disease.
HIV is a sexually transmitted infection. It can also be spread by contact with infected blood, or from mother to child during pregnancy, childbirth or breast-feeding. It can take years before HIV weakens your immune system to the point that you have AIDS.
There's no cure for HIV/AIDS, but there are medications that can dramatically slow the progression of the disease. These drugs have reduced AIDS deaths in many developed nations. But HIV continues to decimate populations in Africa, Haiti and parts of Asia.
Symptoms:
The symptoms of HIV and AIDS vary, depending on the phase of infection.
Primary infection
The majority of people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible symptoms include:
Clinical latent infection
In some people, persistent swelling of lymph nodes occurs during clinical latent HIV. Otherwise, there are no specific signs and symptoms. HIV remains in the body, however, as free virus and in infected white blood cells.
Clinical latent infection typically lasts eight to 10 years. A few people stay in this stage even longer, but others progress to more-severe disease much sooner.
Early symptomatic HIV infection
As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such as:
If you receive no treatment for your HIV infection, the disease typically progresses to AIDS in about 10 years. By the time AIDS develops, your immune system has been severely damaged, making you susceptible to opportunistic infections — diseases that wouldn't trouble a person with a healthy immune system. The signs and symptoms of some of these infections may include:
If you think you may have been infected with HIV or are at risk of contracting the virus, see a health care provider as soon as possible.
Causes:
Scientists believe a virus similar to HIV first occurred in some populations of chimps and monkeys in Africa, where they're hunted for food. Contact with an infected monkey's blood during butchering or cooking may have allowed the virus to cross into humans and become HIV.
How does HIV become AIDS?
HIV destroys CD4 cells — a specific type of white blood cell that plays a large role in helping your body fight disease. Your immune system weakens as more CD4 cells are killed. You can have an HIV infection for years before it progresses to AIDS.
People infected with HIV progress to AIDS when their CD4 count falls below 200 or they experience an AIDS-defining complication, such as:
To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. You can't become infected through ordinary contact — hugging, kissing, dancing or shaking hands — with someone who has HIV or AIDS. HIV can't be transmitted through the air, water or via insect bites.
You can become infected with HIV in several ways, including:
HIV infection weakens your immune system, making you highly susceptible to all sorts of infections and certain types of cancers.
Infections common to HIV/AIDS
There's no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each of the classes of anti-HIV drugs blocks the virus in different ways. It's best to combine at least three drugs from two different classes to avoid creating strains of HIV that are immune to single drugs. The classes of anti-HIV drugs include:
Current guidelines indicate that treatment should begin if:
HIV treatment regimens may involve taking multiple pills at specific times every day for the rest of your life. Side effects can include:
Some health issues that are a natural part of aging may be more difficult to manage if you have HIV. Some medications that are common for age-related cardiovascular, metabolic and bone conditions, for example, may not interact well with anti-HIV medications. Talk to your doctor about other conditions you're receiving medication for. There are also known interactions between anti-HIV drugs and:
Your response to any treatment is measured by your viral load and CD4 counts. Viral load should be tested at the start of treatment and then every three to four months during therapy. CD4 counts should be checked every three to six months.
HIV treatment should reduce your viral load to the point that it's undetectable. That doesn't mean your HIV is gone. It just means that the test isn't sensitive enough to detect it. You can still transmit HIV to others when your viral load is undetectable.
Definition:
AIDS is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight the organisms that cause disease.
HIV is a sexually transmitted infection. It can also be spread by contact with infected blood, or from mother to child during pregnancy, childbirth or breast-feeding. It can take years before HIV weakens your immune system to the point that you have AIDS.
There's no cure for HIV/AIDS, but there are medications that can dramatically slow the progression of the disease. These drugs have reduced AIDS deaths in many developed nations. But HIV continues to decimate populations in Africa, Haiti and parts of Asia.
Symptoms:
The symptoms of HIV and AIDS vary, depending on the phase of infection.
Primary infection
The majority of people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible symptoms include:
- Fever
- Muscle soreness
- Rash
- Headache
- Sore throat
- Mouth or genital ulcers
- Swollen lymph glands, mainly on the neck
- Joint pain
- Night sweats
- Diarrhea
Clinical latent infection
In some people, persistent swelling of lymph nodes occurs during clinical latent HIV. Otherwise, there are no specific signs and symptoms. HIV remains in the body, however, as free virus and in infected white blood cells.
Clinical latent infection typically lasts eight to 10 years. A few people stay in this stage even longer, but others progress to more-severe disease much sooner.
Early symptomatic HIV infection
As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such as:
- Fever
- Fatigue
- Swollen lymph nodes — often one of the first signs of HIV infection
- Diarrhea
- Weight loss
- Cough and shortness of breath
If you receive no treatment for your HIV infection, the disease typically progresses to AIDS in about 10 years. By the time AIDS develops, your immune system has been severely damaged, making you susceptible to opportunistic infections — diseases that wouldn't trouble a person with a healthy immune system. The signs and symptoms of some of these infections may include:
- Soaking night sweats
- Shaking chills or fever higher than 100 F (38 C) for several weeks
- Cough and shortness of breath
- Chronic diarrhea
- Persistent white spots or unusual lesions on your tongue or in your mouth
- Headaches
- Persistent, unexplained fatigue
- Blurred and distorted vision
- Weight loss
- Skin rashes or bumps
If you think you may have been infected with HIV or are at risk of contracting the virus, see a health care provider as soon as possible.
Causes:
Scientists believe a virus similar to HIV first occurred in some populations of chimps and monkeys in Africa, where they're hunted for food. Contact with an infected monkey's blood during butchering or cooking may have allowed the virus to cross into humans and become HIV.
How does HIV become AIDS?
HIV destroys CD4 cells — a specific type of white blood cell that plays a large role in helping your body fight disease. Your immune system weakens as more CD4 cells are killed. You can have an HIV infection for years before it progresses to AIDS.
People infected with HIV progress to AIDS when their CD4 count falls below 200 or they experience an AIDS-defining complication, such as:
- Pneumocystis pneumonia
- Cytomegalovirus
- Tuberculosis
- Toxoplasmosis
- Cryptosporidiosis
To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. You can't become infected through ordinary contact — hugging, kissing, dancing or shaking hands — with someone who has HIV or AIDS. HIV can't be transmitted through the air, water or via insect bites.
You can become infected with HIV in several ways, including:
- During sex. You may become infected if you have vaginal, anal or oral sex with an infected partner whose blood, semen or vaginal secretions enter your body. The virus can enter your body through mouth sores or small tears that sometimes develop in the rectum or vagina during sexual activity.
- Blood transfusions. In some cases, the virus may be transmitted through blood transfusions. American hospitals and blood banks now screen the blood supply for HIV antibodies, so this risk is very small.
- Sharing needles. HIV can be transmitted through needles and syringes contaminated with infected blood. Sharing intravenous drug paraphernalia puts you at high risk of HIV and other infectious diseases such as hepatitis.
- From mother to child. Infected mothers can infect their babies during pregnancy or delivery, or through breast-feeding. But if women receive treatment for HIV infection during pregnancy, the risk to their babies is significantly reduced.
HIV infection weakens your immune system, making you highly susceptible to all sorts of infections and certain types of cancers.
Infections common to HIV/AIDS
- Tuberculosis (TB). In resource-poor nations, TB is the most common opportunistic infection associated with HIV and a leading cause of death among people living with AIDS. Millions of people are currently infected with both HIV and tuberculosis, and many experts consider the two diseases twin epidemics.
- Salmonellosis. You contract this bacterial infection from contaminated food or water. Symptoms include severe diarrhea, fever, chills, abdominal pain and, occasionally, vomiting. Although anyone exposed to salmonella bacteria can become sick, salmonellosis is far more common in people who are HIV-positive.
- Cytomegalovirus (CMV). This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.
- Candidiasis. Candidiasis is a common HIV-related infection. It causes inflammation and a thick white coating on the mucous membranes of your mouth, tongue, esophagus or vagina. Children may have especially severe symptoms in the mouth or esophagus, which can make eating painful and difficult.
- Cryptococcal meningitis. Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus that is present in soil. It may also be associated with bird or bat droppings.
- Toxoplasmosis. This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasites in their stools, and the parasites may then spread to other animals.
- Cryptosporidiosis. This infection is caused by an intestinal parasite that's commonly found in animals. You contract cryptosporidiosis when you ingest contaminated food or water. The parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhea in people with AIDS.
- Kaposi's sarcoma. Kaposi's sarcoma is a tumor of the blood vessel walls. Although rare in people not infected with HIV, it's common in HIV-positive people. Kaposi's sarcoma usually appears as pink, red or purple lesions on the skin and mouth. In people with darker skin, the lesions may look dark brown or black. Kaposi's sarcoma can also affect the internal organs, including the digestive tract and lungs.
- Lymphomas. This type of cancer originates in your white blood cells. Lymphomas usually begin in your lymph nodes. The most common early sign is painless swelling of the lymph nodes in your neck, armpit or groin.
- Wasting syndrome. Aggressive treatment regimens have reduced the number of cases of wasting syndrome, but it does still affect many people with AIDS. It is defined as a loss of at least 10 percent of body weight and is often accompanied by diarrhea, chronic weakness and fever.
- Neurological complications. Although AIDS doesn't appear to infect the nerve cells, it can still cause neurological symptoms such as confusion, forgetfulness, depression, anxiety and trouble walking. One of the most common neurological complications is AIDS dementia complex, which leads to behavioral changes and diminished mental functioning.
- Kidney disease. HIV-associated nephropathy (HIV AN) is an inflammation of the tiny filters in your kidneys that remove excess fluid and wastes from your bloodstream and pass them to your urine. Because of a genetic predisposition, the risk of developing HIV AN is much higher in African Americans. Regardless of CD4 count, anti-retroviral therapy should be started in people diagnosed with HIV AN who are not already being treated.
There's no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each of the classes of anti-HIV drugs blocks the virus in different ways. It's best to combine at least three drugs from two different classes to avoid creating strains of HIV that are immune to single drugs. The classes of anti-HIV drugs include:
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
- Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).
- Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
- Entry or fusion inhibitors. These drugs block HIV's entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
- Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its genetic material into CD4 cells.
Current guidelines indicate that treatment should begin if:
- You have severe symptoms
- Your CD4 count is under 500
- You're pregnant
- You have HIV-related kidney disease
- You're being treated for hepatitis B
HIV treatment regimens may involve taking multiple pills at specific times every day for the rest of your life. Side effects can include:
- Nausea, vomiting or diarrhea
- Abnormal heartbeats
- Shortness of breath
- Skin rash
- Weakened bones
- Bone death, particularly in the hip joints
Some health issues that are a natural part of aging may be more difficult to manage if you have HIV. Some medications that are common for age-related cardiovascular, metabolic and bone conditions, for example, may not interact well with anti-HIV medications. Talk to your doctor about other conditions you're receiving medication for. There are also known interactions between anti-HIV drugs and:
- Contraceptives and hormones for women
- Medications for the treatment of tuberculosis
- Drugs to treat hepatitis C
Your response to any treatment is measured by your viral load and CD4 counts. Viral load should be tested at the start of treatment and then every three to four months during therapy. CD4 counts should be checked every three to six months.
HIV treatment should reduce your viral load to the point that it's undetectable. That doesn't mean your HIV is gone. It just means that the test isn't sensitive enough to detect it. You can still transmit HIV to others when your viral load is undetectable.
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