Health Check; HIV/AIDS
Some fifteen years or thereabouts ag, the sensitization and awareness on HIV/AIDS was high. With new diseases like Ebola, Zika and Lassa fever, attention seems to be waning on HIV/AIDS. Yet, the disease is still very much with us.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
HIV stands for human immunodeficiency virus. If left untreated, HIV can lead to the disease AIDS (acquired immune deficiency syndrome). Unlike some other viruses, the human body can’t get rid of HIV completely. So once one has HIV, it is for life.
HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. If left untreated, HIV reduces the number of CD4 cells (T cells) in the body, making the person more likely to get infections or infection-related cancers. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS, the last state of HIV infection.
No effective cure for HIV currently exists, but with proper treatment and medical care, HIV can be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART. If taken the right way, every day, this medicine can dramatically prolong the lives of many people with HIV, keep them healthy, and greatly lower their chance of transmitting the virus to others.
Today, a person who is diagnosed with HIV, treated before the disease is far advanced, and stays on treatment can live nearly as long as someone who does not have HIV. The only way to know for sure if one has HIV is to get tested. Testing is relatively simple. Ask your healthcare provider for a HIV test. Many medical clinics, substance abuse programs, community health centers, and hospitals offer them too.
ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
AIDS stands for acquired immune deficiency syndrome. AIDS is the final stage of HIV infection. Not everyone who has HIV advances to this stage. AIDS is the stage of infection that occurs when the immune system is badly damaged and one becomes vulnerable to opportunistic infections. When the number of CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3), one is considered to have progressed to AIDS. (Normal CD4 counts are between 500 and 1,600 cells/mm3). One can also be diagnosed with AIDS if they develop one or more opportunistic infections, regardless of their CD4 count.
Without treatment, people who are diagnosed with AIDS typically survive about 3 years. Once one has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. People with AIDS need medical treatment to prevent death.
WHERE DID HIV COME FROM?
Scientists identified a type of chimpanzee in Central Africa as the source of HIV infection in humans. They believe that the chimpanzee version of the immunodeficiency virus (called simian immunodeficiency virus, or SIV) most likely was transmitted to humans and mutated into HIV when humans hunted these chimpanzees for meat and came into contact with their infected blood. Studies show that HIV may have jumped from apes to humans as far back as the late 1800s. Over decades, the virus slowly spread across Africa and later into other parts of the world. We know that the virus has existed in the United States since at least the mid - to late 1970s.
HOW IS HIV SPREAD?
HIV can be transmitted only through specific activities. Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use. HIV is not spread easily. Only certain body fluids from a person who has HIV can transmit HIV:
These body fluids must come into contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (by a needle or syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.
If one thinks they may have been exposed to HIV, they should get tested. Test centres are available at healthcare provider’s offices, clinics, community stand alone centres and other locations.
WAYS HIV IS TRANSMITTED
HIV does not survive long outside the human body (such as on surfaces) and it cannot reproduce outside a human host. It is not spread by:
HIV TREATMENT REDUCES TRANSMISSION RISK
People with HIV who are using antiretroviral therapy (ART) consistently and who have achieved viral suppression (having the virus reduced to an undetectable level in the body) are very unlikely to transmit the virus to their uninfected partners. However, there is still some risk of transmission, so even with an undetectable viral load, people with HIV and their partners should continue to take steps to reduce the risk of HIV transmission.
IF ONE HAS HIV, DOES THAT MEAN THEY HAVE AIDS?
No.
The terms “HIV” and “AIDS” can be confusing because both terms refer to the same disease. However, “HIV” refers to the virus itself, and “AIDS” refers to the late stage of HIV infection, when an HIV-infected person’s immune system is severely damaged and has difficulty fighting diseases and certain cancers. Before the development of certain medications, people with HIV could progress to AIDS in just a few years. But today, most people who are HIV positive do not progress to AIDS. That’s because if one has HIV and they take ART consistently, they can keep the level of HIV in their body low. This will help keep the body strong and healthy and reduce the likelihood that one will ever progress to AIDS. It will also help lower their risk of transmitting HIV to others.
HOW CAN ONE TELL IF THEY HAVE HIV?
One cannot rely on symptoms to tell whether they have HIV. The only way to know for sure is to get tested. Knowing one's status is important because it helps one make healthy decisions to prevent getting or transmitting HIV.
The symptoms of HIV vary, depending on the individual and what stage of the disease they are in:
EARLY STAGE OF HIV
Some people may experience a flu-like illness within 2-4 weeks after HIV infection. But some people may not feel sick during this stage.
Flu-like symptoms can include:
These symptoms can last anywhere from a few days to several weeks. During this time, HIV infection may not show up on an HIV test, but people who have it are highly infectious and can spread the infection to others. One should not assume they have HIV just because they have any or a combination of these symptoms. Each of these symptoms can be caused by other illnesses. And some people who have HIV do not show any symptoms at all for 10 years or more.
If one thinks they may have been exposed to HIV, get an HIV test. Most HIV tests detect antibodies (proteins the body makes as a reaction against the presence of HIV), not HIV itself. But it takes a few weeks for the body to produce these antibodies, so if one tests too early, they might not get an accurate test result. A new HIV test is available that can detect HIV directly during this early stage of infection. So one should let the tester know if they think they may have been recently infected with HIV. After getting tested, it’s important to find out the result of the test so one can talk to the healthcare provider about treatment options if they’re HIV positive or learn ways to prevent getting HIV if they’re HIV negative. One is at high risk of transmitting HIV to others during the early stage of HIV infection, even if they have no symptoms. For this reason, it is very important to take steps to reduce risk of transmission.
CLINICAL LATENCY STAGE
After the early stage of HIV infection, the disease moves into a stage called the clinical latency stage (also called “chronic HIV infection”). During this stage, HIV is still active but reproduces at very low levels. People with chronic HIV infection may not have any HIV related symptoms, or only mild ones. For people who aren’t taking medicine to treat HIV (called antiretroviral therapy or ART), this period can last a decade or longer, but some may progress through this phase faster. People who are taking medicine to treat HIV the right way, every day may be in this stage for several decades because treatment helps keep the virus in check. It’s important to remember that people can still transmit HIV to others during this phase even if they have no symptoms, although people who are on ART and stay virally suppressed (having a very low level of virus in their blood) are much less likely to transmit HIV than those who are not virally suppressed.
PROGRESSION TO AIDS
If one has HIV and they are not on ART, eventually the virus will weaken the body’s immune system and you will progress to AIDS.
Symptoms can include:
Each of these symptoms can also be related to other illnesses. So the only way to know for sure if one has HIV is to get tested. Many of the severe symptoms and illnesses of HIV disease come from the opportunistic infections that occur because the body’s immune system has been damaged.
THE GLOBAL HIV/AIDS EPIDEMIC
HIV, the virus that causes AIDS, is one of the world’s most serious health and development challenges.
According to the World Health Organization (WHO) Exit Disclaimer, there were approximately 36.9 million people worldwide living with HIV/AIDS at the end of 2014. Of these, 2.6 million were children (<15 font="" old="" years="">
According to WHO, Exit Disclaimer an estimated 2.0 million individuals worldwide became newly infected with HIV in 2014. This includes over 220,000 children (<15 africa="" and="" breastfeeding.="" by="" childbirth="" children="" during="" font="" hiv="" in="" infected="" live="" most="" mothers="" of="" or="" positive="" pregnancy="" sub-saharan="" their="" these="" were="" years="">
A UNAIDS report Exit Disclaimer shows that of the 36.9 million people living with HIV globally, 17.1 do not know they have the virus and need to be reached with HIV testing services, and around 22 million do not have access to HIV treatment, including 1.8 million children. The vast majority of people living with HIV are in low and middle income countries. According to WHO, Exit Disclaimer sub-Saharan Africa is the most affected region, with 25.8 million people living with HIV in 2014. Sub-Saharan Africa accounts for almost 70 percent of the global total of new HIV infections.
According to WHO, Exit Disclaimer an estimated 34 million people have died from AIDS-related causes so far, including 1.2 million in 2014. Even today, despite advances in our scientific understanding of HIV and its prevention and treatment as well as years of significant effort by the global health community and leading government and civil society organizations, most people living with HIV or at risk for HIV do not have access to prevention, care, and treatment, and there is still no cure. However, effective treatment with antiretroviral drugs can control the virus so that people with HIV can enjoy healthy lives and reduce the risk of transmitting the virus to others.
The HIV epidemic not only affects the health of individuals, it impacts households, communities, and the development and economic growth of nations. Many of the countries hardest hit by HIV also suffer from other infectious diseases, food insecurity, and other serious problems. Despite these challenges, there have been successes and promising signs. New global efforts have been mounted to address the epidemic, particularly in the last decade. Prevention has helped to reduce HIV prevalence rates in a small but growing number of countries and new HIV infections are believed to be on the decline. In addition, the number of people with HIV receiving treatment in resource poor countries has dramatically increased in the past decade.
According to UNAIDS, Exit Disclaimer in June 2015, 15.8 million people living with HIV were accessing antiretroviral therapy (ART) globally, up from 13.6 million in June 2014. Progress has been made in preventing mother-to-child transmission of HIV and keeping mothers alive. According to UNAIDS, Exit Disclaimer in 2014, 73% of the estimated 1.5 million pregnant women living with HIV globally were accessing antiretroviral therapy to avoid transmission of HIV to their children; new HIV infections among children were reduced by 58% from 2000 to 2014.
HUMAN IMMUNODEFICIENCY VIRUS (HIV)
HIV stands for human immunodeficiency virus. If left untreated, HIV can lead to the disease AIDS (acquired immune deficiency syndrome). Unlike some other viruses, the human body can’t get rid of HIV completely. So once one has HIV, it is for life.
HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. If left untreated, HIV reduces the number of CD4 cells (T cells) in the body, making the person more likely to get infections or infection-related cancers. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS, the last state of HIV infection.
No effective cure for HIV currently exists, but with proper treatment and medical care, HIV can be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART. If taken the right way, every day, this medicine can dramatically prolong the lives of many people with HIV, keep them healthy, and greatly lower their chance of transmitting the virus to others.
Today, a person who is diagnosed with HIV, treated before the disease is far advanced, and stays on treatment can live nearly as long as someone who does not have HIV. The only way to know for sure if one has HIV is to get tested. Testing is relatively simple. Ask your healthcare provider for a HIV test. Many medical clinics, substance abuse programs, community health centers, and hospitals offer them too.
ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)
AIDS stands for acquired immune deficiency syndrome. AIDS is the final stage of HIV infection. Not everyone who has HIV advances to this stage. AIDS is the stage of infection that occurs when the immune system is badly damaged and one becomes vulnerable to opportunistic infections. When the number of CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3), one is considered to have progressed to AIDS. (Normal CD4 counts are between 500 and 1,600 cells/mm3). One can also be diagnosed with AIDS if they develop one or more opportunistic infections, regardless of their CD4 count.
Without treatment, people who are diagnosed with AIDS typically survive about 3 years. Once one has a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year. People with AIDS need medical treatment to prevent death.
WHERE DID HIV COME FROM?
Scientists identified a type of chimpanzee in Central Africa as the source of HIV infection in humans. They believe that the chimpanzee version of the immunodeficiency virus (called simian immunodeficiency virus, or SIV) most likely was transmitted to humans and mutated into HIV when humans hunted these chimpanzees for meat and came into contact with their infected blood. Studies show that HIV may have jumped from apes to humans as far back as the late 1800s. Over decades, the virus slowly spread across Africa and later into other parts of the world. We know that the virus has existed in the United States since at least the mid - to late 1970s.
HOW IS HIV SPREAD?
HIV can be transmitted only through specific activities. Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use. HIV is not spread easily. Only certain body fluids from a person who has HIV can transmit HIV:
- Blood
- Semen (cum)
- Pre-seminal fluid (pre-cum)
- Rectal fluids
- Vaginal fluids
- Breast milk
These body fluids must come into contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (by a needle or syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.
If one thinks they may have been exposed to HIV, they should get tested. Test centres are available at healthcare provider’s offices, clinics, community stand alone centres and other locations.
WAYS HIV IS TRANSMITTED
- Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV.
- Anal sex is the highest-risk sexual behavior. For the HIV-negative partner, receptive anal sex (“bottoming”) is riskier than insertive anal sex (“topping”).
- Vaginal sex is the second highest-risk sexual behavior.
- Sharing needles or syringes, rinse water, or other equipment (“works”) used to prepare injection drugs with someone who has HIV. HIV can live on a used needle up to 42 days depending on temperature and other factors.
- From mother to child during pregnancy, birth, and/or breastfeeding. Although the risk can be high if a mother is living with HIV and not taking medicine, recommendations to test all pregnant women for HIV and start HIV treatment immediately have lowered the number of babies who are born with HIV.
- By being pricked with an HIV-contaminated needle or other sharp object. This is a risk mainly for health care workers.
- Oral sex - putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (rimming). In general, there is little to no risk of getting HIV from oral sex. But transmission of HIV, though extremely rare, is theoretically possible if an HIV-positive man ejaculates in his partner’s mouth during oral sex.
- Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This was more common in the early years of HIV, but now the risk is extremely small because of rigorous testing of blood supply and donated organs and tissues.
- Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver’s mouth mixes with food while chewing. The only known cases are among infants.
- Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken.
- Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids.
- Deep, open-mouth kissing. If the person with HIV has sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream of the HIV-negative partner. HIV is not spread through saliva.
HIV IS NOT SPREAD BY
HIV does not survive long outside the human body (such as on surfaces) and it cannot reproduce outside a human host. It is not spread by:
- Air or water.
- Mosquitoes, ticks or other insects.
- Saliva, tears, or sweat that is not mixed with the blood of an HIV-positive person.
- Shaking hands, hugging, sharing toilets, sharing dishes/drinking glasses, or closed-mouth or “social” kissing with someone who is HIV-positive.
- Drinking fountains.
- Other sexual activities that don’t involve the exchange of body fluids (for example, touching).
HIV TREATMENT REDUCES TRANSMISSION RISK
People with HIV who are using antiretroviral therapy (ART) consistently and who have achieved viral suppression (having the virus reduced to an undetectable level in the body) are very unlikely to transmit the virus to their uninfected partners. However, there is still some risk of transmission, so even with an undetectable viral load, people with HIV and their partners should continue to take steps to reduce the risk of HIV transmission.
IF ONE HAS HIV, DOES THAT MEAN THEY HAVE AIDS?
No.
The terms “HIV” and “AIDS” can be confusing because both terms refer to the same disease. However, “HIV” refers to the virus itself, and “AIDS” refers to the late stage of HIV infection, when an HIV-infected person’s immune system is severely damaged and has difficulty fighting diseases and certain cancers. Before the development of certain medications, people with HIV could progress to AIDS in just a few years. But today, most people who are HIV positive do not progress to AIDS. That’s because if one has HIV and they take ART consistently, they can keep the level of HIV in their body low. This will help keep the body strong and healthy and reduce the likelihood that one will ever progress to AIDS. It will also help lower their risk of transmitting HIV to others.
HOW CAN ONE TELL IF THEY HAVE HIV?
One cannot rely on symptoms to tell whether they have HIV. The only way to know for sure is to get tested. Knowing one's status is important because it helps one make healthy decisions to prevent getting or transmitting HIV.
The symptoms of HIV vary, depending on the individual and what stage of the disease they are in:
- The early stage.
- The clinical latency stage.
- AIDS (the late stage of HIV infection).
EARLY STAGE OF HIV
Some people may experience a flu-like illness within 2-4 weeks after HIV infection. But some people may not feel sick during this stage.
Flu-like symptoms can include:
- Fever
- Chills
- Rash
- Night sweats
- Muscle aches
- Sore throat
- Fatigue
- Swollen lymph nodes
- Mouth ulcers
These symptoms can last anywhere from a few days to several weeks. During this time, HIV infection may not show up on an HIV test, but people who have it are highly infectious and can spread the infection to others. One should not assume they have HIV just because they have any or a combination of these symptoms. Each of these symptoms can be caused by other illnesses. And some people who have HIV do not show any symptoms at all for 10 years or more.
If one thinks they may have been exposed to HIV, get an HIV test. Most HIV tests detect antibodies (proteins the body makes as a reaction against the presence of HIV), not HIV itself. But it takes a few weeks for the body to produce these antibodies, so if one tests too early, they might not get an accurate test result. A new HIV test is available that can detect HIV directly during this early stage of infection. So one should let the tester know if they think they may have been recently infected with HIV. After getting tested, it’s important to find out the result of the test so one can talk to the healthcare provider about treatment options if they’re HIV positive or learn ways to prevent getting HIV if they’re HIV negative. One is at high risk of transmitting HIV to others during the early stage of HIV infection, even if they have no symptoms. For this reason, it is very important to take steps to reduce risk of transmission.
CLINICAL LATENCY STAGE
After the early stage of HIV infection, the disease moves into a stage called the clinical latency stage (also called “chronic HIV infection”). During this stage, HIV is still active but reproduces at very low levels. People with chronic HIV infection may not have any HIV related symptoms, or only mild ones. For people who aren’t taking medicine to treat HIV (called antiretroviral therapy or ART), this period can last a decade or longer, but some may progress through this phase faster. People who are taking medicine to treat HIV the right way, every day may be in this stage for several decades because treatment helps keep the virus in check. It’s important to remember that people can still transmit HIV to others during this phase even if they have no symptoms, although people who are on ART and stay virally suppressed (having a very low level of virus in their blood) are much less likely to transmit HIV than those who are not virally suppressed.
PROGRESSION TO AIDS
If one has HIV and they are not on ART, eventually the virus will weaken the body’s immune system and you will progress to AIDS.
Symptoms can include:
- Rapid weight loss
- Recurring fever or profuse night sweats
- Extreme and unexplained tiredness
- Prolonged swelling of the lymph glands in the armpits, groin, or neck
- Diarrhea that lasts for more than a week
- Sores of the mouth, anus, or genitals
- Pneumonia
- Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
- Memory loss, depression, and other neurologic disorders
Each of these symptoms can also be related to other illnesses. So the only way to know for sure if one has HIV is to get tested. Many of the severe symptoms and illnesses of HIV disease come from the opportunistic infections that occur because the body’s immune system has been damaged.
THE GLOBAL HIV/AIDS EPIDEMIC
HIV, the virus that causes AIDS, is one of the world’s most serious health and development challenges.
According to the World Health Organization (WHO) Exit Disclaimer, there were approximately 36.9 million people worldwide living with HIV/AIDS at the end of 2014. Of these, 2.6 million were children (<15 font="" old="" years="">
According to WHO, Exit Disclaimer an estimated 2.0 million individuals worldwide became newly infected with HIV in 2014. This includes over 220,000 children (<15 africa="" and="" breastfeeding.="" by="" childbirth="" children="" during="" font="" hiv="" in="" infected="" live="" most="" mothers="" of="" or="" positive="" pregnancy="" sub-saharan="" their="" these="" were="" years="">
A UNAIDS report Exit Disclaimer shows that of the 36.9 million people living with HIV globally, 17.1 do not know they have the virus and need to be reached with HIV testing services, and around 22 million do not have access to HIV treatment, including 1.8 million children. The vast majority of people living with HIV are in low and middle income countries. According to WHO, Exit Disclaimer sub-Saharan Africa is the most affected region, with 25.8 million people living with HIV in 2014. Sub-Saharan Africa accounts for almost 70 percent of the global total of new HIV infections.
According to WHO, Exit Disclaimer an estimated 34 million people have died from AIDS-related causes so far, including 1.2 million in 2014. Even today, despite advances in our scientific understanding of HIV and its prevention and treatment as well as years of significant effort by the global health community and leading government and civil society organizations, most people living with HIV or at risk for HIV do not have access to prevention, care, and treatment, and there is still no cure. However, effective treatment with antiretroviral drugs can control the virus so that people with HIV can enjoy healthy lives and reduce the risk of transmitting the virus to others.
The HIV epidemic not only affects the health of individuals, it impacts households, communities, and the development and economic growth of nations. Many of the countries hardest hit by HIV also suffer from other infectious diseases, food insecurity, and other serious problems. Despite these challenges, there have been successes and promising signs. New global efforts have been mounted to address the epidemic, particularly in the last decade. Prevention has helped to reduce HIV prevalence rates in a small but growing number of countries and new HIV infections are believed to be on the decline. In addition, the number of people with HIV receiving treatment in resource poor countries has dramatically increased in the past decade.
According to UNAIDS, Exit Disclaimer in June 2015, 15.8 million people living with HIV were accessing antiretroviral therapy (ART) globally, up from 13.6 million in June 2014. Progress has been made in preventing mother-to-child transmission of HIV and keeping mothers alive. According to UNAIDS, Exit Disclaimer in 2014, 73% of the estimated 1.5 million pregnant women living with HIV globally were accessing antiretroviral therapy to avoid transmission of HIV to their children; new HIV infections among children were reduced by 58% from 2000 to 2014.
Culled and edited. Images: Google
VERY GOOD ARTICLE.
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