Acquired Immune Deficiency Syndrome (AIDS)

What are AIDS and HIV?

The full form of AIDS is Acquired Immunodeficiency Syndrome, and HIV stands for Human Immunodeficiency Virus.

HIV is a virus and AIDS is a medical condition. AIDS appears in advanced stages of HIV infection, whereby there is a complete failure of the immune system in the body. Both the virus and the syndrome are often referred to together as HIV/AIDS.

In simple terms, it means that when the HIV attacks the body, the immune system gets compromised in a major way. The body is unable to fight numerous infections which a person with a healthy immune system can usually do. Therefore “opportunistic” infections set in, which the body is unable to fight and ultimately succumbs.

Causes and risk factors

Causes

HIV which is found in the body fluids (semen, vaginal fluids, blood, and breast milk) of an infected person can enter the body of a healthy individual in the following ways:

  • Unprotected sex with a person who is HIV+ve: Vaginal, oral, and anal sex or sharing sex toys, which causes contact with the infected sexual secretions.
  • From mother to baby: This can happen during pregnancy, childbirth and through breastfeeding.
  • Blood transfusion: Blood transfusion with infected blood which has not been properly screened and sharing infected syringes by drug users.

The thing to understand is that body fluids tend to have a very ‘heavy virus load’ and therefore, even a single episode of contact is enough for getting infected which is very rare.   For example:

  • While eating food, which has been pre-chewed by an HIV-infected person.
  • When an HIV-infected person bites, there is a risk of transmission if the skin is broken.
  • Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids.

There are a lot of misconceptions about HIV/AIDS. The disease cannot spread by:

  • Casual touch like shaking hands, hugging, casual kissing, touching, etc.
  • Sneezing
  • Sharing towels
  • Air or water
  • Insects including mosquitoes or ticks
  • Saliva, tears or sweat
  • Toilet seats

Symptoms and signs

Many people infected with HIV have no symptoms for several years and may, in fact, be even unaware that they are infected. Others may have flu-like symptoms usually two to six weeks after catching the virus and the symptoms can last up to four weeks.

Some of the symptoms of early HIV infection can be:

  • Fever
  • Body ache
  • Sore throat
  • Chills
  • Sweating particularly at night
  • Enlarged glands
  • Red rashes
  • Weakness
  • Weight loss

A Symptomatic HIV infection: Sometimes these initial symptoms may disappear altogether for up to 10 years, and the person may look absolutely healthy and fine. But all the while the virus will silently damage the immune system and will suddenly flare up after so many years.

Late-stage HIV infection: At this point the HIV has destroyed the immune system and left it vulnerable to all infections and illnesses. This stage is termed as AIDS.

Signs and symptoms of late-stage HIV infection: This stage may include chronic and persistent diarrhea, dry cough, blurred vision, shortness of breath,  fever lasting for weeks, extreme weakness, night sweats, weight loss, swollen glands etc. This is also when the illnesses can set in, for instance, pneumonia, cancer, tuberculosis, etc.

Diagnosis

If a person suspects that he/she may have come in contact with the virus, then it is crucial to get tested as soon as possible. Early diagnosis and management of the disease are of prime importance in ensuring a longer and better quality of life.

HIV testing is done through a virology test on blood samples. If the blood test is ‘positive’ then retesting is done several times over a period of time to confirm the diagnosis.

Retesting is necessary because sometimes it takes three weeks to three months for the virus to show up in the blood samples. So if a patient’s most ‘at risk moment’ of infection was within the last three months, then he/she should go for the test immediately.

Treatment and prevention

Treatment

Currently, there is no vaccine or cure for HIV/AIDS and the only aim of treatment is to control the spread of the virus.

  • HAART (Highly Active Antiretroviral Therapy): It is a combination of drugs. The treatment is usually lifelong and in this way the person can hope to live for about 10-15 years.
  • Emergency HIV pills: If the person feels that there has been exposure to the virus in the last 72 hours then post-exposure prophylaxis (PEP) medication (Which lasts up to 4 weeks) is to be taken immediately and it may help to stop the infection.

PREVENTION

There is a saying that prevention is better than cure. This proverb can be applied to AIDS with a slight variation- prevention is better as there is no cure.

Sexual Contact

  • Sex education programmes in schools
  • Easily accessible voluntary counselling and testing centres
  • Promotion of safer sex practices (delaying sexual debut, condom use, and fewer sexual partners)
  • Effective Antiretroviral Therapy treatment of HIV-infected individuals
  • Pre-exposure prophylaxis for high-risk groups
  • Male circumcision

Parenteral

  • Blood Product Transmission: Donor questionnaire, routine screening of donated blood
  • Injection drug use: Education, needle/syringe exchange, avoidance of ‘shooting galleries’, methadone maintenance programmes

Perinatal

  • Measures to reduce vertical transmission Occupational
  • Education/training: Universal precautions, needle stick injury avoidance
  • Learn about birthing options (e.g., vaginal or cesarian).
  • Breastfeeding: New mothers with HIV/AIDS may choose to use formula as an option to breastfeeding.

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Complications

  • Weakening immune system
  • Vulnerability to certain cancers and infections
  • Central nervous system complications
  • Tumors

Next Steps

Increased awareness will lead to changes in attitudes and behaviour pattern. The more people are educated about the ways that a person can get infected, the more precautions that he/she will be able to take to protect oneself. Education will also help in debunking the myths associated with the disease.

Red Flags

Red flags of HIV/AIDs include:

  • Unprotected sex
  • More than one sexual partner
  • History of sexually transmitted diseases
  • Exposure to infected needles or body piercing with unclean needles
  • Blood transfusion from untested source

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References

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  • HIV/AIDS Basics. AIDS.GOV. Accessed 9 Apr 2016. https://www.aids.gov/hiv-aids-basics/
  • HIV Overview. AIDS Info. Accessed 9 Apr 2016. https://aidsinfo.nih.gov/education-materials/fact-sheets/19/45/hiv-aids–the-basics.
  • HIV Basics. Centers for Disease Control and Prevention. Accessed 9 Apr 2016. http://www.cdc.gov/hiv/basics/index.html

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