HIV AIDS

Human Immunodeficiency virus (HIV) attacks the body immune system by destroying the immune cells. Overtime, your body cannot fight infections and diseases. Consequently, opportunistic infections and cancers take an advantage of this condition and lead to the chronic, life-threatening condition called AIDS (acquired immune deficiency syndrome).

As per the estimates of WHO (World Health Organization), nearly 36.9 million people worldwide had HIV/AIDS by the end of 2014. Out of these, there are about 2.6 million children aged below 15 years. In the year 2014, around 2 million new cases of HIV were reported.

Symptoms

Symptoms of HIV infection varies with the stages of infection as detailed below. HIV symptoms in men and HIV symptoms in women may not vary much.

Acute HIV

In the initial stages of the infection, called as acute HIV infection, the patient may have early symptoms of HIV. The virus is rapidly dividing, during which the immune system tries to fight off the virus. HIV symptoms which occur during this stage are similar to the other viral infections and may include:

  • frequent fever and sweats
  • tiredness
  • yeast infections
  • enlargement of the lymph node
  • sore throat
  • persistent skin rashes or skin flakes
  • weight loss

In this stage, it is not possible to detect HIV through antibody tests.

Chronic HIV

In this stage, the virus is well established. You may not have any symptoms, but in few patients, the swelling of the lymph nodes can continue. This can last for nearly 10 years or little less and in the absence of treatment, your immune system gets progressively weakened, and you may develop AIDs.

If you are diagnosed with AIDS, it means that you have immunodeficiency. At this stage, you cannot fight the infections which your body could readily fight in the past. AID symptoms at this stage are mainly due to the opportunistic infections and include:

  • fever
  • dry cough or shortness of breath
  • difficulty or pain during swallowing
  • severe headaches and neck stiffness
  • nausea, vomiting, and abdominal cramps
  • diarrhea lasting for more than a week
  • white spots in and around the mouth
  • pink to brown colored blotches inside the mouth, nose, or eyelids
  • vision loss
  • seizures
  • depression, memory loss, and confusion
  • coma
  • development of various cancers

HIV is transmitted from one person to the other through sexual contact, blood transfusions, sharing needles, mother to child during pregnancy or child birth or breastfeeding.

HIV does not spread through physical contact, air, water or insect bites.

Although HIV can affect anyone, irrespective of age or gender, the risk is however, high in people

  • who have unprotected sex
  • who have another sexually transmitted infection (this allows easy entry of the virus)
  • who use intravenous drugs (due to the sharing of needles and syringes)

Complications

As the HIV weakens your immune system, you will have complications such as infections and cancer.

Tuberculosis: This is the most common opportunistic infection and is the leading cause of death in AIDS patients.

Candidiasis: This is another common infection which occurs with AIDS, and thickens the mucus membrane of tongue, mouth, esophagus and vagina.

Cytomegalovirus: This virus is dormant in the healthy individuals. But in AIDS patients, it remains active and can damage eyes, digestive system, lungs, etc.

Cryptococcal meningitis: It is the infection of the central nervous system which leads to the inflammation of the membranes surrounding the brain and the spinal cord.

Cryptosporidiosis: This infection is caused by an intestinal parasite, which causes a severe and chronic diarrhea in AIDS patients.

Kaposi's sarcoma: This is a cancer of the walls of the blood vessels. This cancer is common in HIV-infected patients but is otherwise rare.

Lymphomas: This is cancer of the white blood cells and first appears in the lymph nodes.

Kidney disease: In HIV-infected patients, the tiny filters of the kidney become swollen. This leads to an increase in the filtration of fluids and wastes materials.

Neurological complications: Dementia complex is the most common complication which leads to a diminished mental functioning and behavioral changes. Other neurological disorders which can occur include confusion, depression, forgetfulness, anxiety and trouble walking.

Wasting syndrome: It involves the loss of body weight by nearly 10% along with diarrhea, weakness, and fever. The incidence of this complication is reduced with aggressive treatment.

Early diagnosis helps in the prevention of the spread of the virus to healthy individuals. During the diagnosis of HIV, the presence of antibodies, produced against the HIV are detected in the saliva and blood. But this is possible only after 12 weeks after the infection.

Home test approved by the FDA is also available. If you test negative, you need to retest after 3 months for confirmation. If the result is positive, then your doctor may perform certain tests to detect the stage of HIV based on which the treatment varies.

CD4 count: HIV can signal to AIDS when your CD4 cells (immune cells) fall below 200 mm3.

Viral load: The target viral load (determinant of HIV activity) with the treatment is below 40-75 copies/mL.

Drug resistance: This test determines if the viral strain is resistant to which of the HIV medications.

HIV or AIDS cannot be cured but can only be managed with a combination of anti viral drugs. There are several drugs available for HIV treatment and are classified as below:

Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs): Examples are abacavir, lamivudine-zidovudine, and emtricitabine-tenofovir.

Non-nucleoside reverse transcriptase inhibitors (NNRTIs): Examples are efavirenz, etravirine and nevirapine.

Protease inhibitors (PIs): Examples are atazanavir, fosamprenavir, darunavir and indinavir.

Integrase inhibitors: Examples are raltegravir (Isentress), elvitegravir (Vitekta) and dolutegravir.

Entry or fusion inhibitors: Examples are enfuvirtide and maraviroc.

Treatment should begin for every HIV infected patient with antiviral agents. But immediate initiation is more important for people:

  • with opportunistic infections
  • who have severe symptoms
  • whose CD4 count is below 350 mm3
  • who are pregnant
  • who are treated for hepatitis B or C
  • who have the associated kidney disease

Treatment involves taking multiple drugs at the scheduled time every day for your lifetime.

Treatment with medications is not avoidable for patients with AIDS. However, taking certain measures can help you to stay healthy during the treatment.

Eat healthy: To support your immune system and keep you strong and energetic, eat diet including fruits, vegetables, lean proteins and whole grains. Avoid raw eggs, unpasteurized dairy products, etc.

Get immunized: To prevent infections such as pneumonia and flu, get vaccinated (specifically with killed vaccines).

Be careful with pet animals: Some animals contain parasites lodged on their dander and can increase the risk of infections. Keep away from your pet animals or wash your hands thoroughly after handling them.

As AIDS is a life-threatening condition, the patient needs emotional, social and financial assistance to cope up with the disease. There are several HIV clinics and resources which provide counseling and other services to support AIDS patients.