HIV (human immunodeficiency virus) is the virus that causes AIDS, a condition that affects over 33 million people worldwide. When HIV enters the body, it attacks the immune system by destroying CD4 positive (CD4+) T cells, a type of white blood cell vital to fighting off various infections, and it eventually overwhelms the immune system's capacity to regenerate or to fight other infections. HIV can also affect bystander cells with toxic byproducts (AEGIS, 2012). Scientists believe HIV came from a similar virus that first occurred in some populations of chimps and monkeys in Africa, where they're hunted for food. During butchering or cooking, people may have come in contact with the infected blood, and this may have allowed the virus to cross into humans and transform into HIV (Mayo Clinic, 2012). When HIV/AIDS first surfaced in the United States, it predominantly affected homosexual men. However, it is now clear that anyone of any age, race, gender, or sexual orientation can become infected – globally, 85% of HIV transmission is through heterosexual intercourse (Nettleman, 2012).
You cannot become infected with HIV through ordinary human contact, such as hugging, closed-mouth kissing, dancing, or shaking hands. You can become infected in a number of ways, though, such as vaginal, anal, or oral sex with an infected partner – the virus enters the body through sores or small tears that develop during sexual activity – blood transfusions, or sharing needles, syringes, or other drug paraphernalia contaminated with infected blood. In addition, infected mothers can transmit the virus to their babies during pregnancy or delivery, when small amounts of blood may be shared, or through breast-feeding.
Hahn, Payne, & Lucas (2010) indicate that because of the danger of tearing tissues in the rectal area, HIV transmission risk is increased during sex if the male, who inserts his penis into the female, is infected. Unless it is absolutely certain that both partners are uninfected, the inserting male should always wear a condom. Even with a condom, however, disease transmission is possible because condoms are more likely to tear during anal intercourse than during penis-vaginal intercourse. As a result, infected couples practicing anal sex must not follow it with insertion into the mouth or vagina because of the likelihood of transmitting the virus.
In the body, the HIV virus attaches to a specific type of immune system cell called a dendritic cell, which is found in mucosal membranes that line the mouth, the vagina, the rectum, the penis, and the upper gastrointestinal tract. Scientists think that these dendritic cells transport the virus from the site of the infection to the lymph nodes, from where they can infect other immune cells (AIDS.gov, 2009).
Once infected, the person may experience an acute illness anywhere from two weeks to three months later. With symptoms such as fever, chills, a rash, night sweats, muscle aches, sore throat, mouth ulcers, and swollen lymph glands, it resembles the flu, but it is much more severe. This is called acute retroviral syndrome (ARS), or primary HIV infection, and it’s the body’s natural response to the virus. During primary HIV infection, high levels of the virus circulate in the blood, which means that people can more easily transmit the virus to others at this time (AIDS.gov, 2009).
After the initial infection dies down, the HIV virus becomes less active in the body, although it is still present. As many people do not have any symptoms of HIV infection during this period, it is called the “chronic” or “latency” phase. This period can last up to 10 years, and sometimes even longer (AIDS.gov, 2009). When the HIV infection becomes active again, it can progress to AIDS (Acquired Immunodeficiency Syndrome). AIDS is diagnosed when the number of CD4 cells begins to fall below 200 cells per cubic millimeter of blood (200 cells/mm3) – normal CD4 counts are between 500 and 1,600 cells/mm3. At this stage, patients suffer from fatigue, diarrhea, nausea, vomiting, a fever that can last several weeks, chills and night sweats, and, during the late stages, wasting syndrome – a loss of at least 10% of body weight (AIDS.gov, 2009; Mayo Clinic, 2012). Many AIDS patients also suffer from opportunistic infections, such as from yeast or bacteria, which are common in people with damaged immune systems. In addition, patients may develop tuberculosis, cytomegalovirus (CMV) infection, kidney disease, or even some forms of cancer (Mayo Clinic, 2012).
HIV is most commonly diagnosed by testing blood or saliva for the presence of antibodies to the virus. These tests may look for several things: 1) The CD4 count, the number of the type of white blood cell that's specifically targeted and destroyed by the HIV virus; 2) The viral load, or the amount of virus contained in the blood; and 3) The strain of HIV’s drug resistance to certain anti-HIV medications, as well as its reaction to the ones that might work better. However, the results may take a few weeks to get. A newer type of test checks for HIV antigen, a protein produced by the virus immediately after infection. This test is much faster, and you can get the results within only a few days.
There is no cure for HIV infection, but there are treatments. The primary treatment is antiretroviral therapy (ART), medications that prevent a retrovirus, such as HIV, from replicating. ART involves taking a combination of anti-HIV medications (known as a regimen) every day. The medications are grouped into six drug classes according to how they fight the virus; recommended HIV treatment regimens include three or more anti-HIV medications from at least two different drug classes.
The best combination of anti-HIV medications for you depends on your individual needs, and you should discuss this with your healthcare provider. Current guidelines indicate that treatment should begin if: 1) You have severe symptoms; 2) Your CD4 count is under 500; 3) You're pregnant; 4) You have HIV-related kidney disease; and 5) You're being treated for hepatitis B (Mayo Clinic, 2012).
As mentioned before, there is no cure for HIV/AIDS; however, there are tests to detect its presence and treatments to slow or stop its advancement. If you believe you may be infected, speak to your healthcare professional and get yourself tested as soon as possible. A little knowledge can go a long way toward preventing the spread of this insidious disease.
References
AIDS Global Education Information System (AEGIS). (2012). Biology of HIV. National Institute of Allergy and Infectious Diseases. Retrieved from http://www.aegis.org/en/
AIDS.gov. (2009). HIV/AIDS Basics. U.S. Department of Health & Human Services. Retrieved from http://aids.gov/hiv-aids-basics/
Hahn, D. B., Payne, W.A. & Lucas, E.B. (2010). Preventing Infectious Diseases. In Focus on Health (10th ed.), (275-305). New York, NY: McGraw-Hill.
Mayo Clinic. (2012). HIV/AIDS: Tests and Diagnosis. Mayo Foundation for Medical Education and Research. Retrieved from
http://www.mayoclinic.com/health/hiv-aids/DS00005/DSECTION=tests-and-diagnosis
Nettleman, M. (2012). HIV/AIDS. eMedicine Health. Retrieved from http://www.emedicinehealth.com/hivaids/article_em.htm
