HIV-AIDS Symptoms, Risks, Diagnosis and more
Acquired immunodeficiency syndrome or AIDs is a disease that manifests during the late stages of HIV infection. AIDs is caused by the Human immunodeficiency virus, commonly known as HIV. HIV itself is not a disease and but a viral pathogen and AIDs does not include all the spectrum of HIV infection.
The prevalence of HIV infection has been rapidly increasing in the recent past despite having effective preventive methods. According to the Joint United Nations Programme on HIV/AIDS worldwide in the year 2015, approximately 1% of the global adult population between the ages of 15-49 were affected with HIV virus. 31.6 million–44.5 million people globally were living with HIV in 2019
How does the HIV virus affect the humans?
HIV virus primarily affects the immune system of the humans. It infects the immune cells known as CD4 lymphocytes or T helper cells. T helper cells are the key regulators of the immune system. CD4 cells are involved in evoking an immune response following exposure to a potential pathogen. Failure of this response mediated by the CD4 cells, leads to impaired immunity and subsequent severe infections. The HIV virus destroys the CD4 cells, thus dramatically retard the immune functions.
How does the HIV infection progresses with time?
Following an exposure to the HIV virus, patient develops flu-like symptoms after about 3-6 weeks of the exposure. This is called as the acute seroconversion. This is followed up by a latency period where the patient doesn’t have any symptoms. This may last for years or even decades depending on the strength of the immune system. Even though the patient doesn’t have any symptoms, he’s infective throughout the period and his CD4 cells count drops in a gradual manner. Rarely, progression of the disease may halt at this stage in some patients, making them perfect carriers of infection.
Symptoms start to appear when CD4 cell count fall below 500 cells/ mm3. AIDs stage is the very end of the spectrum where the CD4 cell count has fallen below 200/ mm3.
Symptoms of the disease
Fever, joint pain, malaise and rash during the seroconversion
Generalized lymph node enlargement may be the only symptom during the latency period
End of the latency period is marked by sudden weight loss, night sweats, reduced appetite and other constitutional symptoms
AIDs stage is characterized by repeated, severe and disseminated infections of atypical microorganisms that do not usually have the potential to infect the normal population.
Risk factors for HIV infection
Classically, HIV infection is labeled as a sexually transmitted disease. Even though it’s the commonest cause, it’s not the only cause of the disease. Following exposures are well known to cause HIV infection.
- Unprotected sexual intercourse with an infected partner – Can be oral, vaginal or anal. Homosexuality carries the highest risk of transmission.
- Needle prick injuries – Common among health care workers
- Intravenous drug abuse
- Sharing tattoo equipment
- Breastfeeding – If the mother is infected.
Diagnostic tests are based on detecting antibodies against the virus or viral RNA. Enzyme-linked immunosorbent assay (ELISA) is the routine test used for the screening. Those who receive positive results undergo a diagnostic test, the Western blot test. Both the screening and diagnostic test depend on detection of HIV specific antibodies.
Viral load assays are done to assess the infectivity of known HIV patients. High viral load indicates high infectivity and vice versa. In addition, it’s commonly used as a tool to monitor the response to therapy.
Anti-retroviral drugs are the main line of treatment of HIV infections. Anti-retroviral drugs include several subclasses of drugs that are prescribed together. At least two classes of drugs should be given together to prevent the immune deterioration.
Treatments should be initiated as early as possible after a potential exposure. This is called the post-exposure prophylaxis and ideally should be initiated within 72 hours of exposure.
Pre-exposure prophylaxis is given to the people whom have a high chance of getting infected with HIV virus (e.g. – Healthcare professionals)
In addition to the anti-retro viral drugs, prophylactic antibiotics and antifungals are given to the patient whom have progressed to the AIDS stage.
Prevention of HIV infection
- Safer sex – Do not have multiple sex partners
- Protection methods – Always wear condoms during sexual intercourse unless you only have a single and regular partner.
- HIV screening – Get yourself screened after a potential exposure
- Universal precautions – Wear gloves and adhere to universal precautions if you are a healthcare worker
- Adherence to the anti-retroviral therapy if you are a HIV patient
Life expectancy of a HIV patient
Due to the high effectiveness of anti-retroviral therapy, a newly diagnosed HIV patient in early stages, has a life expectancy equal to a normal person. Proper anti-retroviral therapy most of the time brings the viral load in blood absolutely to zero. At this level, the patient has no risk of transmission of the disease even during a sexual intercourse.
However, if the patient is diagnosed at AIDs stage, life expectancy tends to be poor due to the already depleted immune system.