HIV/AIDS

Perhaps one of the most well-known and feared STDs, HIV, or human immunodeficiency virus, is a retrovirus that affects that immune system. As the infection progresses, your immune system becomes increasingly compromised until it is overwhelmed by the HIV virus. Although HIV can lead to AIDS (Acquired Immunodeficiency Syndrome) and eventually death, with proper treatment, it is possible to live a long life well after being infected.

What is HIV?

The human immunodeficiency virus is a highly contagious infection that is commonly spread through sexual contact although it is also possible to contract the infection through other means. When infected, HIV sets about attacking your immune system, specifically your T4 cells, also known as CD4 cells and T-helper cells, which are vital to the proper operation of your immune system. Once the virus enters a T4 cell, it destroys the cell while making a copy of itself. In this way, the virus spreads and grows while your immune system is slowly depleted. After HIV has destroyed enough T4 cells, the immune system loses its ability to function properly. This makes it easier for opportunistic infections to take hold. Additionally, HIV attacks the heart, kidney and brain and, in its advanced stages, can cause kidney failure and dementia, among other things. When your T4 cell count drops to 200 cells/uL or you have developed a disease from the Centers of Disease Control and Prevention’s “AIDS Defining Condition” (a list originally compiled by the American organization in 1992 that is often used worldwide), you will be diagnosed with AIDS.

HIV Transmission

HIV is transmitted through bodily fluids including semen, vaginal fluids, blood and breast milk. In order to be infected, you must come into direct contact with one of these fluids from an infected individual. Common modes of infection include:

• Vaginal, anal, or oral sex
• Using contaminated needles
• Pregnancy or during birth (mother-to-child infection)
• Breastfeeding
• Blood transfusions

It is important to note that, in many parts of the world, risk of infection through blood transfusions is minimal. This is due mainly to strict screening procedures; many countries enforce mandatory screening for HIV in all blood that is to be used for transfusions. However, some countries with lower hygienic practices may not test their blood. People who work in certain health care settings may also be at an increased risk of HIV infection. Proper use of condoms during sex can significantly decrease your chances of contracting HIV.

HIV Stages

HIV is categorized into four stages: Primary Infection: This is the period immediately following exposure to the virus. During this time, the virus rapidly replicates itself. You may also develop some flu-like symptoms, such as fatigue, sore throat, swollen lymph glands, fever, and headache, and possibly a rash. However, beyond this, there does not seem to be any early HIV symptoms. Throughout this stage, you are highly contagious and can easily spread the virus to others. Clinical Latency: Within weeks of being infected, your body will begin to mobilize its own immune response to the virus. Although you are still contagious and the virus is still continuing to duplicate itself and destroy your T4 cells, it is unlikely that you will display any HIV symptoms. This stage may last as little as two weeks or as long as 20 years. On average, however, it takes about 10 years before symptoms begin to develop. If you are tested and found to be infected during this time, you may be started on treatment. Symptoms of Early Infection: At this stage, hiv symptoms begin to manifest and indicates that your T4 cell count is beginning to drop (from 1000 cells/uL of blood to about 500 cells/uL of blood). A variety of symptoms of HIV may occur, and can include:

• Diarrhoea
• Unexplained weight loss
• Oral thrush
• Recurring yeast infections
• Periods of extreme fatigue
• Bruising easily
• Recurrent oral ulcerations
• Recurrent respiratory infections (i.e. bronchitis)
• Recurrent or unusual rashes
• Chronic dry cough
• Recurring fever
• Growths on mouth or skin that are discoloured or have a purplish hue
• Unexplained bleeding from skin growths, mucous membranes or any bodily opening
• Experiencing extreme numbness in hands and feet
• Inability to control muscles and reflexes
• Paralysis
• Weakened muscles
• Changes in personality or state of consciousness
• Mental deterioration

AIDS: This is the final stage of HIV, though with improved treatment methods, this stage can be put off for many years while some may never develop AIDS.

HIV Testing

To determine whether you have HIV, an HIV test will be administered. There are a few different types of tests available, but most of them work by looking for the presence of HIV antibodies in your system. If these antibodies are detected, then you are HIV positive. The absence of these antibodies means that you do not have HIV, although it is possible to get a false negative if you test too early. The problem with HIV testing is that HIV antibodies can take as much as six months to show up your system. The period from the time of infection to the presence of detectable antibodies is known as the window period. If you test for HIV during the window period, you may get a negative result although you are infected. You are also contagious during this time. There are tests available that look specifically for the HIV virus. However, these tests are more expensive and slightly less accurate. This is why adults commonly receive HIV antibody testing. In newborns, though, tests that can detect the HIV virus itself are more common. Since babies receive all of their antibodies at birth from their mother, testing a newborn for HIV antibodies will always produce a positive result, even if the baby is not infected. These antibodies stay with the child long after birth and therefore testing for the antibodies cannot be done until the child is 18 months. By using an HIV virus test, parents and doctors can know much sooner whether a newborn is infected and requires treatment. Avoid transmission of HIV by having STD tests if there are symptoms.