HIV

HIV

HIV stands for Human Immunodeficiency Virus. Some viruses, such as HIV, never go away. When a person becomes infected with HIV, that person becomes "HIV positive" and will always be HIV positive. HIV kills or damages the body's immune system cells, destroying a person's ability to fight disease. People with damaged immune systems are highly susceptible to common diseases as well as to certain cancers and infections that seldom infect healthy people.

AIDS (Acquired Immunodeficiency Syndrome) is a disease that is caused by HIV. The term AIDS refers to an advanced stage of HIV infection, when the immune system has sustained substantial damage. Not everyone who has HIV infection develops AIDS.

What causes HIV/AIDS?

HIV is spread through direct contact with bodily fluids such as blood, semen, vaginal fluid, breast milk, and amniotic fluid. It may be spread through:

• Anal, vaginal, or oral sex with an HIV-infected person;
• The sharing of needles or injection equipment with someone who is infected with HIV;
• Other contact with infected blood;
• HIV-infected women to their babies before or during childbirth or through breast-feeding.

The HIV virus invades immune system calls called CD4-positive (CD4+) T cells, and incorporates into the cell nucleus (control centre), replicates and ultimately kills the host cell. As the amount of virus particles increases, CD4+ Tcell numbers decrease. The damaged immune system loses its ability to defend against diseases caused by bacteria, viruses, and infections. A large decrease in CD4+ T cells also leaves the body vulnerable to certain cancers.

There can be a long time, sometimes ten years that pass between the first infection with the virus and the diagnosis of full blown AIDS. This time cannot be predicted for an individual person.

What are possible symptoms of HIV?

The early symptoms of HIV infection are 'flu-like' symptoms of fever, tiredness, swollen glands, sore throat and difficulty swallowing, headache, aching muscles and rash. Early signs of HIV are often mistaken for other viral infections. Persistently severe symptoms may not appear for a decade or more, and infected individuals may carry the virus for years without knowing it. Meanwhile, infected individuals are capable of spreading the disease.

As the disease takes hold, the virus kills or damages the body's immune system cells, destroying a person's ability to fight disease. People with damaged immune systems are highly susceptible to diseases that seldom infect healthy people such as:

• Tuberculosis (TB),
• Kaposi's sarcoma -a rare type of cancer that appears as pink or purple painless spots on the surface of the skin or in the mouth,
• Pneumocystis carinii pneumonia - a lung infection caused by an uncommon fungus
• AIDS wasting syndrome. The involuntary weight loss of 10 percent of baseline body weight plus either chronic diarrhoea (two loose stools per day for more than 30 days) or chronic weakness and documented fever (for 30 days or more, intermittent or constant) in the absence of a concurrent illness or condition other than HIV infection that would explain the findings.

Blood tests to check the CD4+ T cell count and quantity of virus particles are part of the diagnosis and monitoring.

Can HIV be treated?

Prevention of transmission by screening of blood supplies for transfusion, and education about safe sex and contaminated injecting equipment is critical. There is no cure for AIDS, but medical treatments can slow down the rate at which HIV weakens the immune system. As with other diseases, early detection offers more options for treatment and preventing complications.

Medications called antiretrovirals are designed to attack HIV by interfering with certain processes within infected cells at specific stages. They fall into six categories:

• Nucleoside reverse transcriptase inhibitors (NRTIs);
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs);
• Protease inhibitors (PIs);
• Integrase inhibitors;
• Entry inhibitors;
• Fusion inhibitors.

Most patients take a combination of 3 or 4 of these medicines, and have to take a high number of pills or tablets every day. The complicated timing of the doses, and unpleasant side effects make it quite difficult to follow the prescribed treatment.

Research is continuing to look for simpler treatments.

For more information see your Doctor or Healthcare Professional.

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