HIV Infection And AIDS
What are HIV and AIDS?
HIV is the abbreviation used for the human immunodeficiency virus. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome). AIDS is a preventable and life threatening disease. However, new treatments allow people who are infected with HIV to live many years. HIV attacks the body’s immune system. The immune system is the body’s defense against infections. With time, HIV weakens your ability to fight off serious infections and some cancers. When this happens, HIV infection becomes AIDS.
The infection-fighting cells of the immune system are a type of white blood cell called CD4 cells or T-helper cells. Months to years after infection with HIV, the virus begins to destroy the CD4 cells. HIV infection becomes AIDS when so many of the CD4 cells are destroyed that you lose your ability to fight off serious infections or tumors. Various infections called opportunistic infections develop. They are called opportunistic because they take advantage of the weakened immune system. These infections would not normally cause severe or fatal health problems. However, when you have AIDS, the infections and tumors are more serious and are harder to treat successfully.
What is the cause?
HIV is not spread through the air, in food, or by casual social contact such as shaking hands or hugging. The virus is passed on only when the blood or sexual secretions, such as semen, enter another person’s body. HIV can also be spread to babies during pregnancy and by the breast milk of an infected mother. You can get infected with HIV through:
· Unprotected sexual activity
· Sharing IV needles
· Contact with infected blood or semen
· Transfusion of blood or blood products in countries where the blood is not carefully tested.
People of all ages and both genders are at risk for AIDS. The following groups have the highest risk for HIV infection and the development of AIDS:
· sexually active homosexual men
· men who have sex with both men and women
· men and women with more than 1 sexual partner
· heterosexual women whose partner has sex with more than one partner or with men
· people who share needles (for IV drug use, tattooing, or piercing)
· people given transfusions of blood or blood products in countries where the blood is not rigorously tested
· people who have sex with an HIV-infected partner or with anyone in the above groups if they do not always use a latex or polyurethane condom
· babies born to or breast-fed by HIV-infected mothers
What are the symptoms?
The symptoms of HIV infection and AIDS are usually the symptoms of the diseases that are able to attack the body because of the infection:
· loss of appetite or weight
· nausea and vomiting
· swollen “glands” (lymph nodes)
· sore throat
· sores on the skin or mouth
· repeated, severe yeast infections in the mouth or vagina despite treatment
· muscle and joint pain
· blurry vision or other problems with vision
How is it diagnosed?
Tests for HIV are done in 2 steps. The first test is a screening test of your blood or saliva. If this test is negative, it usually means that you don’t have HIV. However, it is possible to have a negative test if you have been just recently infected. If you have a negative test result but you are at high risk for infection, you may need to have another test in 3 to 6 months.
A positive test result means that you are probably infected with HIV. A second, more specific blood test is then done to confirm the results.
Once you have confirmed positive HIV test results, you must have a thorough medical exam. The exam includes discussing your history of sexual practices and infections. Your healthcare provider will also ask about any history of drug abuse.
You will have some lab tests. Comparing the results of the physical exam and these first lab tests with results of tests done weeks or months later can help your healthcare provider know how the virus is affecting your body. It can also help your provider know how well any medicines you may be taking are working.
You will be tested for certain infections that can worsen quickly when you have HIV, such as tuberculosis (TB), syphilis, and hepatitis B. These diseases can also pose a serious risk to others.
HIV-positive women should have a Pap test according to the schedule recommended by their healthcare provider (usually every 6 to 12 months). The HPV virus, which causes cervical cancer, can spread and cause problems much more quickly if you are infected with HIV. Pap tests can detect HPV before it has caused cancer of the cervix or when the cancer is early and can be cured.
How is it treated?
Your treatment depends on when you were infected with HIV, your test results, and whether you have symptoms. Several different types of medicines are used to treat HIV/AIDS. There is much ongoing research to find ever better treatments. Currently, your treatment may include:
· antiretroviral medicines, such as iamivudine-zidovudine (also called ZDV or AZT,Combivir), efavirenz-emtricitabine-tenofovir disoproxil fumarate (Atripla), fosamprenavir calcium (Telzir), and tenofovir disoproxil fumarate (Viread).
· protease inhibitors, such as indinavir sulfate (Crixivan), saquinavir mesylate(Invirase), nelfinavir(Viracept), saquinavir (Fortovase ).
In addition to being treated with medicines that work to keep the virus from making more viruses, it is very important to follow the other recommended treatments for HIV/AIDS infection, such as:
· lab tests every few weeks or months, as recommended by your healthcare provider
· regular dental exams
· preventive treatment for such infections as:
· toxoplasmosis (be sure to avoid raw meat and cat litter boxes)
· hepatitis B
· treatment for infections and tumors as they develop
Treatment with antiretroviral drugs and possibly other medicines will depend on how low your CD4 cell count is and how high your viral load is.
· The CD4 cell count is a good way to know how well your immune system is working.
· The viral load test measures how much HIV is in your blood.
Antiretroviral medicines can slow down the disease, but they are not a cure. Many new drug treatments and combinations are being prescribed or studied.
Vision problems are often an early sign of opportunistic infection in HIV-positive individuals. Tell your healthcare provider promptly about any eye symptoms.
Getting care in an office or clinic that offers case management is perhaps the most important part of treatment. This means a team of providers will be giving you care. Your care will be coordinated by a case manager. The case manager helps you communicate with all who are caring for you. Other advantages include:
· Up-to-date medical care will be available to you.
· You will get treatment for both the medical and social aspects of your illness.
· You will have help in finding medical, social, and financial resources.
How long do the effects last?
The full effects of AIDS may not appear until 5 to 10 years after you are first infected with HIV. Although in past years AIDS was almost always a fatal disease, new treatments have allowed people to live longer with the disease.
How can I take care of myself?
If you are in a high-risk group but have not tested positively for HIV, see your healthcare provider regularly. They will check your health and recommend how often your blood should be tested for HIV. You should talk with your provider about ways you might be able to lower your risk.
If you are HIV positive:
· Discuss your treatment with your healthcare provider.
· See your provider on a regular schedule to keep up to date on new treatments.
· Contact a local AIDS support network. Your provider should be able to help you find one.
Ask your healthcare provider:
· How and when you will hear your test results
· What activities you should avoid and when you can return to normal activities
· What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
How can I help prevent HIV infection?
Practice safe sex to keep from getting infected, or to prevent spreading the infection to others:
· Have just 1 sexual partner who is not sexually active with anyone else.
· Avoid exposure to blood, vaginal secretions, semen, and other sexual secretions during foreplay and intercourse. Use latex or polyurethane condoms every time you have oral, vaginal, or anal sex.
· Do not use a spermicide containing nonoxynol 9 and do not use condoms coated with this spermicide. Research has found that this chemical can irritate the lining of the vagina and rectum. These irritated areas make it easier for the virus to enter the body.
· If you use a lubricant, use one that is water based. Do not use oil-based lubricants made with petroleum jelly, mineral oil, vegetable oil, or cold cream. They can damage the condom.
· Ask any new sexual partner about his or her sexual and injection drug use history.
· If you have not been tested for HIV, get tested and ask sexual partners to be tested for HIV.
· Do not share needles for drug use, tattooing, or body piercing.
· If you are HIV positive:
· Do not donate blood, plasma, or semen.
· Do not donate organs from your body.
· Tell your healthcare providers that you are HIV positive. Discuss any concerns you may have about confidentiality with your healthcare provider.
· To avoid passing HIV to a baby, women should talk to their healthcare provider before getting pregnant.
· If you have been exposed to HIV, antiretroviral drugs may be used to prevent infection.
The treatment must be started as soon as possible and no more than 72 hours after the exposure. This preventive treatment is not recommended for people who are often at risk of exposure to HIV, such as people who have sex partners with HIV.
How can I keep up to date on treatments for HIV infection?
Researchers are learning more about HIV. As a result, recommended treatments change often. Ways you can seek up-to-date information and care are:
· Get your healthcare at a clinic that offers case management, and follow the recommended appointment schedule.
· Contact the following organizations:
AIDS Coalition of Nova Scotia
1668 Barrington Street, Suite 401
Halifax NS B3J 2A2
Telephone (902) 425 4882 / (902) 429 7922 or toll-free at: (800) 566 2437
AIDS PEI website at:
The Public Health Agency of Canada website at: http://www.phac-aspc.gc.ca/aids-sida/index-eng.php
Healthy Canadians website at: http://www.healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/hiv-vih-eng.php
CATIECanadian Aids Treatment Information Exchange
555 Richmond Street West
Suite 505, Box 1104
Telephone tool-free at: 1-800-263-1638