Human immunodeficiency virus (HIV) is a virus that causes disease by damaging the immune system.
HIV therapy protects the immune system by controlling the virus and preventing disease progression.
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What Is HIV?
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HIV stands for the human immunodeficiency virus.
The virus targets and attacks a pop in of white blood cell called aCD4 T-cell lymphocyte.
These are the “helper” cells that help coordinate the immune response by stimulating otherimmune cellsto fight infection.
After numerous copies of the virus have been made, the infected cell dies.
These are calledopportunistic infections (OIs).
What Is AIDS?
AIDS stands for acquired immunodeficiency syndrome.
The status of a person’s immune function is measured by aCD4 count.
The CD4 count literally counts the number of CD4 T-cells in a sample of blood.
The normal CD4 count range is 500 to 1,500 cells per cubic millimeters (cells/mm3) of blood.
Some people progress far more quickly.
Recap
HIV is avirus that can lead to AIDSif left untreated.
AIDS is the most advanced stage of HIV infection where the body’s immune defenses have been compromised.
HIV Symptoms
HIV progresses in stages as CD4 T-cells are progressively destroyed.
Other people may have no symptoms at all.
At the same time, the virus will imbed itself in tissues throughout the body called latent reservoirs.
These reservoirs effectively hide HIV from detection by the immune system.
If symptoms do occur, they tend to be non-specific and easily mistaken for other illnesses.
Rashes are a common part of HIV infection.
A rash may also be a sign of acute HIV infection.
An HIV rash is described as beingmaculopapular.
This means that there will be flat, reddened patches of skin covered with small bumps.
The rash can be itchy and even painful.
In most cases, the rash will clear within a week or two.
HIV Symptoms in Men
The symptoms of HIV are generally the same for all sexes.
With that said, males may experience certain symptoms differently or exclusively.
These includesexually transmitted infections (STIs)that commonly occur alongside HIV.
Cancer is also a concern among males living with HIV.
Examples include:
The symptoms of AIDS vary by the opportunistic infection and the organ affected.
AIDS-defining illnesses can affect practically every organ system of the body.
With that said, somemodes of transmissionare more effective than others.
Tattooing, body piercing, and dental procedures are theoretical sources of HIV infection.
It can also be passed from mother to child during pregnancy or breastfeeding.
Healthcare workers are at risk of infection from needlestick injuries and other occupational injuries.
Diagnosing HIV
HIV is diagnosed with blood, oral fluid, or urine tests.
HIV antibodies can be found in blood, oral fluid, and urine.
Combination Antibody/Antigen Tests
Combination antibody/antigen tests are the common method of HIV testing in the United States.
Combination antibody/antigen tests are commonly performed as a point-of-care test using blood from a vein.
There is also a POC version that requires a finger prick.
The NAT can also be used if initial HIV test results are indeterminate (neither positive nor negative).
It is used to screen donated blood or test newborns suspected of having HIV.
What Is the Window for HIV?
TheHIV window periodis the time between exposure to HIV and when it becomes detectable in blood or saliva tests.
An HIV test may show a negative result during the window period even if you have HIV.
In such cases, you may be advised to return in several weeks or months to get retested.
HIV can be diagnosed with antibody tests, antibody/antigen tests, and nucleic acid (NAT) tests.
There are also rapid antibody tests that can detect HIV in a little as 20 minutes.
Treatment Options
HIV is treated withantiretroviral drugs.
This is a group of drugs that are used in combination to control the virus and slow disease progression.
Antiretrovirals work by blocking a stage in thevirus' life cycle.
Without the means to make complete the life cycle, the virus cannot make copies of itself.
The ultimate goal of antiretroviral therapy is to achieve and sustain an undetectable viral load.
Antiretrovirals do not “cure” HIV.
They simply suppress the virus if used as directed.
If you stop treatment, the viral population will rebound and relaunch its assault on CD4 cells.
HIV is treated with antiretroviral drugs that prevent the virus from making copies of itself.
HIV Medications
There are currently six classes of antiretroviral drugs used in combination HIV therapy.
Most are delivered in oral form (tablets or liquids), while others are delivered by injection.
Many of these are used to make fixed-dose combination (FDC) drugs containing two or more antiretrovirals.
Some FDC drugs can treat HIV with a single pill taken once daily.
Side Effects
As with all drugs, antiretroviral can cause side effects.
Some may occur when treatment is first started, while others develop over time as drug toxicities develop.
Most short-term side effects are relatively mild and tend to clear within several days or weeks.
These include:
Antiretroviral therapy is associated withgynecomastia(abnormal breast enlargement) in some men taking antiretroviral drugs.
Delayed or longer-term side effects are often more severe.
Others are due to hypersensitivity reactions in which the immune system suddenly overreacts to a drug.
Fortunately, there are ways to reduce the cost of antiretroviral therapy even if you don’t have insurance.
Eligibility for most is based on your family’s annual income.
Practice Safer Sex
Condomsstill remain the frontline defense against HIV.
Equally important is a reduction in your number of sex partners.
While effective in preventing HIV, PrEP does not reduce the risk of other STIs.
HIV post-exposure prophylaxis (PEP)is used to avert infection in someone who is accidentally exposed to HIV.
Education is your first step to coping with HIV.
These includes:
HIV Statistics
HIV does not affect all communities equally.
People of color are also disproportionately affected.
There is arguably no better example of this thanBlack MSMin the United States.
Epidemiology of HIV/AIDS
Globally, around 38 million people are living with HIV.
More than half of all people living with HIV today are in Africa.
In the United States, around 1.2 million people are currently living with HIV.
Of those infections, an estimated 13% remain undiagnosed.
Among those who have been diagnosed, only 65% have been able to achieve an undetectable viral load.
Deaths have also been on the decline with a total of 5,115 deaths attributed to HIV-related complications.
Is There an HIV Vaccine?
This is due in part to the fact that HIV mutates rapidly.
Rather than multiplying, these viruses lay in hiding, largely unseen by the immune system.
Is There a Cure?
Today, scientists are largely focused on a “kick-kill” strategy.
Other scientists are focused on developing a “functional cure” for HIV.
If left untreated, HIV can progress to AIDS.
If a positive result is received, medications called antiretrovirals are prescribed to can stop the virus from replicating.
There are currently more than two dozen different antiretroviral agents used in combination to treat HIV.
If treatment is started early, a person can expect to live a near-normal life expectancy.
But, to do so, it’s crucial that you be treated.
or live with the fear of disclosure, stigma, or discrimination.
If left untreated, HIV can progress to AIDS in about eight to 10 years.
Some people progress more quickly.
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