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AIDS symptoms - what are they?

What are the symptoms of HIV and AIDS?

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What are HIV and AIDS?

HIV is a human immunodeficiency virus which is a virus that damages the cells of your immune system which in turn weakens the body’s ability to fight everyday infection and disease.

The definition of AIDS is acquired immune deficiency syndrome and is the name used to describe the condition which can develop once the immune system has been severely damaged by the HIV infection. It manifests itself as a syndrome that comprises a number of potentially life-threatening illnesses and infections.

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AIDS cannot be transmitted from person to person whereas HIV, which is the virus itself can. There is currently no absolute cure for this disease but most people can expect to live with the virus and have a long and healthy life; this is thanks to some highly effective medication regimes. If the disease is diagnosed early then there is no reason why they should, thanks to the treatment, develop any life-threatening diseases and so go on to live a fairly normal length of time.

 

What causes HIV infection?

The most common way of transmitting HIV is via unprotected sexual contact, vaginal or anal, with an infected person. It is possible to contract the illness through oral sex but the risk is much lower unless you have mouth ulcers, sores or bleeding gums whilst giving oral sex or the person receiving the oral sex is recently infected with HIV so has a higher viral load.

You are more at risk of catching HIV if the following is true:

  • You have a current or previous or previous partner who is HIV positive
  • If you have a previous or current partner who is from an area with high HIV rates
  • If you are a person from an area with high rates of HI
  • People who take part in ‘chemsex’. The reason for this is that this may be associated with risky sexual behaviour such as having multiple sexual partners as well as not using condoms.
  • Men who have unprotected sex with other men
  • Women who have unprotected sex with men who have sex with men
  • People who are intravenous drug users and share equipment
  • People who have sex with intravenous drug users
  • People who share sex toys with an HIV positive person
  • People who have had multiple sexual partners
  • People who have had a history of sexually transmitted infections
  • People who have been sexually assaulted and the assault has involved penetrative sex, orally, vaginally or anally
  • People who have had a blood transfusion or organ transplant in a location that does not thoroughly screen for HIV
  • Healthcare workers who may prick themselves accidentally with an infected needle
  • Babies who have mothers with untreated HIV 

 

Transmission of HIV

HIV can be found in the blood of an infected person as well as some of their bodily fluids. In order to contract HIV, it has to involve blood to blood contact or blood to infected fluid contact.

Bodily fluids that can contain the HIV virus are:

  • Semen
  • Vaginal fluids including menstrual blood
  • Breast milk
  • Blood vessels - including those lining the anus

Saliva, urine and sweat do not contain sufficient virus to infect another person.

The main points of entry for the virus are:

  • Via injections
  • Through the lining of the mouth, eyes, vagina, anus or genitalia
  • Via cuts and sores on the skin

HIV cannot be transmitted in the following ways:

  • Spitting
  • Kissing
  • Being bitten/contact with healthy skin that is unbroken
  • Being sneezed on
  • Sharing baths, towels or cutlery
  • Using the same toilets or swimming pools
  • Via mouth to mouth resuscitation

 

How HIV causes damage to the immune system

Immune system cells called CD4 cells are the target for the virus. On entering the bloodstream, the virus attaches itself to and enters the CD4 cells where it uses the cell to replicate thousands of times. The copies then vacate the CD4 cell which kills the CD4 cell. This is a continuous process that in the long term will result in the CD4 cell levels becoming so low that the immune system ceases to work.

 

Symptoms of HIV infection

The first clue that you may have contracted HIV is to have an illness similar to flu about 2 - 6 weeks after becoming infected. Following this, it is not unusual to be symptom-free for several years.

As many as 80% of people who contract HIV have this flu-like illness and the common symptoms are:

  • Sore throat
  • Fever
  • Rash on the body

Other symptoms are:

  • Tiredness
  • Swollen glands
  • Joint and muscle pain

This illness can last up to two weeks or longer and signifies that your immune system is working to get rid of the virus. If you think you may have been exposed to the virus and are experiencing some of the symptoms it is important to get an HIV test.

After this period, although you may not be experiencing any symptoms, the virus is still busy and is progressively causing damage to your immune system.  It may take as long as ten years for full blown AIDS to the surface although this may vary from person to person.

At this point, you will begin experience symptoms which can include:

  • Recurrent infections
  • Serious life-threatening illnesses
  • Weight loss
  • Chronic diarrhoea
  • Skin problems
  • Night sweats

If you have been tested and diagnosed before this point then treatment would have averted this situation.  If you feel that you were at risk at some point in the past it is always worth being tested, if only to be sure that you do not carry the infection.

 

How is HIV diagnosed?

HIV diagnosis can only be definite if a test is carried out. The reason for this being that in many cases, symptoms do not begin to appear for many years.

Testing for HIV is provided free of charge by the NHS; it is possible to get test results on the same day in many cases but home testing kits are also available.

For some people, the risk of contracting HIV is particularly high, for example, people working in the sex industry, and in these cases, regular testing is advisable. It is not advisable to leave it for too long to be tested if you think you have been exposed; the earlier treatment can begin the better the prognosis. In some cases, a repeat test may be required 1 - 3 months after exposure but in the first instance, you should not wait so long.

Another reason for being tested as soon as possible after exposure is that a prophylactic medication now exists for HIV. The post-exposure prophylactic (PrEP), provided it is taken within 72 hours of exposure, can prevent your body from becoming infected with the virus.

Places where HIV tests are available include:

  • Some GP surgeries
  • Charities such as the Terrence Higgins Trust run clinics where testing is offeredGenitourinary health and sexual health clinics also offer the service
  • Some contraception and young people's clinics can give HIV testing
  • Drug dependency services
  • If you are pregnant, ante-natal clinics offer HIV testing
  • You can attend a private clinic for testing but there will be a charge for this

 

Types of HIV testing

The four types of tests which can detect HIV infection are as follows:

  • Blood test - a sample of blood is taken at a clinic and sent for laboratory tests. Results are relatively rapid and you will receive them wither on the same day or within a few days.
  • Point of care test - either a spot of blood or a saliva sample taken in a clinic.  With this test, the sample is tested at the clinic and the result is available within a few minutes.
  • Home sampling kit - a saliva sample or spot of blood is taken at home and the samples are sent by post for testing.  Within a few days, you will be contacted and given the result.
  • Home testing kit - the blood or saliva sample is taken and tested at home with the result being available within a few minutes.  It is important to be sure that a home testing kit is of good enough quality with a CE mark as well as being licenced for sale in the UK.

The blood test is the most effective and can give reliable results as soon as a month after exposure to the infection.

In the case of the other tests, they are not as accurate and will require you to wait for a long time after exposure in order to obtain a reliable result.  If one of these tests gives a positive result it is important that you have this confirmed with a blood test.

 

HIV screening if you are pregnant

The NHS now offers all pregnant women a routine HIV test. The reason for this is that HIV if left untreated, can be passed to the unborn child during pregnancy.

 

What are the treatments for HIV?

Prophylactic drugs for HIV were covered briefly earlier in this article. The PrEP (post-exposure prophylaxis) must be administered within 72 hours of exposure to the virus. This treatment is only recommended if the encounter was high risk, for example, your sexual partner is HIV positive.

PEP treatment must be taken daily for one month and in order to stand the best chance of working, they must be taken as soon as possible. PrEP drugs have some side effects which include:

  • Tiredness
  • Diarrhoea
  • Nausea
  • Vomiting
  • General malaise

If you are tested positive for HIV you will need to have regular blood tests to track the progress of the virus. The two most important tests are:

  • Viral load test which tracks how much of the virus is circulating in your system
  • CD4 lymphocyte cell count is able to indicate to what extent the virus has damaged the immune system

Antiretroviral drug treatment for HIV - these drugs operate by preventing the virus from reproducing in the CD4 cells. Doing this allows the immune system to regenerate itself as well as preventing further damage.

Combinations of the medications are prescribed and may be changed due to the fact that HIV can become resistant. It is not unusual for HIV patients to be taking 1 - 4 pills daily. Different medications work for different people and treatments are specific to them.

Regular checks on the viral load within the body are an invaluable ‘yardstick’ to gauge how well the treatment is going. Once the viral load cannot be measured it is known as ‘undetectable’.

When you are taking antiviral drugs it is important to avoid some substances which can interfere with antiretrovirals and they include:

  • Some nasal sprays and inhalers 
  • Some herbal remedies including St. John’s Wort
  • Some recreational drugs

It is important to check with your HIV clinic before taking any other medication.

 

Living with HIV

With careful management, it is possible to live a nearly normal life if you are HIV positive. It is recommended that you keep as healthy as possible and reduce the risk of becoming ill with some positive lifestyle changes:

  • Eating a healthy, balanced diet
  • Taking regular exercise
  • Quitting smoking

There are other ways that being HIV can affect your life and they include:

  • It will not be possible to donate blood or organs
  • You will be unable to join the armed services
  • You may find it difficult to qualify for life insurance although there are specialist companies who will now offer life cover
  • Some countries will not allow you to visit

You will find an enormous amount of support from your HIV support team which will be based at a specialist HIV clinic; it is important to build a good relationship with these people who will be able to help with most problems associated with the disease.

 

Conclusion

Fortunately for people who are HIV positive today, the diagnosis is no longer a death sentence as it was in the 1980s.

With very effective drug treatments the disease can be effectively managed and survival into old age is to be expected for most HIV-positive people.

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