HIV and AIDS

What is the difference between HIV and AIDS?

HIV stands for Human Immunodeficiency Virus; this virus attacks white blood cells which help the body fight infection. If a person infected with HIV does not seek treatment it can develop into AIS which is Acquired Immunodeficiency Syndrome. This is a syndrome or collection of illnesses that are caused by a virus that is ‘acquired’ which makes their immune system weak or ‘immunodeficient’.

The earliest known case of infection with HIV-1 in a human was detected in a blood sample collected in 1959 from a man in Kinshasa, the Democratic Republic of the Congo.

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Causes of HIV

Infection with HIV is brought about by having unprotected vaginal or anal sex; it is also possible to contract the virus through oral sex although the risk is much lower. Oral sex can be riskier however if the person who is giving the oral sex has mouth ulcers, sores or bleeding gums.

HIV is transmitted when the virus, which lives in the blood and some body fluids, is passed from a person with the virus into the blood of the person being infected.

The body fluids which carry enough HIV virus to infect another person are:

  • Semen
  • Vaginal fluid including menstrual blood
  • Breast milk
  • Blood Lining inside the anus

Other bodily fluids such as saliva, sweat and urine do not contain enough HIV virus to infect another person.

The main ways for the virus to enter a person's bloodstream are:

  • Using needles to inject into the bloodstream that has also been used by a person suffering from HIV
  • Through the lining of the vagina, anus or genitals
  • Through the lining of the mouth or eyes
  • Through cuts and sores on the skin

 

HIV is not passed on by

  • Kissing
  • Being bitten
  • Spitting
  • Contact with unbroken, healthy skin
  • Being sneezed on
  • Sharing baths, towels or cutlery
  • Using the same toilet
  • Using the same swimming pool
  • During mouth to mouth resuscitation
  • Contact with animals

 

HIV Diagnosis

As the symptoms of HIV may not appear for several years it is advisable to have a test if you suspect that you may be infected. Tests are available free of charge by the NHS and in most cases, the results will be available on the same day. It is also possible to obtain kits for testing at home.

People who are at high risk of being HIV positive include:

  • Men who have sex with other men. The risk for this group increases if a man has multiple partners and practices unprotected sex
  • Black African men and women who have unprotected sex with new or casual partners should be regularly tested
  • People who share needles or syringes with other people

 

Symptoms of HIV - how can you tell you have it?

There is really only one way to tell if you have HIV and that is to have a test.  Symptoms for HIV can be difficult to spot because they are the type of symptoms that may be experienced if you have any variety of infections such as a cold or flu and not everyone experiences the same symptoms. In fact, some people who contract HIV will have a flu-like illness shortly after contracting the virus. The majority of sufferers will not notice any further symptoms until several years later.

As discussed most people who have HIV will experience a short, flu-like illness in the few weeks after contracting the virus but the most common symptoms to be experienced in the seroconversion stage of HIV are:

  • Sore throat
  • Fever
  • A rash on the body

 

Stages of the infection

HIV infection, if left untreated, will progress through a series of stages:

  • Seroconversion illness - if a person experiences a short illness after first becoming infected with the virus it is known as primary or acute HIV infection or seroconversion illness. For many people, this stage will pass unnoticed but as mentioned above, some people may experience mild flu-like symptoms but others can experience more severe symptoms and have to seek the help of their GP. At this point in their infection, a person is at their most infectious.

  • The asymptomatic stage of HIV - after the seroconversion phase the majority of people do not have any further symptoms and feel well; this is the asymptomatic stage that can last for a number of years. Despite the fact that a person may feel well during this time, the virus is actively infecting new cells, replicating itself and systematically damaging the person's immune system rendering it less and less effective at fighting disease.

  • Symptomatic HIV - as time progresses and if the virus remains untreated the less the immune system will be able to fight disease; this is when a person is at risk of becoming ill. Once a person starts to become ill they are now in the symptomatic phase of HIV.

  • Late stage HIV - once the HIV has had the chance to damage the immune system sufficiently it is at that point that a person is likely to catch random infections and cancers. As well as cancers, these illnesses include TB and pneumonia and are known as AIDS defining illnesses.

 

Treating HIV

Treatment for HIV has come a very long way since the 1980s with extremely effective treatments enabling people with the virus to live an almost normal life.

 

Emergency HIV drugs

If you have been exposed to HIV, there is treatment now available that can prevent an infection from occurring; it is known as PEP or post-exposure prophylaxis.

For this, to work, the PEP must be started within 72 hours of exposure to the virus and is recommended when high risk exposure has occurred, for example when a person has had sexual intercourse with a person known to be infected. The treatment involves taking PEP every day for a month and it may cause some side effects including headache, lethargy, nausea and diarrhoea and in rare cases, liver problems.

If a person tests positive for HIV then, to begin with, the person will have blood tests on a regular basis in order to assess how the disease is progressing.

The blood tests involved are:

  • HIV viral load test which monitors how much of the virus is in the blood

  • CD4 lymphocyte cell count gives a gauge of how the virus is affecting the immune system

Once these things have been assessed then treatment can begin

 

Antiretroviral drugs

These drugs operate by preventing the replication of the virus in the bloodstream. The result of this is that it gives the immune system a chance to heal itself whilst also preventing further damage from the virus.

HIV is a very adaptable virus and can become resistant to the drugs so different combinations may be required for different people at different times.  The viral load test is the one that can give a gauge as to how well the drugs are working. When it reaches the point that the viral load is undetectable it is not possible to pass the infection on through sexual intercourse; this is achievable after 6 months of treatment.

 

Living with the disease

Provided the condition is being properly managed then it is possible to live an almost normal life. Maintaining and improving general health is recommended to people living with HIV. Ways to do this include:

  • Taking regular exercise
  • Eating a healthy, balanced diet
  • Not smoking

There are some negative aspects to having HIV whereby blood and organ donation is not allowed, it is not possible to join the armed forces, getting life insurance may be difficult and some countries do not allow entry to HIV positive individuals.

Support in coping with the disease can be found in the healthcare team which looks after the sufferer; if needed they can provide advice and counseling.

Whilst it may not be easy to discuss having the condition it is very important that a person's present and past sexual partners are informed of the situation so that they can be tested.  It is also important that future sexual partners are told.

People with HIV are not legally obligated to inform their employer of the situation unless they have a front line job in the armed forces or a person is a healthcare professional who is involved with invasive procedures.

Finally, if you are HIV positive and pregnant there is a 25% chance that the child will become infected. Treatment is available today which will reduce that chance down to less than 1%.

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