HIV/AIDS, hiv, aids, treatments

HIV/AIDS – Stages, Symptoms, Treatment, and Transmission

AIDS is a medical condition caused by HIV. There is no cure for AIDS today but advances in treatment increase the life expectancy significantly.

HIV infection in a very initial stage show some symptoms but these symptoms disappear and come up in the later stage.

HIV infection cannot be treated completely but can be slow down and advancement can be prevented if caught in the early stage.

In this article, we will discuss symptoms of HIV/AIDS, cause of HIV/AIDS, its transmission, stages, treatments, and risk factors.

AIDS is an advanced stage of HIV Virus infection which cause the failure of the immune system and develops into AIDS.

What is AIDS?

AIDS is an advanced stage of HIV Virus infection.

If sufferer person does not get treatment, this cause failure of immune system, and develops into AIDS,

However, advancement in ART decreasing the number of people progress to this stage.

AIDS virus

AIDS caused by a virus called Human Immunodeficiency Syndrome, generally we called HIV.



AIDS full form

Aids stands for Acquired Immune Deficiency Syndrome.

Definition

It is a condition caused by the human immunodeficiency virus. In this condition, HIV virus targets the immune system of human which increase the risk of other diseases.

Without treatment this infection can progress to an advanced stage, is called AIDS.



Stages of HIV infection

HIV destroy over immune system. Without treatment it advances in its stages and eventually become AIDS.

There are 3 main stages of HIV infection

1. Acute infection

An initial stage of HIV infection is known as the primary HIV or acute retroviral syndrome.

After exposure of 2-4 weeks, Influenza-like illness (ILI) or Mononucleosis like illness (MLI) may be seen, while in some people no symptom of HIV infection seen.

Symptoms may occur in 50% to 90% of cases.

Due to the nonspecific symptom, these symptoms are not recognized as HIV infection.

Early stage Symptom

  • Influenza-like illness like malaise, dry cough, shivering, loss of appetite.
  • Mononucleosis-like illness like sore throat, swollen glands, tired, nausea, abdominal pains, headaches, body aches, etc.
  • Gastrointestinal symptoms like diarrhea, vomiting
  • Neurological symptoms like muscle loss, cramps, bone degeneration, changes in skin, nails, and hair, impaired balance, muscle weakness, abnormality in heart rate and blood pressure.
  • Maculopapular rash
  • Opportunistic infections

2. Clinical latency

In which stage initial symptom of HIV infection can be seen is called chronic HIV.

Without treatment, this stage can last for 20 years. While in the beginning no or few symptoms are seen.

But near the end of this stage, symptoms can be seen like gastrointestinal problems, weight loss, etc.

If a person doesn’t get any treatment, then this can lead to AIDS.

Symptoms

  • Fever
  • Weight loss
  • Muscle pain
  • gastrointestinal problems
  • Enlarged painless lymph node for over 3-6 months.

3. AIDS

This is the last stage of HIV infection. Without getting any treatment in the early stage of HIV, around 50% of people infected with HIV develop into AIDS within 10 years.

Symptoms

  • Shortness of breath
  • Unintentional Weight loss
  • Night Sweats
  • The fever lasts for 10 days or more
  • Nonproductive cough
  • Muscle atrophy
  • Fatigue
  • Loss of appetite
  • Weakness
  • Painful or difficult swallowing
  • Headaches
  • Sore throat
  • Nasal congestion

Does HIV cause Rash?

Yes, HIV cause rash. About 90% of people with HIV experience rash or experience change in their skin.

Usually, the HIV rash appears as a small lesion that can be flat or raised.

1. HIV rash

Rashes can occur as a result of recent HIV exposure and typically appear after 2 to six months.

These are described as maculopapular, macule describes flat discolored spots while people describe small raised bumps.

2. Seborrheic Dermatitis

This skin condition occurring in over 80% of people with advanced diseases.

It appears when the CD4 count is less than 500.

These are inflammatory skin disorder and affect the most scalp, torso, and face.

3. Drug Hypersensitivity Reaction

Rashes develop due to the allergic reaction to drugs like antibiotics and HIV antiretrovirals.

4. Stevens-Johnson syndrome (SJS)

Is a life-threatening form of a rash. In this top layer of skin begin to detach from the lower layer of skin.

It causes due to disorder in the immune system.

Transmission of AIDS

There are three main cause of transmission of AIDS

1. sexual

The most common cause of transmission of HIV is through sexual intercourse with an infected person (HIV positive).

The risk of transmission of HIV through anal sexual intercourse is 1.4 to 1.7% per sexual act.

However, the risk of transmission through oral sex is nearly nil or 0-04% of oral intercourse.

The risk of transmission is increased if the other person has sexually transmitted infection, genitals ulcer gonorrhea, chlamydia, or trichomoniasis.

If the person is in late-stage, then the rate of transmission is increased 8 times.

2. Body fluid

This is the second most common cause of transmission of HIV infection.

  • The HIV virus can be transmitted through Bloodborne transmission like needle sharing during drug use, needle stick, or transfusion of blood product. The average risk of infection during drug is 0.8%. HIV/AIDS transmitted in about 93% of blood transfusion using infected blood.
  • Unsafe medical injections also play significantly in spreading HIV. sharing injection with patients who are likely to be HIV positive.
  • HIV can also be acquired by organ transplantation. However, this is very rare due to screening.

3. Mother to child

HIV can be transmitted to the child during pregnancy, breastfeeding, during delivery.

This is the third most common mode of transmission of the HIV world.

If it’s not treated, then the risk of transmission before or during is 20% and 35% in those who breastfeed.

In 2008, transmission accounts for about 90% of HIV cases in children.

Diagnosis

HIV/AIDS is diagnosed in a laboratory and staged on the basis of symptoms.

HIV screening is recommended by United States Preventive Services Task Force for all the people.

Additionally, some test is also recommended to the people with the sexually transmitted disease.

HIV testing

Most people develop seroconvert within 1 to 12 weeks after the initial infection.

Positive results obtained by PCR antibody and after that confirm by PCR or a different type of antibody.

The antibody test is typically inaccurate due to the presence of maternal antibody.

Thus, HIV can only be diagnosed by PCR testing.

1. Antibody Screening test

These tests check protects what your body makes in response to HIV infection after 2-8 weeks later.

They are also called ELISA test and these tests are very accurate  but don’t catch the infection in the early stage.

Technicians usually need a small sample of blood, urine or fluid from your mouth.

2. Antibody and Antigen Combination Tests

It can detect HIV earlier than the antibody screening test.

They check for protein p24, which is HIV antigen, a part of the virus that shows up 2-4 weeks after infection.

3. In-Home Test Kits

It is two type and also available online. Make sure that you are using is FDA-approved.

The first method, send a small sample to the lab. You will get your result within few business days.

They will also do follow up test if your blood sample is positive.

The second method, collect fluid from upper and lower gums and test the sample in a small bottle.

You will get result in around 20 minutes. If you find it positively, then does follow up test because this may get a false negative.

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4. Follow up tests

If you found a positive result, it means there are some traces of HIV, after that you should get a standard library to confirm the diagnosis.

HIV/AIDS stages

  • Primary HIV infection: this associated with an acute retroviral syndrome.
  • Stage 1: CD4 count ≥ 500 cells/µl and HIV infection are asymptomatic. May include painless node enlargement.
  • Stages 2: CD4 count 350 to 500 cells/µl. The symptom may include minor mucocutaneous and upper respiratory tract infections.
  • Stages 3: CD4 count of fewer than 350 cells/µ. So advance symptom may be shown like severe bacterial infections, including tuberculosis of the lung, diarrhea longer than a month etc.
  • Stage 4 or AIDS: CD4 count ≤ 200 cells/µl. sever symptom seen candidiasis of the esophagus, bronchi or lungs, trachea, Kaposi’s sarcoma and toxoplasmosis of the brain, etc.

Prevention of HIV/AIDS

HIV/AIDS spreads through body fluids such as vaginal fluid, breast milk,semen and blood but not spread through saliva or through kissing.

1. Pharmaceutical

You should use only a medically proven method for preventing HIV. during sexual intercourse, use condoms.

If you are an HIV-positive mother and wishing to prevent the spread of HIV to your children during birth use antiretroviral drugs.

This is a medically proven the drug to reduce the spread of the infection.

2. Social strategies

This doesn’t require any drug, therapy, and tool, but the person requires to gain more knowledge and protection from HIV.

This includes sex education, safe sex, LGBT sex education, immigration regulation, needle exchange program, etc.

3. Sexual contact

Condom use consistently reduces the risk of HIV transmission by 80% over the long term.

If one person is infected, then consistent use of condom results the rate of HIV infection to an uninfected person is less than 1% per year.

A vaginal gel, reverse transcriptase inhibitor when used before sex decrease the infection rate by 40%.

There is some evidence that when men have sex then the penetrative partner has a lower risk of contracting HIV.

4. Before exposure to HIV

Early treatment of HIV-infected people protected 96% of partners from infection.

Precautions with the healthcare environment are believed to very helpful and effective in decreasing the risk of HIV.

opioid substitution therapy Needle exchange programs also appear effective in decreasing the risk of HIV in a broader community.

5. After exposure

If you are exposed to HIV positive blood or genital secretions then you should take A course of antiretrovirals within 48-72 days.

Use of zidovudine reduces the risk of HIV infection five-time.

This treatment is recommended after sexual assault when a felon is HIV positive.

Current treatment typically uses lamivudine/zidovudine and lopinavir/ritonavir may decrease the risk further.

6. Mother to child

Programs to prevent the transmission of HIV from mother to child can significantly decrease the RISK of transmission of HIV by 90-99%.

In this, we use the combination of antivirals during pregnancy and after pregnancy, use bottle feeding rather than breastfeeding.

7. Gene therapy

A certain mutation in the CCR5 gene makes certain people able to catch AIDS. modifying CCR5 using gene therapy

Treatment

There is no cure for HIV/AIDS, but there are many drugs available to control the virus. These treatments called antiretroviral therapy.

Each type of drug block in different ways. It is recommended to combine different drugs from two classes to avoid creating drug-resistant HIV.

There six classes of drugs, which are used to treat HIV in combination.

1. Entry inhibitor

It interferes with fusion, binding, and the entry of HIV-1 to the cell by blocking targets. There is enfuvirtide and maraviroc two currently available agents in this class.

Maraviroc target CCR5, located on the human helper T-cell.  Enfuvirtide prevents the fusion of the virus with the host membrane.

2. A nucleotide reverse transcriptase inhibitors (NtRTI) and nucleoside reverse transcriptase inhibitors (NRTI)

Nucleotide reverse transcriptase inhibitors (NtRTI) and nucleoside reverse transcriptase inhibitors (NRTI) or nucleotide analogs and nucleoside which inhibit reverse transcription.

HIV is an RNA, and hence it can’t be integrated into the DNA. so it must “reverse” printed in DNA. Since conversion RNA to DNA performed by the viral protein which makes it a selective target for inhibition.

Currently used drugs in NRTIs include emtricitabine, abacavir, zidovudine, tenofovir, and lamivudine.

3. Non-NRTIs

NNRTIs include tow generation. First generation and second generation.

The first generation includes efavirenz and nevirapine, and the second generation includes rilpivirine and etravirine.

4. Integrase inhibitors

Integrase inhibitors inhibit the viral enzyme integrase, which is responsible for the unification of viral DNA into the DNA of an infected cell.

Raltegravir is first integrase inhibitors, which are approved by the FDA in 2007.  

Dolutegravir and elvitegravir are two medically approved integrase inhibitors.

5. Protease inhibitors

These block the viral protease enzyme. These drugs prevent the cleavage of pol precursor and gag precursor protein.

Protease inhibitors include ritonavir. Darunavir, nelfinavir, amprenavir, lopinavir, atazanavir.

AIDS wasting syndrome

The AIDS wasting syndrome is not a disease, but when someone with AIDS lost 10% of body weight, especially muscle is called an AIDS wasting syndrome.

In this condition, the patient may have diarrhea for at least for a month, or extreme weakness.

Cause

  • You may not be taking ART medication.
  • You may not be eating well and your body is not getting the proper nutrients.
  • Your body may not be absorbing nutrients that you are getting because HIV can damage the lining of your intestine.
  • HIV may affect your metabolism.
  • Your body may not be getting enough calories because when you have HIV your immune system is working hard.

Treatment

  • Megestrol acetate is a hunger stimulant, but some doctor does not recommend it because slow the release of hormone from sex glands and builds fat.
  • Dronabinol, it works like marijuana to improve your body weight and stabilize your body weight.
  • Marijuana, can lessen your pain, and increase the hunger.

Facts

  • In 2015 there were around a million cases of HIV-positive. And 2016 medical professional diagnosed is an estimated 18,160 people.
  • In 2014 in the US, men aged between 13-24 accounted for 92% of new diagnosis among all men in their group and 27% of new diagnosis among all bisexual and gay.
  • In the same year in the US, 28% of transgender women and 15% of gay have an HIV positive test in the US.
  • Globally, the most common transmission is sexual contact with the opposite gender, but it varies with countries.
  • It is estimated that in 2017 globally there were 36.9 million people living with HIV. Around 25% don’t know their status.
  • Out 36.9 million 1.8 million were children.
  • Since starting 77.3 million people infected with HIV and around 35 million people died due to AIDS-related disease.
  • In 2017, 940,000 people died due to AIDS-related diseases.
  • As the end of 2017, 59% (21.7million) people were receiving the ART treatment globally.
  • 1 million out of 10.4 million people who have developed TB were HIV positive.

HIV/AIDS books

If you want to read some stories of people, who are HIV positive you can click here.

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HIV/ AIDS charity

If you want to help some other people and want to donate. You can go there and donate.

These charities spend all the money on the program.

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