ViH

What is HIV?

Human Immunodeficiency Virus, also known as HIV, is a retrovirus that attacks the immune system by destroying white blood cells, which are responsible for fighting infections. This causes the person affected by HIV to contract serious diseases.

The immune system is the body’s natural defense against infectious organisms such as fungi, viruses or bacteria that try to invade a person’s body.

HIV is an infection that is transmitted through sexual intercourse, by coming into contact with the blood of an affected person, from mother to child during pregnancy, during childbirth or through breastfeeding.

The term AIDS is used when the person reaches the final stage of the disease, i.e. the person has acquired immunodeficiency syndrome. It should be noted that not all people infected with HIV develop AIDS.

Prognosis of the disease

To date, there is still no specific treatment that can put an end to AIDS. However, it should be noted that the life expectancy of people affected by this disease is higher than it was a few years ago, although life expectancy is still far from that of a healthy person.

In the absence of adequate treatment, AIDS is a fatal disease. Death is not caused by HIV, but usually by neurological diseases, cancer or pneumonia.

Antiretroviral therapy is of vital importance in increasing life expectancy and improving quality of life by keeping HIV levels inhibited.

Picture of HIV

Symptoms of HIV

When talking about the symptoms of the disease, a series of phases should be highlighted, since the signs of the disease vary according to the entry of the virus into the organism and its degree of involvement.

Primary, acute or early infection.
This is the first phase of HIV infection. In most of those affected, the signs are of feeling sick, as in the early stages of influenza. In this first stage of the disease the viral load in the blood is very high, and it is very easy to transmit the disease. This occurs in the first two to four weeks, this being the body’s natural response to infection. Some of the usual signs are:

  • Fever
  • Muscle pain
  • Joint pain
  • Headache
  • Appearance of painful mouth sores
  • Sore throat
  • Swollen lymph nodes in the neck
  • Skin rash

Latent clinical infection, chronic HiV

In this case we speak of an intermediate phase, in which HIV is still active but reproduces at low levels. It is usual that during this phase the patient does not feel sick or tired. If the infection is not being treated, the intermediate phase can last up to a decade.

During this stage the virus can be transmitted, although those who maintain an inhibited viral load are less likely to do so.

Symptomatic HIV infection and progression to AIDS

As the virus continues to reproduce and destroy new cells, the patient may manifest some signs such as the following:

  • Fatigue
  • Fever
  • Diarrhea
  • Weight loss
  • Candidiasis
  • Herpes

Finally, when the viral load is high inside the organism, and the CD4 lymphocytes (the ones attacked and destroyed by HIV) are below 200. If left untreated, HIV becomes AIDS within a decade.

By the time AIDS as such appears, the immune system is already impaired and the patient is more prone to infections, opportunistic cancers… It can be said that the patient can become ill with diseases that would not affect a person with a healthy immune system.

In this phase, some signs of infection may be:

  • Heavy night sweats
  • Chronic diarrhea
  • Recurrent fever
  • Appearance of white patches on the tongue
  • Appearance of unusual lesions in the mouth and/or on the tongue
  • Unintentional weight loss
  • Skin rashes
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The main problem with AIDS is that it weakens a person’s immune system, making the person prone to numerous infections or some types of cancer.

  • Common HIV infections
    • Tuberculosis
    • Candidosis
    • Cryptococcal meningitis
    • Cytomegalovirus
    • Toxoplasmosis
    • Cryptosporidiosis
  • Frequent cancer in people with AIDS
    • Lymphoma
    • Kaposi’s sarcoma
  • Other complications
    • Neurological diseases
    • Renal diseases
    • Wasting syndrome

Worldwide prevalence of AIDS

Medical tests for HIV

A blood or saliva test can diagnose HIV infection by identifying antibodies to the virus, although it can take up to three months to develop.

A quick way to test for the presence or absence of HIV is to check for the presence of the virus antigen, a protein that is produced once infection has begun.

There is also a kind of home test to check whether or not infection is present, one with dried blood or saliva. If the test is positive, the person should see a specialist. On the other hand, if the test is negative, it should be repeated two months later.

If a person has been diagnosed with AIDS, there are several tests to identify the stage of the disease:

  • CD4 lymphocyte count
  • Viral load test
  • Drug resistance

What causes HIV?

HIV is a disease that is spread through body fluids such as blood, vaginal fluids, etc. Transmission can occur in the following ways:

  • Unprotected sexual intercourse with an infected person. The virus can enter the body through mouth sores, fissures…
  • Blood transfusion
  • Sharing needles: in case the patient shares contaminated intravenous drug materials, such as needles and syringes.
  • During pregnancy, childbirth or breastfeeding. The mother can transmit the virus to her child, so treatment can be taken to reduce the risk of infection.

Can HIV be prevented?

There is no exact way to prevent HIV infection, just as there is no cure for AIDS. However, there are a number of measures to protect yourself from the risk of infection:

  • Use a new condom or condom with every sexual intercourse.
  • In people at risk of infection, taking emitrictabine-tenofovir can reduce the risk of infection.
  • If you have HIV, you should tell your partner.
  • If you are taking drugs, you should use clean needles.
  • If you are pregnant, you should see a specialist immediately.
  • Male circumcision reduces the risk of HIV infection in men.

Treatments for HIV

Neither HIV nor AIDS can be cured, although there are a number of drugs that can control the virus. This is known as antiretroviral treatment, which blocks the virus in different ways.

It is recommended to use and combine at least three drugs from two classes to avoid drug-resistant strains. The drugs are as follows:

  • Non-nucleoside reverse transcriptase inhibitors, which inactivate a protein that HIV needs to reproduce.
  • Protease inhibitors inactivate it from HIV, so the virus is unable to reproduce.
  • Nucleoside or nucleotide analogue reverse transcriptase inhibitors are disrupted versions of the building blocks the virus needs to reproduce.
  • Entry or fusion inhibitors block the entry of HIV into lymphocytes.
  • Integrase inhibitors, which deactivate the protein that the virus uses to introduce its genetic material into lymphocytes.

Which specialist treats HIV?

The approach to HIV or AIDS is multidisciplinary, with different specialists who can intervene in the diagnosis or treatment of the disease, as well as its possible complications.

Thus, the Immunologist would be the specialist who would treat AIDS in the first instance, although others such as Internists, Oncologists, Dermatologists… may intervene depending on the needs.