What you need to know?
When HIV/AIDS came on the scene, it caused a worldwide panic. At the time, it was considered a death sentence. As a result of years of research and hard work, advances have been made in treating and preventing it. People who have the virus are able to live long lives with less health concerns. What are these improvements? Are there still things that can be done?
Definition
The human immunodeficiency virus (HIV) is transmitted through infected blood, semen, or vaginal secretions. This usually occurs via sexual contact, sharing contaminated needles or blood transfusions (this is uncommon in the US since blood is screened before it’s cleared to be transfused). It can also be passed from mother to child during pregnancy, childbirth, or breastfeeding. The virus is not spread through air/water, hugging, kissing, dancing, insect bites, or shaking hands. Anyone is susceptible; it doesn’t matter your age, race, sex, or sexual orientation. You’re especially at risk if you have unprotected sex, have multiple sexual partners, already have another sexually transmitted infection (STI), or use intravenous (IV) drugs.
Over time, HIV transitions into acquired immunodeficiency syndrome (AIDS). This happens because the virus destroys CD4 T cells, which are a type of white blood cell that plays a significant role in your immune system to protect you against diseases. The fewer of these that your body has means that your immune system is weak, leaving you susceptible to infections. Infectious complications can include pneumocystis pneumonia (PCP) (the most common type of pneumonia for those with AIDS), candidiasis (thrush), tuberculosis (TB) (the leading cause of death among individuals with AIDS), cytomegalovirus (a healthy immune system can fight off this virus), cryptococcal meningitis (a common central nervous system infection for those with AIDS), and toxoplasmosis. Cancers that are common complications of AIDS are lymphoma and Kaposi’s sarcoma. Other complications are wasting syndrome, neurological issues, kidney disease, and liver disease.
There are several stages of symptoms. Primary (Acute) HIV occurs within two to four weeks after the virus enters your body. It can last for a few weeks and often includes fever, headache, muscle aches, joint pain, rash, sore throat/mouth sores, swollen lymph nodes (especially in the neck), diarrhea, weight loss, cough and night sweats. Since these symptoms are common to many illnesses, like the flu, it’s easy to misinterpret the cause. For some individuals, the symptoms are mild enough that they don’t even notice them. However, the amount of virus in your bloodstream (viral load) is exceptionally high during this period, meaning that you can easily spread the virus to others. The next stage is Clinical Latent Infection (Chronic HIV). During this phase, HIV is still in your body, but most people don’t have symptoms. This period can last for several years and the person isn’t as infectious as they were during the acute stage. As the virus persists in destroying your immune system cells, you might have mild infections or chronic symptoms, like fever, fatigue, swollen lymph nodes (typically one of the first signs of HIV), diarrhea, weight loss, thrush, shingles, and pneumonia. This stage is known as Symptomatic HIV Infection. If left untreated, HIV turns into AIDS in about 8-10 years. By this time, your immune system is severely damaged and your body is prone to opportunistic infections or cancers. Symptoms of these complications are often sweats, chills, recurring fever, chronic diarrhea, swollen lymph nodes, persistent white spots or unusual lesions on your tongue or in your mouth, persistent/unexplained fatigue, weakness, weight loss, and skin bumps/rash.
Treatment
Although there isn’t a cure, today’s treatments help prevent the progression of HIV to AIDS. To select the right treatment, your doctor will need to stage your disease. This is done via several tests. The first is your CD4 T cell count. Even if you don’t have symptoms, your infection can progress to AIDS if your level drops below 200. The second test is the viral load (HIV RNA). This measures how much virus is in your blood. The goal of treatment is to have an undetectable viral load. The final test is to see if your strain of HIV is resistant to any medications because this will help your doctor determine which ones to prescribe. Your doctor might also consider testing for any complications if there are additional symptoms.
The medicines used to treat HIV/AIDS are called antiretroviral therapy (ART). Regardless of your stage or complications, you should be started on it. ART usually involves taking a combination of three or more medications from several different classes of drugs. This is done to maximize suppression of the virus in the blood while taking into account individual drug resistance and trying to avoid creating new drug-resistant strains of HIV. Often two drugs from one class and a third drug from a different category are used. Many of them are combined into a single pill that’s taken once a day. There are five different classes. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) turn off the protein needed by HIV to make copies of itself. Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) provide faulty versions of the building blocks that HIV uses to duplicate itself. Protease inhibitors (PIs) inactivate HIV protease, a different protein that HIV has that also promotes making replicas of itself. Integrase inhibitors disable a protein, integrase, that HIV uses to insert its genetic material into CD4 T cells. Entry or fusion inhibitors block the entry of HIV into CD4 T cells.
For ART to be effective and keep you healthy, you must take it as prescribed without missing or skipping any doses. This will help keep your viral load undetectable, your immune system strong, decrease your chances of having complications, and reduce the odds of transmitting the virus to others. However, the therapy can be challenging to follow. It can cause side effects, such as nausea, vomiting, diarrhea, heart disease, kidney/liver damage, weakened bones, abnormal cholesterol levels, high blood sugar, sleep problems, and cognitive/emotional problems. If you have any of these issues, don’t stop taking your medication. Instead, talk to your doctor and they’ll help you find a solution. It’s also vital to let your doctor know about any other medical conditions that you have and medications that you’re taking.
Besides following ART, there are other things you can do to help stay healthy. The most important is to eat a diet that is rich in fresh fruits/vegetables, whole grains, and lean proteins. This will keep you healthy, give you more energy, and support your immune system. Since foodborne illnesses pose more of a threat to you, avoid unpasteurized dairy products and raw meat, eggs, and seafood. It’s essential to get any vaccinations recommended by your doctor to prevent opportunistic infections, such as flu, pneumonia, HPV, hepatitis A, and hepatitis B. Keep in mind vaccines that contain live viruses aren’t safe due to your weakened immune system. Since animals can carry parasites, be sure to wash your hands thoroughly after handling pets or their food and waste. Be careful with nutritional supplements because they can interact with your medications. So, before taking any, it’s a good idea to talk with your doctor. It’s crucial to have a good support system. Being diagnosed with HIV/AIDS can be devastating. Talking with family, friends, and/or a therapist can help.
Prevention
There isn’t a vaccine available to prevent an HIV infection, but you can reduce your risk. The easiest thing to do is to use a new condom every time you have sex, whether it’s anal or vaginal. There are both male and female condoms, along with dental dams. So, there are a variety of options to keep you safe. If any of the products are latex-based, be sure to use water-based lubricants only. Before using any of them, check the expiration date and make sure that the packaging isn’t damaged. When opening, be careful and don’t use your teeth or nails since this could damage the product. Always use a new product each time you engage in sexual contact.
If you’ve been exposed or think you’ve been exposed to HIV, it’s essential to contact your doctor or go to the nearest emergency room immediately. You can receive post-exposure prophylaxis (PEP) within the first 72 hours, which will significantly decrease your chances of contracting the virus. You’ll also need to take medication for the next 28 days. While this might seem like a long time, it’s better than having to deal with HIV/AIDS.
If you’re in a high-risk population, you should consider preexposure prophylaxis (PrEP). This can decrease your risk of contracting HIV from sex by over 90% and IV drug use by more than 70%. You can only receive the medication if you don’t already have HIV, which means that you must be tested before you start taking it and every three months while on it. Keep in mind that the medicine must be taken every day to be effective and it doesn’t prevent other STIs.
If you have HIV, you must tell your current and past sexual partners because they’ll need to get tested. To avoid spreading the virus, you can use treatment as prevention (TasP). This means taking your medication exactly as prescribed and getting regular checkups to keep your viral load undetectable, which should keep you from giving the virus to your partner. If you have HIV and become pregnant, you need to get medical care immediately. This will help to reduce the chances of spreading the infection to your baby. If you use IV drugs, make it a habit to use a sterile needle and don’t share it with others. Often, there are needle-exchange programs that can assist with obtaining clean needles. If you desire, you can also get help to quit using drugs.
HIV/AIDS is a severe illness. However, with the proper prevention techniques, you won’t have to deal with it. If you already have it, the treatment options can help you stay healthy. If you have any questions or concerns about HIV/AIDS, please speak with your doctor. If you would like more information, please visit HIV.gov HIV/AIDS page at https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids