Definition

HIV is a virus that attacks white blood cells called helper T cells (CD4). These cells are part of the immune system. They fight off infections and disease. As a result, an HIV infection can leave you vulnerable to severe illnesses.

AIDS is a late stage of HIV infection. It reflects severe damage to the immune system. One or more opportunistic infections will also likely exist. This is a type of infection that only occurs in people with compromised immune systems.

Causes

The HIV virus is spread through contact with HIV-infected blood or other body fluids. This includes semen, vaginal fluid, and breast milk.

AIDS is caused by the destruction of T cells. The destruction is caused by the HIV virus.

Immune System

Immune system white blood cell

HIV destroys white blood cells vital to the immune system.

Copyright © Nucleus Medical Media, Inc.

HIV is spread through:

    
  • Sexual contact with an HIV-infected person, especially intercourse or anal sex
  • Transfer of HIV from a mother to child during pregnancy, childbirth, or breastfeeding
  • A prick from an HIV-contaminated needle
  • A blood transfusion with HIV-infected blood (rare today, due to testing of all donated blood for HIV infection beginning in 1985)

    • Rarely, HIV can be spread through:

        
  • Blood from an HIV-infected person getting into an open wound of another person
  • Being bitten by someone infected with HIV
  • Sharing personal hygiene items with an HIV-infected person (razors, toothbrushes, etc.)

    • Risk Factors

    Factors that increase your chance of getting HIV include:

        
  • Having multiple sexual partners
  • Being a man who has sex with other men and engages in other high-risk behavior (having unprotected sex, using drugs during sex)
  • Being a woman who has sex with other women and men and also engages in high-risk behavior
  • Injecting illegal drugs, especially with used or dirty needles
  • Having regular exposure to HIV-contaminated blood or other body fluids (a concern for healthcare workers and people who work in correctional facilities)
  • Being born to an HIV-infected mother
  • Receiving donor blood products, tissue, organs, or artificial insemination
  • Being an immigrant from geographic locations with high numbers of AIDS patients
  • Having a sexual relationship with a high-risk individual or a partner already infected with HIV

    • The risk factor for AIDS is having HIV.

    Symptoms

    HIV may not cause symptoms for a number of years.

    Early symptoms may appear a month or two after becoming infected. They may last a couple of weeks. These include:

        
  • Rapid weight loss
  • Dry cough
  • Sore throat
  • Recurring fever
  • Night sweats
  • Extreme, unexplained fatigue
  • Swollen lymph nodes in armpits, neck, or groin
  • White spots on the tongue or in the mouth or throat
  • Headache
  • Discomfort from light
  • Rash
  • Depression
  • Irritable mood
  • Memory loss or other neurological disorder

    • After these initial symptoms pass, there may be no symptoms for months to years. Then, the following symptoms may occur over the course of 1-3 years:

        
  • Swollen lymph glands all over the body
  • Fungal infections of the mouth, fingernails, toes
  • Repeated vaginal infections (yeast and Trichomonas)
  • Development of lots of warts
  • Exacerbations of prior conditions, such as eczema, psoriasis, herpes infection
  • Shingles
  • Night sweats
  • Weight loss
  • Chronic diarrhea

    • It can be 10 years or more before HIV progresses to AIDS. This happens when T helper cell levels fall below certain levels and opportunistic infections arise. Examples of opportunistic infections and other complications of AIDS include:

        
  • Thrush (an overgrowth of yeast)
  • Pneumonia (particularly Pneumocystis jiroveci pneumonia)
  • Invasive fungal infections (resulting in brain and/or lung infections)
  • Toxoplasmosis infection
  • Tuberculosis
  • Viral brain infection
  • Kaposi's sarcoma
  • Lymphoma
  • Cervical cancer
  • Eye disease due to cytomegalovirus infection
  • Severe intestinal infections, especially due to shigella, salmonella, and campylobacter
  • Severe weight loss (wasting syndrome)
  • Severe skin rashes
  • Reactions to medications
  • Psychiatric problems, including depression and dementia

    • Diagnosis

    The doctor will ask about your symptoms, medical history, and risk factors. A physical exam will be done. Your doctor may order tests, such as:

        
  • ELISA test—used to detect HIV infection     
  • 95% will have a positive test within three months of infection
  • 99% will have a positive test within six months of infection
  • If an ELISA test is negative, but you think you may have HIV, test again in 1 to 3 months
  • Western blot blood test—usually done to confirm the diagnosis if ELISA was positive

    • Treatment

    Medicines can prevent, delay, or control the development of AIDS in many people infected with HIV.

    Drugs That Fight HIV

    These drugs are often given in combination. They include:

    Nucleoside reverse transcriptase inhibitors:

        
  • AZT (Zidovudine or ZDV)
  • ddC (Zalcitabine)
  • ddI (dideoxyinosine)
  • d4T (Stavudine)
  • 3TC (Lamivudine)
  • Emtricitabine (Emtriva)
  • Abacavir (Ziagen)     
  • In some patients, abacavir can cause a hypersensitivity reaction, which can be life threatening. Researchers found that screening for a particular gene can help to prevent this reaction.

    • Nucleotide reverse transcriptase inhibitors:

        
  • Delavirdine (Rescriptor)
  • Nevirapine (Viramune)
  • Efavirenz (Sustiva)
  • Etravirine (Intelence)

    • Protease inhibitors:

        
  • Ritonavir (Norvir)
  • Saquinavir (Invirase)
  • Indinavir (Crixivan)
  • Amprenavir (Agenerase)
  • Fosamprenavir (Lexiva)
  • Nelfinavir (Viracept)
  • Lopinavir (Kaletra)
  • Atazanavir (Reyataz)
  • Tipranavir (Aptivus)
  • Darunavir (Prezista)

    • Combination pill:

        
  • Atripla (Efavirenz, Tenofovir, and Emtricitabine)

    • Others:

        
  • Enfuvirtide (Fuzeon)
  • Raltegravir (Isentress)
  • Maraviroc (Selzentry)

    • Drugs That Fight AIDS-Related Infections and Cancers

    People who have developed AIDS are treated with numerous drugs that help prevent:

        
  • Pneumonia
  • Thrush
  • Repeated herpes infections
  • Toxoplasma brain infections

    • Prevention

    To prevent becoming infected with HIV:

        
  • Abstain from sex.
  • If you do have sex use a male latex condom. This includes any sexual act that results in the exchange of bodily fluids.
  • Do not share needles for drug injection.
  • Limit your number of sexual partners.
  • Avoid sexual partners who are HIV-infected or injection drug users.
  • Avoid receiving transfusion of unscreened blood products.
  • If you are a healthcare worker or work in a correctional facility:     
  • Wear appropriate gloves and facial masks during all procedures.
  • Carefully handle and properly dispose of needles.
  • Carefully follow universal precautions.
  • If you live in a household with an HIV-infected person:     
  • Wear appropriate gloves if handling HIV-infected bodily fluids.
  • Cover all cuts and sores, yours and the HIV-infected person's, with bandages.
  • Do not share any personal hygiene items such as razors, toothbrushes, etc.
  • Carefully handle and properly dispose of needles used for medication.

    • Recent studies found that circumcised men were significantly less likely to develop HIV infection compared to uncircumcised men.

    To prevent spreading HIV to others if you are HIV infected:

        
  • Abstain from sex.
  • If you do have sex, use a male latex condom. This includes any sexual act that results in the exchange of bodily fluids.
  • If you are prescribed medicines, be sure that you are taking them.
  • Inform former or potential sexual partners.
  • Do not donate blood or organs.
  • Ask your doctor about contraception.
  • If you do wish to become pregnant, talk to your doctor. There are ways to lower your baby's risk of being born infected with HIV.
  • If you have a baby, do not breastfeed.