HIV/AIDS, Hidden but still growing

HIV/AIDS: A Comprehensive Guide

HIV (human immunodeficiency virus) is a virus that attacks the immune system, the body’s natural defense system against disease. AIDS (acquired immunodeficiency syndrome) is a condition that occurs when the immune system has been weakened by HIV, making the person susceptible to a wide range of infections, some of which can be life-threatening. HIV/AIDS is a global pandemic that has claimed millions of lives over the past four decades. Despite advances in medical treatments, HIV/AIDS remains a significant public health concern, particularly in low-income countries where access to treatment and prevention measures are limited.

This comprehensive guide provides an overview of HIV/AIDS, including its causes, symptoms, diagnosis, treatment, and prevention.

Chapter 1: The History of HIV/AIDS

HIV/AIDS was first recognized as a new disease in the early 1980s. The first cases were reported among gay men in the United States, but it soon became clear that the virus was spreading among other populations, including people who inject drugs, women, and children. The cause of AIDS was unknown at the time, and it was not until 1983 that the virus that causes AIDS was identified by French scientist Dr. Luc Montagnier and his colleagues.

HIV is believed to have originated in chimpanzees in Central Africa, where the virus was transferred to humans through the consumption of infected bushmeat. The virus then spread through the population, primarily through sexual contact and the sharing of contaminated needles by people who inject drugs.

The initial response to the AIDS epidemic was slow, with many governments and health organizations failing to recognize the seriousness of the disease. Stigma and discrimination against people living with HIV/AIDS were widespread, and access to treatment was limited. However, over time, there have been significant advances in medical treatments for HIV/AIDS, as well as increased awareness and funding for prevention and treatment programs.

Chapter 2: Causes of HIV/AIDS

HIV is transmitted through the exchange of bodily fluids, including blood, semen, vaginal fluids, and breast milk. The most common modes of transmission are:

• Sexual contact: HIV is most commonly spread through sexual contact, including vaginal, anal, and oral sex. The virus can enter the body through small cuts or tears in the mucous membranes of the genital area or the mouth.
• Sharing needles: HIV can be transmitted through the sharing of needles or other injection equipment by people who inject drugs.
• Mother-to-child transmission: HIV can be passed from an HIV-positive mother to her child during pregnancy, childbirth, or breastfeeding.
• Blood transfusion: HIV can be transmitted through blood transfusions, although this is rare in countries with well-established blood screening programs.

Chapter 3: Symptoms of HIV/AIDS

The symptoms of HIV/AIDS vary depending on the stage of the disease. During the early stages of HIV infection, many people have no symptoms or only mild flu-like symptoms, such as fever, headache, and fatigue. These symptoms usually disappear within a few weeks, and the person may not be aware that they have been infected with HIV.

The next stage of HIV infection is known as the clinical latency stage or the asymptomatic stage. During this stage, the virus continues to replicate in the body, but the person may not experience any symptoms. This stage can last for several years, during which time the virus is still active and can be transmitted to others.

The final stage of HIV infection is AIDS, which occurs when the immune system is severely damaged and the person is susceptible to a wide range of infections and cancers. Symptoms of AIDS can include:

• Rapid weight loss
• Recurring fever or profuse night sweats
• Extreme and unexplained fatigue
• Prolonged swelling of the lymph glands in the armpits, groin, or neck

The final stage of HIV infection is AIDS

AIDS occurs when the immune system is severely damaged and the person is susceptible to a wide range of infections and cancers. Without treatment, the average time from HIV infection to AIDS is approximately 10 years, although this can vary depending on factors such as age, overall health, and access to medical care.

Chapter 4: Diagnosis of HIV/AIDS

The only way to know for sure if someone has HIV is to get tested. HIV testing is recommended for everyone at least once in their lifetime, and more frequently for those who are at higher risk of infection, such as people who have multiple sexual partners or who inject drugs.

There are several types of HIV tests, including:

• Antibody tests: These tests detect the presence of HIV antibodies, which are proteins that the body produces in response to the virus. Antibody tests can take several weeks to months after infection to become positive.
• Antigen tests: These tests detect the presence of HIV antigens, which are proteins produced by the virus. Antigen tests can detect HIV infection earlier than antibody tests, usually within a few weeks of infection.
• Combination tests: These tests detect both HIV antibodies and antigens and are the most accurate type of HIV test.

If an HIV test is positive, it is important to confirm the result with a second test. If both tests are positive, the person is diagnosed with HIV/AIDS and will need to begin medical treatment.

Chapter 5: Treatment of HIV/AIDS

While there is no cure for HIV/AIDS, there are several medications that can slow down the progression of the disease and improve the quality of life for people living with HIV. These medications are known as antiretroviral therapy (ART) and work by suppressing the replication of the virus in the body.

ART usually involves taking a combination of medications, known as a regimen, which may include:

• Nucleoside reverse transcriptase inhibitors (NRTIs)
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
• Protease inhibitors (PIs)
• Integrase inhibitors (INSTIs)
• Entry inhibitors

ART is highly effective at reducing the amount of virus in the body, known as the viral load, and can improve the immune system’s ability to fight off infections. With proper medical care, people living with HIV can live long and healthy lives.

Chapter 6: Prevention of HIV/AIDS

Prevention is key to reducing the spread of HIV/AIDS. There are several strategies that can help prevent HIV infection, including:

• Safe sex practices: Using condoms and other barriers during sexual activity can greatly reduce the risk of HIV transmission.
• Needle exchange programs: Providing sterile needles and other injection equipment to people who inject drugs can reduce the risk of HIV transmission.
• HIV testing and counseling: Knowing your HIV status and getting regular testing can help prevent the spread of the virus.
• Pre-exposure prophylaxis (PrEP): PrEP is a medication that can prevent HIV infection in people who are at high risk of infection.
• Post-exposure prophylaxis (PEP): PEP is a medication that can prevent HIV infection after exposure to the virus, such as through unprotected sex or needle sharing.
• Treatment as prevention: HIV-positive people who are on ART and have an undetectable viral load are much less likely to transmit the virus to others.

Dr.A.Arrazaghi.MD,FRCPC