HIV/AIDS

What is HIV?  What is AIDS?
HIV is the Human Immunodeficiency Virus.  AIDS stands for Acquired Immune Deficiency Syndrome, which is the latter stage of infection with HIV.  In the United States, there have been 950,000 people infected with the virus since the disease was first noted in 1982; 510,000 people have died. Currently, 40,000 people are infected per year in the U.S. Approximately 20,000 of those infections occur in those under age 25, of which 10,000 are in those under age 20. Globally, 42-45 million people are living with the virus; 25 million people have died.  There are 14,000 new HIV infections occurring on Planet Earth every day; 8,000 people die every 24 hours.
A person who has the virus is said to be HIV positive.  Once the virus is in a human body, it does what any virus does: "hi-jacks" certain cells, instructing them to make copies of the virus, instead of performing their normal function.  In the case of HIV, it takes over certain cells (CD4’s) of the immune system that are responsible for directing immune system functions.  Over time, this weakens the body’s defense against microorganisms, leading to increasing vulnerability to infections that a healthy immune system normally throws off without difficulty.  As the immune system gradually declines, the HIV positive person becomes more and more likely to get various illnesses and life-threatening infections.  An HIV positive person who has had certain of these illnesses or infections, or meets other medical criteria in regard to blood tests, is then diagnosed with AIDS.

Transmission

• Blood, semen, vaginal fluids, and breast milk, of an infected person.  Any other body fluid that contains any of the above fluids, is also able to transmit the virus.  
• Infected mother to her newborn during vaginal childbirth.
• Infected woman to her breast-feeding infant.
• Sharing injection drug use equipment,
• The virus may also be found in amniotic fluid (surrounding an unborn baby), cerebrospinal fluid (in the spinal canal and surrounding the brain), and synovial fluid surrounding bone joints.
• A person who has become infected with the virus is sometimes capable of passing it on to others within 48 hours of infection, long before any HIV screening test will turn positive.

• Approximately one-half of those who become infected with the virus will have a flu-like illness between one and six weeks after infection, as the body mounts a defense against the virus.  This response is called the acute infection syndrome.    Fever, sore throat, swollen glands, night sweats, aching muscles, fatigue, cough, and diarrhea may be present.  This may be mild enough to go unnoticed, or else thought to be flu.  These symptoms go away on their own after a few days or a week.  
• Following the initial flu-like symptoms (for those who noted them), the sequence of signs and symptoms, along with the time frame, varies widely from person to person. Many who have the virus look and feel just fine, as the immune system is able to outlast the virus for quite some time.  We now know, however, that even though an infected individual is feeling well, the virus is still hard at work, destroying the immune system.  
• As more and more CD4 cells of the immune system are taken over, there are fewer of them to fight off microorganisms that a healthy immune system easily destroys.  The HIV positive person may begin to experience symptoms, such as swollen lymph glands, recurring fevers, night sweats, constant fatigue, weight loss for no apparent reason, rashes, diarrhea, and /or generally not feeling well.  They may also seem to have a constant cold or flu.  
• As the immune system is further weakened by the progression of the virus, certain illnesses begin to take advantage of the poorly functioning immune system to cause infections that a healthy system easily controls.   Tuberculosis, Candidiasis (fungal infection of the mouth, throat, or vagina), Kaposi’s sarcoma, Pneumocystis carinii pneumonia (PCP), toxoplasmosis, malaria, shingles, and Cytomegalovirus (CMV), among many others. These are known as opportunistic infections.
• Once a person has had one or more of a specific group of these opportunistic infections, they are said to have progressed to having AIDS.

• HIV screening tests looks for antibodies to the virus.  Antibodies are proteins the body produces in response to infection with a virus to remove the virus from the body.  
• It can take anywhere from 3 weeks to 6 months for the body to produce antibodies in sufficient numbers to respond to the test.
• 96% of people who become infected will test positive by day 30 after infection.  A small percent will not test positive for six months to a year after becoming infected.
• Antibody screening tests can be performed on blood, urine, or a scraping from the inside of the cheek (NOT saliva).
• Antibody screening tests are of a type called an ELISA.  A test that reacts is usually repeated, and a second reactive ELISA is confirmed by a more specific and expensive test called a Western Blot.  
• A diagnosis of AIDS is made when an HIV positive person has either had one or more of the opportunistic illnesses specified as being an  AIDS defining illness, or when their CD4 cells (certain white blood cells of the immune system targeted by HIV) fall below 200.  A CD4 count in a healthy immune system varies between 600-1600.  
• The average time between infection with HIV and a diagnosis of AIDS is almost 11 years.  
• The average time from a diagnosis of AIDS until death is 5 years.

• Treatment is aimed at reducing HIV reproduction in the body, leading to slowing of the damage to the immune system.
• Medications used to slow reproduction of the virus are called anti-retrovirals. Different groups of anti-retro-virals act in various stages of the reproductive cycle of the virus to slow it down.
• Treatment usually consists of medications from two or more of the anti-retroviral groups.  The treatment is known as HAART, standing for Highly Active AntiRetroviral Therapy.
• HAART therapy can cause unpleasant side effects in those taking these medications
• Medications to counter the side effects of HAART.
• In addition to HAART, treatment programs encourage healthy lifestyles, such as a good diet, exercise, plenty of rest, all of which help to strengthen the immune system.
• Antibiotics and other medications may be used to prevent or combat opportunistic infections that may occur.

• The opportunistic infections discussed above, plus numerous others.   
• Side effects of HAART medications may include: fatigue, diabetes, high cholesterol, nausea, vomiting, severe diarrhea, strokes, high blood pressure, body fat redistribution, depression, severe nerve pain in the arms and legs, insomnia, bone marrow damage, kidney damage, skin peeling off in sheets.
• If the HAART medications are not taken exactly as directed, HIV quickly develops resistance (is no longer affected by) to the medicines.  
• The latter stages of AIDS may include dementia, as the virus affects the brain.  

• Use latex or polyurethane condoms correctly every time you have sex.  Latex has been shown to be an essentially impenetrable barrier to HIV.  When latex condoms are used correctly and every time a person has oral, anal, or vaginal sex, the risk of contracting HIV is extremely low.  
• Practice sexual abstinence, or limit sexual contact to one uninfected partner
• Pregnant women are encouraged to be tested
• HIV positive women should not breast-feed their infants.
• Anyone who has had unprotected sex or shared needles should consider being tested.
• If you do use injecting drugs, do not share needles with anyone.
• If you do share needles, learn how to clean them properly to reduce the risk for HIV and other blood-borne diseases.
• Get tested for other STD's.  Infection with other STD’s increases the risk of HIV infection. 

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