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HIV Infection and AIDS

(Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome)

Definition

Human immunodeficiency virus (HIV) is a viral infection. It attacks white blood cells called T-cells (CD4). They help the body fight infections and diseases. If you have HIV, it can leave you at risk for many health problems.

AIDS is a late stage of HIV. Immune system damage from HIV allows opportunistic infections (OIs) to take hold in the body.

Causes    TOP

HIV-1 or HIV-2 viruses cause infection. HIV spreads between people from direct contact with fluids from the body of someone who has it. This means blood, semen, vaginal fluid, and breast milk.

HIV destroys T-cells, leading to AIDS.

Immune System

Immune system white blood cell
HIV destroys white blood cells vital to the immune system.
Copyright © Nucleus Medical Media, Inc.

You can get HIV by:

  • Having vaginal or anal sex (most common)
  • Sharing needles to inject drugs
  • Using dirty needles
  • Working in high risk jobs such as healthcare
  • Working with high risk groups such as prisoners

Rarely, HIV spreads by:

  • A blood transfusion
  • Open cuts
  • A human bite
  • Sharing personal items such as a toothbrush or razor

A mother can pass HIV to her child during pregnancy, birth, or breastfeeding.

Risk Factors    TOP

Your chances of HIV are higher if you:

  • Have sex with people who have HIV
  • Have sex with many people
  • Have sex without a condom
  • Have other sexually transmitted infections (STIs)
  • Share dirty needles or use illegal drugs
  • Work in high risk jobs
  • Are born to a mother with HIV
  • Live in or travel to places where HIV and AIDS are common
  • Have an uncircumcised penis

Having HIV is the only risk factor for developing AIDS.

Symptoms    TOP

HIV may not cause problems for a number of years. Early symptoms may appear 1-2 months after infection. They’re similar to the flu:

  • Fever
  • Joint and muscle aches
  • Night sweats
  • Rash
  • Sore throat
  • Swollen lymph nodes
  • Weight loss
  • Headache
  • Nausea or vomiting
  • Diarrhea
  • Ulcers in the mouth or on the genitals

The symptoms will pass on their own, but the virus remains. You may not have problems for months to years. Over time, it’s harder to fight infections. Many symptoms on the list above come back. In addition, you may notice:

  • Lasting cough
  • Regular infections—can be anywhere in the body
  • Chronic diarrhea
  • Warts
  • Fungal infections of the mouth and nails
  • Flare-ups of prior conditions, such as eczema or psoriasis

Without care, HIV infection progresses to AIDS. People with AIDS are at high risk for OIs that happen anywhere in the body. AIDs may cause:

Diagnosis    TOP

The doctor will ask about your symptoms. You will also be asked about your health and sexual history. Your answers and a physical exam may point to HIV. You may also have:

  • Blood tests to:
    • Look for certain proteins in the blood
    • Measure the amount of HIV in the blood

Treatment    TOP

Medicines can prevent or slow progression to AIDS in many people. A combination of antiviral medicines are often used. These may include:

  • Nucleoside reverse transcriptase inhibitors
  • Nonnucleoside reverse transcriptase inhibitors
  • Protease inhibitors HIV-1 integrase inhibitors
  • HIV-1 fusion inhibitors
  • CC chemokine receptor 5 antagonists

Medicines help fight or stop OIs for those with AIDS. These may include antibiotics or antifungal medicines.

Prevention    TOP

To lower your chances of HIV:

  • Always use a latex condom or an oral barrier while having sex.
  • Don’t share needles.
  • Openly talk about STIs with your partners.
  • Let your doctor know if you share needles or have sex with someone who has HIV. Your doctor may want to start medicine to prevent HIV.
  • Get regular testing for STIs and HIV as advised.
  • Talk to your doctor about the value of pre- or post-exposure prophylaxis.

If you work with people or are in a household where HIV is present:

  • Wear appropriate gloves if handling fluids from the body.
  • Bandage your and their cuts and sores.
  • Don’t share personal items such as razors or toothbrushes.
  • Handle and dispose of any needles used for medicine as advised.

If you have HIV:

  • Always use a latex condom. This includes any sexual act that results in the exchange of fluids from the body. Options to consider:
    • Use a male or female latex condom.
    • Use a barrier during oral sex.
  • Take all medicines as advised.
  • Talk to your sexual partners about HIV.
  • Encourage them to get tested.
  • Don’t donate organs or blood.
  • Talk to your doctor about birth control if you’re not ready to have a baby. If you are ready, your doctor can guide you on how to do it safely.
  • Don’t breastfeed your baby.

RESOURCES:

AMFAR—The Foundation for AIDS Research
http://www.amfar.org
Centers for Disease Control and Prevention
https://www.cdc.gov

CANADIAN RESOURCES:

AIDS Committee of Toronto
http://www.actoronto.org
Canadian AIDS Society
http://www.cdnaids.ca

References:

2015 Sexually transmitted diseases treatment guidelines. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated January 25, 2017. Accessed May 30, 2018.
Acute HIV infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T902526/Acute-HIV-infection. Updated October 26, 2016. Accessed May 30, 2018.
Bailey RC, Moses S, Parker CB, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial. Lancet. 2007;369(9562):643-656.
Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657-666.
Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. AIDS Info website. Available at: https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf. Updated March 27, 2018. Accessed May 30, 2018.
HIV/AIDS. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/hiv. Updated May 29, 2018. Accessed May 30, 2018.
HIV/AIDS: The basics. AIDS info website. Available at: https://aidsinfo.nih.gov/education-materials/fact-sheets/19/45/hiv-aids--the-basics. Updated August 22, 2017. Accessed May 30, 2018.
HIV diagnostic testing. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T902526/Acute-HIV-infection. Updated September 26, 2017. Accessed May 30, 2018.
Montaner JS. Treatment as prevention: A double hat-trick. Lancet. 2011;378(9787):208-209.
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/nchhstp/Default.htm. Updated May 21, 2018. Accessed May 30, 2018.
Overview of HIV infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 8, 2018. Accessed May 30, 2018.
Pre-exposure prophylaxis (PrEP). AIDS website. Available at: https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis. Accessed May 30, 2018.
Preventing transmission of HIV. AIDS info website. Available at: https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/20/48/the-basics-of-hiv-prevention. Updated May 24, 2018. Accessed May 30, 2018.
Rey D, Krebs M, Partisani M, Hess G, et al. Virologic response of zidovudine, lamivudine, and tenofovir disoproxil fumarate combination in antiretroviral-naive HIV-1-infected patients. J Acquir Immune Defic Syndr. 2006;43(5): 530-534.
Ross LL, Parkin N, Gerondelis P, et al. Differential impact of thymidine analogue mutations on emtricitabine and lamivudine susceptibility. J Acquir Immune Defic Syndr. 2006;43(5):567-570.
Last reviewed May 2018 by EBSCO Medical Review Board David L. Horn, MD, FACP
Last Updated: 5/29/2018

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