HIV


Since AIDS was first described in the early 1980's, the worldwide epidemic has claimed the lives of 22 million men, women, and children of all genders, ethnicities, and sexual orientations. Another 40 million live with HIV (human immunodeficiency virus), the virus that causes AIDS. Although research into an HIV vaccine and similar preventative measures is under way, at the present time education, prevention, and treatment are our most important weapons in the fight against this terrible epidemic.

What is HIV?

HIV is a retrovirus with two primary types: HIV-1 and HIV-2. There are many strains of both types and all mutate rapidly, which has made it particularly difficult for researchers to find an effective vaccine or treatment for the virus. HIV infection is often mostly or entirely asymptomatic (without symptoms) and the most common signs, which include fever, fatigue, rash, and lymphadenopathy (swollen lymph nodes), are often mistaken for mononucleosis, flu, or similar, comparatively harmless diseases. Eventually, full-blown AIDS (Acquired Immune Deficiency Syndrome) develops in the vast majority of cases.

Because the virus is so often asymptomatic, it is extremely important to have yourself tested for it if you suspect you might have been exposed, in order to prevent further infection and slow the spread of the infection in your own body through proper treatment. Testing is done by looking at a blood sample for HIV antibodies. These antibodies are present starting about three months from the time of infection. Some countries now require HIV testing for all visitors staying beyond a certain length of time and testing is also routine for pregnant women in many places, so treatment may be started as soon as possible in order to reduce the risk of transmission to the unborn child.

HIV and AIDS are so lethal because they attack the very system that is supposed to protect against viral and bacterial infection: the immune system. They infect a type of white blood cell called T cells. A normal T cell is responsible for identifying foreign bodies such as viruses and bacteria in the body, ensuring that other white blood cells attack and kill it. In an infected T cell, the virus takes control and uses the T cell to replicate itself and spread other viruses throughout the body. Eventually, virtually all an infected person's T cells may be attacked in this way, dramatically weakening the body's ability to fight off diseases of any kind. Very few people die directly of AIDS. Most succumb to other diseases, such as pneumonia or tuberculosis, which their AIDS-weakened immune systems are unable to fight off.

Preventing HIV Infection

HIV is found in blood and other bodily fluids that contain red and white blood cells. It can be passed by:
  • Unprotected vaginal, oral, or anal intercourse with an HIV-infected person of either sex or orientation. Intercourse while a woman is having her period or during an outbreak of sores or lesions caused by herpes, gonorrhea or another sexually transmitted disease increases the risk. Although no barrier method is fully effective, the use of condoms in particular greatly reduces the risk of HIV transmission.

  • Sharing needles or other drug equipment with an HIV-infected person, being accidentally stuck by a sharp object covered in HIV-contaminated blood, or otherwise coming into contact with contaminated blood or bodily fluids.

  • Infected blood used in transfusions, and infected blood products used in the treatment of certain diseases before March, 1985, when federal regulation mandated the screening of blood used in transfusions and other treatments for HIV.

  • Pregnancy, childbirth, or breast-feeding can result in transmission of the virus from an infected mother to her child without proper preventative measures
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HIV cannot be passed through casual contact with an infected person, such as hugging, sharing toilet seats or cutlery, shaking hands, etc. Mosquitoes and other biting insects also do not transmit the disease. Dry kissing and pecking are considered safe; open mouth kissing, although considered very low risk, is not recommended with an infected person, particularly if it is prolonged, as there is the slim possibility of damage to mouth or lips resulting in transmission of the disease.

Treatment of HIV and AIDS

The average time of progression from HIV infection to full blown AIDS varies widely from person to person. Some patients begin to develop AIDS symptoms within a few months after infection, others have remained asymptomatic for as long as 20 years. The average time of progression from infection to full blown AIDS seems to be about 8 to 10 years, if the disease goes untreated. With treatment, it can be much longer.

Although research is ongoing, no cure has yet been found for the disease. The most successful treatment currently known is a complex “cocktail” of drugs that attacks the virus at various stages in its lifecycle. These drugs include protease inhibitors, which slow down the virus's ability to duplicate itself, reverse transcriptase inhibitors, which slow the virus's ability to complete the infection of a cell, and entry inhibitors, which inhibit viral entry to a cell.

Unfortunately, these drugs have many side effects, some of them life-threatening in their own right. Some of the most common include nausea, diarrhea, liver damage or failure, and jaundice. Frequent blood tests are necessary to ensure that the virus is not developing immunity. Despite these problems, mortality is much lower for those who begin treatment early than for those who wait until the symptoms of immune system collapse begin to appear. For this reason, it is very important to get tested as soon as possible if you believe you have been exposed to the HIV virus.

Although it is difficult for many people to come to terms with the reality of living with a fatal disease (counseling and support services can help), the benefits of knowing, in terms of increased lifespan and quality of life, far outweigh the consequences.

By Kerry Given           


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