An overview of Hiv

HIV (human immunodeficiency virus) is a virus that damages the cells in your immune system and weakens your ability to fight everyday infections and disease.

HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood and from illicit injection drug use or sharing needles. It can also be spread from mother to child during pregnancy, childbirth or breastfeeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS.

HIV is caused by a virus. It can spread through sexual contact, illicit injection drug use or sharing needles, contact with infected blood, or from mother to child during pregnancy, childbirth or breastfeeding.

HIV is found in the body fluids of an infected person. This includes semen, vaginal and anal fluids, blood and breast milk.

HIV destroys CD4 T cells — white blood cells that play a large role in helping your body fight disease. The fewer CD4 T cells you have, the weaker your immune system becomes.

HIV cannot be transmitted through sweat, urine or saliva.

After the first month or so, HIV enters the clinical latency stage. This stage can last from a few years to a few decades.

Some people don’t have any symptoms during this time, while others may have minimal or nonspecific symptoms. A nonspecific symptom is a symptom that doesn’t pertain to one specific disease or condition.

These nonspecific symptoms may include:

1. headaches and other aches and pains

2. swollen lymph nodes

3. recurrent fevers

4. night sweats

5. fatigue

6. weight loss

7. Nausea, vomiting or diarrhea

8. skin rashes

9. recurrent oral or vaginal yeast infections

10. pneumonia

11. shingles

The best way to reduce your risk of HIV is to be aware of how it spreads and protect yourself during certain activities. Having sex without a condom and sharing needles to take drugs are the most common ways that HIV spreads.

These are some ways to reduce your risk:

1. Use latex condoms (rubbers) whenever you have any type of sex (vaginal, anal or oral).

2. Don't use condoms made from animal products (like lambskin).

3. Use water-based lubricants (lotion).

5. Never share needles to take drugs.

6. Get tested and treated for other STIs. Other STIs can put you at higher risk for an HIV infection.

7. Avoid getting drunk or high. Intoxicated people might be less likely to protect themselves.

8. If you are at high risk of HIV exposure, ask your healthcare provider if you should be taking pre-exposure prophylaxis (PrEP).

9. If you think you’ve been exposed to HIV, contact your healthcare provider as soon as possible to see if you should take post-exposure prophylaxis (PEP).

10. Consider getting tested to know if you can pass HIV to others.

HIV can be diagnosed through rapid diagnostic tests that provide same-day results. This greatly facilitates early diagnosis and linkage with treatment and care. People can also use HIV self-tests to test themselves. However, no single test can provide a full HIV positive diagnosis; confirmatory testing is required, conducted by a qualified and trained health or community worker at a community centre or clinic

Most widely-used HIV diagnostic tests detect antibodies produced by the person as part of their immune response to fight HIV. In most cases, people develop antibodies to HIV within 28 days of infection. During this time, people experience the so-called window period – when HIV antibodies haven’t been produced in high enough levels to be detected by standard tests and when they may have had no signs of HIV infection, but also when they may transmit HIV to others. After infection without treatment and viral suppression, an individual may transmit HIV transmission to a sexual or drug-sharing partner or for pregnant women to their infant during pregnancy or the breastfeeding period.

Following a positive diagnosis, people should be retested before they are enrolled in treatment and care to rule out any potential testing or reporting error prior to starting life-long treatment. It is important to support people with HIV to stay on treatment and provide counselling messages and services when there are concerns about the accuracy of their diagnosis or if they stop treatment and care and need to be re-engaged

While testing for adolescents and adults has been made simple and efficient, this is not the case for babies born to HIV-positive mothers. For children less than 18 months of age, rapid antibody testing is not sufficient to identify HIV infection – virological testing must be provided as early as birth or at 6 weeks of age. New technologies are now available to perform this test at the point of care and enable same-day results, which will accelerate appropriate linkage with treatment and care.

Treatment should begin as soon as possible after a diagnosis of HIV, regardless of viral load.

HIV is treated with a combination of medicines (pills) taken by mouth every day. This combination of pills is called antiretroviral therapy (ART).

Antiretroviral therapy helps keep HIV from progressing to AIDS. It also helps reduce the risk of transmitting HIV to others.

When treatment is effective, the viral load will be “undetectable.” The person still has HIV, but the virus is not visible in test results.

However, the virus is still in the body. And if that person stops taking antiretroviral therapy, the viral load will increase again, and the HIV can again start attacking CD4 cells.

So the goal of ART is to reduce HIV in the blood (viral load) to an amount that’s not detectable by an HIV test and to slow HIV’s weakening of your immune system.

Medications used to treat HIV

These antiretroviral medications are grouped into seven classes:

1. nucleoside reverse transcriptase inhibitors (NRTIs)

2. non-nucleoside reverse transcriptase inhibitors (NNRTIs)

3. protease inhibitors

4. fusion inhibitors

5. CCR5 antagonists, also known as entry inhibitors

6. integrase strand transfer inhibitors

7. attachment inhibitors