HIV/AIDS (Acquired Immunodeficiency Syndrome)

AIDS is caused due to human immunodeficiency virus(HIV) infection. This retrovirus attacks the immune system, especially the CD4 cells(T- helper cells), which help to keep infections at bay. Therefore, AIDS patients are highly susceptible to infections and infection related cancers.

Transmission of HIV

1. Having unprotected sex with an infected person.
2. Sharing injectable drugs with an infected person
3. Sharing needles during body piercing and tattooing.
4. Transmission from an infected mother to baby via breastfeeding
5. Using HIV infected blood for transfusion (Rare)

Staging and Symptoms of HIV

Stage 3: Acquired Immunodeficiency Syndrome (AIDS): It is the advanced stage of infection where the levels of CD4 drop below 200(Normal-500-1500). Common symptoms of AIDS include- chills, fever, sweats, swollen lymph glands, weakness, and weight loss. People who do not take any treatment for AIDS may survive for 3 years. This duration can be lesser if the patient contracts a dangerous infection.

Diagnosis of HIV

1. Antibody test: This test detects the presence of HIV antibodies in blood or oral fluids. It detects HIV sooner than any other test. However, these antibodies can be produced only around 3- 12 weeks after infection.
2. Combination (Antigen/ Antibody) test: This test looks for both the HIV antigen and antibodies in blood. Antigens are the foreign substances that activate your immune system. Antibodies are produced by the immune system in response to infection. When you are infected with HIV, an antigen p-24 is produced much before the antibodies develop. It takes around 2 to 6 weeks for a combination test to detect HIV infection.
3. Nucleic Acid Tests: This test detects HIV virus in blood. This test can detect HIV infection as soon as 7-28 days after a person is infected with HIV. This test yields accurate results but is very expensive and not routinely done for HIV screening.

Tests to plan the treatment

1. CD4 count: CD4 are the white blood cells that are specifically targeted and destroyed by the HIV virus. When your CD4 count is less than 200, it means that you have AIDS.
2. Viral Load: This test determines the amount of virus in blood.
3. Drug Resistance: This test would help to find out if the strain of HIV that has infected you would respond to the anti-HIV drug that is prescribed.

Treatment of HIV

Prevention of HIV infection

1. Safe sex: Use a new condom everytime when you have sex. Water based lubricants should be preferred as oil based lubricants weaken the condom.
2. Avoid sharing needles: If you use needles to inject drugs make sure it is cleaned and sterilized properly before use. Never share the needle that has been already used once.
3. Consider male circumcision: Studies have proven that circumcision decreases the risk of HIV in males.
4. If you are HIV+ve: Please let your partner know so that they can get tested and receive appropriate medical care. Do not donate blood or other body tissues. Avoid sharing personal items such as toothbrushes and razors.
5. If you are HIV+ve and pregnant: Your baby is at high risk of acquiring HIV. Early and prompt treatment reduces the risk of infection in the baby. Avoid breastfeeding.

References