Acquired Immuno Deficiency Syndrome also called AIDS, is a spectrum of conditions caused by the Human immunodeficiency virus (HIV).
A person diagnosed with the virus is called HIV positive, and without proper treatment, his/her condition progresses to AIDS.
HIV infection when has the T cell count below 200 cells per µL or the occurrence of specific diseases associated with HIV infection, is considered progression to AIDS.
The disease had held a certain stigma about it, when it was first identified in the late 70’s. It was identified as a disease only present in homosexual men, that sharing food, clothing or shelter with an infected person could get them infected, or that it would spread by casual non-sexual contact.
Over the years many antiviral or as AIDS medicines are called, antiretroviral drugs have been introduced that have significantly reduced the severity of the condition & its symptoms, thereby improving the quality of life.
Although, AIDS/HIV has no cure.
SIGNS & SYMPTOMS
- In the initial or primary phase, various symptoms are seen;
- Influenza like illness
- Glandular swelling
- Fever & headache
- Rash
- Nausea & vomiting
- Throat inflammation & mouth sores
- Enlargement of lymph nodes which cause pain
- Muscle weakness
- Nerve damage
- Enlargement of spleen
- Malaise
- Opportunistic infections.
CAUSES & RISK FACTORS
- Due to unprotected sexual intercourse, oral sex, anal sex.
- There is a higher chance of transmission when someone is already affected with an existing STD/STI like gonorrhea, chlamydia, vaginosis, genital ulcers, etc.
- Blood transfusion in unhygienic conditions or procedure.
- Sharing of needles or using unsterilized needles.
- Usage of street drugs like heroin, meth, crack by sharing needles.
- Due to coming in contact with infected blood.
- By mother to fetus, during childbirth & breastfeeding, in an infected mother.
- There is no risk of acquiring HIV if exposed to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are contaminated with blood.
COMPLICATIONS DUE TO AIDS/HIV
- Pneumonia due to fungi
- Wasting or atrophy of the muscle
- Candidiasis (Fungal infection) of the esophagus also called oral thrush
- Tuberculosis, a leading infection in people with AIDS
- Infection by Herpes Virus
- Lymphoma
- Cervical cancer
- Conjunctival cancer
- Tumor of the walls of blood vessels
- CNS complications
- Nephritis & kidney disease
- Hepatitis & liver disease.
DIAGNOSIS OF AIDS/HIV
- Antigen test to detect the presence of HIV antigen in the blood, usually done a few weeks after suspected exposure.
- Antibody test to detect the presence of antibodies mediated by the immune system in reaction to the presence of viral antigen. Can take from 3 – 12 weeks.
- Detection of viral load, by nucleic acid tests, usually done by withdrawing blood from the veins.
Blood test | Days after exposure |
---|---|
Antibody test (rapid test, ELISA 3rd gen) | 23–90 |
Antibody and p24 antigen test (ELISA 4th gen) | 18–45 |
PCR | 10–33 |
Diagnosis of the stage of infection on the basis of classification of T cell count:
- Primary infection – Asymptomatic
- 1) Stage I – Asymptomatic, T cell count > 500/µl of blood.
- 2) Stage II – Mild infections like respiratory tract infection, T cell count < 500/µl of blood.
- 3) Stage II – Advanced symptoms like chronic diarrhea, TB of the lungs, T cell count < 350µl of blood.
- 4) Stage IV or AIDS – Severe symptoms, fungal infections of the esophagus, bronchi, sarcoma of the blood vessels, T cell count < 200µl of blood.
TREATMENT FOR AIDS/HIV
- The drugs used for the management of HIV virus are called antiretrovirals.
- There are several classes of antiretroviral drugs, some of them in instance are, Zidovudine, lamivudine, tenofovir, etc.
- People diagnosed with HIV are advised to start the retroviral therapy whatever the stage of infection be, in order to keep the viral load in check & prevent progression to AIDS.
- As HIV can significantly weaken the immune system, therefore opportunistic infections like Tuberculosis, pneumonia, hepatitis may develop.
- Patients can get hepatitis vaccination, influenza vaccination, & tuberculosis preventive therapy.
PREVENTION & MANAGEMENT
- Using protection before sexual intercourse.
- Application of antiretroviral vaginal gel seems to reduce incidence of infection.
- Communicating to your partner if you have an STD.
- Pre-exposure antiretroviral therapy can be effective, but along with it comes side effects of these drugs.
- Programmed retroviral therapy for Pregnant mother who are infected can prevent chances of transmission to fetus, similarly bottle feeding is encouraged, rather than breast feeding.
- Not sharing needles or injections if you are involved in IV drug use.
- Nutrient & dietary supplements like probiotics, multivitamins, Zinc, Selenium, iron, etc.
- HIV/AIDS patient require mental support because of the stigma associated with it, many patient do not follow their medicine course, & show be counselled & supported.