AIDS: Symptoms, Causes, Treatment & Prevention.

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

  1. Antigen test to detect the presence of HIV antigen in the blood, usually done a few weeks after suspected exposure.
  2. 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.
  3. 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.