HIV & AIDS

HIV & AIDS

Overview

Human immunodeficiency virus (HIV) is an infection by one of two viruses (HIV1 and HIV2) that progressively destroy white blood cells (lymphocytes) that protect the body against illness and infection.

This can lead to the development of acquired immunodeficiency syndrome (AIDS), a collection of illnesses that affect people infected with HIV. A person with HIV is considered to have AIDS when they develop an AIDS defining illness.

In the UK, 47% of all patients seen for HIV care are heterosexual, and 45% are gay or bisexual men. The growth in the epidemic in the heterosexual population is fuelled largely, though not entirely, by HIV diagnoses among immigrants from sub-Saharan Africa.

The transmission of HIV requires contact with a body fluid that contains infected cells or virus particles such as blood, semen or vaginal secretions. Unprotected sex is the most common way in which people become infected with HIV. Infection can also result from the injection or infusion of contaminated blood through a blood transfusion, the sharing of needles by drug users or an accidental needle prick in a healthcare setting. Infection can also be passed from an infected mother to a child during pregnancy, childbirth or through breast-feeding.

It is not possible to get HIV through daily social contact such as social kissing, touching, sharing a toilet and eating facilities, or through coughing, tears and sneezing.

Symptoms and Diagnosis

Some people develop a short illness soon after infection called 'seroconversion illness' which is a result of the body developing an immune reaction to the virus. Common symptoms include a fever, rashes, swollen lymph nodes and general discomfort than can last between 3 and 14 days. Most symptoms then disappear and additional symptoms may not appear for years, although large amounts of the virus are present in the blood and body fluids. This period is called 'asymptomatic HIV infection' and during this time the person is well.

A person may have HIV infection for years before developing the more distinctive symptoms of AIDS which are a result of opportunistic infections taking advantage of the body's compromised immune system.

A relatively simple, highly accurate blood test (ELISA test) can be used to screen people for HIV infection.

Treatments

Currently, there are no vaccines available to prevent HIV infection and there is no cure for AIDS although there is much research underway into both of these. Drugs are available that slow the progression of the disease by preventing the virus from reproducing. Reducing the levels of virus in the blood stream has been shown to reduce the risk of becoming ill or dying from HIV. These drugs are called anti-retrovirals, and have been very successful at prolonging the lives of people infected by HIV.

When HIV patients start on treatment, it is usually a combination of drugs from four different drug classes. The drugs can cause unpleasant side effects and so these combinations are tailored to the individual. It is important for HIV patients to adhere to their HIV medication in order to keep viral levels low and an HIV patient should always consult his/her doctor if at all concerned about the side effects he/she may be experiencing.

Prognosis

The prognosis for people living with HIV has changed dramatically since the first cases of AIDS were diagnosed in the early 1980s. The timely use of effective treatments has led to dramatic improvements in prognosis, and many doctors specialising in the treatment of HIV now believe that as long as a person with HIV receives effective anti-HIV treatment before their immune system has been too damaged by the virus, and if they take their drugs properly and can tolerate them, then they could live a more or less normal life span.

Medical Information/Conditions

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