HIV and AIDS
Are HIV and AIDS the same? Information about the causes, symptoms, transmission methods, and treatments for the human immunodeficiency virus.
Symptoms and Causes
The human immunodeficiency virus (HIV) affects the immune system by gradually reducing its defenses (especially CD4 T lymphocytes). When the infection is in an advanced stage, it causes AIDS (acquired immunodeficiency syndrome), a phase of the disease in which immunosuppression prevents the body from fighting off illnesses.
HIV infection progresses through three stages:
Acute or primary infection: Lasts between two and four weeks. It occurs after transmission and produces flu-like symptoms or symptoms similar to other viral conditions.
Latent infection: Can last between 2 and 10 years. During this phase, the person is usually asymptomatic. Although the immune system deterioration is slow, some severe illnesses may develop due to the body's weakened defenses.
AIDS: The immune system is severely compromised, making patients more susceptible to frequent illnesses.
Current treatments effectively control the virus and have significantly increased life expectancy. Additionally, they greatly improve the quality of life of people with HIV, including those who have reached the AIDS stage.
HIV transmission occurs through sexual contact (mucosal or fluid exchange, including oral sex), exposure to infected blood (such as sharing needles used by infected individuals), or vertical transmission (from mother to child during childbirth or breastfeeding). Transmission can also occur through transfusions of contaminated blood or blood products, although this is now rare due to the stringent safety measures in healthcare systems.
Symptoms
During primary infection, the most common symptoms include:
- Fever
- Skin rash
- Diarrhea
- Muscle and joint pain
- Weight loss
- Headache
- Cough
In intermediate stages of the disease, symptoms may include fatigue, swelling of multiple lymph nodes, recurrent pneumonia, shingles, increased weight loss, and the appearance of sores in the mouth, anus, and genitals.
In the AIDS stage, symptoms can be more severe and intense, often associated with serious infectious diseases or even the development of tumors.
Causes
HIV is transmitted through sexual intercourse or contact with the blood of an infected person. Additionally, women can pass the virus to their children during pregnancy, childbirth, or breastfeeding.
AIDS results from the progression of an HIV infection.
Risk Factors
The main risk factors for contracting HIV are:
- Engaging in unprotected sexual activity. The primary preventive method remains the use of condoms during sexual intercourse.
- Having a sexually transmitted disease.
- Using injection drugs with shared or reused needles.
Complications
HIV-positive patients are more susceptible to infections such as pneumonia, tuberculosis, and meningitis. They are also at increased risk of developing certain types of cancer, including Kaposi's sarcoma, cervical cancer, and lymphoma.
Prevention
HIV infection can be prevented by using condoms in all sexual encounters and by using new, sterile needles when injecting drugs.
To prevent transmission to sexual partners when already infected with HIV, it is recommended to take prescribed medications as directed by a doctor. These medications reduce the viral load to undetectable levels, preventing transmission to others (undetectable = untransmittable).
Another form of prevention is taking medication (usually daily) to prevent HIV infection. This type of prevention is recommended for individuals at high risk of contracting the virus due to their sexual practices.
What Doctor Treats HIV and AIDS?
HIV and AIDS are diagnosed and treated by immunologists, microbiologists, infectious disease specialists, internists, or palliative care experts. Depending on the side effects experienced, other medical specialties may also be involved in treatment.
Diagnosis
Blood tests are crucial for diagnosing HIV. The most common tests include:
- Antigen tests: Detect specific substances produced by the virus. Effective when a few weeks have passed since exposure.
- Nucleic acid test (NAT): Directly detects the virus in the blood and can quantify it (viral load test) within approximately 10 days after exposure. This is often used to identify infection during the acute phase.
- Antibody test: The most widely used test, detecting the antibodies produced by the immune system against HIV. These antibodies can be detected in blood or saliva, but they take longer to appear (4-8 weeks, and up to 12 weeks for reliable detection).
In rare cases where these tests are inconclusive, a Western blot test is performed to confirm the diagnosis. This test detects the gp120 protein, which is present in the HIV envelope.
In recent years, the World Health Organization has recommended rapid tests, which provide results in just 30 minutes using a small blood sample from a fingertip. If the result is positive, a confirmatory lab test is required. If the result is negative, no further testing is needed.
Once diagnosed, additional tests are typically performed to determine the disease stage:
- CD4 T lymphocyte count: In the AIDS stage, these counts are usually below 200.
- Drug resistance test: Determines whether the virus strain is resistant to certain available medications, helping to tailor the appropriate treatment.
Treatment
HIV cannot be cured, so prevention is key to avoiding infection. However, antiretroviral therapy (ART) reduces the virus's activity, alleviates symptoms, and improves patients' quality of life. This treatment is recommended for all HIV-positive individuals and consists of a combination of drugs that prevent the virus from replicating, thereby reducing viral load. Since each patient has unique characteristics and needs, the medication that works for one person may not be effective for another. Fortunately, a wide variety of HIV medications are available today, ensuring effective treatment for nearly 100% of people living with HIV.
The side effects of ART are generally minimal with today's medications, and treatments can be adjusted if adverse effects occur.
