Basics on HIV

               HIV (Human Immunodeficiency Virus) is a virus that attacks the immune system which if left untreated may lead to AIDS (Acquired Immunodeficiency Virus). The virus fights off eminent cells that help protect our body from diseases and infections. HIV can be transmitted into different modes such as sexual contact, blood or blood products, sharing of infected needles, needle pick injury, or mother-to-child. Currently, there is no effective way to cure HIV, but with proper medical care and treatment, it can be controlled.

HIV Transmission

·        HIV is not transmitted through (1) air or water, (2) saliva, sweat, tears, kissing, (3) insects or pets, (4) sharing toilets, food or drinks.

·        HIV can be transmitted through specific activities; commonly through sexual behaviors and needle or syringe use.

·     Transmission of HIV happens when certain body fluids such as blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk are transferred from one person to another. When these fluids come in contact with a mucous membrane, damaged tissue or be directly injected into the bloodstream (using a needle or syringe) HIV transmission will occur. The mucous membranes can be found inside the rectum, vagina, penis, and mouth of a person.

·    Having anal and/or vaginal sex with someone who has HIV can cause transmission, especially if a condom was not used or no medicines were taken to prevent or treat HIV.

·    The sexual behavior with the highest-risk of HIV is anal sex. Specifically, receptive anal sex (bottoming) is riskier than insertive anal sex (topping).

·    The second-highest sexual behavior with the risk of HIV is vaginal sex.

·    Sharing of needles or syringes, rinse water, and other tools used to inject drugs transmits HIV. Depending on the temperature and other factors, HIV can live in a used needle up to 42 days

·    HIV can also be transmitted from mother to child during pregnancy, birth, or breastfeeding. The risk of transmitting HIV can be high if a mother is living with HIV and not taking proper medicine.

·    HIV can also be transmitted if a HIV-contaminated needle has been injected.

[Source: http://www.cdc.gov/hiv/basics/testing.html]

HIV Testing

It is highly recommended that people between the ages of 13 and 64 should get tested for HIV at least once as part of routine health care. Those who have certain risk factors should get tested more often.

If you are a HIV-negative but you answered yes to any of the following questions, you should get tested because these are factors that increase your chances of getting HIV:

Are you a man who has had sex with another man?

Have you had sex—anal or vaginal—with an HIV-positive partner?   

Have you had more than one sex partner since your last HIV test?

Have you injected drugs and shared needles or works (for example, water or cotton) with others?

Have you exchanged sex for drugs or money?

Have you been diagnosed with or sought treatment for another sexually transmitted disease?

Have you been diagnosed with or treated for hepatitis or tuberculosis (TB)?

Have you had sex with someone who could answer yes to any of the above questions or someone whose sexual history you don’t know?

·        A person should be tested for HIV for at least once a year if you are regularly doing any of these things. Sexually active gay and bisexual men may benefit from more frequent testing, every 3 to 6 months.

·        If you’re pregnant, talk to your health care provider about getting tested for HIV and other ways to protect you and your child from getting HIV. Also, anyone who has been sexually assaulted should get an HIV test as soon as possible after the assault and should consider post-exposure prophylaxis (PEP), taking antiretroviral medicines after being potentially exposed to HIV to prevent becoming infected.

·        Before having sex for the first time with a new partner, you should be aware of the person’s sexual and drug-use history, disclose your HIV status, and consider getting tested for HIV and learning the results.

[Source: http://www.cdc.gov/hiv/basics/testing.html]

In-Depth Information on HIV

What is HIV in general?

Human Immunodeficiency Virus (HIV) is the virus that can lead to Acquired Immunodeficiency Syndrome (AIDS) if not treated. HIV cannot be removed from the body completely unlike any other viruses. Thus, once you get HIV, you will have it in your lifetime.

HIV weakens the body’s immune system by attacking the CD4 cells (T cells).  CD4 cells help the immune system defend the body against infections. Therefore, the less CD4 cells that a person has, the more likelihood a person can get other infections or infection-related cancers. Over time, HIV can destroy so many CD4 cells that it disables the body to fight off infections and diseases. Once a person acquires a lot of infections and diseases due to a very weak immune system, it signals that the person has AIDS, the last stage of HIV infection.

Where did HIV come from?

From the rigorous research and experiments of scientists, they have identified a type of chimpanzee in Central Africa as the source of HIV infection in humans. The chimpanzee version of the immunodeficiency virus called simian immunodeficiency virus (SIV) was believed to be transmitted to humans and mutated into HIV when humans hunted these chimpanzees for meat and came into contact with their infected blood. Studies show that HIV may have jumped from apes to humans as far back as the late 1800s. Over decades, the virus slowly spread across Africa and later into other parts of the world.

Is there a cure for HIV?

Presently, there is no effective cure that exists, but HIV can be controlled with proper medical care. The medicine used to treat HIV is called antiretroviral therapy or ART. If taken the right way, every day, this medicine can dramatically prolong the lives of many people infected with HIV, keep them healthy, and greatly lower their chance of infecting others.

    Is there a test for HIV infection?

      Yes. There are a number of tests that detect either antibodies to HIV or HIV itself.

            Your body produces antibodies to fight germs. People who are infected with HIV have HIV antibodies in their body fluids. There are two types of HIV antibody tests: a blood test and an oral test. For adults and children age 18 months or older, both types of HIV antibody test are more than 99% accurate in determining whether a person is infected.

          HIV antibody tests do not measure the amount of virus in the bloodstream. The tests cannot tell if a person has AIDS, which is a late stage of HIV disease.

            Other tests measure HIV directly rather than measuring antibodies to the virus. These test are usually used to measure the amount of HIV in the bloodstream of someone who has already had a positive HIV antibody test. In some special situations (for example, to test newborn babies of HIV-infected women), tests that measure HIV directly are used to detect HIV infection. However, the HIV antibody test is by far the most common test for HIV infection.

What are the symptoms of HIV infection?

           Shortly after being infected with HIV, some people – but not all people – have flu-like symptoms (fever, muscle aches, feeling tired) that last a few days and then go away. This is sometimes called seroconversion illness or acute HIV infection. Most people with HIV have no symptoms for many years. However, even without symptoms, people who are newly infected have large amounts of HIV circulating in their blood and are highly infectious at that time.

          HIV infection cannot be diagnosed from symptoms alone. The symptoms of worsening HIV infection and AIDS – swollen glands, fever, and skin rashes – can also be caused by other illnesses, many of which are more common than HIV infection.

When does a person with HIV infection have AIDS?

          According to the Centers for Disease Control and Prevention (CDC), a person with HIV infection has AIDS when:

–  the person’s CD4 cell count falls below 200 cells/ml

or

–  the person is diagnosed with any of the following conditions or diseases:

Candidiasis of bronchi, trachea, or lungs

Candidiasis, esophageal

Cervical cancer, invasive

Coccidioidomycosis, disseminated or extrapulmonary

Cryptococcosis, extrapulmonary

Cryptosporidiosis, chronic intestinal (>1 month duration)

Cytomegalovirus disease (other than liver, spleen, or nodes)

Cytomegalovirus retinitis (with loss of vision)

Encephalopathy, HIV-related

Herpes simplex: chronic ulcer(s) (>1 month duration)

Histoplasmosis, disseminated Isosporiasis, chronic intestinal (> 1 month duration)

Kaposi’s sarcoma

Lymphoid interstitial pneumonitis (in children)

Lymphoma, Burkitt’s (or equivalent term)

Lymphoma, immunoblastic (or equivalent term)

Lymphoma, primary, of brain

Mycobacterium avium complex or M. Kansasii, disseminated or extrapulmonary

Mycobacterium tuberculosis, any site (pulmonary or extrapulmonary)

Mycobacterium, other species or unidentified species, disseminated or extrapulmonary

Pneumocystis carinii pneumonia

Pneumonia, recurrent

Progressive multifocal leukoencephalopathy

Salmonella septicemia, recurrent

Toxoplasmosis of brain

Wasting syndrome due to HIV

– A person who is HIV negative or of undetermined serostatus may be diagnosed with AIDS when other causes of immunodeficiency are ruled out and the person is definitively diagnosed with one of the AIDS indicator diseases listed above.

Do women with HIV need special medical care?

Yes. Some medical problems are more common in women with HIV. These include:

• Cervical cancer. HIV-infected women also have high rates of HPV (human papillomavirus) infection, especially those types that lead to the development of cervical cancer. Treatment with antiretroviral drugs may be able to change the course of HPV infection, but this has not yet been proven.

•  Vaginal yeast infections, which may be more frequent and need longer treatment in women with HIV.

        Women with HIV should have yearly pelvic exams and PAP smears to look for cervical cancer. Women with HIV also need to know how to prevent pregnancy (if they do not wish to become pregnant) and how to prevent passing HIV to their babies if they do choose to get pregnant. They should talk to a doctor about family planning, including how birth control pills interact with some HIV medicines.

       It is especially important for pregnant women with HIV to get medical care, because there are medicines that women with HIV can take to greatly reduce the risk of their babies being born with HIV. Children with HIV infection also need medical care as early as possible.

What are CD4 cell counts and viral load tests?

     CD4 cells are part of the immune system. Over time, HIV kills CD4 cells, making the immune system weaker. A person’s CD4 cell count shows the strength or weakness of the immune system.

       Viral load is the amount of HIV in a person’s blood. Over time, without treatment, the viral load of a person living with HIV gets higher. HIV treatment with HAART (Highly Active Anti-Retroviral Therapy) usually lowers the viral load. When the amount of HIV in the blood is so low that blood tests cannot find it, it is called an undetectable viral load. A person with an undetectable viral load is less likely to get sick but still has HIV and can pass the virus to others.

        CD4 cell count tests and viral load tests give people with HIV and their doctors important information about a person’s HIV infection and immune system strength. These tests help show whether a person should consider taking medicines for opportunistic infections and/or medicines to fight HIV (HAART).

        They also show how well HAART is working. People with HIV should have a CD4 cell count test and a viral load test done at least every six months. If they are taking HAART, these tests should be done at least every four months.