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HIV Infection and AIDS
 
What are HIV and AIDS?
HIV is the abbreviation used for the human immunodeficiency virus. HIV is the virus that causes AIDS (acquired immunodeficiency syndrome), a life-threatening disease.

HIV attacks the body's immune system. The infection-fighting cells of the immune system are called CD4 cells or T-helper cells. Months to years after a person is infected with HIV, the virus destroys the CD4 cells. When the CD4 cells are destroyed, the immune system can no longer defend the body against infections and cancers.

HIV infection becomes AIDS when you lose your ability to fight off serious infections or tumors. Various infections called opportunistic infections develop. They are called opportunistic because they take advantage of the weakened immune system. These infections would not normally cause severe or fatal health problems. However, when you have AIDS, the infections and tumors are serious and can be fatal.

How does it occur?
HIV is not
spread through the air, in food, or by casual social contact such as shaking hands or hugging. The virus is passed on only when the blood or sexual secretions enter another person's body. It can also be spread to babies by the breast milk of an infected mother. Spread of the virus can occur during such activities as:
  • unprotected sexual activity
  • sharing IV needles
  • being born to or breast-fed by an HIV-infected mother
  • blood transfusions (now rare in the US because of current screening tests).

The following groups have the highest risk for HIV infection and the development of AIDS:
  • sexually active homosexual men
  • bisexual men and their partners
  • IV drug users and their sexual partners
  • people who share needles (for IV drug use, tattooing, or piercing)
  • heterosexual men and women with more than one sexual partner
  • people given transfusions of blood or blood products in countries where the blood is not rigorously tested
  • immigrants from areas with many cases of AIDS (such as Haiti and east central Africa)
  • people who have sex with an HIV-infected partner or with anyone in the above groups if they do not always use a latex or polyurethane condom
  • babies born to HIV-infected mothers.

What are the symptoms?
The symptoms of HIV infection and AIDS are usually the symptoms of the diseases that attack the body because of a weakened immune system:
  • fever that lasts from a few days to longer than a month
  • loss of appetite or weight, especially loss of more than 10% of body weight
  • nausea and vomiting
  • tiredness
  • prolonged swelling of the lymph nodes
  • sore throat
  • long-lasting or multiple viral skin problems, such as herpes sores or plantar warts
  • repeated, severe yeast infections in your mouth or vagina despite treatment
  • chronic muscle and joint pain
  • diarrhea, especially if it lasts longer than a month
  • headache
  • enlarged spleen and liver.

The serious opportunistic diseases that most often affect someone with AIDS include a type of cancer called Kaposi's sarcoma and these infections: Pneumocystis carinii pneumonia (PCP), tuberculosis, meningitis, and herpes simplex infections.

How is it diagnosed?
Usually the first test, the ELISA test, is a blood test although in some hospitals and facilities a new test that involves swabbing the gums may be done. The ELISA test is done to see if you are infected with HIV. If this test is positive, another more specific blood test, usually the Western blot test, is done to confirm the results.

Once you have confirmed positive HIV test results, you must have a thorough medical exam. Your health care provider will ask about your medical history and symptoms and will examine you.

The medical history and physical exam includes discussing your history of sexual practices and sexually transmitted diseases. Your health care provider will also ask about any history of drug abuse.

You will have some lab tests. Comparing the results of the physical exam and these first lab tests with results weeks or months from now can help your health care provider diagnose new symptoms you may have in the future. It can also help your provider know how well your medicines are working.

You will be tested for certain infections, such as tuberculosis (TB), syphilis, and hepatitis B. These infections can worsen rapidly when you have HIV. They also pose a serious risk to others.

HIV-positive women should have a Pap test according to the schedule recommended by their health care provider (usually every 6 to 12 months).

How is it treated?
Your treatment depends on if it is known when you became infected with HIV and whether you have symptoms. Your treatment may include:
  • antiviral medicines, such as zidovudine (also called ZDV or AZT), didanosine (ddI), and lamivudine (3TC), and protease inhibitors
  • lab tests every few weeks to see how well your immune system is working, to measure the amount of HIV in your blood, and to screen for infections or other medical problems
  • regular dental exams because people who are HIV positive often have mouth problems, including gum disease
  • preventive treatment for such diseases as:
    • Pneumocystis carinii pneumonia (PCP)
    • tuberculosis
    • toxoplasmosis (be sure to avoid raw meat and cat litter boxes)
    • tetanus
    • hepatitis B
    • pneumococcal infections
    • influenza
  • treatment for infections and tumors as they develop.

Your health care provider will probably recommend starting treatment with antiviral drugs and antipneumonia drugs if you are having symptoms of HIV infection. Even if you are not having symptoms, your provider may recommend starting treatment if:
  • Your CD4 cell count is below 350 cells per cubic millimeter, or
  • Your viral load is over 30,000 copies per milliliter (mL) when using the branched DNA test, or more than 55,000 copies/mL when using the RT-PCR test.




  Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

  HIA File INF4516F.HTM Release 9.0/2006. Copyright © 2006 McKesson Corporation and/or one of its subdiaries. All Rights Reserved.


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