HIV and AIDS: Key Information

1. What is HIV?

• HIV stands for Human Immunodeficiency Virus.
• It's a virus that attacks the body's immune system, specifically targeting and destroying CD4 cells (T-helper cells). These cells are crucial for the immune system's ability to fight off infections and diseases.
• HIV is a retrovirus, meaning it works backward by inserting its genetic material into the host cell's DNA.

2. What is AIDS?

• AIDS stands for Acquired Immunodeficiency Syndrome.
• It is the most advanced stage of HIV infection.
• A person is diagnosed with AIDS when their immune system is severely damaged, making them highly vulnerable to opportunistic infections and certain cancers that a healthy immune system would normally fight off.
• Diagnosis of AIDS is typically based on a CD4 count below 200 cells/mm³ or the presence of specific AIDS-defining illnesses.

3. How is HIV Transmitted? HIV is transmitted through specific body fluids from an infected person, including:

• Blood
• Semen
• Pre-seminal fluid
• Vaginal fluids
• Rectal fluids
• Breast milk

Common modes of transmission include:

• Unprotected sexual contact: Anal or vaginal sex without condoms or pre-exposure prophylaxis (PrEP).
• Sharing needles or syringes: For injecting drugs.
• Mother-to-child transmission (MTCT): During pregnancy, childbirth, or breastfeeding.
• Blood transfusions/organ transplants: Extremely rare in countries with strict screening protocols.
• Occupational exposure: Rare, primarily in healthcare settings through needle sticks.

HIV is NOT transmitted through:

• Casual contact (hugging, kissing, shaking hands)
• Sharing food or drinks
• Coughing or sneezing
• Toilet seats
• Mosquitoes or other insects

4. Stages of HIV Infection (if untreated):

• Stage 1: Acute HIV Infection (Seroconversion Illness)
  • Occurs 2-4 weeks after infection.
  • Some people experience flu-like symptoms (fever, headache, rash, sore throat, fatigue, swollen lymph nodes).
  • HIV multiplies rapidly, and viral load is very high, making the person highly infectious.
  • Symptoms often subside within 1-2 weeks, even without treatment.
• Stage 2: Chronic HIV Infection (Clinical Latency or Asymptomatic HIV Infection)
  • HIV continues to multiply in the body, but at lower levels.
  • Many people have no symptoms or very mild ones during this stage.
  • Can last for many years (average 8-10 years) without antiretroviral therapy (ART).
  • The virus continues to damage the immune system, even if the person feels well.
• Stage 3: Acquired Immunodeficiency Syndrome (AIDS)
  • The immune system is severely compromised (CD4 count below 200 cells/mm³).
  • Body can no longer effectively fight off opportunistic infections and certain cancers.
  • Without treatment, life expectancy is typically about 3 years.

5. Impact of HIV on the Immune System:

• HIV primarily attacks CD4 T-lymphocytes, which are vital white blood cells that coordinate the immune response.
• As HIV replicates, it destroys CD4 cells, leading to a progressive decline in the immune system's ability to fight off pathogens.
• This weakening makes the body susceptible to various infections and diseases that wouldn't normally affect a healthy person.

6. Symptoms of HIV Infection:

• Early (Acute) Symptoms: Flu-like symptoms (fever, rash, sore throat, fatigue, muscle/joint pain, swollen glands). These are non-specific and can be mistaken for other illnesses.
• Later (Symptomatic HIV, prior to AIDS): As the immune system weakens, more persistent or severe symptoms may appear, such as:
  • Weight loss
  • Chronic diarrhea
  • Night sweats
  • Skin problems
  • Recurrent infections (e.g., oral thrush)
  • Persistent swollen lymph nodes
• AIDS-Defining Illnesses (Symptoms of advanced disease): These are severe infections or cancers that occur due to a severely weakened immune system. Examples include:
  • Pneumocystis pneumonia (PCP)
  • Kaposi's sarcoma
  • Tuberculosis (TB)
  • Cryptococcal meningitis
  • Cytomegalovirus (CMV) infections
  • HIV wasting syndrome
  • Certain lymphomas
  • Invasive cervical cancer

7. HIV Treatment: Antiretroviral Therapy (ART)

• ART is a combination of HIV medicines taken daily.
• ART cannot cure HIV, but it effectively suppresses the virus, reduces the viral load (amount of HIV in the blood) to undetectable levels, and allows the immune system to recover.
• Benefits of ART:
  • Improved health and longevity: People on effective ART can live long, healthy lives.
  • Prevention of transmission: When viral load is consistently undetectable, HIV cannot be transmitted sexually (Undetectable = Untransmittable or U=U). It also significantly reduces mother-to-child transmission.
  • Prevention of AIDS: ART prevents HIV from progressing to AIDS.

8. HIV Prevention Methods:

• Condom Use: Consistent and correct use of condoms during sexual activity.
• HIV Testing: Regular testing to know one's status and encourage partners to test.
• Treatment as Prevention (TasP): For people living with HIV, taking ART as prescribed to achieve an undetectable viral load prevents sexual transmission.
• Pre-Exposure Prophylaxis (PrEP): HIV-negative individuals at high risk of exposure take daily medication to prevent infection.
• Post-Exposure Prophylaxis (PEP): HIV-negative individuals who may have been exposed to HIV (e.g., sexual assault, needle stick) take ART within 72 hours of exposure for 28 days to prevent infection.
• Syringe Service Programs (SSPs): Providing clean needles and syringes to people who inject drugs to prevent sharing.
• Prevention of Mother-to-Child Transmission (PMTCT): ART for pregnant women living with HIV, and medication for newborns, significantly reduces the risk of transmission to the baby.
• Voluntary Medical Male Circumcision (VMMC): Reduces the risk of HIV acquisition in men by approximately 60% in certain settings.

9. Global Impact and Challenges:

• HIV/AIDS remains a major global public health issue, especially in sub-Saharan Africa.
• Stigma and discrimination continue to be significant barriers to testing, treatment, and support.
• Access to ART and prevention services still varies globally, with disparities in resource-limited settings.