HIV and AIDS: A Comprehensive Guide 2023

What is AIDS?

AIDS is a disease that can develop in HIV-positive individuals. This is the most advanced stage of HIV infection. However, just because someone carries HIV does not mean they will acquire AIDS.

CD4 cells are killed by HIV. CD4 counts in healthy persons range from 500 to 1,600 per cubic millimeter. AIDS is diagnosed when a person’s CD4 count falls below 200 cells per cubic millimeter.

If a person with HIV develops an opportunistic illness or malignancy that is uncommon in HIV-negative people, they may be diagnosed with AIDS.

Pneumocystis jiroveci pneumonia is an opportunistic infection that only affects people who are extremely immunocompromised, such as those with advanced HIV infection (AIDS).

HIV can escalate to AIDS in a decade if left untreated. AIDS has no cure at the moment, and without treatment, a person’s life expectancy after diagnosis is roughly three years.

If the person has a severe opportunistic illness, this time frame may be reduced. Treatment with antiretroviral medications, on the other hand, can prevent the development of AIDS.

If AIDS develops, it signifies that the immune system has been substantially weakened, to the point that it can no longer respond effectively to most diseases and infections.

As a result, a person living with AIDS is susceptible to a variety of ailments, including:

• pneumonia
• tuberculosis
• oral thrush, a fungal condition in the mouth or throat
• cytomegalovirus (CMV), a type of herpes virus
• cryptococcal meningitis, a fungal condition in the brain
• toxoplasmosis is a brain condition caused by a parasite
• cryptosporidiosis is a condition caused by an intestinal parasite
• cancer, including Kaposi sarcoma (KS) and lymphoma

Untreated AIDS is associated with a shorter life expectancy, however, this isn’t a direct outcome of the disease. Rather, it’s the effect of the infections and difficulties that come with having an AIDS-weakened immune system.

HIV symptoms in its early stages

The acute infection stage refers to the first few weeks after someone obtains HIV.

The virus multiplies fast during this time. The immune system of a person responds by creating HIV antibodies, which are proteins that help the body fight infection.

Some folks have no symptoms at all during this time. Many people, however, suffer symptoms in the first month or so after contracting HIV, but they are typically unaware that HIV is the cause of those symptoms.

This is because the acute stage’s symptoms might be extremely similar to the flu or other seasonal viruses, such as:

• They might range from minor to severe.
• They may come and go at any time.
• They can last anywhere between a few days to a few weeks.

Among the first signs of HIV infection are:

• fever
• chills
• lymph nodes swollen
• aches and pains in general
• rashes on the skin
• throat irritation
• headache
• nausea
• stomach ache

Because these symptoms are similar to those of common illnesses such as the flu, the individual experiencing them may not believe they require medical attention.

Even if they do, their doctor might think it’s the flu or mononucleosis and won’t even think about HIV.

What are the HIV symptoms?

HIV reaches the clinical latency stage after about a month. This period can extend anything from a few years to several decades.

During this time, some people may have no symptoms, while others may have minor or nonspecific symptoms. A nonspecific symptom is one that is not associated with a specific disease or condition.

The following are examples of vague symptoms:

• aches and pains, including headaches
• lymph nodes swollen
• fevers that come and go
• sweating during night
• fatigue
• nausea
• vomiting
• diarrhoea
• slimming down
• rashes on the skin
• recurring yeast infections in the mouth or vaginal area
• pneumonia
• shingles

HIV is still transferable throughout this stage, even if there are no symptoms, and can be transmitted to another person.

A person will not know if they have HIV unless they are tested. It’s critical to get tested if someone has these symptoms and suspects they’ve been exposed to HIV.

At this stage, HIV symptoms may come and go or progress fast. With treatment, this advancement can be significantly delayed.

Chronic HIV can endure for decades with consistent use of antiretroviral therapy, and if treated early enough, it is unlikely to progress to AIDS.

Is a rash a sign of HIV?

Many HIV patients see changes in their skin. The rash is one of the most common early signs of HIV infection. An HIV rash usually appears as a series of little red lesions that are flat and elevated.

The rash caused by HIV

Because HIV damages immune system cells that fight infection, people with HIV are more likely to develop skin disorders. The following co-infections can induce a rash:

• molluscum contagiosum
• simplex herpes
• shingles

The rash’s origin determines:

• way it seems
• how long will it be?
• The manner in which it can be treated is determined by the reason.

Medication-induced rash

While HIV co-infections can create a rash, medicines can also cause it. Some HIV medications and other medications might create a rash.

This rash usually emerges one to two weeks after starting a new medicine. Occasionally, the rash will go away on its own. If it doesn’t, a medication adjustment may be required.

A rash caused by an adverse reaction to a medicine might be life-threatening.

Other signs and symptoms of an allergic reaction are:

• breathing or swallowing problems
• dizziness
• fever

Stevens-Johnson syndrome (SJS) is an allergic reaction to HIV treatment that is extremely rare. Fever and swelling of the cheeks and tongue are among the symptoms. A blistering rash forms and spreads swiftly, affecting the skin and mucous membranes.

Toxic epidermal necrolysis is a life-threatening illness that occurs when 30% of the skin is damaged. If this continues, immediate medical attention is required.

While a rash may be associated with HIV or HIV drugs, it’s crucial to remember that rashes are frequent and can be caused by a variety of factors.

Is there a difference in HIV symptoms in males and women?

HIV symptoms differ from person to person, however, men and women have comparable symptoms. These symptoms may appear and disappear, or they may worsen with time.

If a person has been infected with HIV, they may have also been infected with other sexually transmitted illnesses (STIs). These are some of them:

• gonorrhea
• chlamydia
• syphilis
• trichomoniasis

STI signs such as sores on the genitals may be more noticeable in men and individuals with a penis than in women. Men, on the other hand, do not seek medical attention as frequently as women.

Is there a difference in HIV symptoms in males and women?

The majority of HIV symptoms are the same in men and women. However, the symptoms they experience as a whole may differ depending on the risks men and women face if they have HIV.

STIs are more common among HIV-positive males and women. Women and those who have a vaginal canal, on the other hand, maybe less prone than men to notice tiny spots or other alterations in their genitals.

• Furthermore, HIV-positive women are at a higher risk of:
• recurring yeast infections in the vaginal area
• bacterial vaginosis and other vaginal infections
• Inflammation of the pelvis (PID)
• alterations in the menstrual cycle
• HPV is a human virus that can cause genital warts and cervical cancer.

Another concern for HIV-positive women is that the virus can be passed to a baby during pregnancy, which is unrelated to the virus’s symptoms. Antiretroviral medication, on the other hand, is deemed safe during pregnancy.

Antiretroviral therapy-treated women have a very minimal risk of transmitting HIV to their kids during pregnancy and delivery. Breastfeeding is also hampered in HIV-positive women. The virus can be passed from mother to child through breast milk.

Women with HIV are advised not to breastfeed their babies in the United States and other countries where formula is readily available and safe. The use of the formula is suggested for these mothers.

What are the signs and symptoms of AIDS?

The acronym AIDS stands for acquired immunodeficiency syndrome. The immune system is impaired in this state as a result of HIV infection that has gone untreated for many years.

A person with HIV who is diagnosed and treated with antiretroviral medication early on is unlikely to develop AIDS.

People with HIV who are not diagnosed until later in life or who are aware that they have HIV but do not take their antiretroviral therapy consistently may develop AIDS.

They may also acquire AIDS if they have an HIV strain that is resistant to (and does not react to) antiretroviral therapy.

People living with HIV are more likely to get AIDS if they do not receive effective and consistent therapy. By that time, the immune system has suffered significant damage and is having a difficult time responding to infection and disease.

Antiretroviral medication allows a person to have a persistent HIV infection without acquiring AIDS for decades.

AIDS symptoms can include:

• fever that comes and goes
• lymph glands are swollen for a long time, especially in the armpits, neck, and groin
• chronic exhaustion
• sweating during night
• black splotches beneath the skin or within the mouth, nose, or eyelids
• mouth and tongue sores, patches, or lesions, genitals, or anus
• Rashes, pimples, or lesions on the skin
• diarrhea that is recurrent or chronic
• the weight reduction is rapid
• Concentration issues, memory loss, and confusion are all examples of neurologic issues.
• Anxiety and sadness are two conditions that affect people.

Facts about HIV transmission

HIV can infect anyone. The virus is spread through bodily secretions such as:

• blood
• semen
• fluids in the vaginal and rectal canals
• milk from a mother
• HIV can be passed from person to person in a variety of ways, including:
• The most prevalent route of transmission is through vaginal or anal intercourse.
• by exchanging needles, syringes, and other injectable drug-related things
• by using tattoo equipment that hasn’t been sterilized between uses
• throughout a pregnant person’s pregnancy, labor, or birth of their infant
• when you’re breastfeeding
• Premastication, or chewing a baby’s food before feeding it to them, is one way to do this.
• by contact with HIV-positive people’s blood, sperm, vaginal and rectal fluids, and breast milk, such as through a needle stick

A blood transfusion or an organ and tissue transplant can also spread the virus. In the United States, however, strict HIV testing among blood, organ, and tissue donors guarantees that this is extremely unusual.

It’s theoretically possible, but considered extremely rare, for HIV to be transmitted through:

• Oral sex (only if the person’s gums are bleeding or there are open sores in the mouth)
• being bitten by an HIV-positive individual (only if the saliva is bloody or the person’s mouth has open sores)
• contact between broken skin, wounds, or mucous membranes and an HIV-positive person’s blood

HIV does not spread through the following:

• skin-to-skin communication
• embracing, handshakes, and kisses
• whether it’s air or water
• sharing food and beverages, including water fountains
• saliva, tears, or perspiration are all examples of bodily fluids (unless mixed with the blood of a person with HIV)
• sharing a toilet, towels, or mattress is not a good idea.
• Insects such as mosquitoes or other insects

It’s crucial to remember that if a person with HIV is being treated and has a viral load that is consistently undetectable, it’s nearly impossible for the virus to spread to another person.

HIV’s Causes

HIV is a type of virus that can be passed from African chimps to humans. Scientists believe the simian immunodeficiency virus (SIV) spread from chimps to humans when individuals ate virus-infected ape meat.

The virus transformed into what we currently know as HIV once it entered the human population. This happened in the 1920s, most likely.

Over the course of several decades, HIV spread from person to person across Africa. The virus eventually spread to other parts of the globe. HIV was found in a human blood sample for the first time in 1959.

HIV is assumed to have been present in the United States since the 1970s, but it wasn’t widely recognized until the 1980s.

HIV/AIDS Treatment Options

Regardless of viral load, treatment should begin as soon as possible after an HIV diagnosis.

Antiretroviral therapy, a combination of daily drugs that prevent the virus from reproducing, is the most common treatment for HIV. This aids in the protection of CD4 cells, allowing the immune system to remain robust enough to combat disease.

Antiretroviral therapy (ART) is a drug that prevents HIV from developing into AIDS. It also reduces the risk of HIV transmission to others.

The viral load will be “undetectable” when treatment is effective. Despite the fact that the person still has HIV, the virus is not visible in test results.

Anti-HIV drugs

To treat HIV, many antiretroviral therapy medicines have been licensed. They try to stop HIV from multiplying and killing CD4 cells, which aid the immune system in generating an infection response.

This helps to lower the risk of HIV-related problems as well as the spread of the virus to others.

These antiretroviral drugs are divided into six categories:

• Inhibitors of nucleoside reverse transcriptase (NRTIs)
• inhibitors of non-nucleoside reverse transcriptase (NNRTIs)
• inhibitors of proteases
• Inhibitors of fusion
• CCR5 antagonists, also known as entrance inhibitors, are drugs that block the receptor CCR5.
• Inhibitors of strand transfer in integrase

Treatment regimens

A starting regimen of three HIV drugs from at least two of these drug classes is commonly recommended by the US Department of Health and Human Services (HHS).

This combination helps to prevent HIV from developing drug resistance. (The term “resistance” refers to a drug’s inability to treat a virus.)

Many antiretroviral drugs are coupled with others, so an HIV patient usually only needs to take one or two pills every day.

A healthcare provider can assist someone living with HIV in deciding on a treatment plan depending on their overall health and particular circumstances.

These medications must be used on a daily basis and according to the instructions. If they’re not taken correctly, virus resistance can develop, necessitating a new treatment plan.

Blood tests will be used to see if the treatment is keeping the viral load low and the CD4 count high. If an antiretroviral medication regimen isn’t working, the person’s healthcare professional will move them to a different regimen that’s more successful.

Costs and side effects

Antiretroviral therapy can cause nausea, headaches, and dizziness, among other things. These symptoms are frequently transient and fade away with time.

Swelling of the mouth and tongue, as well as liver and renal damage, are all serious side effects. The drugs can be modified if the side effects are severe.

Antiretroviral therapy costs vary depending on where you live and what kind of insurance you have. Assistance programs are available from several pharmaceutical firms to aid with the expense.

What’s the link between HIV and AIDS?

A person must have contracted HIV in order to develop AIDS. However, carrying HIV does not guarantee that a person will acquire AIDS.

HIV cases are divided into three stages:

stage 1: acute stage, the first few weeks after transmission

stage 2: clinical latency, or chronic stage

stage 3: AIDS

As HIV reduces the CD4 cell count, the immune system weakens. CD4 counts in adults range from 500 to 1,500 per cubic millimeter. AIDS is diagnosed when a person’s count falls below 200.

The rate at which an HIV infection advances through the chronic stage varies greatly from person to person. It can continue up to a decade without therapy before progressing to AIDS. It can be treated and made to last eternally.

Although there is no cure for HIV, it can be controlled. With early antiretroviral medication, people with HIV can often have a near-normal lifespan.

In a similar vein, there is currently no known cure for AIDS. Treatment, on the other hand, can raise a person’s CD4 count to the point where they are no longer diagnosed with AIDS. (A count of 200 or above qualifies for this point.)

Treatment can also aid in the management of opportunistic infections.

Although HIV and AIDS are closely connected, they are not the same thing.

Causes of AIDS

HIV is the virus that causes AIDS. If you haven’t contracted HIV, you can’t get AIDS.

CD4 counts range from 500 to 1,500 per cubic millimeter in healthy people. HIV continues to grow and destroy CD4 cells in the absence of treatment. AIDS is diagnosed when a person’s CD4 count goes below 200.

Furthermore, even if a person with HIV develops an opportunistic infection linked to the virus, they can still be diagnosed with AIDS if their CD4 count is above 200.

What tests are used to determine whether or not someone has HIV?

HIV can be diagnosed using a variety of assays. The best test for each person is determined by healthcare providers.

Antibody/antigen tests

The most prevalent testing is antibody/antigen assays. They can show positive results in as little as 18–45 days after a person develops HIV.

These tests look for antibodies and antigens in the blood. Antibodies are proteins produced by the body in response to infection. The portion of the virus that triggers the immune system is called an antigen.

Antibody tests

These tests just look for antibodies in the blood. Most patients produce detectable HIV antibodies between 23 and 90 days after transmission, which can be identified in the blood or saliva.

There is no need to prepare for these tests, which are performed utilizing blood tests or oral swabs. Some tests can be performed in a healthcare provider’s office or clinic and yield results in 30 minutes or less.

Other antibody tests that can be performed at home include:

• OraQuick HIV Test: In as little as 20 minutes, a mouth swab can yield findings.

• HIV-1 Home Test System: this is a system that allows you to test your HIV-1 status at home. A blood sample is sent to a licensed laboratory after the person pricks their finger. They can stay anonymous and call the next business day for results.

If someone feels they’ve been exposed to HIV but received a negative result on a home test, they should test again in three months. If the test results are positive, they should confirm with their healthcare physician.

Nucleic acid test (NAT)

This costly test is not used for routine screening. It’s for persons who are showing early signs of HIV infection or who have a recognized risk factor. This test looks for the virus itself, rather than antibodies.

HIV can be detected in the blood for anywhere between 5 and 21 days. An antibody test is frequently performed in conjunction with or in confirmation of this test.

Getting tested for HIV is now easier than ever.

What’s the HIV window period?

HIV begins to replicate in a person’s body as soon as they contract it. Antibodies are produced by the immune system in response to antigens (parts of the virus) (cells that take countermeasures against the virus).

The HIV window period is the interval between being exposed to HIV and it becoming detectable in the blood. Within 23 to 90 days of infection, the majority of persons generate detectable HIV antibodies.

If someone takes an HIV test during the window period, they’ll almost certainly get a negative result. During this time, they can still spread the illness to others.

If someone suspects they were exposed to HIV but tested negative at this time, they should retest after a few months to confirm their suspicions (the timing depends on the test used). They must also use condoms or other barrier techniques to avoid the spread of HIV during this time.

Post-exposure prophylaxis may be beneficial for someone who tests negative during the window (PEP). This is an antiretroviral medicine that is used after an HIV infection has occurred.

PEP should be taken as soon as feasible after exposure; it should be taken no later than 72 hours after exposure, preferably sooner.

HIV prevention

Despite the efforts of many researchers, there is presently no vaccine available to prevent HIV transmission. Certain precautions, on the other hand, can aid in the prevention of HIV transmission.

Safer sex

HIV is most commonly transmitted during anal or vaginal sex without the use of a condom or other barrier techniques. This danger cannot be completely minimized unless intercourse is absolutely avoided, but it can be significantly reduced by taking a few precautions.

If you’re worried about your HIV risk, you should:

Obtain an HIV test.

It’s critical that they understand their own and their partner’s status.

Other sexually transmitted infections should be tested for (STIs).

They should get treated if they test positive for one because having an STI increases the chance of developing HIV.

Condoms should be used.

They should learn how to use condoms properly and use them every time they have sex, whether vaginal or anal intercourse. It’s vital to remember that HIV can be found in pre-seminal secretions (the fluids that come out before male ejaculation).

If they have HIV, they must take their meds exactly as prescribed.

This reduces the likelihood of the virus spreading to their sexual partner.

Living with HIV: What to expect and tips for coping

In the United States, more than 1.2 million people have HIV. Everyone is different, but with treatment, many people may expect to live a long and productive life.

The most crucial step is to begin antiretroviral therapy as soon as feasible. People living with HIV can maintain their viral load low and their immune system robust by taking drugs exactly as prescribed.

It’s also crucial to keep in touch with your doctor on a frequent basis.

Other approaches for HIV-positive persons to enhance their health include:

• Make their well-being a priority. Steps to help HIV-positive persons feel their best include:

1. a well-balanced diet to power their bodies
2. regular physical activity
3. getting enough sleep
4. Cigarettes and other substances should be avoided
5. reporting any new symptoms to their doctor as soon as possible

• Pay attention to their mental well-being. They might want to consult a qualified therapist who has expertise in treating HIV patients.

• Safer sex techniques should be used. Make contact with their sexual partner (s). Test for various sexually transmitted infections (STIs). Also, whenever they have vaginal or anal intercourse, they should use condoms or other barrier techniques.

• Discuss PrEP and PE with their healthcare physician. Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) can reduce the odds of transmission when taken regularly by a person without HIV. PrEP is most commonly suggested for HIV-negative persons in relationships with HIV-positive people, although it can also be used in other contexts. PrEP Locator and PleasePrEPMe are two online resources for locating a PrEP provider.

• Surround themselves with people they care about. When telling others about their illness for the first time, they should start slowly by telling someone who can preserve their trust. They may wish to find someone who will not judge them and would encourage them to take care of their health.

• Obtain assistance. They can join an HIV support group, either in person or online, to meet people who are dealing with similar issues. Their healthcare professional can also direct them to a number of local resources.

When you have HIV, there are numerous ways to make the most of your life.

Know the facts about HIV life expectancy.

In the 1990s, an HIV-positive 20-year-old had a 19-year life expectancy. A 20-year-old HIV-positive individual might expect to live another 53 years by 2011.

It’s a huge step forward, thanks in large part to antiretroviral medication. Many HIV patients can expect to live a normal or near-normal life if they receive effective treatment.

Of course, a person with HIV’s life expectancy is influenced by a variety of factors. Among them are the following:

• CD4 cell count
• viral load
• serious HIV-related illnesses, including hepatitis
• misusing drugs
• smoking
• access, adherence, and response to treatment
• other health conditions
• age

It is also important to consider where a person lives. Antiretroviral treatment may be more readily available in the United States and other industrialized nations.

The use of these medications on a regular basis can help prevent HIV from developing into AIDS. Without treatment, HIV progresses to AIDS, with a life expectancy of roughly 3 years.

Antiretroviral medication was used by about 20.9 million HIV-positive persons in 2017.

Statistics on life expectancy are only suggestions. HIV-positive people should speak with their healthcare physician to learn more about what to expect.

Is there an HIV vaccine?

There are currently no vaccinations available to prevent or cure HIV. Experimental vaccinations are still being researched and tested, but none are close to being licensed for widespread use.

HIV is a difficult virus to understand. It rapidly mutates (changes) and is frequently able to evade immune system reactions. Only a tiny percentage of HIV patients generate broadly neutralizing antibodies, which can react to a wide range of HIV strains.

In 2016, the first HIV vaccine effectiveness study in seven years began in South Africa. The experimental vaccination is an improved version of one that was tested in Thailand in 2009.

• pneumonia: recommended for all children younger than 2 and all adults 65 and older

• influenza: recommended for all people over 6 months old annually with rare exceptions

• hepatitis A and B: ask your doctor if you should get vaccinated for hepatitis A and B, especially if you are in a higher-risk group

• Meningitis: The meningococcal conjugate vaccine is recommended for all preteens and teenagers between the ages of 11 and 12, with a booster dose at the age of 16, as well as anybody at risk. Anyone 10 years or older who is at risk for meningococcal disease should get vaccinated against serogroup B.

• shingles: recommended for those ages 50 or older

Statistics on AIDS

Today’s HIV statistics are as follows:

• In 2019, around 38 million people throughout the world were infected with HIV. 1.8 million of those were youngsters under the age of 15.
• Antiretroviral treatment was used by 25.4 million persons living with HIV by the end of 2019.
• 75.7 million individuals have caught HIV since the epidemic began, and 32.7 million people have died from AIDS-related illnesses.
• AIDS-related illnesses claimed the lives of 690,000 persons in 2019. This is a decrease from the previous year’s figure of 1.9 million.
• Eastern and Southern Africa have taken the worst of the damage. In these locations, 20.7 million individuals were living with HIV in 2019, and 730,000 more had caught the infection.
• More than half of all HIV-positive persons in the world live in this region.

• In 2018, women, including adults and adolescents, accounted for 19 percent of new HIV diagnoses in the United States. African Americans account for nearly half of all new cases.
• A woman with HIV who is not treated has a 15–45 percent possibility of transferring HIV to her kid during pregnancy or nursing if she is not treated. The risk is less than 5% if antiretroviral medication is used during pregnancy and breastfeeding is avoided.
• In the 1990s, an HIV-positive 20-year-old had a life expectancy of 19 years. It has improved to 53 years by 2011. If antiretroviral medication is begun immediately after getting HIV, life expectancy is now approaching normal.

As access to antiretroviral therapy continues to improve around the world, these statistics will hopefully keep changing.