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HIV (Human Immunodeficiency Virus Infection)

What is HIV?

Alternative Name: Human Immunodeficiency Virus Infection

HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight.

Asymptomatic HIV infection is a variable phase during chronic viral infection with HIV characterized by the absence of clinical symptoms of HIV infection.

Early symptomatic HIV infection is the stage of viral infection caused by HIV where symptoms have begun to manifest, but before the development of AIDS (which involves life-threatening infections).

What Causes HIV?

Acute HIV infection may be associated with symptoms resembling mononucleosis or the flu within 2 to 4 weeks of exposure. HIV seroconversion (converting from HIV negative to HIV positive) usually occurs within 3 months of exposure.

People who become infected with HIV may have no symptoms for up to 10 years, but they can still transmit the infection to others.

Meanwhile, their immune system gradually weakens until they are diagnosed with AIDS.

Acute HIV infection progresses over time to asymptomatic HIV infection and then to early symptomatic HIV infection and later, to AIDS (advanced HIV infection):

HIV Infection (acute HIV infection) » early asymptomatic HIV infection »
early symptomatic HIV infection » AIDS 

Most individuals infected with HIV will progress to AIDS if not treated. However, there is a tiny subset of patients who develop AIDS very slowly, or never at all. These patients are called non-progressors.

HIV has spread throughout the United States. Higher concentrations of the disease are found in inner city areas.

What are the Symptoms of HIV?

Any symptoms of illness may occur, since infections can occur throughout the body.

Special symptoms relating to HIV infection include:

  • Sore throat
  • Mouth sores, including candidal infection
  • Muscular stiffness or aching
  • Headache
  • Diarrhea
  • Swollen lymph glands
  • Fever
  • Fatigue
  • Rash of various types, including seborrheic dermatitis
  • Frequent vaginal yeast infections

Note: At the time of diagnosis with HIV infection, many people have not experienced any symptoms.

Signs and Tests:

  • An HIV ELISA/Western blot may show positive HIV antibody (right).
  • If it is negative, the test should be repeated in 3 months.
  • CD4 count may show suppression of the immune system.
  • HIV RNA viral load indicates amount of virus in the bloodstream.
  • A blood differential may show abnormalities.

How is HIV Treated?

Drug therapy is often recommended for patients who are committed to taking all their medications and have a CD4 count less than 500 (indicating immune system suppression) or a high viral load (amount of HIV virus in the bloodstream).

It is extremely important that patients take all doses of their medications, otherwise the virus will rapidly become resistant to the medications. Therapy is always given with a combination of antiviral drugs.

People with HIV infection need to receive education about the disease and treatment so that they can be active partners in decision making with their health care provider

Support Groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems.

Expectations (prognosis):

HIV is a chronic medical condition that can be treated, but not yet cured. There are effective means of preventing complications and delaying, but not preventing, progression to AIDS. At the present time, not all persons infected with HIV have progressed to AIDS, but time has shown that the vast majority do.

Complications:

  • Opportunistic infections
  • Pneumocystis carinii pneumonia
  • Candidiasis
  • Cytomegalovirus infection
  • Toxoplasmosis
  • Cryptococcus
  • Cryptosporidium enterocolitis
  • Mycobacterium avium complex (MAC)
  • HIV dementia
  • HIV lipodystrophy
  • Chronic wasting from HIV infection

Calling your health care provider:

Call for an appointment with your health care provider if you have had a possible or actual exposure to AIDS or HIV infection.

How Can HIV be Prevented?

  1. Do not have sexual contact with persons known or suspected of being infected with HIV.
  2. Do not have sex with numerous people or with people who have multiple partners.Do not have sex with prostitutes.
  3. Do not use intravenous drugs. If IV drugs are used, do not share needles or syringes. (Boiling or cleaning them with alcohol does not guarantee sterility.)
  4. Do not have sex with people who use IV drugs.
  5. People with AIDS or who have had positive HIV antibody tests may pass the disease on to others. They should not donate blood, plasma, body organs, or sperm. They should not exchange body fluids during sexual activity.
  6. Avoid oral, vaginal, or anal contact with semen.
  7. Avoid anal intercourse, since it causes small abrasions in the rectal tissues, through which HIV in an infected partner's semen may be injected directly into the recipient's blood.
  8. Avoid oral contact with the anus, and do not engage in the insertion of fingers or fists into the anus, as either an active or receptive partner.
  9. Do not allow a partner's urine to enter your mouth, anus, eyes, or open cuts or sores.
  10. Safer sex behaviors may reduce the risk of acquiring the infection. There is a risk of acquiring the infection even if "safe sex" is practiced with the use of condoms. Abstinence is the only sure way to prevent sexual transmission of the virus.