What is HIV? What is AIDS?
HIV (human immunodeficiency virus) is a virus that attacks the immune system, the body’s natural defense system. Without a strong immune system, the body has trouble fighting off disease. Both the virus and the infection it causes are called HIV.
White blood cells are an important part of the immune system. HIV invades and destroys certain white blood cells called CD4+ cells. If too many CD4+ cells are destroyed, the body can no longer defend itself against infection.
The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). People with AIDS have a low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be deadly.
But having HIV does not mean you have AIDS. Even without treatment, it takes a long time for HIV to progress to AIDS—usually 10 to 12 years. If HIV is diagnosed before it becomes AIDS, medicines can slow or stop the damage to the immune system. With treatment, many people with HIV are able to live long and active lives.
What causes HIV?
HIV infection is caused by the human immunodeficiency virus. You can get HIV from contact with infected blood, semen, or vaginal fluids.- Most people get the virus by having unprotected sex with someone who has HIV.
- Another common way of getting the virus is by sharing drug needles with someone who is infected with HIV.
- The virus can also be passed from a mother to her baby during pregnancy, birth, or breast-feeding.
What are the symptoms?
HIV may not cause symptoms early on. People who do have symptoms may mistake them for the flu or mono. Common early symptoms include:
- Fever.
- Sore throat.
- Headache.
- Muscle aches and joint pain.
- Swollen glands (swollen lymph nodes).
- Skin rash.
Symptoms may appear from a few days to several weeks after a person is first infected. The early symptoms usually go away within 2 to 3 weeks.
After the early symptoms go away, an infected person may not have symptoms again for many years. Without treatment, the virus continues to grow in the body and attack the immune system. After a certain point, symptoms reappear and then remain. These symptoms usually include:
- Swollen lymph nodes.
- Extreme tiredness.
- Weight loss.
- Fever.
- Night sweats.
A doctor may suspect HIV if these symptoms last and no other cause can be found.
Treatment usually keeps the virus under control and helps the immune system stay healthy.
How is HIV diagnosed?
The U.S. Food and Drug Administration (FDA) has approved tests that detect HIV antibodies in urine, fluid from the mouth (oral fluid), or blood. If a test on urine or oral fluid shows that you are infected with HIV, you will probably need a blood test to confirm the results. If you have been exposed to HIV, your immune system will make antibodies to try to destroy the virus. Blood tests can find these antibodies in your blood.
Most doctors use two blood tests, called the ELISA and the Western blot assay. If the first ELISA is positive (meaning that HIV antibodies are found), the blood sample is tested again. If the second test is positive, the doctor will do a Western blot to be sure.
It may take as long as 6 months for HIV antibodies to show up in a blood sample. If you think you have been exposed to HIV but you test negative for it:
- Get tested again in 6 months to be sure you are not infected.
- Meanwhile, take steps to prevent the spread of the virus. If you are infected, you can still pass HIV to another person during this time.
Some people are afraid to be tested for HIV. But if there is any chance you could be infected, it is very important to find out. HIV can be treated. Getting early treatment can slow down the virus and help you stay healthy. And you need to know if you are infected so you can prevent spreading the infection to other people.
You can get HIV testing in most doctors’ offices, public health clinics, hospitals, and Planned Parenthood clinics. You can also buy a home HIV test kit in a drugstore or by mail order. But be very careful to choose only a test that has been approved by the U.S. Food and Drug Administration (FDA). If a home test is positive, see a doctor to have the result confirmed and to find out what to do next.
How is it treated?
The standard treatment for HIV is a combination of medicines called highly active antiretroviral therapy (HAART). Antiretroviral medicines slow the rate at which the virus multiplies. Taking these medicines can reduce the amount of virus in your body and help you stay healthy.
It may not be easy to decide the best time to start treatment. There are pros and cons to taking HAART before you have symptoms. Discuss these with your doctor so you understand your choices.
To monitor the HIV infection and its effect on your immune system, a doctor will do two tests:
- Viral load, which shows the amount of virus in your blood.
- CD4+ cell count, which shows how well your immune system is working.
If you have no symptoms and your CD4+ cell count is at a healthy level, you may not need treatment yet. Your doctor will repeat the tests on a regular basis to see how you are doing. If you have symptoms, you should consider starting treatment, whatever your CD4+ count is.
After you start treatment, it is important to take your medicines exactly as directed by your doctor. When treatment doesn't work, it is often because HIV has become resistant to the medicine. This can happen if you don't take your medicines correctly. Ask your doctor if you have questions about your treatment.
Treatment has become much easier to follow over the past few years. New combination medicines include two or three different medicines in one pill. Many people with HIV get the treatment they need by taking just one or two pills a day.
To stay as healthy as possible during treatment:
- Don't smoke. People with HIV are more likely to have a heart attack or get lung cancer. Smoking can increase these risks even more.
- Eat a healthy, balanced diet to keep your immune system strong.
- Get regular exercise to reduce stress and improve the quality of your life.
- Don't use illegal drugs, and limit your use of alcohol.
Learn all you can about HIV so you can take an active role in your treatment. Your doctor can help you understand HIV and how best to treat it. Also, consider joining an HIV support group. Support groups can be a great place to share information and emotions about HIV infection.
How can you prevent HIV?
HIV can be spread by people who don't know they are infected. To protect yourself and others:
- Practice safe sex. Use a condom every time you have sex (including oral sex) until you are sure you and your partner are not infected with HIV.
- Don't have more than one sex partner at a time. The safest sex is with one partner who has sex only with you.
- Talk to your partner before you have sex the first time. Find out if he or she is at risk for HIV. Get tested together and retested 6 months later. Use condoms in the meantime.
- Don't drink a lot of alcohol or use illegal drugs before sex. You might let down your guard and not practice safe sex.
- Don't share personal items, such as toothbrushes or razors.
- Never share needles or syringes with anyone.
Symptoms
HIV infection progresses in stages. These stages are based on your symptoms and the amount of the virus in your blood. Most people go through the following stages after being infected with HIV:
Initial stage (acute retroviral syndrome)
Acute retroviral syndrome is an illness with symptoms like mononucleosis. It often develops within a few days of infection, but it may occur several weeks after the person is infected. Symptoms may include:
- Abdominal cramps, nausea, or vomiting.
- Diarrhea.
- Enlarged lymph nodes in the neck, armpits, and groin.
- Fever.
- Headache.
- Muscle aches and joint pain.
- Skin rash.
- Sore throat.
- Weight loss.
These first symptoms can range from mild to severe and usually disappear on their own after 2 to 3 weeks.
Chronic stage
It may take years for HIV symptoms to develop. But even though no symptoms are present, the virus is multiplying (or making copies of itself) in the body during this time. HIV multiplies so quickly that the immune system cannot destroy the virus. After years of fighting HIV, the immune system starts to weaken.
A doctor may suspect HIV if symptoms persist or if a cause of the symptoms (such as the flu) cannot be identified. HIV may also be suspected when several of the following symptoms are present:
- Diarrhea or other bowel changes
- Fatigue
- Fever
- Loss of appetite or unexplained weight loss
- Dry cough or shortness of breath
- Nail changes
- Night sweats
- Swollen lymph nodes in the neck, armpits, and groin
- Pain when swallowing
- Confusion, difficulty concentrating, or personality changes
- Repeated outbreaks of cold sores or genital herpes sores
- Tingling, numbness, and weakness in the limbs
- Mouth sores or a yeast infection of the mouth (thrush)
- More than 3 vaginal yeast infections in one year that are not related to the use of antibiotics
- Recurrent pelvic inflammatory disease (PID)
- Abnormal Pap test or cervical cancer
Late stage
AIDS occurs during the last stage of infection with HIV. If HIV goes untreated, AIDS develops in most people within 12 to 13 years after the initial infection. With treatment for HIV, the progression to AIDS may be delayed or prevented.
After your immune system starts to weaken, you are more likely to develop certain infections or illnesses, called opportunistic infections. Examples include some types of pneumonia or cancer that are more common when you have a weakened immune system.
A small number of people who are infected with HIV are rapid progressors. They develop AIDS within a few years if they do not receive treatment. It is not known why the infection progresses faster in these people.
