HIV

For over forty years, HIV has remained one of the key problems of modern society. Therefore, HIV diagnosis is now attracting a lot of attention and resources. After all, the sooner one detects a virus that destroys the body’s immune system, the higher are the chances of avoiding a fatal outcome.

What is HIV / AIDS?

HIV infection is an infectious process in the human body caused by the human immunodeficiency virus, characterized by a slow course, damage to the immune and nervous systems, followed by the development of opportunistic (concomitant) infections and neoplasms against this background, leading to death of HIV-infected.

AIDS (acquired immunodeficiency syndrome) is the terminal stage of HIV infection, which occurs in most cases after a very long period from the moment of infection with the virus.

The History of HIV

The first clinical discoveries associated with acquired immunodeficiency syndrome date back to 1981. At that moment, American doctors began to identify rare forms of opportunistic infections in drug addicts and homosexual men. Shortly thereafter, epidemiologists also noted the frequent detection of Kaposi’s sarcoma in young people. This is a rare type of malignant tumor that develops in patients with immune pathologies. At that time, doctors still had no idea about the reasons for the active spread of such diseases, but already in 1982, experts described the pathology of the body’s defense systems as acquired immunodeficiency syndrome (AIDS).

After the discovery of the dangerous virus, scientists focused on studying the etiology of the disease. It was assumed that the infection is transmitted only through anal sex or injecting drugs. In 1983, French and American experts independently discovered and described a virus that provoked the development of the disease. This was a significant discovery, which allowed scientists to further study all the features of the infection and develop effective drugs.

The origin of the immunodeficiency virus is still a controversial issue, however, scientists are inclined to the theory of zoonosis. The results of numerous studies have shown that the precursor of the virus was distributed among monkeys in West and Central Africa. Due to constant mutations, the pathogen has more dangerous properties, due to which the disease is not stopped by the body’s defense systems.

How is HIV transmitted?

The virus is present in any biological material, but one can get infected only through blood, seminal fluid, breast milk, lymph and the secret produced in the vagina. Infection can occur when these biological materials enter the bloodstream or lymphatic system of a healthy person. According to statistics, the infection will not occur when contaminated material gets on a bleeding wound.

Human immunodeficiency virus infection often occurs during unprotected sex with a sick person and with repeated use of non-sterile medical instruments. Knowing how HIV is transmitted, you can pre-warn this point. For example, the virus is not transmitted by domestic means, which means that you can absolutely calmly communicate with a sick person (sit at the same table and use common dishes). The fact is that HIV is very weak and dies in almost a matter of seconds in an open environment. It ceases to exist at a temperature of 130 degrees F and above.

The likelihood of contracting HIV infection is very high among healthcare providers who give injections. They are given prophylaxis in the form of monthly therapy with antiretroviral drugs.

Symptoms of HIV infection

The incubation period of HIV is from 3 weeks to 3 months, but in some cases, it can last up to a year. All this time it does not manifest itself. A person denies a deterioration in health, but the virus is actively growing and multiplying, penetrating into all organs and systems of the body. During this period, an infectious disease can only be diagnosed by laboratory testing of human biological material.

Symptoms of HIV in the early stages:

• general weakness, constant malaise, loss of strength;
• periodical rashes on the skin and mucous membranes;
• swollen lymph nodes;
• enlarged liver and spleen.

As the disease progresses, a person experiences frequent sore throats and tonsillitis, herpetic diseases, pneumonia of various types. Over time, all common diseases disappear – the latent period begins. The only manifestation of the disease in the latent stage is pairwise enlarged lymph nodes.

The latent stage of the disease can last up to 20 years, but the average period is 6-7 years. It is followed by the terminal stage, which is characterized by irreversible pathological processes in all organs and systems of a person. Even drug therapy for HIV in the terminal stage does not give positive results.

Risk factors

In addition to transmission routes, risk factors must also be considered. These are certain conditions and signs that increase the likelihood of infection. Some form of predisposition to the disease must be taken into account in prevention.

Key risk factors include:

1. Unprotected sex. Viral particles can be easily transmitted through the mucous membranes, so latex or polyurethane condoms must be used. These protective agents minimize the risk of invasion;
2. Anal sex. A high risk of infection with such sexual contact is due to a large number of micro damages of the intestinal mucosa;
3. The presence of sexually transmitted diseases. Primary infections affecting human genitals increase the risk of HIV invasion. Also, such pathologies disrupt the functions of the patient’s immune system;
4. Reusable use of syringes and needles. This risk factor is primarily associated with drug addiction;
5. The uncut foreskin of the penis. Studies have shown that circumcised men are at a lower risk of infection.

Pathogenic particles can enter the body of any person, regardless of gender, race and age. In this case, a high probability of invasion can also be associated with the characteristics of the course of the disease in the sexual partner. With high viral load and frequent unprotected sex, the transmission is the most likely outcome.

Diagnostics

The specific method for diagnosing the disease depends on the intended stage of HIV infection. Most hospitals and medical centers can offer the patient a wide range of laboratory tests to detect the disease at any stage of development. In this case, the most common way to detect the disease is a test for the presence of antibodies to HIV. Specific immunoglobulins most often appear in the patient’s blood within 2-3 months after the invasion, therefore such a laboratory test is constantly used as a screening. At the same time, such an analysis is not suitable for patients with a terminal form of pathology since antibodies may not be synthesized with severe immunodeficiency.

Basic diagnostic methods

1. Enzyme-linked immunosorbent analysis makes it possible to detect specific immunoglobulins in the patient’s blood;
2. Immune blotting is a more accurate method for detecting antibodies in the blood. This analysis is usually used to confirm the result of an enzyme immunoassay;
3. Polymerase chain reaction – a direct test necessary to detect the genetic particles of the virus in the patient’s body;
4. Rapid tests based on immunochromatography, agglutination reactions, and other methods. The accuracy of such analyzes is significantly inferior to other laboratory studies.

For a thorough examination and competent selection of laboratory analysis, it is recommended to consult a doctor. The specialist will ask the patient about complaints, examine the medical history and conduct a physical examination. One should keep in mind that antibody tests do not detect HIV during the window period (from 2 weeks to six months), therefore, even when a patient has a negative result, a second examination may be required.

How to treat HIV infection?

Medicine still does not know the method of completely eliminating the virus from the body, however, existing antiviral medicines can significantly slow down the course of infection, as well as eliminate the symptoms and complications of HIV. With the timely use of drugs, it is possible to preserve a person’s life span. As a result, patients receiving antiretroviral therapy live a full life.

At the same time, the virus constantly mutates, therefore the already developed treatment regimens for infection cannot be used for a long time. Doctors need to evaluate the patient’s laboratory parameters and select new drugs if pathogens have formed a resistance. Another limitation of drug therapy may be patient intolerance to certain drugs.

The main classes of drugs:

1. Non-nucleoside reverse transcriptase inhibitors. These drugs block the enzyme necessary for virus replication;
2. Nucleotide reverse transcriptase inhibitors. Once in the human body, these drugs are converted to diphosphates or triphosphates, which block reverse transcriptase. The action of nucleotide inhibitors is also aimed at preventing HIV replication;
3. Protease inhibitors – drugs that block the final stage of replication;
4. Fusion inhibitors that prevent the virus from entering the target cell;
5. Integrase inhibitors. These chemical compounds block the protein used by the virus to incorporate its own genetic information into CD4 cells.

Many medications can cause dangerous side effects. Therefore, before choosing a therapy, the doctor must exclude the presence of contraindications in the patient. Antiviral drugs must be taken throughout life.

Complications

HIV infection has only one complication – AIDS, and AIDS can lead to the following consequences:

• tuberculosis – can become fatal in the AIDS stage. Due to circulatory disorders in the lungs, septic shock may develop;
• pneumonia, in which mortality is about 50% in the AIDS stage;
• hepatitis – as a result of taking drugs on the liver, a negative effect;
• fungal infections of the brain;
• herpesvirus infection of the respiratory tract;
• cold sore;
• toxoplasmosis;
• Kaposi’s sarcoma;
• infectious and fungal diseases;
• death.

Disease development

The human immunodeficiency virus belongs to the family of retroviruses. It is a virion – a particle consisting of a shell and a protein-nucleic acid complex. Outside the host cell, it shows no signs of biological activity. But as soon as the HIV virion joins the living cell of the immune system (T-lymphocyte), it merges with it and transfers its genetic information to it. An immunity cell infected in this way is unable to perform its functions and is a favorable environment for virion replication – HIV begins to create its own copies. New virus particles bud, enter the bloodstream and find a new host cell. An old virus carrier cell dies, and new T-lymphocytes fall under the scope. And this repeats ad infinitum! – until the immune system is completely destroyed. During this time, the human body goes through all stages of the development of the disease.

1. HIV enters the body – infection with a virus;
2. Virions begin to attack T-lymphocytes – the incubation period;
3. The number of replicated virions increases dramatically – the acute phase;
4. The rate of HIV reproduction is balanced by the body’s immune response – a latent stage in which there are no symptoms;
5. The number of replications is growing, and the number of healthy T-lymphocytes is steadily decreasing – the immune system does not fulfill its functions and AIDS develops.

Thus, infection and HIV infection are not fatal to humans. Antiretroviral therapy can suppress the activity of the virus, inhibiting the progression of the disease. In fact, the patient is constantly in a latent stage and leads a familiar lifestyle.

How long can a person live with HIV?

In this case, it all depends on three important factors – the timing of the diagnosis, the treatment and the general health of the patient. The statistics for HIV and AIDS include the following figures;

• Timely diagnosis and subsequent HAART – life expectancy is 20-50 years;
• Detection of HIV infection in the later stages and subsequent HAART – 10-40 years;
• Undetected infection without treatment – 9-11 years;
• AIDS without treatment – 6-9 months.

An equally important factor affecting the life expectancy of HIV-infected patients is the general state of health and immunity. Naturally, people with strong immunity who do not have chronic diseases and congenital pathologies will live longer. At the same time, a weakened body resists the virus worse. Therefore, in addition to HAART, all HIV-positive patients are recommended to lead a healthy lifestyle and have proper nutrition. They must protect themselves from infectious and colds, strengthen immunity, take care of their body and undergo a regular examination.

Preventative measures

Doctors insist that every person must undergo an examination after unprotected intercourse with an unreliable partner. At any time, you can take an anonymous blood test for HIV and make sure that no infection has occurred, or get qualified help if you confirm the infection. After receiving the test results, the doctor will conduct a conversation with the patient, give recommendations for prevention and tell him or her which drugs should be included in the anti-HIV medicine kit.

To prevent infection with the immunodeficiency virus, the following preventive measures should be followed:

1. Sexual intercourse should be performed only in a condom since no other contraceptives save you from infection;
2. Injection addiction is a direct way to HIV infection, therefore, maximum efforts should be made to treat drug addiction or, in case the process is irreversible, use only sterile disposable syringes;
3. Tattoos and piercings should be performed only in specialized salons in compliance with all hygiene rules.

One should be familiar with nosocomial prophylaxis. First of all, this concerns medical workers who must perform all manipulations with gloves.