HIV has existed in the United States since at least the mid to late 1970s. Rare types of pneumonia, cancer, and other illnesses were reported by doctors from 1979 – 1981. The term “AIDS” began being used in 1982. The virus that first caused AIDS was discovered in 1983 by scientists. They at first named it HTLV-III/LAV (human T-cell lymphotrophic virus). This name was later changed to HIV.
In 1999, a team of international researchers found the orgins of HIV-1. It came from a subspecies of chimpanzees native to west equatorial Africa. Researches believe that the virus was first spread when hunters came into contact with infected blood.
HIV is most commonly spread by the following:
- Sexual contact – including oral, vaginal, and anal sex
- Through blood – sharing needles, syringes, rinse water, accidental needle sticks, and blood transfusions
- Through childbirth – infected mothers can transmit the virus through the blood shared with their fetus, or during breast-feeding
Less common ways HIV is transmitted are:
- Receiving blood transfusions, blood products, or organ/tissue transplants contaminated with HIV.
- Unsafe or unsanitary injections or other medical or dental practives
- Eating food that has been pre-chewed by an HIV- infected person
- Being bitten by a person with HIV
HIV cannot be transmitted outside of the human body. It is NOT spread by:
- Air or water
- Insects
- Saliva, tears, or sweat
- Shaking hands or sharing dishes
- Social kissing
In the first stages of HIV, the majority of patients do not show any symptoms. However, during this early stage of the disease, the virus can still be transmitted to others so knowing your HIV status is essential even if you do not show any obvious external signs.
Within the initial month or two after infection, the individual may experience a flu-like illness including symptoms like:
- Fever
- Headache
- Tiredness and fatigue
- Enlarged lymph nodes in the neck and groin
These early symptoms typically disappear within a week to a month after their initial onset and are often mistaken for another viral infection, such as the flu. However, during this stage in the condition, the individual is highly infectious because at this time, HIV is present in greater amounts in genital fluids and blood.
Some infected with HIV may have more severe and noticeable symptoms at first or symptoms that last for an extended period of time while others may show no symptoms for twelve years or more.
During the late stages of HIV infection, the virus severely damages the body’s immune system and creates serious symptoms such as:
- Rapid weight loss
- Recurring fever
- Profuse night sweats
- Extreme and unexplainable tiredness
- Prolonged swelling of the lymph glands in the armpits, groin, or neck
- Diarrhea lasting more than a week
- Sores of the mouth, anus, or genitals
- Pneumonia
- Red, brown, pink, or purple blotches on or beneath the skin or inside of the mouth, nose, or eyelids
- Memory loss
- Depression
- Other neurologic disorders
The majority of symptoms associated with HIV can be attributed to a variety of other conditions thereby making diagnosis difficult. The only way to find out if you are infected with HIV is to be properly tested by a doctor or health care professional. Even if you do not show symptoms, it is essential to be tested in order to take precautionary measures and seek treatment.
HIV (human immunodeficiency virus) is a virus that causes the progressive destruction of the human body’s immune system, eventually resulting in the condition called AIDS (acquired immunodeficiency syndrome). It is the sixth leading cause of death for people ages 25-44 in the United States.
By gradually destroying the body’s immune system, HIV makes it harder for individuals to fight off diseases. Parasites, bacteria, yeasts, and viruses that commonly do not cause serious disease in people with normal immune systems can cause fatal illnesses in people with AIDS.
HIV has been found in:
- saliva
- tears
- nervous system tissue and spinal fluid, blood
- semen
- Pre-seminal fluid- the liquid that comes out before ejaculation
- vaginal fluid
- breast milk
There are two types of HIV, but in the United States “HIV” refers to HIV-1 unless otherwise stated. HIV-1 and HIV-2 both destroy immune cells called CD4+ T cells. These blood cells are important in the body’s fight against diseases. When the CD4+ T cells are below 200 cells per cubic millimeter, then the infection has progressed to AIDS.
HIV-2 is a second type of HIV that was discovered in 1986. It has the same modes of transmission as HIV-1 and the same association with AIDS. However, it progresses more slowly in its early development and progresses faster as the disease advances. HIV-2 is mostly found in Africa.
HIV is classified as a retrovirus. This class of viruses contains those that use RNA (ribonucleic acid) as their genetic material. HIV infects a cell and then uses an enzyme called reverse transcriptase to change its RNA into DNA (deoxyribonucleic acid). The virus then replicates itself using the machinery of the victim cell.
There are similar kinds of HIV viruses that target nonhuman species. Examples of these include the feline immunodeficiency virus (FIV) that affects cats and the simian immunodeficiency virus (SIV) that affects monkeys and other primates. These viruses help scientists research the virus, although they are not exactly the same as HIV.
In the decades since the HIV/AIDS epidemic began in the early 1980s, treatment for the illness has progressed significantly. Over thirty years ago, people with AIDS were not likely to live longer than a few years.
Today, there are 31 antiretroviral drugs approved by the Food and Drug Administration for the treatment of HIV. While these treatments do not cure the infection, they help to suppress the virus, sometimes to undetectable levels. By suppressing HIV, people infected can now lead longer and healthier lives. However, they can still transmit the virus to others and must continuously take antiretroviral medication in order to maintain their health.
The antiretroviral pharmaceuticals used to treat HIV/AIDS are organized into major drug classes:
- Reverse Transcriptase (RT) Inhibitors: These drugs interfere with the critical step during the HIV life cycle called reverse transcription. During this phase, the HIV enzyme RT converts HIV RNA to HIV DNA. RT inhibitors act as faulty DNA building blocks so when they are incorporated into the HIV DNA, the DNA chain cannot be completed thereby blocking HIV from replicating in a cell. The medication also interferes with the HIV enzyme’s ability to convert HIV RNA into HIV DNA.
- Protease Inhibitors: This medication interferes with the protease enzyme that the HIV virus uses to produce additional infectious viral particles.
- Fusion/Entry Inhibitors: These interfere with the virus’ ability to fuse with the cellular membrane, blocking entry into the host cell.
- Integrase Inhibitors: These block integrase, the enzyme which HIV uses to integrate genetic material of the virus into its target host cell.
Doctors may prescribe multidrug combination products which combine drugs from more than one class into a single product. To combat virus strains from becoming resistant to medication, a doctor or health care professional may recommend those infected take a combination of antiretroviral drugs known as highly active antiretroviral therapy (HAART).
The most common and widely used pharmaceutical treatment for HIV is AZT or zidovudine.
However, the most effective form of treatment against the epidemic of HIV/AIDS is prevention. There is currently no vaccine to prevent the infection however, there are precautionary steps and regulations to take in order to avoid being infected. Get tested for HIV regularly, no matter if you suspect you may have it or not. Because symptoms rarely show until the late stages of the disease, it is wise to get checked with each physical examination. Practicing abstinence, remaining faithful to your partner or spouse, not sharing needles and always using latex or polyurethane condoms help to reduce your risk of receiving or transmitting HIV.
There are approximately 1.1 million Americans living with HIV today, of whom 21% do not know they have the virus. These people may not have any symptoms and can unknowingly spread the virus to others. The Centers for Disease Control and Prevention (CDC) recommends testing for HIV during routine medical care for adults, adolescents, and pregnant women. If someone is concerned about confidentiality, the test may be performed anonymously.
Testing Adults
There are two blot tests used to detect antibodies to the HIV virus in the blood that most both be positive to confirm HIV. These tests are the HIV ELISA blot test and the HIV Western blot test. If the test is negative then no antibodies were found. However, if the patient has risk factors for HIV then they should be tested again in three months. If both of these tests are positive, then there are other blood tests doctors can use to figure out how much HIV is in the patients blood stream.
Doctors can use a complete blood count (CBC) and white blood cell differential to find abnormalities in the patient’s blood cells.
Doctors usually perform a blood test to measure the patient’s level of CD4+ T cells. T cells are part of the immune system and are often referred to as “helper cells.” A person is diagnosed with AIDS if they are HIV positive and have a CD4+ cell count below 200 cells/mm3.
A test called HIV RNA level, also known as viral load, can be used to monitor patients. Regular cervical Pap smears and screening lab tests are necessary to monitor patients with HIV. Anal Pap smears are important for both HIV positive men and women to detect possible cancers.
Testing Infants
The Centers for Disease Control and Prevention (CDC) recommends that all pregnant women get tested for HIV before or during delivery. If the doctor knows the mother’s HIV status then he or she can prevent the mother from transmitting HIV to her baby. The doctor can prescribe her antiretroviral treatment to the mother and the newborn infant. Testing infants for the virus is difficult because babies have their mothers’ HIV antibodies for several months. However, now doctors test infants between 3 and 15 months for the virus. Researchers are in the process of looking for a reliable blood test for babies younger than 3 months.
One of the most important things for people with HIV to do to stay healthy is to take their medication. There are many reasons why people don’t want to take it. The most common are:
- Depression and mental illness
- Substance abuse
- Complicated medical instructions
- Medication side effects
- Dietary restrictions
- Difficulty reading or understanding directions
- Stigma
- Travel
Because HIV weakens the immune system, immunizations can play a big role in keeping a person with HIV healthy. A doctor will recommend immunizations that are right for each patient. The most commonly recommended immunizations for adults with HIV are:
- Hepatitis A and B
- Influenza
- Polysaccharide Pneumococcal (pneumonia)
- Tetanus, Diphtheria, Pertussis
HIV/AIDS is a relatively new epidemic. Now that there are medications to help infection patients live longer, the aging issue is a new one. The following diseases can be worsened by aging and HIV (or HIV treatments):
- Dementia
- Depression
- Insulin resistance
- High cholesterol and triglycerides
- Infections
- Medication interactions
HIV can be as manageable as a chronic disease. People living with HIV can live healthy lives. It requires daily medication, regular laboratory monitoring, and lifestyle changes. The advances in medicine have made it possible for HIV patients to suppress the disease.
Look for a support system. You can turn to your friends, family, or members of your community for support. If you are not ready to tell others you have the disease, there are other options. Look for a community support group or professional organization for one-on-one counseling, peer counselors, or health educators.
Living with HIV/AIDS will entail several doctor visits. Always remember to:
- Bring along materials you or your doctor might need (lab slips, x-rays, meds, etc)
- Be on time
- Write down your questions before you go and write down your doctor’s answers.
- Ask your doctor about what you need for the next appointment and write it down
- Ask for a list of your upcoming appointments before you leave
It is important that adults are routinely tested for HIV. Limiting the number of sex partners as well as always using a condom is the best way to prevent contracting HIV.
An individual who has other sexual transmitted diseases (STDs) is more likely to also have HIV then an individual who does not have any STDs. Get routinely tested for STDs as well.
If an individual has been diagnosed with HIV or AIDS, they should ask a doctor about the best method of treatment. It is also important that those living with HIV or AIDS remember to take all of their prescribed doses of medication.
For more information on HIV and AIDS, contact the following organizations:
- AIDS.gov
- Department of Health and Human Services – AIDS info
- National Institute of Allergy and Infectious Diseases Division of Acquired Immunodeficiency Syndrome