What is HIV?
Human Immunodeficiency Virus, also known as HIV, is a virus that attacks the immune system, particularly white blood cells called T-helper cells, specifically a subset of T-cells called CD4 cells. These cells normally protect you from infection-causing microorganisms, such as viruses, fungi and bacteria. When one is infected with HIV, these cells are killed off and the virus rapidly creates new copies of itself, leaving you unable to fight off germs and vulnerable to a variety of illnesses and opportunistic infections, thus making it harder or impossible for the body to fight infections and cancers.
Who is affected by HIV?
First identified in around 1986, HIV has two subtypes, HIV-1 and HIV-2. Infection with either has no racial, age, or geographical predilection and there are reported cases in nearly every country. About 38 million people are living with HIV around the world today with 1.8 million being newly infected in 2018, and over two-thirds of them live in Africa.
In 2018, 770 000 people died from HIV-related causes globally according to the World Health Organisation with 1.7 million new infections. HIV is commonest in the following groups:
- Sex workers and their clients;
- Men who have sex with men;
- People who inject drugs;
- People in prisons;
- Transgender people.
What is AIDS?
AIDS (acquired immune deficiency syndrome) is the final stage of HIV infection. It can take years for someone who is infected with HIV to reach this stage, even without treatment. When someone has a very low number of CD4 cells (less than 200 per cubic millimetre), has had one or more specific infections or certain cancers, that person is considered to have AIDS. Healthy adults have between 500 to 15000 CD4 cells per cubic millimetre.
How is HIV transmitted?
The virus is present in semen, blood, breast milk and vaginal as well as anal fluids. It is commonly transmitted through:
- unprotected vaginal or anal sex with an infected partner. This is responsible for a large majority of cases. It can also be transmitted via oral sex.
- blood and blood products transfusions,
- sharing needles and other equipment among drug users,
- organ transplantation,
- infected needle-stick injuries to healthcare workers,
- or from mother to child during pregnancy, delivery or breast-feeding.
HIV cannot be spread by ordinary day-to-day contacts such as kissing, hugging, shaking hands, or sharing personal objects, food or water.
What are the Symptoms of HIV?
Within 3 to 6 weeks of infection with HIV, more than 50 per cent of individuals experience some symptoms. Here, the body reacts to the killing of CD4 cells and the spread of HIV copies leading to the symptoms seen which may include the following:
- Rashes or sores on the skin
- Muscle pain and weakness
- Night sweats
- Yeast infections
- Nausea and/or vomiting
- Shortness of breath
- Short-term memory loss
- Weight loss
- Swollen lymph nodes
For some, this initial phase does not lead to any symptoms. Generally, people living with HIV are most infectious in this early stage and can easily transmit the virus to others. After this initial phase, the symptoms tend to disappear, signalling that the virus has now been established in the body and able to replicate and spread uninhibited. This is the second stage of infection.
HIV silently develops over 5 to 10 years, killing off and impairing CD4 cells, leading to the development of a state of little or no immunity (called AIDS -acquired immune deficiency syndrome). At this stage, a barrage of diseases caused by viruses and opportunistic infections (AIDS-defining illnesses) may result, causing varying symptoms and complications in different systems affected, as well as cancer.
How is HIV testing done?
HIV can be diagnosed using simple and affordable rapid diagnostic tests, as well as self-tests administered by the interested individual. If a screening test is positive, your healthcare provider will request a confirmatory test. After exposure, one should expect a positive result around 28 days later. This is the period by which the body can mount a response to the virus, which is how the testing is done. If one is infected, testing before the end of this window period may show a negative result.
Over 8 million people with HIV did not know that they were infected in 2018. It is important to test for HIV and practice safe sexual practices to prevent it.
How Can I Protect Myself from Contracting HIV?
The following tips are necessary for protecting yourself from HIV
- Abstain from sex. If you are sexually active, use condoms for penetrative sexual acts and dental dams for oral sex.
- Get tested for HIV and other sexually transmitted infections.
- Be faithful to your HIV-negative partner who is equally faithful.
- Treat sexual infections as soon as you notice symptoms
- Do not share sharp objects, like razor blades or injections.
Is there a cure for HIV?
At this time, there is no cure for HIV. This is because the virus can hide in hard-to-reach areas of the body, making it difficult for current treatment options to deal with it. While there is no cure for an HIV infection currently, the condition can be treated to prevent complications and delay the progression to AIDS.
Research into a cure for HIV has been ongoing for years and there has been significant progress in the recent past however, complete eradication of the virus is not available at this time.
How is HIV treated?
Specific medications designed to slow or halt the spread of HIV within the cells in the body via different mechanisms have been designed. These drugs work in different ways and are often combined (three or more medications) to keep the viral load (amount of HIV cells in the body) to a minimum. These medications (called Anti-Retroviral or ART) are very effective and can help people living with HIV live normal lives.
What is Pre-exposure prophylaxis (PreEP)?
This is the daily use of antiretroviral drugs by HIV-negative people to block the acquisition of HIV. It can also be designed around the timing of the high-risk activity (e.g. sexual intercourse). Speak with your doctor if you are HIV negative and are in a sexual relationship with a person living with HIV
What is post-exposure prophylaxis (PEP)?
PEP is the use of antiretrovirals after an exposure to HIV at work (for health workers) and at other situations. Typically, the medications are started within 72 hours and given for 28 days. If you have been exposed to HIV, speak with your doctor.