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HIV/AIDS - causes, symptoms and complications

Written by Dr Anitha Anchan |Updated : August 27, 2014 10:33 AM IST

HIV/AIDS has claimed over 25 million lives in the last 30 years. It's estimated that over 34 million people are living with HIV. One of the biggest problems associated with HIV/AIDS is misinformation. So how exactly is it caused? How is it transmitted? How can we prevent the disease from spreading? What medicines can we take for it? Here are the answers to some frequently asked questions about HIV/AIDS:

What is HIV?

The human immunodeficiency virus (HIV) is a retrovirus that destroys or impairs the function of the body's immune system making the person more susceptible to infections. Unless treated, it develops into full-blown acquired immunodeficiency syndrome (AIDS). The virus infects humans when it comes in contact with tissues lining the vagina, anal area, mouth and eyes, or through a break in the skin. There are two main types - HIV-1 and HIV-2. HIV-2 is typically found in Africa and parts of Asia. HIV-2 is typically found in Africa and parts of Asia. Asia can thus no longer be considered free of HIV-2, and testing for HIV-2 appears mandatory, at least in India. Worldwide, when people refer to HIV they are usually referring to HIV-1.

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What is AIDS?

Acquired immune deficiency syndrome (AIDS) isn't a disease in itself. It is a condition in caused by HIV in which the body's immune system fails to battle foreign microorganisms. This leads to various opportunistic infections and/or certain cancers. It is the most advanced stage of HIV infection.

How long does it take for HIV infection to develop into AIDS?

The time taken for HIV infection to develop into AIDS varies widely between individuals. The majority of HIV infected people will develop signs of HIV related diseases within 5 to 10 years, if left untreated. However, HIV infection can take 10 15 years or longer to progress into AIDS. Antiretroviral therapy (ART) can slow down the process even further.

How is HIV transmitted?

HIV infection is spread from person to person when human blood and sexual fluids (semen and vaginal secretions) are shared. HIV can be transmitted through:

  • Unprotected sexual intercourse (vaginal, anal or oral*)
  • Transfusion of contaminated blood
  • Sharing of contaminated needles used for injectable drugs
  • Sharing infected needles for tattoos and body piercing
  • Oral sex (the risk is small, though)
  • From HIV infected mother to her child during pregnancy, child birth or breast feeding

* The chances of HIV transmission through oral sex are low but it can't be completely ruled out.

The virus cannot survive for long outside the human body and dies quickly when the body fluid in which it is contained dries up. This is why it can't be spread by insects, can't spread like the flu virus (public surfaces, coughing, sneezing, etc.) The virus does not live in saliva, tears, urine or perspiration. Hence, casual contact with these body fluids does not be spread HIV. Hugging, shaking hands, or sharing personal objects, food or water does not transmit HIV.

How does HIV progress? What are the stages of HIV?

Our blood has something called white blood cells along with red blood cells and thrombocytes. The main function of white blood cells called CD4 cells or T-cells is to fight disease. It's these cells that are attacked and destroyed by HIV, making the person more susceptible to illnesses. There are three stages of HIV infection:

  • Stage 1: Initial stage of infection that occurs within weeks of acquiring the virus. It is characterized by flu-like illness which generally disappears within weeks. AIDS-related conditions are not seen. The CD4+ cells are at least 29% of all lymphocytes with a count greater than 500 (which is a good thing).
  • Stage 2: It is a stage with a long duration of infection without symptoms that may last for eight to 10 years. AIDS-related conditions are still not seen. The CD4+ cells fall and are between 14% and 28% of all lymphocytes with a count 200 to 499.
  • Stage 3: It is the stage in which the body's immune system is suppressed and complications develop. It is called the acquired immunodeficiency syndrome (AIDS). AIDS-related conditions are present. The CD4+ cells are even less; around 14% of all lymphocytes with a count lower than 200.

What are the symptoms of HIV/AIDS?

HIV symptoms vary from person to person. Some people experience a flu-like illness such as fever, headache or sore throat in the first few weeks after which the symptoms vanish. A person can have HIV for many years before developing any symptoms.

As the infection gradually progresses the person's immune system weakens and they might experience persistent yeast infections on the tongue (thrush). Women may develop severe vaginal yeast infections as well. Some of the other signs and symptoms are frequent fevers, diarrhoea, cough, swollen lymph nodes, persistent skin rashes, lack of energy, weight loss, mouth, genital or anal sores from herpes infections, short-term memory loss, etc.

Opportunistic infections are common in people with AIDS which affects nearly every organ system. Some of the signs that HIV is turning into AIDS include:

  • Persistent fever
  • Extreme fatigue not related to stress or lack of sleep
  • Persistent diarrhoea
  • Severe malnutrition, losing weight
  • Swollen glands in the neck, groin, etc.
  • Difficulty in swallowing
  • Oral thrush
  • Headache, confusion and forgetfulness
  • Increased risk of developing various cancers like Kaposi sarcoma, lymphomas, cervical cancer, etc.

What are the complications of AIDS?

People with AIDS are extremely susceptible to infection. Some of the following conditions are commonly associated with AIDS:

  • Tuberculosis (TB) - a bacterial infection that primarily infects the lungs. It is a leading cause of death in people living with HIV. Nearly a quarter of a million fall prey to it each year.
  • Herpes Simplex - a virus that causes cold sores or genital herpes (painful blisters in the genital area). Severe HSV lesions are common in the advanced stages of AIDS.
  • Kaposi's sarcoma - a skin tumour with purple blotches on the skin or in the mouth. It is caused by herpes virus.
  • Lymphoma - tumours develop from white blood cells in the lymphatic system. A common disease associated with AIDS in which cancer cells are found in the lymph systems of AIDS patients.
  • Pneumocystis pneumonia (PCP) - an infection that causes inflammation and fluid build-up in the lungs. It is the most common opportunistic infection in HIV infected people.
  • Oral thrush - an infection of the mouth caused by the fungus candida. Candida infection is more likely to develop in HIV infection.
  • Cytomegalovirus infection - cytomegalovirus (CMV) causes HIV-associated infections. The virus usually remains dormant in a healthy person. The most common illnesses that CMV causes in a HIV infected person are blindness, pneumonia, liver disease, etc.
  • Toxoplasmosis - a parasitic disease which rarely causes any symptoms in healthy adults. But it can be a serious disorder for people with HIV/AIDS. It causes brain lesions in HIV infected people.

Also read: HIV/AIDS: Diagnosis, treatment and prevention

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