Medically Verified By: Dr. Sachin Shelke
HIV (human immunodeficiency virus) is a viral infection transmitted through the sexual route. Intravenous needle sharing, infected blood transfusions and transmission from mother to child during birth and breastfeeding can also cause HIV infection. The symptoms become manifest two to four weeks after HIV infection. Symptoms can also be delayed for as long as ten months. HIV causes acquired immunodeficiency syndrome (AIDS) and can cause complications. Treatment of HIV / AIDS comprises antiretroviral drugs and lifestyle management. The patient may suffer from opportunistic infections, which are usually fatal. Hence control of infection in an HIV positive patient is a crucial part.
HIV is classified into two different types:
The stages and progression of HIV infection is as following:
Asymptomatic phase: HIV infection initial stages without any significant symptoms. However, changes in the immune system are noted. This phase can last up to 3 months. Primary infection to develop into HIV disease and immunosuppression takes many years.
Primary infection: The patient replicates the HIV in his bloodstream and lymph nodes in this phase of the disease.
Symptomatic stage: this is known as the late phase of HIV disease, also known as acquired immunodeficiency syndrome. The patient is at risk of developing opportunistic infections such as tuberculosis, candidiasis during this phase of infection.
Patients may remain asymptomatic initially after infection. Symptoms progress over two to three weeks after infection, the delay in symptoms for ten months has also been noted in many patients. Non-specific symptoms of HIV may occur during the Acute retroviral phase of the illness. Symptoms pointed out during this phase are as following-
Following are the routes of acquiring HIV/AIDS infection:
The following measures can prevent the spread of HIV infection:
Screening test and confirmatory test are the mainstays for the diagnosis of HIV infection. A complete blood count is performed to assess thrombocytopenia, leukopenia or anaemia. CD4 cell count and viral load are also essential in the diagnosis of HIV infection. Differential diagnosis also plays a significant role in testing for HIV infection. For example, considering cardiovascular disorders, order cardiac biomarkers.
In the case of acquired immunodeficiency syndrome, pneumonia is a significant complication. Planning of chest X-Ray may be valuable to detect pulmonary infiltrates. Arterial blood gases provide essential information about an HIV infected person. Tuberculosis testing should be done. Sputum cultures are necessary for detecting bacterial infections. Other diagnostic tests such as CT scan may be crucial if disseminated TB is a possible diagnosis, especially in patients with acquired immunodeficiency syndrome. Individual with AIDS and decreased cd4 cell counts are at risk for pancreatitis and cholecystitis. Industries diagnostic tests such as bilirubin, transaminase and light base are functional.
Esophagogastroduodenoscopy is essential in patients with dysphagia. Diarrhoea is a common symptom in patients with AIDS. In these patients testing for bacteria, parasite, and ova should be performed. In severe refractory cases, colonoscopy is essential. Neurological complaints of HIV and AIDS should be detected using CT scan, CSF analysis, and lumbar puncture.
Antiretroviral drugs: Antiretroviral drugs are the mainstay of treatment in HIV infected patients. Nucleoside/ nucleoid reverse transcriptase inhibitors in many combinations available. Along with this, CCR5 inhibitors and protease inhibitors are also used in the treatment of HIV infected patience.
Highly active antiretroviral therapy (HAART) is a vital part of HIV treatment.
Prognosis
The progress of a patient suffering HIV with CD4 count greater than 500 lives a normal life compared to a person with a low CD4 level. Patients with AIDS who have untreated opportunistic infections have a low life expectancy.
Complications
A major complication to HIV is its progression to AIDS. It can be recognised when there is a low CD4 count with signs of opportunistic infections.
AIDS usually occurs when the lymphocyte count is below a specific level, and one of the following infections is present:
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It reveals a novel target for developing therapeutic intervention.
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"It will empower the people affected with the disease by giving them legal sanctity," Health Minister J. P. Nadda said.
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