The estimates of WHO suggest that globally, 76 million people have been affected by Human immunodeficiency virus (HIV) since its inception. About 38 million people from all over the world were living with this virus at the end of 2019 alone, finds this world body. According to their figures, an estimated 33 million people have lost their live to acquired immune deficiency syndrome (AIDS), the disease caused by this virus. The global burden of this contagious virus, however, is different in different countries and regions. The WHO African region is currently the worst prey to this virus with 3.7 per cent adults living with HIV. This accounts for above two-third of the global population affected by this virus.
What is HIV/AIDS?
HIV virus resides in our blood, sexual fluids and breast milk. When it attacks our defence mechanism, a very important member of our immune system, named T-cell, is destroyed. Our immune system stops functioning when the count of T-cells drops to dangerously low levels (below 200) and we lose the capacity to fight germs and diseases. This happens at an advanced stage of HIV infection and the condition is known as AIDS. Failure of our immune mechanism makes us vulnerable to multiple ailments and diseases. Unsafe sexual practices and unhealthy needle sharing habits are majorly responsible for the transmission of HIV/AIDS.
HIV symptoms occur in three stages and they vary according to the stage at which the virus is. At the first stage, known as acute HIV infection, the symptoms start manifesting within two to six weeks after one comes in contact with the virus. Similar to those of any viral illness, the manifestations of the initial stage of HIV include:
- Aching muscles
- Sore throat
- Swollen lymph nodes
- A red rash on the tors that doesn't itch, usually on your torso
The second stage of an HIV infection is known as the asymptomatic or chronic stage when the flu-like symptoms subside and you hardly have any symptoms, as the name suggests. However, at the chronic stage, the count of your T cells drops as untreated HIV attacks the immune system and kills them.
The third stage of an HIV infection is known as AIDS when the T cell count drops below 200. If you have AIDS, you are vulnerable to diseases like Kaposi's sarcoma (a form of skin cancer) and pneumocystis pneumonia (a lung disease). The common symptoms of AIDS include the following:
- Extreme fatigue
- Swollen lymph nodes in your neck or groin
- Long-lasting fever (more than 10 days)
- Night sweats
- Unexplained weight loss
- Purple-coloured spots on your skin that persist
- Shortness of breath
- Severe, long-term diarrhoea
- Yeast infections in your mouth, throat, or genitals
- Unexplained bruises or bleeding
What Causes HIV/AIDS?
As already mentioned, AIDS is caused by HIV virus and the transmission occurs through blood, semen, vaginal secretions, anal fluids and breast milk. The risk of transmission increases if you have unprotected vaginal or anal intercourse with an infected person or share needles with a person who is HIV positive and touch his or her open wounds. Transfusion of contaminated blood can also lead to this fatal condition while an infected mother can pass it on to the child at birth.
People with AIDS are extremely susceptible to various infections. Some of the following conditions are commonly associated with AIDS:
- Tuberculosis (TB): This is a bacterial infection that primarily infects the lungs. It is one of the leading causes of death in people living with HIV. Nearly a quarter of a million fall prey to it each year.
- Herpes Simplex: This is 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: This is 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. This is a common disease associated with AIDS in which cancer cells are found in the lymph systems of AIDS patients.
- Pneumocystis pneumonia (PCP): This is 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: It is an infection of the mouth caused by the fungus candida. Candida infection is more likely to develop in HIV infection.
- Cytomegalovirus (CMV) infection: It 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: It is 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.
Diagnosis of HIV/AIDS
All the tests available for the diagnosis of HIV infection are based on the basics of immunology. Here’s a low-down on them
Antigen tests: Antigens are certain substances on the HIV virus itself. They are detectable. The results of this blood test can be positive only after a few weeks of exposure to HIV.
Antibody tests: Your body produces antibodies against a germ or a virus only after being exposed to it. This is a blood test that check the levels of antibodies in your blood or saliva. It’s possible to get a positive result 12 weeks after exposure to the virus.
Nucleic acid tests (NATs): This is a blood test that tells your doctor about the presence of HIV.
T cell count: It is again a blood test that helps reveals if the count of these cells has dropped below 200. A drop in the count of these cells below 200 conforms AIDS.
Drug resistance: Some strains of HIV don’t respond to medications. This diagnostic measure tells your doctor if the particular strain you’re suffering from is resistant to any drug. The results will help your doctor figure out an effective treatment modality that suits your condition.
Treatment of HIV/AIDS
Currently, there is no cure for HIV/AIDS. However, there are medications that keep the condition under control and reduce the chance of further complications.
The medications used for treating this condition are known as antiretroviral therapy (ART). In this therapy, three or more medicines from different drug classes are used in combination to block the virus in various ways. Typically, the combination includes two drugs from one class and a third one from another class. The classes of anti-HIV drugs include:
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
- Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs)
- Protease inhibitors (PIs)
- Integrase inhibitors
- Entry or fusion inhibitors.
The first three classes aim to inhibit the HIV from replicating itself. Integrase inhibitors, on the other hand, disables a protein that the HIV needs to impart its genetic materials in the T cells. Entry or fusion inhibitors are the class of drugs that prevent HIV from entering the T cells.
Prevention of HIV/AIDS
Fortunately, HIV is a preventable disease. Here are the measures you should take to inhibit this deadly virus from entering your body:
- Use condom while having sex. This will prevent the transmission of HIV virus from semen or vaginal fluid
- Don’t share your needles with anyone. Sharing needles for intravenous drug injection is one of the most common culprits behind HIV transmission.
- Doctors and healthcare workers should use gloves, masks, shields and other protective gear to prevent exposure to the blood and body fluids of infected people.