What is HIV Disease and AIDS?

HIV (Human Immunodeficiency Virus) weakens the body's immune defenses by destroying CD4 (T-cell) lymphocytes, a group of white blood cells that help guard against attacks from bacteria, viruses, and other germs by coordinating the immune system. When HIV destroys T-cells, the body becomes vulnerable to many different types of opportunistic infections, which are not contagious and are usually found only in immuno-suppressed people, not the general public. When someone with HIV Disease is diagnosed with an opportunistic infection and/or their T-cell count is below 200 (normally we have around 800-1200 T-cells) the individual is diagnosed with AIDS (Acquired Immune Deficiency Syndrome).

How does HIV Disease occur?

HIV is transmitted through blood, semen and vaginal secretions from an infected person. It is also transmitted through sharing needles, including tattoo and body-piercing tools. An infected mother can transmit HIV to her baby during birth, but this happens in less than 2% of cases if the mother gets treatment during her pregnancy. Pre-1985, HIV was also transmitted through blood transfusions and blood products.

HIV infection is a global pandemic, with 95% of the cases occurring in developing countries where a small percentage of the world's prevention and treatment resources are deployed.

• According to the CDC, in 2003, an estimated 1,039,000-1,185,000 people in the United States were living with HIV and approximately one-fourth of these people did not know they were infected.
• 50% of all new HIV infections occur in people younger than 25.
• AIDS is the LEADING cause of death among African Americans between the ages of 25-44, the third leading cause of death among Latinos in this age group, and the fifth leading cause of death of all U.S. residents age 25-44.

What are the symptoms/disease progression?

HIV is present and can be transmitted at any and all stages of infection.

Without treatment, the progression of HIV disease averages 10-12 years from infection to diagnosis of AIDS.

Acute/Primary HIV Disease:

• Occurs days to weeks after infection in a majority of people who are infected.
• May produce mono-like symptoms, such as chills, enlarged lymph nodes, and loss of appetite.
• A very high level of virus is present in infectious body fluids.
• An HIV antibody test is negative.
• This stage lasts days to weeks.

Asymptomatic HIV Disease:

• An HIV antibody test will come back positive.
• The virus is very active in lymph tissue, so damage to the immune system is starting to occur.
• This stage lasts 3-5 years (without long-term effective treatment).

Chronic, Symptomatic HIV Disease:

• CD4 (T-cell) lymphocyte count ranges from 200-500.
• Symptoms include fever, night sweats, lymph node enlargement, weight loss, and diarrhea.
• Symptoms usually worsen if HIV Disease progresses and may become debilitating, even without the diagnosis of AIDS.
• This stage lasts 5-7 years (without long-term effective treatment).

AIDS - Acquired Immune Deficiency Syndrome

• The individual develops serious opportunistic illnesses (OIs), which are the actual cause of disability and death. Remember, OIs are not found in the general public, only in immune-suppressed people because non-immune-suppressed people either already have had them in a milder form or have been exposed to them in the environment and built immunity to them.
• Odd cancers develop, such as Kaposi's sarcoma (KS), lymphatic cancers (e.g., non-Hodgkin's lymphoma, etc.)
• The CD4 lymphocyte count is below 200.
• HIV dementia may occur.
• This stage lasts 2-4 years (without long-term effective treatment) and could possibly end in death.

How is it diagnosed?

HIV tests look for the presence of HIV antibodies; they do not test for the virus itself. The CDC states that most people infected with HIV will have detectable antibodies within 3 months of exposure to HIV, the average time being 25 days. Rarely, it can take up to six months to develop detectable antibodies. An HIV test can be done with blood, urine and oral fluid. Urine testing for HIV antibodies is not as sensitive or specific as blood testing, so it is rarely used. The oral fluid test is collected from inside the mouth. Another type of test is the rapid HIV test that usually produces results in up to 20 minutes.

HIV testing consists of an initial screening with two types of tests commonly used to detect HIV infection. The most commonly used initial test is an enzyme immune assay (EIA). If EIA test results show a reaction, the test is repeated on the same blood sample. If the result is repeatedly the same or either duplicate test is reactive, the results are confirmed using a second test such as the Western blot. This more specific (and more expensive) test can tell the difference between HIV antibodies and other antibodies that can react to the EIA and cause false positive results. False positive EIA results are uncommon, but can occur. A person is considered infected (HIV positive) following a repeatedly reactive result from the EIA and confirmed by the Western blot test.

How is it treated?

There is no cure for HIV Disease. Antiretroviral medications are available, but they don't kill HIV. They slow HIV reproduction rates so that immune damage slows, maybe even stops. Combinations of medications, sometimes called a "drug cocktail", may suppress the viral load to below a measurable level, given currently available lab technology. However, undetectable does not mean zero or HIV-negative or cured. Not all HIV drugs work for all patients over the long term. It is estimated that HIV drugs only work for 50% of those living with HIV Disease. Medications are extremely expensive, hard to obtain for some people, extremely toxic, often cause side effects, and must be taken on an extremely rigid schedule; otherwise, HIV develops resistance to the drugs, and therapy fails.

What can be done to prevent HIV Disease?

• Abstain from sexual activity.
• Use of male/female condoms consistently and correctly.
• Both partners need to get tested before engaging in sexual activity.
• Do not shoot drugs. If you shoot drugs, stop and get into a treatment program. If you can't stop, never share drugs, needles, syringes, water, or "works".

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