HIV / AIDS: Causes, Symptoms and Treatments


Symptoms of HIV and AIDS

What is the difference between a sign and a symptom? A sign is something other people, apart from the patient can detect, such as a swelling, rash, or change in skin color. A symptom is something only the patient feels and describes, such as a headache, fatigue, or dizziness.
For the most part, the symptoms of HIV are the result of infections caused by bacteria, viruses, fungi and parasites. These conditions do not normally develop in individuals with healthy immune systems, which protect the body against infection.

Signs and symptoms of early HIV infection

Symptoms of AIDS
Image by Mikael Häggström
Many people with HIV have no symptoms for several years. Others may develop symptoms similar to flu, usually two to six weeks after catching the virus. The symptoms can last up to four weeks.
Symptoms of early HIV infection may include:
  • fever
  • chills
  • joint pain
  • muscle ache
  • sore throat
  • sweats (particularly at night)
  • enlarged glands
  • a red rash
  • tiredness
  • weakness
  • weight loss
Asymptomatic HIV infection
In many cases, after the initial symptoms disappear, there will not be any further symptoms for many years. During this time, the virus carries on developing and damages the immune system. This process can take up to 10 years. The infected person will experience no symptoms, feel well and appear healthy.
Late-stage HIV infection
If left untreated, HIV weakens the ability to fight infection. The person becomes vulnerable to serious illnesses. This stage of infection is known as AIDS.
Signs and symptoms of late-stage HIV infection may include:
  • blurred vision
  • diarrhea, which is usually persistent or chronic
  • dry cough
  • fever of above 37C (100F) lasting for weeks
  • night sweats
  • permanent tiredness
  • shortness of breath
  • swollen glands lasting for weeks
  • weight loss
  • white spots on the tongue or mouth
During late-stage HIV infection, the risk of developing a life-threatening illness is much greater. Examples include:
  • esophagitis (an inflammation of the lining of the lower end of the esophagus)
  • infections to the nervous system (acute aseptic meningitis, subacute encephalitis, peripheral neuropathy)
  • pneumonia
  • some cancers, such as Kaposi's sarcoma, invasive cervical cancer, lung cancer, rectal carcinomas, hepatocellular carcinomas, head and neck cancers, cancers of the immune system known as lymphomas
  • toxoplasmosis (a disease caused by a parasite that infects the brain. It can also cause disease in the eyes and lungs)
  • tuberculosis
Life-threatening illnesses may be controlled and treated with proper HIV treatment.

Diagnosis of HIV/AIDS

A 2011 report issued by the CDC (Centers for Disease Control and Prevention), USA, found that about 1 in every 5 HIV-positive Americans is unaware of their HIV-status, and only 49% of those who are aware receive ongoing medical care and treatment.
HIV blood test
Diagnosis is made through a blood test that screens specifically for the virus.
If the HIV virus has been found, the test result is "positive". The blood is re-tested several times before a positive result is given to the patient.
For those whose tests came back positive, they will be asked to undergo some other tests to see how the infection has progressed, and also to decide when to start treatment.
Virology blood tests for HIV/AIDS
A virology form for HIV blood tests.
If a person has been exposed to the virus, it is crucial that they get tested as soon as possible. The earlier HIV is detected, the more likely the treatment will be successful. Also, precautions can be taken to prevent the virus from spreading to other people.
After infection with HIV, it can take up from three weeks to three months for the virus to show up in testing. Re- testing may be necessary.
If a patient's most at risk moment of becoming HIV infected was within the last three months, he/she can have the test immediately. However, a good doctor will urge that another test be carried out within a few weeks.
Ultra-sensitive HIV sensor - scientists from Imperial College London reported in Nature Nanotechnology (October 2012 issue) that they have developed an extremely sensitive sensor that detects viral infections, including HIV. They say the sensor is ten times more sensitive at detecting an HIV biomarker that anything else on the market today; it is also extremely cheap. The doctor can see the results by looking at the color change in a liquid solution.
Recent developments on HIV from MNT news
Genetic changes identified that make HIV elusive to drugs - Scientists have identified two locations where slight differences in genetic code can change the way human immunodeficiency virus infects cells - a change associated with worsening symptoms and resistance to antiretroviral drugs.
Scripps team lays 'spectacular' foundations for HIV vaccine - "A leap forward" has been made to develop a vaccine against HIV, claim the authors of two new studies that are published concurrently in the journals Cell and Science.
WHO: Cuba is first country to eliminate mother-to-child HIV and syphilis - Cuba is the first country in the world to receive validation from the World Health Organization for wiping out mother-to-child transmission of HIV and syphilis. Dr. Margaret Chan, Director-General of the World Health Organization (WHO), describes the achievement as a "major victory" and an "important step" toward an AIDS-free generation.
Latent HIV cells only 'wake up' once a week after antiretroviral therapy, study finds - A new study published in PLOS Pathogens provides new insight into how often HIV cells "wake up" among individuals undergoing antiretroviral therapy for the virus, bringing researchers one step closer to getting patients off the treatment for good and into remission.

Treatments for HIV/AIDS

Earlier HIV antiretroviral treatment is crucial - it improves quality of life, extends life expectancy and reduces the risk of transmission, according to the World Health Organization's guidelines issued in June 2013.
When an HIV-positive adult's CD4 cell count is 500 cells/mm3 or lower they should start treatment immediately.
According to Margaret Chan, WHO Director-General "These guidelines represent another leap ahead in a trend of ever-higher goals and ever-greater achievements. With nearly 10 million people now on antiretroviral therapy, we see that such prospects - unthinkable just a few years ago - can now fuel the momentum needed to push the HIV epidemic into irreversible decline."
Currently, there is no vaccine or cure for HIV/AIDS. But treatments have evolved which are much more efficacious - they can improve patients' general health and quality of life considerably.
Emergency HIV pills. If an individual believes they have been exposed to the virus within the last 72 hours (three days), anti-HIV medication, called PEP (post-exposure prophylaxis) may stop infection. The treatment should be taken as soon as possible after contact with the virus.
PEP is a very demanding treatment lasting four weeks. It is also associated with unpleasant side effects (diarrhea, malaise, nausea, weakness and fatigue).
After a positive HIV diagnosis, regular blood tests are necessary to monitor the progress of the virus before starting treatment. The therapy is designed to reduce the level of HIV in the blood.
Antiretroviral drugs. HIV is treated with antiretrovirals (ARVs). The treatment fights the HIV infection and slows down the spread of the virus in the body. Generally, patients take a combination of medications called HAART (highly active antiretroviral therapy).
The combination of drugs is adapted to each individual. HIV treatment is usually permanent and lifelong. HIV treatment is based on routine dosage. Pills must be taken on a regular schedule, every time. Common side effects include nausea, fatigue, diarrhea, skin rashes, moodiness, alterations to the adipose (fat) tissue, birth defects.
Antifungal cream Ciclopirox eradicates HIV - researchers at the Rutgers New Jersey Medical School reported in the journal PLoS ONE that Ciclopirox, a widely used antifungal cream, as well as Deferiprone, a medication used to remove excess iron from the body, eradicate HIV in cultured cells. They added that when treatment stops, the virus does not return.
Complementary or alternative medicine. Although widely used, alternative/complementary medications, such has herbal ones, have not been proven to be effective or ineffective. According to some limited studies, mineral or vitamin supplements may provide some benefits. Patients are urged to discuss these options with their doctors.

New clue towards an AIDS vaccine

The outer shell of HIV has a vulnerable spot, which enabled two HIV-positive people to make antibodies powerful enough to kill off the majority of HIV types known globally.
A glycan, a form of sugar, in a specific part on the protein coat that covers HIV (location known as "position 332") is a vulnerable spot that allows the body to mount an effective attack using broadly neutralizing antibodies.
The scientists, from the University of the Witwatersrand, Johannesburg, South Africa, said their discovery offers new clues about stimulating the body to produce "broadly neutralizing antibodies". They believe these antibodies are key for making an AIDS vaccine, because they destroy most of the HIV types around the world. They published their findings in Nature Medicine (21 October, 2012 issue).
April 2013 - A step closer to an HIV vaccine
A team led by scientists from the Duke Human Vaccine Institute, and the NIH Vaccine Research Center say they have charted a new route that may help develop a vaccine which boosts an individual's ability to destroy HIV. They published their findings in the journal Nature (April 2013 issue).
Barton F. Haynes, M.D., John Mascola, M.D. and team stuied an HIV-infected patient whose immune system attacked the virus, allowing them to describe the co-evolution of the antibodies.
HIV has proven especially difficult in inducing an antibody response, making it very hard to develop a vaccine. As soon as HIV antibodies are produced, the virus changes rapidly to avoid them.
The team used a new form of technology that can detect infection early on and track the body's immune system.
Recent developments in HIV treatment from MNT news
Designer protein 'blocks all known strains of HIV' - A novel drug candidate against HIV has been created by a joint team led by researchers at The Scripps Research Institute in Jupiter, FL. The scientists consider it to be so potent and effective that it could form the basis of a vaccine alternative.
HIV's reliance on sugar could be its downfall, study suggests - It turns out that having a sweet tooth is not just the downfall of many of us humans. According to a new study, a taste for sugar could also be HIV's major weakness and a target for future treatment.
Preclinical trial data brings new hope for HIV vaccine - Publishing data from preclinical trials in nonhuman primates in the journal Science, Crucell Holland B.V, one of the Janssen Pharmaceutical Companies of Johnson & Johnson, reveal encouraging results for their HIV vaccine.
First case of prolonged remission in HIV-infected child reported - Doctors have found that an 18-year-old woman infected with HIV at birth via mother-to-child transmission has been in remission despite not receiving any antiretroviral therapy for the past 12 years.
Researchers from the HIV, Inflammation and Persistence Unit at the Institut Pasteur in Paris believe that the patient has benefited from treatment initiated shortly after birth and ended 6 years later.
New drugs reawaken latent HIV to eradicate virus
A new study suggests a class of drugs already being tested in clinical trials for the treatment of cancer may also hold the key to complete eradication of HIV.

HIV Prevention

Unprotected sex. Having sex without a condom can put a person at risk of being infected with HIV and other sexually transmitted infections (STIs). HIV can be spread by having unprotected sex (vaginal, oral and anal sex). It can also be caught from sharing sex toys with someone infected with HIV.
Even hours after sex, a vaginal gel could protect women against HIV - A research team, led by investigators from the Centers for Disease Control and Prevention, has developed a new vaginal gel that they say could protect women from HIV. The researchers state that they need to improve the gel's effectiveness before it can be entered into human clinical trials and point out that although the gel protected the majority of monkeys against HIV, it may not necessarily have the same effect in humans.
Drug abuse and needle sharing. Intravenous drug use is an important factor in HIV transmission in developed countries. Sharing needles can expose users to HIV and other viruses, such as hepatitis C.
Strategies such as needle-exchange programs are used to reduce the infections caused by drug abuse.
Body fluid exposure. Exposure to HIV can be controlled by employing precautions to reduce the risk of exposure to contaminated blood. At all times, health care workers should use barriers (gloves, masks, protective eyewear, shields, and gowns). Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection.
Pregnancy. Anti-HIV medicines can harm the unborn child. But an effective treatment plan can prevent HIV transmission from mother to baby. Precautions have to be taken to protect the baby´s health. Delivery through caesarean section may be necessary. Breastfeeding may have to give way to bottle-feeding if the mother is infected.
A study by scientists from Columbia University, New York, found that breastfeeding for 6+ months with antiretroviral therapy could help reduce mother-to-child HIV transmission as well as improve chances of infant's survival.
Education. Health education is an important factor in reducing risky behavior.


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