Understanding Human Immunodeficiency Virus (HIV): Causes, Symptoms, and Management

What is it?

Human immunodeficiency viruses (HIV) is a retrovirus passed by blood, semen, preseminal fluid, rectal vaginal fluid and breast milk. Less common spread is via birth and pregnancy and usage of contaminated needle. HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4+ T cells). When the amount of CD4+ cell decreases, cell-mediated immunity is lost, and the body becomes gradually more prone to opportunistic infections, leading to the development of AIDS. Acute HIV infection persists for 2-4 weeks and 10-60% of the patients are asymptomatic. Chronic HIV infection is a condition of stable viral level with decreasing CD4 count. It can range from 8-10 years. Aids is primarily a consequence of continuous, high- level replication of HIV, leading to virus and immune mediated killing of CD4 lymphocytes. In recent years, researches have found that transmission through sex is zero when the HIV carrier has undetectable viral load.

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Additional names

This group contains additional names:
- Acquired immune deficiency syndrome (AIDS)
- Cachexia associated with acquired immunodeficiency syndrome (finding)
- Cognitive impairment due to human immunodeficiency virus infection
- Nephropathy due to HIV
- Myelitis due to HIV
- Postpartum aids

Signs & symptoms

In acute HIV infection most patients are asymptomatic - they have been infected but are not even aware of it, and up to 60% arrive undiagnosed. Even when intensive follow-up is performed, 30% have no complaints and therefore it is very difficult to diagnose the disease based on the acute infection alone, so risk groups need to be considered. If an acute disease appears, it will happen two weeks later. Symptoms may include sore throat, headache, muscle aches, rash and gastrointestinal symptoms like nausea, vomiting and diarrhea.
In the chronic stage of infection, the patient is usually in a stable condition, with no complaints and no clear illness. The viral load is stable, as is the CD4 count. Some patients will present with generalized lymphadenopathy. Symptoms that can be seen even when the CD4 count is above 200: oral trush, oral hairy leukoplakia, zoster, thrombocytopenia. In general, diseases of the mucosa and skin are more common. Only when the CD4 level drops below 200 (about 8 years later) does AIDS appear.

AIDS symptoms include retinitis, pneumonia, recurrent bacterial diseases and invasive cervical cancer.
The disease is characterized by an increased incidence of opportunistic infections and also anemia and leukopenia (decrease in white blood cells).

Diagnosis

A fourth generation test is currently being done that tests 3 things: antibodies to HIV1, antibodies to HIV2 and antibodies to T24 - an antigen of HIV.
If the test results are positive a more specific test like western blot id done. It is customary to perform repeated tests so as not to make mistakes. If the western blot test is positive, the person is defined as HIV POSITIVE.

Treatment

HIV treatment is a combination of lifelong antiretroviral drugs and thanks to it HIV has become a chronic disease in many parts of the world, and it rarely develops into AIDS. It is recommended to start treatment immediately upon discovery of the carrier. Preventive treatment can be given to someone who is suspected of being infected, 72 hours from the moment of infection by a combination of 2 medications. If a pregnant woman with an unknown viral status or if viral lode is above 1000, a cesarean delivery is suggested.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

Learn more about our editorial process for content accuracy.

Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital