Causes and risk factors
AIDS is caused by HIV virus. Common bacteria, parasites, and viruses that usually do not affect people with healthy immune systems can be threatening for AIDS patients. There are two types of HIV- HIV-1 and HIV-2. HIV-1 is the more predominant form of the virus which can be broken down into several subgroups based on location. HIV-2 is found primarily in West Africa and is not as virulent as HIV-1, but it causes AIDS more frequently than type 1. HIV is found in body fluids like nervous system tissue and spinal fluid, blood, semen, pre-seminal fluid [the liquid that comes out before ejaculation], vaginal secretions, and breast milk. But HIV can be transmitted from an infected person to another person only through blood, semen, vaginal fluids, and breast milk. The virus is spread through “high-risk behaviours,” which include things like unprotected oral, vaginal, or anal sexual intercourse. Sharing needles, i.e. needles used to inject drugs, steroids, and other substances, or sharing needles used for tattooing can also transmit HIV. Transfusion of contaminated blood that contains HIV causes the disease. An HIV infected pregnant woman can transmit the virus to the foetus. Breast feeding can also transmit the virus from mother to the baby. HIV infection does not spread by casual contact, mosquitoes, touching or hugging, sharing cups, utensils, or telephones with someone who has HIV/AIDS. Associated risk factors for the disease are – people who have other sexually transmitted disease [STD] [such as syphilis, genital herpes, Chlamydia, gonorrhoea, or bacterial vaginosis are at greater risk for getting HIV during sex with infected partners.
Clinical presentation
AIDS begins with HIV infection. The virus weakens a person’s ability to fight infections, by attacking the immune system. People infected with HIV may have no symptoms for 10 years or longer, but they can still transmit the infection. Symptoms vary, depending on the phase of infection. Early symptoms such as within a month after infection, person experiences flu-like illness, which include fever, headache, tiredness, enlarged lymph nodes in the neck and groin region, muscle soreness, diarrhoea. These symptoms usually disappear within a week. Some HIV infected people may have severe symptoms at first while others may have no symptoms for 12 years or more. Later symptoms rapid weight loss, recurring fever or profuse night sweats, extreme and unexplained tiredness, prolonged swelling of the lymph glands in the armpits, groin, or neck, diarrhoea that lasts for more than a week. Patient has sores of the mouth, anus and genitals. He complains of memory loss, depression and other neurologic disorders. Skin rashes or bumps are observed. There may be vision disturbances such as blurred and distorted vision. Opportunistic infections i.e. infections that normally do not affect an individual with a healthy immune system but AIDS patients are susceptible to these infections. These include viral infections like Herpes simplex virus, Herpes zoster infection, cancers like kaposi sarcoma, non-Hodgkin’s lymphoma, fungal infections like candidiasis, and bacterial infections due to lowered immunity like tuberculosis. Tuberculosis is very commonly diagnosed in AIDS patient. It can be pulmonary or abdominal TB.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. HIV is diagnosed by testing blood for the presence of antibodies to the virus. These HIV tests aren’t positive immediately after infection because it usually takes 12 weeks for your body to develop these antibodies. The HIV tests include Enzyme-linked immunosorbent assay [ELISA], Western blot with PCR. If one is diagnosed as HIV infected, there are several types of tests which helps your doctor to determine what stage of the disease you have. These tests include CD4 count. [CD4 cells are a type of white blood cell that’s specifically targeted and destroyed by HIV. A healthy person’s CD4 count can vary from 500 to more than 1,000. Even if a person has no symptoms, HIV infection progresses to AIDS when his or her CD4 count becomes less than 200]. Viral load – This test measures the amount of virus in your blood. Drug resistance – This blood test determines whether the strain of HIV you have will be resistant to certain anti-HIV medications and the ones that may work better. Screening for pregnant woman for HIV is recommended.
Treatment
There is no cure for HIV/AIDS, but medications such as antiretroviral drugs are used to control or suppress the virus. By suppressing the virus, the HIV infected people can lead longer lives. This helps the immune system to recover from the HIV infection and improve the CD4 count. Medicines are also prescribed to prevent opportunistic infections. To reduce the risk of getting infected with HIV regular check up for HIV, practicing abstinence, avoiding sharing needles, use of condoms, avoiding contact with blood and fluids by wearing protective clothing, masks, etc should be done. Knowing the HIV status of the mother allows the doctor to prevent mother-to-child HIV transmission.
Other Modes of treatment
The other modes of treatment can also be effective in treating AIDS. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating AIDS.
Recent updates
Research on improved gene therapy is being carried out for functional cure for HIV. Recent scientific studies have claimed that HIV has become less deadly and less infectious as it adapts to our immune system.
Facts and figures
Since the beginning of epidemic, 78 million people are affected by HIV and 38 million people have died out of the disease. Globally 35 million people were living with HIV in 2013. 0.8% adults aged between 15 and 45 years are living with the disease. 1.5 million people worldwide died of HIV related diseases in 2013. By the end of 2013, 13 million people were taking antiretroviral therapy [ART], with 11.7 million of these people living in underdeveloped or developing countries. This has led to a 20% fall in HIV-related deaths between 2009 and 2012.
