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23 Jul

AIDS – Causes, Symptoms and Treatment

Overview:

  • AIDS is a disease that can develop in people with HIV. It’s the most advanced stage of HIV. But just because a person has HIV doesn’t mean they’ll develop AIDS.
  • HIV kills CD4 cells. Healthy adults generally have a CD4 count of 500 to 1,500 per cubic millimeter. A person with HIV whose CD4 count falls below 200 per cubic millimeter will be diagnosed with AIDS.
  • A person can also be diagnosed with AIDS if they have HIV and develop an opportunistic infection or cancer that’s rare in people who don’t have HIV. An opportunistic infection, such as pneumonia, is one that takes advantage of a unique situation, such as HIV.
  • Untreated, HIV can progress to AIDS within a decade. There’s no cure for AIDS, and without treatment, life expectancy after diagnosis is about three years. This may be shorter if the person develops a severe opportunistic illness. However, treatment with antiretroviral drugs can prevent AIDS from developing.

 

Causes:

  • AIDS is caused by HIV. A person can’t get AIDS if they haven’t contracted HIV.
  • Healthy individuals have a CD4 count of 500 to 1,500 per cubic millimeter. Without treatment, HIV continues to multiply and destroy CD4 cells. If a person’s CD4 count falls below 200, they have AIDS.
  • Also, if someone with HIV develops an opportunistic infection associated with HIV, they can still be diagnosed with AIDS, even if their CD4 count is above 200.

 

Symptoms:

AIDS refers to acquired immunodeficiency syndrome. With this condition, the immune system is weakened due to HIV that’s typically gone untreated for many years. If HIV is found and treated early with antiretroviral therapy, a person will usually not develop AIDS.

People with HIV may develop AIDS if their HIV is not diagnosed until late, or if they know they have HIV but don’t consistently take their antiretroviral therapy. They may also develop AIDS if they have a type of HIV that’s resistant to (doesn’t respond to) the antiretroviral treatment.

Without proper and consistent treatment, people living with HIV can develop AIDS sooner. By that time, the immune system is quite damaged and has a harder time fighting off infection and disease. With the use of antiretroviral therapy, a person can maintain chronic HIV infection without developing AIDS for decades.

Symptoms of AIDS can include:

  • recurrent fever
  • chronic swollen lymph glands, especially of the armpits, neck, and groin
  • chronic fatigue
  • night sweats
  • dark splotches under the skin or inside the mouth, nose, or eyelids
  • sores, spots, or lesions of the mouth and tongue, genitals, or anus
  • bumps, lesions, or rashes of the skin
  • recurrent or chronic diarrhea
  • rapid weight loss
  • neurologic problems such as trouble concentrating, memory loss, and confusion
  • anxiety and depression

Antiretroviral therapy controls the virus and usually prevents progression to AIDS. Other infections and complications of AIDS can also be treated. That treatment must be tailored to the individual needs of the person.

 

Any affecting Organ:

If AIDS does develop, it means that the immune system is severely compromised. It’s weakened to the point where it can no longer fight off most diseases and infections. That makes the person vulnerable to a wide range of illnesses, including:

  • pneumonia
  • tuberculosis
  • oral thrush, a fungal infection in the mouth or throat
  • cytomegalovirus (CMV), a type of herpes virus
  • cryptococcal meningitis, a fungal infection in the brain
  • toxoplasmosis, a brain infection caused by a parasite
  • cryptosporidiosis, an infection caused by an intestinal parasite
  • cancer, including Kaposi’s sarcoma (KS) and lymphoma

 

Prevention / Treatment:

Treatment should begin as soon as possible after a diagnosis of HIV, regardless of viral load. The main treatment for HIV is antiretroviral therapy, a combination of daily medications that stop the virus from reproducing. This helps protect CD4 cells, keeping the immune system strong enough to fight off disease.

Antiretroviral therapy helps keep HIV from progressing to AIDS. It also helps reduce the risk of transmitting HIV to others.

When treatment is effective, the viral load will be “undetectable.” The person still has HIV, but the virus is not visible in test results. However, the virus is still in the body. And if that person stops taking antiretroviral therapy, the viral load will increase again and the HIV can again start attacking CD4 cells.

Treatment should begin as soon as possible after a diagnosis of HIV, regardless of viral load. The main treatment for HIV is antiretroviral therapy, a combination of daily medications that stop the virus from reproducing. This helps protect CD4 cells, keeping the immune system strong enough to fight off disease.

Antiretroviral therapy helps keep HIV from progressing to AIDS. It also helps reduce the risk of transmitting HIV to others.

When treatment is effective, the viral load will be “undetectable.” The person still has HIV, but the virus is not visible in test results. However, the virus is still in the body. And if that person stops taking antiretroviral therapy, the viral load will increase again and the HIV can again start attacking CD4 cells. Learn more about how HIV treatments work.

 

HIV Medications

More than 25 antiretroviral therapy medications are approved to treat HIV. They work to prevent HIV from reproducing and destroying CD4 cells, which help the immune system fight infection. This helps reduce the risk of developing complications related to HIV, as well as transmitting the virus to others.

These antiretroviral medications are grouped into six classes:

  • nucleoside reverse transcriptase inhibitors (NRTIs)
  • non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • protease inhibitors
  • fusion inhibitors
  • CCR5 antagonists, also known as entry inhibitors
  • integrase strand transfer inhibitors

 

Treatment Regimens

The U.S. Department of Health and Human Services (HHS) generally recommends a starting regimen of three HIV medications from at least two of these drug classes. This combination helps prevent HIV from forming resistance to medications. (Resistance means the drug no longer works to treat the virus.)

Many of the antiretroviral medications are combined with others so that a person with HIV typically takes only one or two pills a day.

A healthcare provider will help a person with HIV choose a regimen based on their overall health and personal circumstances. These medications must be taken every day, exactly as prescribed. If they’re not taken appropriately, viral resistance can develop, and a new regimen may be needed.

Blood testing will help determine if the regimen is working to keep the viral load down and the CD4 count up. If an antiretroviral therapy regimen isn’t working, the person’s healthcare provider will switch them to a different regimen that’s more effective.

 

Side effects and costs

Side effects of antiretroviral therapy vary and may include nausea, headache, and dizziness. These symptoms are often temporary and disappear with time. Serious side effects can include swelling of the mouth and tongue and liver or kidney damage. If side effects are severe, the medications can be adjusted.

Costs for antiretroviral therapy vary according to geographic location and type of insurance coverage. Some pharmaceutical companies have assistance programs to help lower the cost. Learn more about the drugs used to treat HIV.

 

HIV prevention

Although many researchers are working to develop one, there’s currently no vaccine available to prevent the transmission of HIV. However, taking certain steps can help prevent the spread of HIV.

 

Safer sex

The most common way for HIV to spread is through anal or vaginal sex without a condom. This risk can’t be completely eliminated unless sex is avoided entirely, but the risk can be lowered considerably by taking a few precautions. A person concerned about their risk of HIV should:

  • Get tested for HIV. It’s important they learn their status and that of their partner.
  • Get tested for other sexually transmitted infections (STIs). If they test positive for one, they should get it treated, because having an STI increases the risk of contracting HIV.
  • Use condoms. They should learn the correct way to use condoms and use them every time they have sex, whether it’s through vaginal or anal intercourse. It’s important to keep in mind that pre-seminal fluids (which come out before male ejaculation) can contain HIV.
  • Limit their sexual partners. They should have one sexual partner with whom they have an exclusive sexual relationship.
  • Take their medications as directed if they have HIV. This lowers the risk of transmitting the virus to their sexual partners.

 

Other prevention methods:

Other steps to help prevent the spread of HIV include:

  • Avoid sharing needles or other drug paraphernalia.HIV is transmitted through blood and can be contracted by using contaminated materials.
  • Consider PEP. A person who has been exposed to HIV should contact their healthcare provider about obtaining post-exposure prophylaxis (PEP). PEP can reduce the risk of contracting HIV. It consists of three antiretroviral medications given for 28 days. The PEP should be started as soon as possible after exposure, but before 36 to 72 hours have passed.
  • Consider PrEP.A person at a high risk of HIV should talk to their healthcare provider about pre-exposure prophylaxis (PrEP). If taken consistently, it can lower the risk of contracting HIV. PrEP is a combination of two drugs available in pill form.

Healthcare providers can offer more information on these and other ways to prevent the spread of HIV

 

Sources:

  1. https://www.healthline.com/health/hiv-aids#hiv-prevention
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