HIV-1HIV is one of the most prolific viruses known to man, and is currently a worldwide pandemic, with AIDS estimated at killing more than 2.9 million people in 2006 alone (with 84,000 of those deaths occurring in Western and Central Europe). The term HIV positive, where it sounds quite up-beat, is the term for those who have contracted the virus; HIV negative is when the virus is not present in an individual.
HIV is a "retrovirus", retroviruses hijack the bodies natural resources to replicate. HIV eventually causes AIDS, a virus which destroys the immune system leading to the onset of life threatening infections.
Transmission
HIV is mostly transmitted through sex, but can also be transfered in the blood by intravenous drug users and through blood transfusions, the virus can also be transmitted within the womb from pregnant mother to child.
HIV can be contracted if fluids secreted during sex come in contact with the mouth, anus, penis or vagina. Effectively you can contract HIV through oral sex as well as penetrative sex. During sex between two men, or a man and a woman, it is a myth that the "top" (the one who is penetrating) will never contract HIV from the "bottom" (the one who is penetrated) as after ejaculation some fluid is drawn backward into the penis which may have come in contact with the virus and can lead to infection. The mentality that a HIV positive top can just "pull out" at the last minute during sex is equally flawed as pre-ejaculate (or "pre-come") contains the virus in large quantities too.
Another myth is that you can contract HIV through kissing. Although some quantities of HIV have been found in saliva, tears and urine, the amount is very small and the risk of infection by coming into contact with them is slim to none.
The only tried and tested method to reduce the risk of infection at the moment is by using a condom, condoms create an effective barrier against most infectious viruses and HIV is no exception. HIV like many viruses does not always have immediate symptoms, with one in ten infected not showing symptoms for the first few years, it is therefore always recommended that, unless you can be certain that you and your sexual partner are uninfected, you use protection, and should be having regular checkups with a GUM clinic.
Symptoms
Due to its very nature, HIV does not really carry any specific symptoms, testing is the only way to know for sure if you are infected. There are however some symptoms that usually occur along side HIV.
Acute HIV syndrome occurs during the initial period of HIV infection and is due to the rapid replication of the virus taking the immune system "off guard" weakening it until flu-like symptoms such as rashes, diarrhea, a sore throat, aching joints and muscles, and a fever can occur. It is not difficult to see why this can often by misdiagnosed, in the majority of cases it is just flu.
More symptoms include:
- Swelling of the lymph nodes (in the neck, arm pits, groin, chest and abdomen)
- Rapid weight loss
- Poor appetite
- Profound fatigue
- Short breath
- A cough
- Red, brown or purple lesions on the skin
- White patches on the tongue, inside of the mouth or gums
- Depression
- Numbness
- Tingling or burning of feet, hands or face
- Confusion or changes in levels of consciousness
Again, as you can tell, all of these symptoms are quite non-specific to HIV, and can be caused by other illnesses, and in no way indicate being infected by HIV on their own.
AIDS
AIDS, or Advanced Immunodeficiency Syndrome, is a collection of symptoms and infections that develop from HIV. It is effectively the final stage of HIV where degradation of the immune system is at it's most rapid. When not receiving antiretroviral treatments (see below) an HIV suffer can expect to be diagnosed with AIDS after about 9 to 10 years, the average survival time therein is just over 9 months. However, various factors can contribute to the progression of the infection (such as the body having a naturally strong or weak immune system) which means the progression of the disease can take anywhere from 2 weeks to 20 years. It occurs when the HIV virus has killed CD4+ T cells, which are required for the immune system to function, so that there is less than 200 cells per microliter (cubic millimeter) of blood. It is also characterised by one of several "AIDS defining" diseases which include:
- Kaposi's sarcoma
- Cervical cancer
- Lymphomas (cancers of the immune system)
Diagnosis and Treatment
Testing for HIV does not directly check for the virus itself (part of the virus's intelligence is in it's ability to avoid being seen and therefore destroyed within the body), instead the initial test, called the Elisa test, focuses on the presence of HIV antibodies in the bloodstream, if this proves positive a second test is taken. The second test, the Western Blot test, is merely a confirmation that the Elisa test was indeed positive (indicating a presence of the HIV antibodies) it does this by detecting specific protein bands that are present in someone with HIV. The third test is the PCR test which detects specific sequences of genetic material floating free in the blood that indicate the presence of HIV.
Over the years, although no cure has been found, there have been many advancements in treating HIV. The most successful of these are various combinations of antiretroviral drugs which make up a theropy called HAART. HAART normally comes in the form of a cocktail of drugs that are given to HIV sufferers, the levels of which are monitored constantly. The HIV virus, overtime, and especially if treatment stops and starts, can gain a resistance to various antiretroviral drugs at which points new combinations of drugs needs to be assessed and prescribed.
Another effective treatment, which has been marketed heavily recently, is PEP, or Post-Exposure Prophylaxis, which, if taken immediately after exposure to the HIV virus, is said to significantly reduce the risk of infection.