Acquired Immune Deficiency Syndrome

Cause

AIDS is caused by the HIV virus. A person with a HIV infection can infect others. The transfer of HIV takes place over contaminated body fluids, such as blood, sperm and vaginal fluid. The virus can be spread as follows:

• Via unprotected sexual contact.
• By blood transfusion with contaminated blood.
• By using contaminated syringes and needles.
• From a pregnant woman onto her unborn child.
• Via breastfeeding.

The HIV virus can not be transferred via saliva, French kisses, shaking hands or toilet seats. After infection, it takes nine to ten years before the first symptoms occur. After this period, the patient gets reallly sick and has AIDS.

Symptoms

If a person is infected with HIV, it is also said that he or she is seropositive. Many people with HIV have spent years with none to few symptoms. During this period, however, the virus is still active. It reproduces, infects the body and destroys cells of the immune system. Thereby weakening the immune system and creating the AIDS disease.
Possible signs and symptoms are:

• Fatigue.
• Unintentional weight loss.
• Nightly sweats.
• Fever.
• Diarrhea.
• Swollen lymph nodes.
• Infections due to poor immune system, such as tubercolosis, lung infections, herpes infections and fungal infections.
• Malignant tumors, such as Kaposi’s sarcoma, non-Hodgkin lymphoma or cervical cancer.
• Aids dementia.

Without treatment, a person with HIV will eventually die of AIDS.

Diagnosis

HIV infection can be determined by a blood test. The diagnosis can be made with certainty only three months after infection. Before that time, no antibodies may be visible, despite the fact that a person is infected. Once a HIV infection is determined, blood samples are regularly examined to look at what stage the infection has developed. Therefore, two determinations are performed:

• Viral load. This measures the number of HIV particles per milliliter blood. The higher the number, the faster the infection develops.
• CD4 determination. This measures the number of CD4 cells per cubic millimeter blood. This is a measure of how the immune system works. The lower the CD4 count, the worse the immune system and the higher the risk of infections caused by, for example, the HIV virus.

Pregnant women are standard tested for HIV, unless they object. This test is done in the first three months of pregnancy.

Treatment

People with HIV and AIDS are treated with a combination of HIV inhibitors, also known as antiretroviral drugs. Although this treatment does not cure HIV or AIDS, the HIV inhibitors do make HIV spreading less rapidly and less damage is done to the immune system.
Taking these drugs is not easy. The drugs have different side effects. Moreover, the intake is delicate and must be done according to a strict regime. Patients will therefore be supervised by a nurse specialist.

Prognosis

HIV infection cannot be cured, but with the medicines available in Western countries, it is possible to regard the disease rather as a long-term chronic condition than as a rapid fatal disease. However, most people with HIV live in a developing country and their prognosis is poor, because they rarely have access to the necessary medications. Of the infected people who are not treated, half of them gets AIDS within ten years and dies.

Considerations

• HIV infection can be prevented by educating people from childhood about the risks.
• The main precautions that everyone can take to prevent infection via sexual contact, are using condoms during sexual intercourse and avoiding sex with alternating partners.
• It is also recommended that, in a new relationship, both partners do a HIV test before they have unprotected sexual contact.
• Certain groups should take special measures. Those who use intravenous drugs, should use a new sterile needle every time.
• People with HIV should prevent infecting other people, by not letting them come into contact with their body fluids. They must also tell doctors and dentists before treatment that they are seropositive.
• Women who are seropositive and pregnant could use an antiviral agent to prevent the unborn child from getting infected. Giving birth by Caesarean section and refraining from breastfeeding further limit the risks.

Facts

• The HIV virus was discovered in 1984 by the French virologist Luc Montagnier and the American virologist Robert Gallo.
• 0.8% of the worldwide population is infected with HIV. However, the prevalence varies considerably by region and is the highest in African’s sub-Saharan countries with almost 5% in adults.