Overview
AIDS (Acquired Immunodeficiency Syndrome) is a chronic disease caused by HIV (Human Immunodeficiency Virus). HIV weakens the immune system by destroying white blood cells (CD4 T cells, that play a major role to fight disease ) making it harder for the body to fight infections. Without treatment, HIV can turn into AIDS in several years. However, with treatment most people do not develop AIDS.
Transmission of HIV
When body fluids ( such as blood, semen, vaginal fluid, rectal fluid, breast milk) of an HIV infected patient enter into the body of another person by contact with mucous membrane, damaged tissue or directly injected into the bloodstream he may be infected with HIV.Â
Common conditions where somebody may be infected with HIV-Â
Unprotected sex (sex without a condom, vaginal, anal or oral sex ).
Sharing needles or syringes with a HIV infected patient.
From HIV infected donated blood.
An untreated mother passes it to her baby during birth or breastfeeding.
There is no cure for HIV/AIDS, but medicines can control the virus and help people live longer.
Casual contact such as shaking hands, hugging does not spread HIV. It is not spread through air, water or insect bites.
Symptoms of HIV infection
HIV symptoms change depending on the stage of the infection.
stage 1 (Acute HIV)
Some people feel sick 2 to 4 weeks after getting HIV. This may last a few days or weeks. Others have no symptoms. Symptoms may include:
Fever
Night sweats
Weight loss
Cough
Sore throat and mouth sores
Swollen glands in the neck
Headache
Muscle and joint pain
Rash
Diarrhea
These symptoms may also occur in other diseases.
At this stage, HIV spreads easily because the virus is in high amounts in the blood. This stage may last for a few days to several weeks.
Stage 2 (Chronic HIV)
HIV is still in the body but may not cause symptoms for many years. Without treatment, the immune system slowly gets weaker. Some people start feeling sick sooner. This stage may last for several years.
Stage3 (AIDS)-
It is the late stage of HIV infection.
Without treatment, HIV can turn into AIDS usually after several years. AIDS happens when the immune system is very weak. A person with HIV is considered to have AIDS-
when the CD4 cell count is below 200 cells per cubic millimeterÂ
or develop any opportunistic infection irrespective of the CD4 cell count.Â
People with AIDS can get serious infections due to low immunity ( opportunistic infections ) and certain cancers.
Signs of AIDS include:
Recurrent fever and chills
Sweating at night
Diarrhea
Swollen lymph glands
White spots in the mouth
Extreme tiredness
Weight loss
Skin rashes
Complications of HIV/AIDS
HIV weakens your immune system, making it harder for your body to fight infections and certain types of cancer.
Common Infections in People with HIV/AIDS
Pneumocystis pneumonia (PCP): A serious lung infection caused by a fungus. It is less common in the U.S. because of HIV treatments but still a major cause of pneumonia in people with HIV.
Candidiasis (Thrush): A fungal infection that creates a thick white coating in the mouth, tongue, throat, or vagina.
Tuberculosis (TB): A bacterial infection that mainly affects the lungs. TB is a leading cause of death among people with AIDS worldwide.
Toxoplasmosis: A parasitic infection mainly spread by cat feces. It can cause heart disease, seizures, and even death if it reaches the brain.
Cytomegalovirus (CMV): A herpes virus that spreads through body fluids. A healthy immune system keeps it inactive, but HIV can make it active again, damaging the eyes, lungs, and other organs.
Cryptococcal Meningitis: A fungal infection that causes swelling in the brain and spinal cord. It is linked to HIV and spreads through soil.
Common Cancers in People with HIV/AIDS
Lymphoma: A cancer of white blood cells. It usually starts with painless swelling in the neck, armpits, or groin.Â
HPV-related cancers: HIV increases the risk of cancers caused by human papillomavirus (HPV), such as anal, oral, and cervical cancer.
Kaposi Sarcoma: A cancer of blood vessels that causes red, purple, or dark spots on the skin, mouth, and internal organs.
Other Health Problems Linked to HIV/AIDS
Wasting Syndrome: Severe weight loss along with diarrhea, weakness, and fever.
Kidney Disease: HIV can damage the kidneys, especially in Black and Hispanic people.
Liver Disease: Liver problems are common in people with HIV, especially those who also have hepatitis B or C.
Brain and Nervous System Issues: HIV can cause confusion, memory loss, depression, anxiety, and trouble walking. In severe cases, it can lead to dementia.
Prevention of HIV/AIDS
There is no vaccine or cure for HIV, but you can take steps to prevent infection:
Take HIV Prevention Medicine (PrEP)
PrEP (pre-exposure prophylaxis) is a medicine that helps prevent HIV. There are two types:
Pills (Truvada, Descovy- these are different combination drugs containing emtricitabine and tenofovir): Taken daily.
Injections (Apretude, composition cabotegravir): Given by a doctor every two months.
PrEP can lower the risk of getting HIV from sex by 99% and from drug use by at least 74%.
Take Emergency HIV Medicine (PEP)
If you think you’ve been exposed to HIV (through sex, needle use, or workplace accidents), go to a doctor or emergency room immediately. Taking PEP (post-exposure prophylaxis) within 72 hours can lower your risk of infection. You must take it for 28 days.
Use Condoms
Always use a new condom during vaginal or anal sex. Use a dental dam or a cut-open condom for oral sex.
Use Clean Needles
If you inject drugs, use sterile needles and never share them. Many communities offer needle exchange programs.
Get Medical Care If You’re Pregnant
If you are pregnant and have HIV, getting treatment can lower the risk of passing HIV to your baby.
Inform Your Partners
If you have HIV, tell your current and past sexual partners so they can get tested.Â
Take HIV Treatment to Protect Others (TasP)
If you have HIV, taking your medication correctly can lower the virus in your blood to undetectable levels. This means you cannot pass the virus to your sexual partner.
Consider Male Circumcision
Removing the foreskin from the penis (circumcision) has been shown to reduce the risk of getting HIV.
Diagnosis of HIV/ AIDS
Doctors test for HIV using blood or saliva.
Antigen-antibody test – Checks for HIV antigen and antibodies in blood. Works 2 to 6 weeks after infection.
Antibody test – Checks for HIV antibodies in blood or oral fluids. Works 3 to 12 weeks after infection. Home test kits are usually antibody tests.
Nucleic acid test (NAT) – Looks for the virus (viral RNA) in the blood. Detects HIV the earliest (10 to 33 days)
If your test is negative, you may need another test after a few weeks to be sure.
Other Tests
If you have HIV, doctors will do more tests to:
Check how weak your immune system is (CD4 T cell count). If it is below 200, you have AIDS.
Measure the amount of virus in your blood (viral load). The goal is to make this undetectable.
See if your HIV is resistant to medicine.
Test for opportunistic infections and complicationsÂ
Doctors may also check for infections like tuberculosis, hepatitis, and STIs, cytomegalovirus and toxoplasmosis.
Test for liver and kidney function.
Treatment of HIV/AIDS
Medicine can control the virus and prevent opportunistic infections and complications.Â
HIV infection is treated by antiretroviral therapy (ART).
ART is a mix of 2 or more medicines that:
Reduce the virus in the blood.Â
Help the immune system stay strong
Stop the virus from becoming resistant to treatment
Some medicines combine multiple HIV drugs into one pill for easier use.
Types of HIV/ AIDS medicines:
NNRTIs ( Non-nucleoside reverse transcriptase inhibitors) – Stop the virus from making copies (e.g., Efavirenz, Rilpivirine)
NRTIs ( Nucleoside or nucleotide reverse transcriptase inhibitors)- Block virus building blocks (e.g., Tenofovir, Emtricitabine)Â
Integrase inhibitors – Stop the virus from changing immune cells (e.g., Dolutegravir, Bictegravir)
PIs ( Protease inhibitors )– Stop a key virus protein (e.g., Darunavir, Atazanavir)
Entry inhibitors – Block the virus from entering cells (e.g., Maraviroc, Fostemsavir)
Sticking to Treatment
It is important to take HIV medicine every day without missing doses. This helps:
Stop the virus from becoming resistant to treatmentÂ
Keep the immune system strongÂ
Prevent the virus from spreading
Lower the risk of infections
If you have trouble taking medicine, talk to your doctor. They can help manage side effects or find better options.
Side Effects of HIV/AIDS Treatment
Some people may experience:
Nausea, vomiting, diarrheaÂ
Kidney or liver damage
Heart problemsÂ
High cholesterol
High blood sugar
Weak bones
Trouble sleeping or mood changes
If you take other medicines for health problems, tell your doctor to avoid harmful drug interactions.
Monitoring Treatment
Your doctor will check your viral load and immune cells regularly:
First test: 4 to 6 weeks after starting treatment
Then, every 3 to 6 months
The goal is to make the virus undetectable in the blood. This does not mean HIV is gone, but it helps keep you healthy.
