HIV/AIDS: Symptoms,Causes & Treatments

What is HIV?

Human Immunodeficiency Virus (HIV) is a chronic disease that poses a threat to life and is caused by a virus that causes a deficiency of the immune system in humans.

How does the HIV work

HIV robs the body of its ability to fight and resist viruses, germs, and fungi by infecting the immune system, making the body vulnerable to various diseases.

AIDS exposes the human body to certain types of cancer and infections that it could have fought and overcome, such as pneumonia, meningitis, and the virus and the inflammation it causes AIDS is called a virus (Human immunodeficiency virus - HIV).

The term Acquired Immunodeficiency Syndrome AIDS or acquired immunodeficiency syndrome is a definition of HIV in its most advanced stages.

About 39.5 million people around the world are infected with HIV today, although it is inhibited in many countries of the world, its prevalence remains the same and has even increased in other countries.

Pathogenic Mechanisms of HIV Disease

Normally, white blood cells attack and destroy foreign organisms that invade the body, as this reaction is regulated and coordinated by white blood cells called T- lymphocytes (Lymphocytes-CD4).

These lymphocytes are also the central target of HIV, which attacks these cells and penetrates them, and after successfully penetrating these cells, it introduces its genetic material into them and in this way multiplies itself.

New cloned HIV begins to exit the host lymphocyte and enter the bloodstream, where they start looking for new cells to attack.

Meanwhile, the host lymphocyte and neighboring healthy T cells die due to the effects of the attacking HIV, forming a cyclical phenomenon that repeats itself over and over again.

Thus, in this process, millions of new cells of HIV are produced daily, and at the end of this process, the number of T-cells decreases, until reaching a serious immunodeficiency, which means the body's inability to resist viruses and pathogenic germs that attack it.

Groups most at risk of HIV Infection

A person of any age of any gender can be infected with HIV, but the risk of contracting it increases when:

• Having unprotected sexual intercourse with several people, and the degree of danger does not differ whether a person has sex with the opposite sex, with the same sex, or with both sexes, unprotected sexual intercourse means having sexual intercourse without a condom.
• Having a sexual relationship with a partner who carries HIV.
• A person infected with another infectious sexual disease, such as syphilis, herpes, chlamydia, gonorrhea, and viral vaginitis.
• Repeated several times use of common syringes and needles when taking intravenous drugs.
• The lack of a sufficient amount of a gene (CCL3L1) helps fight HIV.
• Newborn babies and babies of mothers who are carriers of HIV, but have not received preventive treatment.

Symptoms of HIV/AIDS 

The symptoms of HIV vary from case to case, and according to the specific stage of the virus.

1. Early Sings of HIV Infection

In the initial stages of exposure to HIV, no symptoms or signs may appear, although in this virus it is very common for flu-like symptoms to appear that soon disappear after two to four weeks from the moment of exposure to HIV. 

Symptoms may include the following:

• Body temperature rises.
• Swelling in the area of the lymph nodes.
• Skin rashes. 

If a person is exposed to HIV, he is likely to be transmitted to other people even if he does not show any symptoms, as once the virus enters the body, the immune system becomes vulnerable to attack.

HIV multiplies inside the lymph nodes, and then begins a slow process of destroying T-lymphocytes (Lymphocytes T CD4) which are white blood cells responsible for coordinating all the processes and activities of the immune system.

2. Advanced Signs of HIV Infection

The patient may not experience any symptoms in the advanced stages of HIV for a period of one to nine years, and sometimes even more.

But in the meantime, HIV continues to multiply and multiply itself, as well as systematically destroy the cells of the immune system, at this stage the sufferer may have some symptoms of chronic aids, such as:

• Swelling of the lymph glands.
• Diarrhea.
• Weight loss.
• Body temperature rises.
• Cough.
• Shortness of breath.

3. The last stages of  HIV infection

In the last stages of the symptoms of HIV infection, which are 10 years and more after the first exposure to the virus, the most serious symptoms of HIV begin to appear and then the inflammation becomes a state that can be called AIDS.

In 1993, the Center for Disease Control and Prevention in the United States of America developed a new definition of AIDS, this definition states that: aids are considered a disease if HIV is found in the body, and this can be confirmed if the results of tests show the presence of antibodies to the HIV in the blood accompanied by one of the following symptoms:

1. Opportunistic infection: occurs when the immune system is weak or infected, such as in the case of Pneumocystis carinii pneumonia – PCP.

2. T-lymphocyte count: the number of T-lymphocytes is 200 or less, knowing that the healthy value should range between 800 - 1200.

As HIV progresses and worsens, the subsequent damage to the immune system intensifies and weakens, making the body easy prey for opportunistic infections.

Symptoms of HIV and some of these infections include the following:

• Excessive night sweats.
• Chills or fever above 38 °C persist for several weeks.
• Dry cough and shortness of breath.
• Chronic diarrhea.
• Permanent white dots or strange wounds on the tongue and in the oral cavity.
• A headache.
• Blurred or disturbed vision.
• He lost weight.

And at a more advanced stage of HIV additional symptoms can appear, such as:

• Permanent inexplicable fatigue.
• Excessive night sweats.
• Chills or fever above 38 degrees Celsius persist for several weeks.
• Swellings in the lymph glands persist for more than three months.
• Chronic diarrhea.
• A constant headache.

HIV infection also increases the risk of certain types of cancer, especially Kaposi's Sarcoma, laryngeal cancer, and lymphoma, although the risk of these diseases can be reduced by preventive treatments.

4. Symptoms of HIV in children

As for the symptoms of HIV that a child develops, they include:

• Problems with high weight.
• Problems with growth.
• Problems with walking.
• Slowing mental development.
• Infection with common inflammatory diseases such as ear infections, inflammation of the lungs, and tonsillitis.

Causes of HIV/AIDS

Infection with HIV may occur in several ways, including the following:

1. Sexual contact

They are one of the most important causes of HIV infection and can be contracted through vaginal, oral, or anal sexual contact with a partner who is a carrier of the virus when one of these things enters the body, such as blood, semen, or vaginal discharge.

The joint use of sex toys that have not been washed and cleaned or have not been wrapped with a clean condom between one use and the other transmits the infection, as HIV lives in semen or in vaginal secretions that enter the body during sexual practice through small wounds or lacerations that are sometimes present in the vagina or the rectum.

If someone is a carrier of another infectious STD, they are more likely to be infected with HIV, and contrary to what researchers thought in the past, even women who use spermicide are also at risk of contracting HIV.

This is because this spermicide alerts the inner mucous membrane of the vagina, which can cause cracks and ruptures through which the virus can penetrate the body.

2. Infection with HIV from inflamed blood

In some cases, the virus can be transmitted through blood or blood products that are given to a person by intravenous injection, which is one of the causes of widespread HIV.

Since 1985, hospitals and blood banks in the United States have been testing donated blood to detect any antibodies to HIV that may be in it, and these tests have significantly reduced the risk of exposure to HIV from intravenous transfusion in addition to improving the screening and filtering of donors.

3. Injection Needles

HIV is easily transmitted by inflamed needles or syringes that have come into contact with contaminated blood, as the use of common tools for intravenous injection increases the risk of exposure to this virus and other viral diseases, such as hepatitis.

The best way to prevent HIV infection is to refrain from using intravenous drugs, but if this possibility is not available, it is possible to reduce the risk of infection by using sterile disposable injection tools.

4. Accidental Needle Prick

The probability of transmission of the AIDS virus between HIV carriers and medical personnel by an accidental needle prick is very small, and specialists tend to estimate the probability at less than 1%.

5. Mother-to-child transmission of HIV

Statistics show that about 600,000 young children become infected with HIV every year, both during pregnancy and as a result of breastfeeding, but the risk of infection of the fetus when the mother takes HIV treatment during pregnancy is very significantly reduced.

In the United States of America, the majority of women undergo early tests to detect antibodies to HIV, and medications for the treatment of retroviruses are also available to them.

However, the situation is different in developing countries, where the majority of women lack awareness of their health conditions and the possibility of HIV infection, and where the opportunities and possibilities of treatment are often very limited or not available at all. 

When medications are not available, it is preferable to give birth by cesarean section instead of regular vaginal delivery, but other possibilities and alternatives, such as vaginal sterilization, for example, have not been proven effective.

6. Other ways of transmission of HIV infection

There are rare cases in which the AIDS virus can be transmitted during organ or tissue transplantation, or through dental instruments if they are not properly sterilized.

Diagnosis of HIV/AIDS

HIV is diagnosed by a blood test or examination of the mucous membrane in the mouth to detect whether there are antibodies to the virus.

The Centers for Disease Control and Prevention in the United States of America recommends these AIDS tests for adolescents and adults, aged 13-64 years, as a basic part of routine medical examinations.

The Centers for Disease Control and Prevention recommends that at least once a year everyone who belongs to any one of the above risk groups should undergo HIV tests.

Unfortunately, HIV tests do not give completely accurate results when they are performed immediately after exposure to the virus, because the human body needs some time to develop appropriate antibodies to HIV.

It may take at least 12 weeks from the moment of exposure to HIV infection, and in some rare cases, the period may even be extended to about six months or more to be able to detect the presence of HIV in the body.

Tests that make it possible to diagnose HIV/AIDS include:

1. Enzyme-linked immunosorbent assay - ELISA

For many years, the only test available to detect the presence of HIV antibodies in the body was the Eliza test, which detects HIV antibodies in a blood sample taken from the person concerned.

If the test results are positive, i.e. indicate the presence of HIV antibodies in the blood, the test is performed a second time.

If the results are positive on the re-examination, that is, also on the second time, then the person concerned himself will have to take an additional blood test.

2. Western Blot Test

The Western smear test is of particular importance in the diagnosis of HIV, because the blood may contain antibodies that are not antibodies to the virus, but they can confuse the results of Eliza's examination and give a positive result, when in fact it is an erroneous one.

The use of these two Tests together made it possible to ensure accurate results, so the diagnosis of HIV confirming the presence of the AIDS virus was considered final and reliable only after obtaining positive results in the three tests detailed above.

But the main and big disadvantage of these tests is the need to wait for two weeks to get the results of all three Tests, which may cost a serious psychological cost and may lead to the failure of the person concerned to return to the clinic to get the results of his tests.

3. Quick Tests

Today many express examinations give accurate and reliable results within 20 minutes, these examinations are aimed at detecting the presence of antibodies to HIV in the blood, and in the fluid in the upper, or lower gums, after taking samples from them.

The examination taken from the oral fluids gives accurate results with the same accuracy as the results given by the blood test and even saves the trouble of taking blood, but when a positive result is obtained in the rapid examination, a blood test must be performed to confirm the result.

4. Home Tests

The US Food and Drug Administration recently approved the use of a home-based test to detect HIV, as this test is characterized by its accuracy similar to that of a laboratory examination, and all positive results obtained in this examination are subjected to another additional examination.

Unlike the pregnancy screening test, the results of the HIV screening test are not self-analyzed, but the person conducting the test must send a sample of his blood to the laboratory and then contact a few days later to get the results of the test.

This method ensures privacy as the person who is the subject of the examination is identified by the code number on each of the kits.

The main disadvantage of this method lies in the fact that the person being examined does not receive the direct personal advice that he could have received when he went to the attending physician or the clinic, although he is offered to direct him medical services or social services.

Regardless of the specific test that a person chooses to undergo and undergo, if he finds out that he is carrying HIV, he must first inform his partner about the matter immediately, so that he too can get tested and take the necessary preventive measures.

If a person receives a positive result that shows that he is carrying the virus, his attending physician can help him estimate the expected stages of its development, as this examination shows the number of viruses present in the blood.

Research has shown that people with a high viral load get sick more often than those with a low viral load, and viral load tests are also performed to determine when to start and when to change drug treatment.

Treatment of HIV/AIDS

When HIV was first discovered in the Eighties of the last century, there were few drugs available to treat it or treat the accompanying infections.

But since that time many drugs have been developed for the treatment of HIV and associated opportunistic infections, and these types of treatment have helped many people, including children, and raised their quality of life.

Researchers at the US National Institutes of Health estimate that the treatment of HIV and antiretroviral drugs given to patients with HIV in the United States since 1989 have given these patients an addition that promises a few years of life.

But none of these drugs is a panacea for HIV, not to mention that many of them have severe side effects in addition to being very expensive.

The treatment of human immunodeficiency disease and taking such drugs for many years, sometimes more than 20 years, loses its effectiveness; since many patients with HIV treated with it develop tolerance and resistance, they are no longer affected by it.

In light of this, intensive research is being conducted to develop and produce new drugs that will be able to help these patients with HIV.

The most prominent methods of treatment include the following:

1. Anti-Retroviral Drugs

Antiretroviral drugs suppress the growth and reproduction of the AIDS virus at different stages of its life cycle, these drugs are available in seven different groups:

• Nucleoside analog reverse-transcriptase inhibitors - NARTIS
• Protease inhibitors - PIs
• Non - nucleoside reverse - transcriptase inhibitors - NNRTIS
• Nucleoside reverse-transcriptase inhibitors - NRTIS
• Fusion inhibitors
• Integrase inhibitors

2. Response to HIV/AIDS Treatment

The extent of the response to HIV treatment is measured by the level of viral load, i.e. the number of viruses in the patient's blood (Viral load), where the viral load should be measured at the start of drug treatment and then periodically every three months for the duration of HIV treatment.

In some special and unusual cases, these tests can be performed at more frequent intervals.

3. Guidelines and directions for the treatment of HIV

A leading group of researchers on the subject of HIV treatment has been drafting a list of recommendations for patients, including guidelines for HIV antiretroviral therapy, based on the best information available at the time of writing the recommendations.

According to the current list of recommendations, treatment should focus on inhibiting and masking the symptoms of the virus for as long as possible, this offensive orientation is known as

The goal of the highly effective antiretroviral treatment program is to reduce the number of viruses present in the patient's blood to such a minimum that they cannot even be noticed or detected, although this does not mean that HIV disappears from his blood completely and completely, and it is possible to reach this result by combining three or more drugs.

Treatment recommendations keep in mind the topic of quality of life, so the main goal is to find the most accessible and simple treatment regimen with the least side effects.

If someone has HIV, it is important to be an effective partner in making decisions about measures and treatment steps for them.

He should discuss the treatment programs offered to him with his attending physician; to assess the risks and benefits of each of these proposed treatments to reach an informed and wise decision on the treatment of HIV, which may be complex and may be prolonged.

Read Also: HIV/AIDS Complications & Prevention