The human immunodeficiency virus (HIV) attacks the immune system, impairing people’s ability to fight off numerous illnesses and certain types of cancer that healthy immune systems can fend off. Due to the virus’s destruction and impairment of immune cells’ function, infected individuals gradually develop immunodeficiency. Typically, immune function is quantified using the CD4 cell count.
Immunodeficiency syndrome (AIDS) is the most advanced stage of HIV infection. Which can develop over the years if left untreated. The development of certain tumours, conditions, or other long-term severe clinical symptoms constitutes AIDS.
Symptoms and signs of HIV
HIV symptoms vary according to the infection stage. Though HIV-positive individuals are most infectious within the first few months following infection. Many are ignorant of their status until later stages. Within the first several weeks following illness, individuals may exhibit no symptoms or symptoms consistent with influenzas, such as fever, headache, rash, or sore throat.
They may develop additional signs and symptoms as the infection gradually affects the immune system, such as swollen lymph nodes, weight loss, fever, diarrhoea, and cough. They may also acquire serious illnesses such as tuberculosis (TB), cryptococcal meningitis, severe bacterial infections, and malignancies such as lymphomas and Kaposi’s sarcoma if they do not receive therapy.
Transmission
HIV is spread through the interchange of bodily fluids between infected individuals, including blood, breast milk, sperm, and vaginal secretions. HIV can also be transmitted during pregnancy and delivery from a woman to her kid. Individuals cannot contract the virus through frequent daily contact such as kissing, hugging, shaking hands, or sharing personal items, food, or water.
It is critical to remember that HIV-positive individuals on ART and virally suppressed do not transfer HIV to their sexual partners. Early access to antiretroviral therapy (ART) and support for adherence is consequently crucial for improving the health of people living with HIV and preventing HIV transmission.
Factors of danger
The following behaviours and conditions increase an individual’s chance of developing HIV:
- having anal or vaginal sex in an unprotected manner;
- being infected with another sexually transmitted infection (STI), such as syphilis, herpes, chlamydia, gonorrhoea, or bacterial vaginosis;
- When injecting drugs, do not share contaminated needles, syringes, or other injecting equipment or drug solutions;
- undergoing ill-advised injections, blood transfusions, and tissue transplantation, as well as medical operations involving unsterile cutting or piercing; and
- enduring needle stick injuries with no fault of their own, notably among health care personnel
HIV Diagnosis
Quick diagnostic tests can detect HIV and offer results on the same day. This significantly simplifies early diagnosis and referral to therapy and care. Individuals can also test for HIV using self-test kits. However, no single test can offer a complete HIV diagnosis; confirmatory testing is required, which should be undertaken in a community centre or clinic by a certified and trained health or community worker. HIV infection can be detected with high accuracy when WHO-prequalified tests are used in conjunction with a nationally accepted testing plan.
The most frequently used HIV diagnostic tests look for antibodies produced by a person’s immune system in response to HIV infection. Antibodies to HIV are typically developed within 28 days after infection. During this period, individuals experience the so-called window period, during which HIV antibodies are not created in sufficient quantity to be detected by routine testing. They may exhibit no symptoms of HIV infection, but also during which they may transmit HIV to others. Following illness, an individual may transmit HIV to a sexual or drug-sharing partner or an infant during pregnancy or lactation.
Following a positive diagnosis, individuals should be retested before initiating treatment and care to rule out any testing or reporting error. Notably, after an individual has been diagnosed with HIV and begun treatment, they should not be retested.
While testing has become more convenient and efficient for adolescents and adults, this is not the situation for infants born to HIV-positive mothers. Serological testing alone is insufficient to detect HIV infection in children younger than 18 months; virological testing should begin at birth or six weeks. New technologies are now available that enable this test to be performed at the point of care and provide same-day findings, thereby expediting optimal connection to treatment and care.
Prevention
Individuals can lower their risk of contracting HIV by avoiding risk factors. The following are some of the most effective HIV prevention strategies, which are frequently used in combination:
- condom use by men and women;
- HIV testing and counselling;
- Testing and counselling to establish connections to tuberculosis (TB) care;
- male circumcision under medical supervision (VMMC);
- prevention with the use of antiretroviral medications (ARVs);
- harm reduction for individuals who inject drugs and use them; and
- Elimination of HIV transmission from mother to child (MTCT).
Treatment
Treatment regimens that include three or more antiretroviral (ARV) medicines are used to treat HIV infection. While current antiretroviral therapy (ART) does not cure HIV infection, it significantly inhibits viral replication within the body. It helps the immune system heal, strengthening and regaining the capacity to fight against opportunistic infections and certain malignancies.
Since 2016, the WHO has advised that all persons living with human immunodeficiency virus get lifelong ART regardless of clinical status or CD4 cell count. This includes children, adolescents, adults, and pregnant and breastfeeding women.
