HIV/AIDS

Overview

HIV refers to human immunodeficiency virus that causes HIV infection, which leads to acquired immunodeficiency syndrome (AIDS). In other words, if HIV infection is not managed, it advances to AIDS.

Through damaging the immune system, HIV interferes with the body’s ability to fight the organisms that cause disease. Precisely, HIV attacks and damages the infection-fighting CD4 cells of the immune system. Once the CD4 cells are destroyed, it becomes difficult for the body to fight infections and certain cancers.

HIV is a sexually transmitted infection (STI) which is spread through contact with infected blood and certain body fluids. These body fluids include rectal fluids, blood, vaginal fluids, semen, breast milk, and pre-seminal fluid. HIV transmission occurs through sexual contact, during pregnancy, during child birth, through breastfeeding, or sharing injection drug equipment such as needles.

Facts and Figures

HIV continues to be a critical international public health issue that has claimed over 35 million lives so far. As of 2017, there were about 36.9 million individuals living with HIV with about 1.8 million individuals becoming newly infected in the same year globally. At the same time, about 940, 000 people died from HIV-related causes globally.

World Health Organization reports that African region is the most affected with about 25.7 million people living with HIV in 2017. In Kenya, 1.5 million people were living with HIV in 2017. At least 4.8% of them were adults aged 15 to 49 years. New infections were 53,000 while about 28,000 people lost their lives due to AIDS.

Kenya is ranked joint fourth largest HIV epidemic in the world, alongside Uganda and Mozambique. Five counties account for nearly half of all the new infections in adults. They are Nairobi (7,159), Homa Bay (4,558), Siaya (4,039), Kisumu (4,012), and Migori (2,812).

These counties also recorded the highest number of deaths from HIV and AIDS and have the highest number of patients on anti-retroviral therapy (ART) and ARVs. Nairobi has 140,000 patients on ART, Kisumu 101,527, Homa Bay 100,667, Siaya 80,000, and Migori 65,820.

Symptoms

The symptoms of HIV/AIDS vary depending on the phase of infection.

Primary infection (Acute HIV)

Once infected with HIV, several individuals develop flu-like illness within one or two months after contracting the virus. Primary infection may last for a few weeks and is associated with symptoms such as:

  • Headache
  • Fever
  • Rash
  • Muscle aches and joint pain
  • Sore throat and painful mouth sores
  • Swollen lymph glands especially on the neck

Note that the amount of virus in the bloodstream (viral load) is extremely high at this time. It means that infection spreads more easily during primary infection compared to the next stage.

Clinical Latent Infection (Chronic HIV)

In some individuals, persistent swelling of lymph nodes takes place during this stage. Otherwise, this stage does not have specific symptoms. HIV remains in the body and in infect white blood cells.

This stage of infection mostly lasts for about 10 years if you are not receiving ART. At times, even with this treatment, it lasts for decades.

Symptomatic HIV Infection

As the virus continues to multiple in the bloodstream, it destroys the immune cells (CD4 cells). You may likely develop mild infections or chronic symptoms such as:

  • Fatigue
  • Fever
  • Diarrhea
  • Swollen lymph nodes – often among the first signs of HIV infection
  • Weight loss
  • Oral yeast infection (thrush)
  • Shingles (herpes zoster)

Progression to AIDS

Untreated HIV often turns into AIDS in about 10 years. When AIDS develops, the immune system has been extremely damaged. At this point, you are likely to develop opportunistic cancers or infections because of poor immune stability.

The signs and symptoms of some of these infections may include:

  • Recurring fever
  • Soaking night sweats
  • Chronic diarrhea
  • Weight loss
  • Persistent, unexplained fatigue
  • Skin rashes or bumps
  • Persistent white spots or abnormal lesions on the tongue or in the mouth

Causes

HIV is caused by human immunodeficiency virus and normally spreads through sexual contact or blood, or from mother to child during pregnancy, during delivery or breast feeding. HIV becomes AIDS after destroying CD4 T cells that fight diseases.

AIDS is diagnosed when the CD4 T cell count falls below 200 or you have an AIDS-defining complication. HIV spreads in several ways:

Risk Factors

HIV/AIDS spreads through both homosexuality and heterosexual sex. Any person of any age, sex, race, or sexual orientation can be infected. However, you are at greatest risk of HIV/AIDS if you:

  • Have a sexually transmitted infection (STI): STIs generates open sores on the genitals that creates channel for HIV to enter the body.
  • Have unprotected sex with an infected person; Note that anal sex is more risk than is vaginal sex.
  • Use intravenous drugs: Most people who use these drugs share syringes and needles which expose them to HIV infection.
  • Uncircumcised man: Studies reveal that lack of circumcision increases the risk of heterosexual transmission of HIV.

Complications

HIV infection weakens the immune system which exposes your body to several infections and particular types of cancer.

Diagnosis

Becoming aware of HIV status is critical for initiating treatment and preventing the development of extreme immune difficulties and ensuing infections.

To diagnose HIV, the doctor can conduct blood test whereby positive results means HIV antibody is detected in the bloodstream.

The blood is re-tested before a positive result is given

HIV might take 3 to 6 months to show up which means testing and re-testing may be necessary for a definitive diagnosis.

Treatment

HIV/AIDS has no cure but it is manageable especially in the early stages. HIV is suppressed by a combination of ART that consists of 3 or more ARV drugs. These drugs suppress viral replication within the body of an infected person and allow the immune system to strengthen and regain the ability to fight diseases. Each class of drug blocks the virus in distinct ways. ART is not recommended for every person irrespective of CD4 T cell counts. The classes of anti-HIV drugs include:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs): They turn off a protein required by HIV to multiply. They include nevirapine, etravirine, and sustiva.
  • Nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs): They are faulty versions of the building blocks that HIV requires to multiple themselves. Examples include Abacavir and the combination drugs emtricitabine, Descovy and lamivudine-zidovudine.
  • Protease inhibitors (PIs): Inactives HIV protease to reduce chance of multiplying
  • Entry or fusion inhibitors: Blocks HIV entry into CD4 T cells.
  • Integrase inhibitors: Works by disabling a protein called integrase that HIV uses to insert its genetic material into CD4 T cells.

Prevention

There is no vaccine to prevent HIV infection and no cure for AIDS. However, you can protect yourself and others from infection. Prevention entails:

  • Using a new condom every time you have sex
  • Consider the drug truvada: It is an emtricitabine-tenofovir drug that helps reduce the risk of STI including HIV.
  • Tell your sexual partners if you have HIV
  • Use a clean needle
  • If you are pregnant, get medical care right away
  • Consider male circumcision

Lifestyle and Home Remedies

  • Eat healthy foods
  • Avoid raw meat, eggs, and more
  • Take care with companion animals
  • Get the right immunizations
  • Use supplements such as whey protein and acetyl-L-carnitine

Sources

https://aidsinfo.nih.gov/understanding-hiv-aids/glossary/113/cd4-t-lymphocyte/

https://aidsinfo.nih.gov/understanding-hiv-aids/glossary/347/immune-system/

https://aidsinfo.nih.gov/understanding-hiv-aids/glossary/4605/transmission

https://www.who.int/news-room/fact-sheets/detail/hiv-aids

https://www.mayoclinic.org/diseases-conditions/hiv-aids/diagnosis-treatment/drc-20373531

https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524

https://www.medicalnewstoday.com/articles/17131.php