Human Immunodeficiency Virus (HIV) is a virus that attacks the body's immune system, specifically the CD4 cells (T cells), which are crucial for fighting infections. If left untreated, HIV can lead to Acquired Immunodeficiency Syndrome (AIDS), a condition where the immune system is severely compromised, making the body vulnerable to opportunistic infections and certain cancers.
Presentation
HIV infection can present in various stages, each with distinct symptoms:
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Acute HIV Infection: This initial stage occurs 2-4 weeks after exposure. Symptoms resemble the flu, including fever, sore throat, rash, and swollen lymph nodes. Some individuals may not experience noticeable symptoms.
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Chronic HIV Infection: Also known as the asymptomatic or clinical latency stage, this phase can last several years. The virus is active but reproduces at low levels. Many people may not have symptoms, but the virus continues to damage the immune system.
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AIDS: This is the most severe phase of HIV infection. Symptoms include rapid weight loss, recurring fever, extreme fatigue, prolonged swelling of the lymph glands, and opportunistic infections like tuberculosis or certain cancers.
Workup
Diagnosing HIV involves several steps:
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Screening Tests: These include antibody tests, antigen/antibody tests, and nucleic acid tests (NATs). Antibody tests detect antibodies to HIV in blood or oral fluid, while antigen/antibody tests can detect both HIV antibodies and antigens.
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Confirmatory Tests: If a screening test is positive, a follow-up test is conducted to confirm the diagnosis. This may include a Western blot or an immunofluorescence assay.
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CD4 Count and Viral Load: Once diagnosed, these tests help assess the immune system's health and the amount of virus in the blood, guiding treatment decisions.
Treatment
HIV is treated with antiretroviral therapy (ART), a combination of HIV medicines taken daily. ART doesn't cure HIV but helps control the virus, allowing individuals to live longer, healthier lives and reducing the risk of transmission. Treatment involves:
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Initiating ART: Recommended for all individuals diagnosed with HIV, regardless of CD4 count.
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Monitoring: Regular follow-ups to monitor viral load and CD4 count, ensuring the effectiveness of ART and adjusting as necessary.
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Adherence: Consistent adherence to ART is crucial for maintaining viral suppression and preventing drug resistance.
Prognosis
With effective ART, individuals with HIV can expect a near-normal life expectancy. Early diagnosis and treatment are key to preventing progression to AIDS and reducing the risk of opportunistic infections. Regular medical care and adherence to ART significantly improve outcomes.
Etiology
HIV is primarily transmitted through:
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Sexual Contact: Unprotected sex with an infected person is the most common mode of transmission.
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Blood Exposure: Sharing needles or syringes with someone who has HIV can transmit the virus.
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Mother-to-Child Transmission: During pregnancy, childbirth, or breastfeeding, an HIV-positive mother can pass the virus to her child.
Epidemiology
HIV is a global health issue, with millions of people living with the virus worldwide. Sub-Saharan Africa is the most affected region, but HIV affects all populations. Efforts to reduce transmission include education, testing, and access to ART.
Pathophysiology
HIV targets the immune system, specifically CD4 cells. The virus enters these cells, replicates, and eventually destroys them, weakening the immune response. Over time, the loss of CD4 cells impairs the body's ability to fight infections and diseases, leading to AIDS if untreated.
Prevention
Preventing HIV involves several strategies:
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Safe Sex Practices: Using condoms and reducing the number of sexual partners can lower the risk of transmission.
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Pre-Exposure Prophylaxis (PrEP): A daily medication for people at high risk of HIV, significantly reducing the chance of infection.
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Post-Exposure Prophylaxis (PEP): An emergency treatment started within 72 hours after potential exposure to HIV.
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Needle Exchange Programs: Providing clean needles to reduce transmission among people who inject drugs.
Summary
HIV is a virus that compromises the immune system, leading to AIDS if untreated. Early diagnosis and consistent treatment with ART can control the virus, allowing individuals to live healthy lives. Prevention strategies are crucial in reducing transmission and managing the global impact of HIV.
Patient Information
If you suspect you have been exposed to HIV or are experiencing symptoms, it's important to get tested. Early detection and treatment are vital for managing the virus and maintaining a healthy life. Regular medical care and adherence to prescribed treatments can significantly improve outcomes and reduce the risk of transmission to others.