HIV symptoms and complications
AIDS or (Acquired Immunodeficiency Syndrome) was first identified in North America in the early 1980s. It is caused by a designated HIV virus (Human Immunodeficiency Virus). The World Health Organization estimates that 36 million people worldwide have died from the virus since its discovery. In 2013, about 35.3 million people had AIDS. In Canada, more than 23,000 AIDS cases were identified by the Public Health Agency of Canada between 1979 and 2014.
HIV is more prevalent in some at-risk populations such as bisexual and homosexual men and people who inject illicit drugs. Infection is also more common in socially disadvantaged communities.
The virus is found in the blood, sperm, vaginal fluid and breast milk of infected people. HIV is also present in saliva, sweat and tears, but not enough to transmit the virus. There is no known case of contamination from sneezing, shaking hands, contact with toilet seats or mosquito bites.
Unprotected sex and needle exchange are the two most common modes of HIV infection in North America. HIV can be transmitted during unprotected heterosexual or homosexual sex, whether vaginal, anal or oral. Although the risk of infection by oral sex is lower, it is important to still use protection such as a dental dam (a square of latex covering the sex or anus) or a condom. HIV can also be transmitted as a perinatal infectionduring the delivery of a woman infected with HIV. The risk of perinatal infection, however, is decreasing thanks to new treatments. HIV can also be transmitted during breastfeeding.
When HIV enters the bloodstream, it invades cells called CD4 + lymphocytes that are essential for the immune response. The virus then inserts its own genes inside the cells that it transforms into tiny factories of new copies of its genetic information. Gradually, the number of viruses increases in the blood while that of healthy CD4 + lymphocytes decreases. The destruction of these cells hinders the body’s ability to fight infections, cancer and other ailments.
Symptoms and Complications
Symptoms of HIV infection appear between 2 and 12 weeks after infection. The virus then quickly infests the immune cells of the blood serum. The symptoms that appear during this phase are similar to those of the flu, including:
fatigue or weakness
an increase in the volume of the ganglia;
The person affected by HIV is very contagious as soon as the first symptoms appear. These usually disappear during the following week or month, and the contaminated person feels well again. The symptoms may, however, reappear occasionally. The symptoms of HIV infection are similar to those of other viral infections. Only an HIV test (HIV) will reveal the presence of the virus in the blood. After an HIV infection, it takes about 3 weeks to detect the virus in the blood, although in some people the antibodies do not become detectable until 3 months. We call seroconversionthe period during which antibodies develop and appear in the blood. After this seroconversion, it is possible to detect the virus by means of a blood test.
The immune system tries to control the virus after the first symptoms have disappeared. The immune system manages to keep the virus in check for a while, but it can not get rid of it completely. Many people will feel healthy for years before their immune system weakens and AIDS evolves. In the absence of treatment, AIDS will develop within 10 years after the infection of about half of HIV-positive people. But for some people, AIDS can settle in a few years after infection. On the other hand, people who resist the evolution of AIDS for longer fall into the group of long-term non-progressors. Rarely, some people known as “elite controllers” can control the virus for decades and never seem to contract AIDS. Several factors can influence the period of time needed for AIDS to develop, including medication, genetic heritage, virus aggressiveness, and general health and lifestyle.
The term “AIDS” refers to the advanced form of HIV infection. AIDS is defined as having contracted HIV and certain specific types of infections (“opportunistic” infection) often associated with AIDS. This infection can be of bacterial, fungal, viral or parasitic origin. Opportunistic infections include toxoplasmosis, pneumocystis jerovicii pneumonia , cryptococcal meningitis, progressive multifocal leukoencephalopathy (PML), cryptosporidium, cytomegalovirus, and Mycobacterium avium complex.(CMA). Through the use of more effective drugs for the treatment of HIV infections, the risk of opportunistic infections has been greatly reduced over the years; however, people with AIDS will need to take medications (like antibiotics) to prevent opportunistic infections.
People with AIDS who are not receiving treatment are also more likely to get cancer, especially cancer of the immune system (lymphoma). Another form of cancer that frequently affects people with AIDS is Kaposi’s sarcoma, a type of cancer that causes bluish red nodules in the legs and spreads to the lymphatic system. Cervical cancer particularly affects women with AIDS. Homosexual men with HIV also have higher rates of infection with human papillomavirus (HPV), a virus that is associated with anal cancer.
Children with AIDS most commonly contract common childhood infections such as conjunctivitis, otitis media, and tonsillitis, but their symptoms are much worse than those of other children.
Abnormal weight loss, or “wasting syndrome,” is a problem for approximately 20% of people with HIV. It is due to an unexplained loss of at least 10% of normal body weight, is associated with chronic diarrhea (persistent 30 days or more), or chronic weakness with fever (persistent 30 days or more).
The majority of those affected die of conditions that AIDS has predisposed to by weakening their immune systems. The virus occasionally infects the brain and causes dementia that progressively worsens.
If you think you have HIV, only an HIV test will reveal the presence of the virus in your blood. This is a voluntary process and you can choose to do it anonymously. Your results will remain confidential. You can be tested in your doctor’s office or at a sexual health clinic, many of which are run by local public health units.
The HIV test can include two types of tests: a preliminary test that detects HIV antibodies and finally a confirmatory test . If the rapid test result that requires a finger prick blood test is positive for HIV, a second laboratory test should be performed to confirm the presence of HIV. However, if the rapid test is negative, no further examination is necessary.
If HIV infection is proven, you will discuss with your doctor therapeutic options as well as support groups and other services that can help you cope with the situation. You will need to tell your sexual partners (past, present and future) to prevent them from contracting HIV or to help them get treatment if they have been infected. Laws on the need to inform partners vary by province, but most provincial authorities have services in this regard. Your doctor, or the Ministry of Health in your province, is able to help your partners with testing and treatment.
Treatment and Prevention
HIV is usually treated with highly active combination antiretroviral therapy (HAART), a potent combination of anti-HIV drugs. HAART does not cure HIV, but it can reduce the number of viruses in the blood, strengthen the immune system and slow the progression of the disease. A combination therapy comprises at least 3 drugs. The use of several drugs acting in a different way prevents the resistance of the virus to treatment. The risk of resistance increases when fewer drugs are used, when too little is given, or when the medication stops, even for a short time.
It is very important to use this medicine as directed by your doctor.If you miss a dose, take a lower dose than you need, or do not take it at the right time, the treatment will be less effective. Synchronizing your medication, meals, and daily activities can be a problem. However, the number of drugs used to treat HIV infections has increased significantly over the last 5 years, as has their tolerability. Many of them are now available in “combined presentations” that group 2,3 or even 4 separate drugs into a single tablet that is taken once a day. Your doctor or pharmacist can help you find a way to adapt your medication to your daily routine. They may recommend you
When someone has AIDS, they can take a range of antibiotic, antiviral, and antifungal drugs that others only take for short periods of time while they are sick. These drugs help fight opportunistic infections. When the person’s immune system has started to recover after the start of HAART, the doctor will stop administering several of these medications. People with the wasting syndrome can get treatments that are appropriate for the cause of their significant weight loss. Agents such as growth hormones, anabolic steroids and appetite stimulants are examples of drugs used to treat this symptom.
Many researchers are actively working on developing new treatments for HIV. Information in this regard is changing rapidly. Keep up to date by talking to your doctor or pharmacist. You will also get timely and confidential information on AIDS treatment from CATIE (Canadian AIDS Treatment Information Network). To contact CATIE, simply call 1-800-263-1638 or visit their website . You can also ask the Ministry of Health for information on provincial and regional programs.
Nobody is immune to HIV infection. Fortunately, there are preventive measures. The main strategies for preventing HIV infection are:
Wearing condoms during sex (whether vaginal, oral or anal).
The choice of a smaller number of sexual partners.
Refusal to re-use syringes or other utensils for the administration of drugs.
You may also consider using pre-exposure prophylaxis (PRP) to allow a person who is not HIV positive to take a daily dose of anti-HIV medication to prevent infection.
Unless you have an exclusive relationship (in which neither partner has sex with a third person) and you are sure that neither you nor your partner is HIV-positive , never miss a condom every time you have sex.In some cases, one of the partners is infected, but the couple, who wants to conceive a child, for example, decides to still have unprotected sex, putting the other partner at risk of infection. If this is your case, discuss it with your doctor. Controlling HIV infection in the infected partner, combined with a PrEP for the uninfected partner, can greatly reduce the risk of transmitting the infection to the uninfected child or partner. Your choice of sex partners is also important because sometimes condoms burst or start to flee. Even if you know that your sexual practices can minimize the risk of HIV transmission and that you do not use dirty syringes, You should also make sure that your sexual partners, and theirs, have taken the same precautions. Needle exchange is very dangerous and poses high risks of HIV infection.
People with other sexually transmitted infections (STIs) such as herpes are more likely to get HIV during sexual contact , possibly because of tiny tears in their skin or vaginal walls. Protecting yourself against other STIs will reduce your risk of HIV infection, but these measures will not be enough to protect you from this infection. That’s why the use of condoms is so important.
If you have HIV, and if a pregnancy occurs, tell your doctor. The risk of infecting the newborn during childbirth has dropped dramatically with medications and, if applicable, caesarean section practice.