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HIV stands for human immunodeficiency virus. This virus infiltrates and destroys the CD4 cells, which are a type of T-helper cells or white blood cells that play an important role in the immune system.
These cells navigate the entire body through the bloodstream and are responsible for detecting any cellular anomalies as well as signs of an infection or disease. Thus, they essentially work as foot soldiers in the body’s natural defense system.
As the HIV virus breaks down more and more of CD4 cells over time, the immune system is rendered weak and incapacitated to fight off everyday infections and more serious ailments such as cancer.
Once contracted, the impact of these conditions is also far more amplified and dangerous. For an HIV victim, even the most minor sickness can end up being fatal if not attended to properly as the damage tends to progressively worsen. (1)
Prevalence of HIV
According to the Centers for Disease Control and Prevention (CDC), more than 1.1 million people are currently HIV infected in the USA, and as many as 15 percent (1 in 7 people) remain unaware of their infection. (2)
Some research demonstrates that there is a disparity in gender incidence for HIV infection and shows that HIV-1 prevalence among girls and young women is double that among males of the same age. (3)
HIV is most commonly transmitted through semen, preseminal discharge, anal discharge, vaginal discharge, breast milk, and blood. The most common ways the HIV virus may enter your body are through high-risk sexual behavior and exposure through injection or infusion. (4)
HIV exposure through sexual behavior
- Engaging in intercourse with an HIV-infected person – Anal intercourse is the first and vaginal intercourse is the second highest-risk sexual behaviors for HIV transmission.
- Engaging in unprotected intercourse with multiple partners – This can lead to other sexually transmitted infections, making you more susceptible to contracting the HIV virus through intercourse.
- Engaging in transactional intercourse (intercourse in exchange for money) – This typically involves multiple partners and high-risk sexual behavior.
HIV exposure through injection or infusion
- Sharing drug-injecting equipment (syringes, needles, and rinsing water) with an HIV-infected person can infect you, too.
- Sharing drug preparation equipment with an HIV-infected person can also infect you.
- Healthcare workers are at high risk of accidentally being struck with an HIV-infected needle.
- Using needles or syringes bought from street sellers can infect you with HIV, as these sellers often repackage used needles and syringes and sell them as new items.
- HIV-contaminated blood transfusions or organ and tissue transplants also raise the risk of spreading HIV.
General Misconceptions About HIV Transmission
There are several myths regarding the spread of HIV that add to the sense of suspicion that shrouds this condition and contribute to the unjust and unwarranted alienation of its victims. People tend to make assumptions without educating themselves about the facts, and as a result, HIV patients are forced to become social pariahs.
Instead of operating out of the fear of a probable infection, one must get his/her facts straight. Unlike your run-of-the-mill viral infections, the HIV virus, contagious as it may be, does not spread through the following:
- Skin-to-skin contact
- Water or air
- Sharing a toilet
- Sharing your bedding or towels
- Fecal excrement or urine of an HIV-positive individual
- Saliva, perspiration, or tears of an infected person
- Vomit of an infected person
- Mosquito or bug bites
- Coughing or sneezing
- Holding hands, hugging, or kissing an HIV patient
- Sharing eating utensils or drinking glasses with a patient
Types of HIV
There are two distinct variants of the HIV virus, namely, HIV-1 and HIV-2. The former is by far the earliest and most predominantly reported of the two, with almost 95 percent of HIV cases worldwide being attributed to the HIV-1 strain.
HIV-2, on the other hand, is fairly less common and is largely concentrated in West Africa, with a few cases reported in other countries. Moreover, this type of HIV infection is also less aggressive in terms of progression and symptoms, thereby accounting for fewer deaths than its counterpart.
HIV-1 and HIV-2 viruses are more or less 55 percent genetically different from each other. Thus, separate tests have been designed to detect each of these viruses that take into account their specific genetic makeup.
One must keep in mind that the individualistic test for either of these viruses will fail to reliably identify the other. However, for convenience sake, there are tests available on the market that are sensitive to both types of viruses. (5)
Stages of HIV
The three stages of HIV infection are:
1. Acute HIV infection
This refers to the earliest phase of HIV infection, which tends to set in within 2 to 4 weeks after contracting the virus. This stage is perhaps when the infection is at its aggressive best as it spreads rapidly throughout the body, wreaking havoc on the infection-fighting CD4 cells of the immune system.
Acute HIV infection is characterized by flu-like symptoms, such as a headache, running a high temperature, and the development of a rash. Moreover, since the virus tends to multiply at increased momentum, the level of HIV in the blood increases significantly during this stage.
Thus, even at this nascent stage of the infection, the risk of HIV transmission tends to be considerably high.
2. Chronic HIV infection
Chronic HIV infection is the next stage of HIV progression, during which the virus continues to proliferate throughout the body but at substantially decreased speed.
In the absence of proper treatment, the HIV virus can continue to replicate itself within the body causing slow but steady organ damage for the next 10 years before transforming into full-blown AIDS.
This lull also implies that there is a marked absence of standard HIV symptoms that were previously noticeable. It is precisely because of this reason that this stage is also referred to as asymptomatic HIV infection or clinical latency. During this stage of the disease, patients tend to feel and appear healthy but can still transmit the HIV virus to others.
3. Acquired immunodeficiency syndrome (AIDS)
Stage three HIV or AIDS is the phase when the infection reaches its peak and becomes largely unmanageable. By the time the HIV infection progresses into AIDS, the immune system becomes so severely damaged and compromised that the body can’t fight off opportunistic infections.
Opportunistic infections refer to a group of infections and infection-related cancers that occur with greater frequency and severity among people with weakened immune systems than in people with healthy immune systems. The CD4 cell count for healthy individuals figures somewhere between 500 cells/mm3 and 1,600 cells/mm3.
However, in a person with AIDS, the magnitude of CD4 cell damage is such that the count plummets to less than 200 cells/mm3. Another identifying factor to determine if an HIV infection has reached this climactic stage is the development of one or more opportunistic illnesses, regardless of your CD4 count.
In the absence of effective ART treatment, an AIDS patient can survive for about 3 years before succumbing to this deadly disease.
Symptoms of HIV
Broadly speaking, symptoms of HIV can be grouped as early symptoms and late symptoms which are as follows.
Once infected with HIV, it is not possible to have it go away. However, with early identification of common symptoms, proper medical treatment, and a healthy lifestyle, it is possible for an HIV-positive person to lead a long and productive life.
Symptoms of an HIV infection may start presenting themselves 2 to 6 weeks after it is contracted.
The following are 11 early signs and symptoms of HIV that you must know:
The most common primary symptom of an HIV infection is a fever and flu-like symptoms.
A fever during the initial HIV stage is likely to be recurrent and persists for 2 to 4 weeks at a time. Night sweats often accompany infection-associated fevers. (6)
Because fevers are the immune system’s response to viral infections, getting a fever in the early stages of HIV is a good sign. It proves your immune system has not weakened yet.
2. Night sweats
If you are unable to sleep because you just cannot stop sweating and you have recently engaged in any of the previously described high-risk behaviors, it might be a cause for concern. (7)
HIV-induced night sweats occur persistently and without exertion. They may drench your clothes and sheets and may be nearly impossible to sleep through.
Night sweats usually accompany a fever in HIV patients.
3. Sore throat
A sore throat is another common symptom of early HIV. It is highly likely to accompany a fever in HIV-positive patients. (8) A sore throat may occur before the onset of fever as an indicative sign in many patients.
You may experience pain when swallowing food, water, and sometimes your own saliva. Your sore throat may last up to 2 weeks and may be accompanied by mouth ulcers.
4. Swollen lymph nodes
Immune system cells are spread throughout the body. One of the primary locations for their distribution is the lymph nodes. Lymph nodes are found in the neck, under the armpits, and in the groin area.
Because the main task of HIV cells is weakening the immune system, they identify the key immunity-boosting parts of the body and attack them. This includes the lymph nodes.
The swelling of the lymph nodes is your body’s way of telling you that your immune system is working hard to minimize the damage caused by the HIV infection. (9)
Lymph nodes are painful and tender to the touch. They can frequently appear and disappear. It is a cause for concern if swelling persists longer than 2 to 4 weeks.
5. Rashes and seborrheic dermatitis
Seborrheic dermatitis on the scalp, face, and chest is one of the earliest symptoms of HIV. (10)
Sebaceous glands are mainly located in the face, head, chest, upper back, and groin area. An early symptom of HIV is the appearance of red, inflamed, itchy, and flaky skin around these regions that may last for 2 to 3 weeks or more. (11)
6. Muscle pain (myalgia) and joint pain (arthralgias)
While these conditions are present throughout the trajectory of the disease, they are also key primary symptoms to identify if you fear that you may have contracted HIV.
Musculoskeletal disorders (those affecting the muscles and bones) are often the initial symptoms of HIV. (12) The muscle and joint pain may manifest itself in the form of moderate to severe pain in two or more joints that lasts between 2 and 24 hours.
In a study published in the Indian Journal of Sexually Transmitted Diseases in 2013, the musculoskeletal symptoms of 300 patients of primary HIV were evaluated for a year. It found that 63.3 percent of patients reported musculoskeletal disorders. Out of these, 46.7 percent reported body aches, 26.7 percent reported joint pain, 8.3 percent reported lower back pain, and 6.7 percent reported osteoporosis. (13)
These symptoms intensify as the disease progresses.
Fatigue from HIV can be described as a lack of energy and a feeling of exhaustion that is not cured with a good night’s sleep. It may be constant and occur without any physical exertion.
A study found that fatigue significantly affected the patient’s ability to perform chores, walk, exercise, work, and engage in other activities. (14)
Headaches are the most common and persistent form of pain experienced by HIV patients. They severely deteriorate the patient’s quality of life and hinder their day-to-day activities. (15)
Primary headaches (migraines, tension-type headaches, and headaches occurring on one side and persisting for weeks) are recurrent headaches not associated with any underlying illness. They may signify that HIV is in its initial stage.
Secondary headaches (sinus headaches or headaches from meningitis) are associated with other illnesses that develop in the later stages of HIV when the immune system further weakens, allowing for opportunistic infections to thrive.
9. Nausea and vomiting
Nausea and vomiting are two of the most common symptoms of HIV, according to a study published in the International Journal of STD & AIDS. (16)
Because the HIV infection compromises the immune system, the body may contract bacterial, fungal, and viral infections even in the initial stages. Nausea is your body’s way of letting you know your system is under attack by these infections.
Furthermore, if you have recently engaged in any of the high-risk behaviors mentioned earlier and have been feeling nauseated regularly, it might be indicative of HIV.
Diarrhea is a disorder of the gastrointestinal tract caused by bacterial, fungal, or viral infections attacking the body when the immune system is weak and fighting an HIV infection. (17)
A common symptom of early HIV, diarrhea severely damages the quality of life of the patient and interferes with his or her routine activities.
11. Yeast infection
Yeast infections are more prevalent among women than men and stem from microscopic fungi that thrive naturally in our mouths and vaginas. Initial exposure to the HIV virus leads to the rapid proliferation of these fungi, often resulting in a full-blown yeast infection. (18)
While HIV has often been associated with subsequent yeast growth, often the infection is rooted in some other underlying health condition such as diabetes or no health condition at all. In fact, women, in particular, are prone to developing this infection without any other culpable cause.
Thus, a symptom such as this cannot suffice to indicate an HIV infection. Instead, one should ideally get the condition checked by a medical practitioner to determine if HIV has a role and then pursue the recommended course of testing and treatment.
Late symptoms (progression to AIDS)
Symptoms that indicate that your HIV infection has progressed to its final stage, that is, AIDS, can include the following:
- You tend to become visibly weaker due to rapid weight loss.
- You tend to experience repeated episodes of fever or profuse night sweats.
- You are plagued by a constant state of extreme and unexplained fatigue.
- You might notice swelling in your lymph glands, including the groin, neck, and armpits, which will persist for an extended period of time.
- You are likely to get loose stools that would last for more than a week.
- Your mouth, anus, or genitals might become painful.
- You may suffer through bouts of pneumonia.
- You are likely to develop red, brown, pink, or purplish blotches on or under the skin as well as inside the nose, eyelids, or mouth.
- You might grapple with neurological disorders such as memory loss and depression.
Because all of the above-mentioned symptoms are not exclusive to AIDS alone and can be indicative of some other unrelated illness, the only way to get a clear diagnosis is to get tested.
If the diagnosis turns out to be AIDS, most of these symptoms can be traced back to one or the other opportunistic infection or illness that may have found its way into your body because of the severely compromised immune system.
The Difference Between HIV and AIDS
It is incorrect to use HIV and AIDS interchangeably. While an HIV infection is a starting point, AIDS is its most advanced and final stage. Thus, a person with HIV need not progress to this late-stage condition called AIDS, but a person with AIDS has to have contracted HIV first.
HIV is a virus that targets and destroys a type of white blood cell called a CD4 cell, thereby diminishing the body’s natural immunity against infection and illness over time. AIDS, on the other hand, is the final outcome, which manifests itself in the form of a syndrome when an HIV patient fails to undergo the stipulated treatment.
Conversely, people who get tested and diagnosed early and subsequently adhere to the doctor-prescribed treatment regimen for HIV are unlikely ever to develop AIDS.
Risk Factors That Can Predispose You to HIV
The odds of sexually contracting an HIV infection is higher among the following groups:
- People who engage in unprotected sex (sex without condoms)
- Gay and bisexual women as well as transgender women who indulge in same-sex activity
- People with multiple sex partners or high-risk partner(s) (if your sexual counterpart has multiple sex partners, is a male who has sex with other men, or shares needles and injection equipment with other users)
- People with an active or recent case of a sexually transmitted infection, such as syphilis or active herpes (19)
- People who inject drugs or steroids, especially if they share needles, syringes, cookers, or other equipment used to inject drugs
- Babies who are born to HIV-positive mothers
Although HIV is a lifelong disease without a cure, early diagnosis and adequate medical care, including a treatment called antiretroviral therapy, can allow patients to live a more normal and long life.
Moreover, getting tested also helps lower the chances of transmitting the virus to healthy individuals.