By Sola Ogundipe,  Health Editor

Human Immunodeficiency Virus (HIV)

HIV stands for human immunodeficiency virus. Unlike some other viruses, the human body can’t get rid of HIV completely. So once you have HIV, you have it for life. HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. If left untreated, HIV reduces the number of CD4 cells in the body, making the person more likely to get infections or infection-related cancers.

Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS, the last state of HIV infection.

Acquired immunodeficiency Syndrome (AIDS)

AIDS is the final stage of HIV infection that occurs when the immune system is badly damaged and you become vulnerable to  opportunistic infections. Not everyone who has HIV advances to this stage. AIDS is the stage of infection that the number of CD4 cells falls below 200 cells/ (Normal  CD4 count of an uninfected adult/adolescent who is generally in good health ranges from 500 cells/mm3  to 1,600 cells/mm3.) You can also be diagnosed with AIDS if you develop one or more opportunistic infections, regardless of your CD4 count.

Without treatment, people diagnosed with AIDS typically survive average of three years. Once someone has a dangerous opportunistic illness life expectancy without treatment falls to about one year. People with AIDS need medical treatment to prevent death.

How HIV spreads

Most commonly, people get or transmit HIV through sexual behaviour and needle or syringe use. HIV is not spread easily. Only certain body fluids from a person who has HIV can transmit HIV: These include blood, semen, pre-seminal fluid, vaginal fluids and breast milk. These body fluids must come into contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (by a needle or syringe) for transmission to occur.

Mucous membranes are found inside the rectum, vagina, penis, and mouth. Anal sex is the highest-risk sexual behaviour; vaginal sex is the second highest-risk sexual behaviour. Sharing needles or syringes or other equipment used to prepare injection drugs with someone who has HIV that can live in a used needle for days depending on temperature and other factors.

Less commonly, HIV may be spread from mother-to- child during pregnancy, birth, or breastfeeding. Although the risk can be high if a mother is living with HIV and not taking medicine. In extremely rare cases, receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV are risky.

HIV does not survive long outside the human body (such as on surfaces) and it cannot reproduce outside a human host. It  is not  spread by air or water; mosquitoes, ticks or other insects, shaking hands, hugging, sharing toilets, dishes/drinking glasses, or closed-mouth or “social” kissing with someone who is HIV-positive.

 Know your HIV status

You cannot rely on symptoms to tell whether you have HIV.  The only way to know for sure if you have HIV is to go for the HIV antibody test. Knowing your status is important because it helps you make healthy decisions to prevent getting or transmitting HIV. After you get tested, it’s important to find out the result of your test so you can talk to your health care provider about treatment options if you’re HIV-positive or learn ways to prevent getting HIV if you’re HIV-negative.

You are at high risk of transmitting HIV to others during the early stage of HIV infection, even if you have no symptoms. For this reason, it is very important to take steps to reduce your risk of infection.

If you have HIV and you are not on ART, eventually the virus will weaken your body’s immune system and you will progress to AIDS.

 If you have HIV, does that mean you have AIDS?

No. “HIV” refers to the virus itself, and “AIDS” refers to the  late stage of HIV infection, when an HIV-infected person’s immune system is severely damaged and has difficulty fighting diseases and certain cancers. Today, most people who are HIV-positive do not progress to AIDS. That’s because if you have HIV and you take ART consistently, you can keep the level of HIV in your body low. This will help keep your body strong and healthy and reduce the likelihood that you will ever progress to AIDS. It will also help lower your risk of transmitting HIV to others.

 Diagnosis

HIV is most commonly diagnosed by testing blood or saliva for antibodies to the virus. Unfortunately, it takes time for your body to develop these antibodies — usually up to 12 weeks. A newer type of test that checks for a protein produced by the virus immediately after infection, can quickly confirm a diagnosis soon after infection. An earlier diagnosis may prompt people to take extra precautions to prevent transmission of the virus to others.

If you receive a diagnosis of HIV/AIDS, tests can help determine what stage of the disease you have. CD4 count –  CD4 cells are a type of white blood cell that’s specifically targeted and destroyed by HIV. Even if you have no symptoms, HIV infection progresses to AIDS when your CD4 count dips below 200.

Viral load –  This test measures the amount of virus in your blood. Studies have shown that people with higher viral loads generally fare more poorly than do those with a lower viral load.

Drug resistance –  This blood test determines whether the strain of HIV you have will be resistant to certain anti-HIV medications.

 Complications

Lab tests to check for other infections or complications, including Tuberculosis, hepatitis, toxoplasmosis, sexually transmitted infections, liver or kidney damage and Urinary Tract Infections.

 No cure yet

No effective cure for HIV currently exists, but with proper treatment and medical care, HIV can be controlled. Drugs used to treat HIV, (antiretroviral therapy or ART, if taken the right way, every day, can dramatically prolong the lives of many people with HIV, keep them healthy, and greatly lower their chance of transmitting the virus to others.

 When to start treatment

Everyone with HIV infection, regardless of CD4 count, should be offered antiviral medication. HIV therapy is particularly important if there are severe symptoms, an opportunistic infection or the CD4 count is under 350. Pregnancy, an HIV-related kidney disease or treatment for hepatitis B or C are also significant.

Treatment can be difficult. HIV treatment regimens may involve taking multiple pills at specific times every day for the rest of your life. Monitoring of the viral load and CD4 counts is crucial to determine response to treatment. Viral load should be tested at the start of treatment and then every three to four months during therapy. Also, CD4 counts should be checked every three to six months.

HIV treatment should reduce viral load to the point that it’s undetectable. That doesn’t mean the HIV is gone or the person ids “cured”. It just means that the test isn’t sensitive enough to detect it. You can still transmit HIV to others when your viral load is undetectable.

 Prevention

There’s no vaccine to prevent HIV infection and no cure for AIDS. But it’s possible to protect yourself and others from infection. That means educating yourself about HIV and avoiding any behaviour that allows HIV-infected fluids — blood, semen, vaginal secretions and breast milk — into your body.

To help prevent the spread of HIV follow the ABC (Abstinence, Be faithful and use Condom rule). If you don’t know the HIV status of your partner, use a new condom every time you have sex. Precautions

 Tell your sexual partners if you have HIV –  It’s important to tell anyone with whom you’ve had sex that you’re HIV-positive. Your partners need to be tested and to receive medical care if they have the virus. They also need to know their HIV status so that they don’t infect others.

Use clean needles –  If you use a needle to inject drugs, make sure it’s sterile and don’t share it. Take advantage of needle-exchange programmes in your community and consider seeking help for your drug use.

 If you’re pregnant, get medical care right away –  If you’re HIV-positive, you may pass the infection to your baby. But if you receive treatment during pregnancy, you can cut your baby’s risk significantly.

 Consider male circumcision –  There’s evidence that male circumcision can help reduce a man’s risk of acquiring HIV.

 Living with HIV

Coming to terms with HIV diagnosis may be difficult and the emotional, social and financial consequences can make coping with especially difficult — not only for the patient, but also for others. But HIV infection is no longer a death sentence. There are so many persons that have been living with HIV for years and they remain strong and healthy.

Numerous services and resources are available and that are clinics with social workers, counsellors or nurses who can help with problems directly or put you in touch with people who can.