HIV Infection and AIDS

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KEY POINTS

• HIV is the virus that causes AIDS. With time, HIV weakens your body’s ability to fight off serious infections and some cancers. When this happens, HIV infection becomes AIDS, which can be life threatening.
• Medicines can slow down the disease, but they are not a cure. Your treatment for HIV/AIDS may include treatment or prevention of other types of infections, tumors, or heart problems.
• The best way to prevent infection with HIV is to practice safe sex and not use illegal drugs. If you have been exposed to HIV, there are medicines that may be used to prevent infection. The treatment must be started as soon as possible and no more than 72 hours after the exposure.

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What are HIV and AIDS?

HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immunodeficiency syndrome). HIV attacks the body's immune system. The immune system is the body's defense against infections. With time, HIV weakens your body’s ability to fight off serious infections and some cancers. When this happens, HIV infection becomes AIDS. AIDS can be life threatening, but it is also a preventable disease.

The full effects of the infection may not show up until 5 to 10 years after you are infected with the virus. New treatments help people to live longer with the disease.

What is the cause?

The infection-fighting cells of the immune system are a type of white blood cell called CD4 cells or T-helper cells. Months to years after infection with HIV, the virus begins to destroy these cells. HIV infection becomes AIDS when so many of the CD4 cells are destroyed that you lose your ability to fight off serious infections or tumors. Various infections called opportunistic infections develop. They are called opportunistic because they take advantage of your weakened immune system. These infections would not normally cause severe or fatal health problems. However, when you have AIDS, the infections and tumors are more serious and are harder to treat successfully.

HIV spreads from person to person when infected blood or sexual secretions, such as semen, enter the body. Men, women, and children of all ages can get HIV. You can get infected with HIV through:

• Unsafe sex
• Needles used by anyone other than you such as when injecting drugs, checking your blood glucose, or getting a tattoo
• Transfusion of blood or blood products in countries where donated blood is not carefully tested

Babies can get infected before they are born or from the breast milk from an infected mother.

HIV is not spread through the air, in food, or by casual social contact such as shaking hands or hugging.

What are the symptoms?

It is important to remember that HIV usually does not cause any symptoms for many months or even a couple years. When you do start having symptoms, they are usually the symptoms of the other infections or tumors that are able to attack the body because of the HIV infection:

• Fever
• Loss of appetite or weight
• Nausea and vomiting
• Tiredness
• Swollen glands
• Sore throat
• Sores on the skin or mouth
• Repeated, severe infections in the mouth or vagina despite treatment
• Muscle and joint pain
• Diarrhea
• Headache
• Blurry vision or other problems with vision

AIDS can also affect the heart and cause:

• Inflammation of the heart muscle, which makes it harder for the heart to pump
• An enlarged and weakened heart muscle
• Inflammation of the sac around the heart may cause chest pain or a buildup of fluid around the heart. Pressure from the fluid may make it harder for the heart to pump blood.
• Infection of the tissue that lines the inside of the heart, which can also severely damage the heart valves

How is it diagnosed?

Tests for HIV are done in 2 steps.

1. The first step is a screening test of your blood or saliva. If this test is negative, it usually means that you don't have HIV. However, it is possible to have a negative test if you have just recently been infected with the virus. If you have a negative test result but you are at high risk for infection, you may need to have this test again within 1 month and then in 3 to 6 months.
2. If the screening test is positive, it means that you are probably infected with HIV. A second, more specific blood test is then done to confirm the results.

Having an HIV test at your healthcare provider’s office or a clinic usually takes about 20 minutes.

• At your home, you can use a test kit that you can buy at most pharmacies or drug stores. Look for a test that is approved by the US Food and Drug Administration (FDA). Other tests may not give you reliable results. Tests include:
  • A blood test uses a small sample of blood from a prick of your finger. You mail the sample to a lab, where a healthcare professional will test the sample for HIV. In about a week, you can call a toll-free number to get your test results.
  • A mouth swab test shows your results in just a few minutes.

Once you have confirmed positive HIV test results, your provider will ask about your symptoms and medical history and examine you. Your healthcare provider will also ask about your history of sexual practices and infections and any history of drug use. When you test positive for HIV, the results are reported (without giving your name) to the local health department and your sexual partners. This will help your partners get prompt testing and treatment for the infection. It can also help prevent new infections.

You will also be tested for other infections or problems that can get worse when you have HIV or AIDS.

How is it treated?

Medicines can slow down the disease, but they are not a cure. Many new drug treatments and combinations are being prescribed. You may need to have lab tests every few weeks or months to see how the virus is affecting your body and how well your treatment is working. Your treatment for HIV/AIDS may include treatment or prevention of other types of infections or problems.

Heart problems caused by AIDS may be treated with medicines. If you have fluid around your heart, the fluid may need to be removed. Valve problems may be treated with surgery.

Getting care in an office or clinic that offers case management can be an important part of your treatment. This means a team of providers will be giving you care and your care will be coordinated by a case manager. The case manager will help you communicate with all who are caring for you. Other advantages include:

• Up-to-date medical care
• Treatment for both the medical and social aspects of your illness
• Help in finding medical, social, and financial resources

How can I take care of myself?

If you have HIV or AIDS, there are things you can do to take care of yourself and help prevent problems.

• Learn about your condition and your treatment options. Discuss your treatment with your healthcare provider.
• Take your medicines exactly as prescribed. Know what to do if you miss a dose.
• See your provider on a regular schedule to keep up to date on new treatments.
• Contact a local AIDS support network. Your provider should be able to help you find one.
• Ask your healthcare provider:
  • How and when you will get your test results
  • If there are activities you should avoid and when you can return to normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.

How can I help prevent HIV infection?

If you do not have HIV or AIDS, the best way to prevent infection with HIV is to practice safe sex and not use illegal drugs.

• Avoid exposure to infected body fluids during sex. Use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex.
• Have just 1 sexual partner who is not having sex with anyone else.
• Don’t use a spermicide containing nonoxynol 9, and don’t use condoms coated with this spermicide. This chemical can irritate the lining of the vagina and rectum and make it easier for the virus to enter the body.
• If you use a lubricant, use one that is water based. Don’t use oil-based lubricants made with petroleum jelly, mineral oil, vegetable oil, or cold cream. They can damage condoms.
• Do not share needles for drug use, tattooing, or body piercing.

In addition:

• Ask any new sexual partner about his or her sexual history, drug use, and tattoos or body piercings.
• If you have not been tested for HIV, get tested and ask sexual partners to be tested for HIV.
• If you have had sex and are worried that you may have been infected, see your healthcare provider even if you don’t have any symptoms.
• If you have been sexually assaulted, you may need to be treated to prevent HIV and other sexually transmitted infections. You should have an exam within a few hours of the assault (and before showering or bathing) even if you don’t want to press charges. Women can also ask about being protected from pregnancy.

If you have been exposed to HIV, there are medicines that may be used to prevent infection. The treatment must be started as soon as possible and no more than 72 hours after the exposure. This preventive treatment is not recommended for people who are often at risk of exposure to HIV, such as people who have sex with HIV-positive partners. There is a daily medicine that can help prevent HIV infection if you are at a high risk of getting infected, such as when you are HIV negative but you have a partner who is HIV positive. However, the medicine may cause side effects and may be costly. It must be used with the usual safe sex recommendations.

If you do have HIV or AIDS, you can prevent spreading HIV to others if you:

• Take your HIV treatment as prescribed.
• Practice safe sex. Tell your partner that you have HIV or AIDS.
• Don’t donate blood, plasma, or semen.
• Don’t donate organs from your body.
• Tell all of your healthcare providers that you are HIV positive and what medicines you take. Discuss any concerns you may have about confidentiality with your healthcare provider.

Women who are HIV positive should talk to their healthcare provider before getting pregnant.

You can get more information from:

• AIDSinfo
  https://aidsinfo.nih.gov
  800-448-0440
• CDC-INFO
  800-232-4636
• CDC National Prevention Information Network
  https://npin.cdc.gov/
  800-458-5231