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HIV Infection and AIDS

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HIV Infection and AIDS

The information provided here is meant to answer some of the most commonly asked questions about HIV and AIDS. It does not replace your need to talk to a health care provider if you have HIV infection or AIDS, or if you have been exposed to, or are at risk of exposure to, HIV infection.

What is HIV infection?
What is AIDS?
How does someone get HIV infection?
What are the risk factors for HIV infection?
How can you protect yourself from getting HIV infection?
What are some symptoms of HIV infection and AIDS?
Can infection with HIV lead to other health problems?
What is the impact of HIV infection on pregnancy?
How is HIV infection diagnosed?
Is there a treatment or cure for HIV infection or AIDS?

What is HIV infection?

HIV is human immunodeficiency virus, the organism that causes AIDS. HIV is found in body fluids (particularly blood, semen, vaginal secretions, and breast milk) of persons infected with the virus. A person can be infected with HIV and not know it. It is currently believed that most people infected with HIV will develop AIDS. However, they can be infected with HIV for many years (often more than 10 years) before they develop AIDS.

What is AIDS?

AIDS (acquired immunodeficiency syndrome) is a condition caused by HIV. It occurs when a person's immune system is weakened due to HIV infection, which limits the body's natural ability to fight other infections and diseases. The U.S. Centers for Disease Control and Prevention defines AIDS as occurring in a person who:

  • Has laboratory-documented HIV infection
  • Has had a CD4 (a certain type of infection-fighting cell) count less than 200
  • Has had one or more AIDS-defining illness (some of which are listed below):
    • Candidiasis (a yeast infection of the esophagus or respiratory tract)
    • Invasive cervical cancer
    • Cryptosporidiosis of more than one month's duration (diarrhea caused by a parasite)
    • Cytomegalovirus (CMV; a virus that may attack many organ systems)
    • Herpes simplex virus infection (HSV); chronic ulcers
    • Kaposi's sarcoma (a type of cancer usually occurring in the skin)
    • Lymphoma (a type of cancer usually involving the lymph nodes or spleen)
    • Mycobacterium avium complex (a bacterial infection that causes fever, weight loss, and gastrointestinal disease)
    • Pneumocystis pneumonia (PCP; a lung infection)
    • Recurrent bacterial pneumonia
    • Toxoplasmosis brain infection (a disease caused by a parasite)
    • Tuberculosis (TB; an infectious disease that often affects the lungs)
    • Wasting syndrome (significant weight loss, diarrhea, and fever)

Living with AIDS is like living with any other chronic disease. Sometimes a person with AIDS suffers from infections and feels sick. At other times, a person may feel fine and participate in normal activities.

How does someone get HIV infection?

HIV infection is spread through blood and body fluids (primarily semen, vaginal secretions, and breast milk) of infected individuals. It can be transmitted through:

  • Sexual contact (primarily unprotected vaginal or anal intercourse). Transmission through oral sex can occur, but the risk is much lower.
  • Blood and other body fluids, by:
    • sharing needles, IV drugs, and drug paraphernalia
    • receiving transfusions of infected blood or blood products and/or transplant of an infected organ
    • using contaminated skin-piercing instruments (needles, syringes, razor blades, tattoo needles, or circumcision instruments)
    • becoming injured from contaminated needles or other sharp objects
    • getting splashed with infected blood or body fluids onto mucous membranes (such as eyes)
  • Perinatal modes (passed from mother to infant during pregnancy, childbirth, or breastfeeding)

Some individuals may not have any symptoms and not know that they are infected with HIV. However, they can still transmit the virus to others. You cannot tell if a person is infected with HIV just by looking at him or her. However, a person cannot get HIV from:

  • Ordinary social contact
  • Shared clothing
  • Touching
  • Shared food, dishes, or eating utensils
  • Kissing and hugging
  • Shaking hands
  • Toilet seats
  • Insect bites
  • Tears
  • Saliva
  • Sweat
  • Living or working with an HIV-infected person

What are the risk factors for HIV infection?

Certain behaviors place people at risk for HIV. People are not at risk simply because of who they are. The primary risk factors for HIV include:

  • Engaging in unsafe sex
  • Having sex with more than one partner or with a partner who has or has had more than one partner or who uses or has used IV drugs
  • Sharing needles, IV drugs, and drug paraphernalia
  • Receiving a transfusion or treatment with blood or blood products
  • Getting a tattoo or piercing
  • Having a job (such as a health care worker) that exposes one to blood or other body fluids

Having an STI also increases the risk of transmitting or acquiring HIV.

How can you protect yourself from getting HIV infection?

Your chance of becoming infected with HIV can be reduced by avoiding high-risk behaviors. Abstinence is the only sure way to prevent getting HIV through sex. Your risk of HIV infection from sex is low if you have been in a long-term monogamous relationship with an uninfected person. The best way to prevent HIV infection is to abstain from unsafe sexual and drug using practices.

To reduce your risk:

  • Use latex or polyurethane condoms during sex
  • Limit your number of sex partners
  • Avoid sharing needles, IV drugs, and drug paraphernalia
  • Avoid having sex with partners who have risky behaviors
  • Avoid using skin-piercing instruments that have not been disinfected
  • Health care workers should practice standard precautions at all times

Remember: You cannot tell if someone is infected with HIV just by looking at them.

What are some symptoms of HIV infection and AIDS?

Persons infected with HIV infection may not have any symptoms. It can take 10 years or more between HIV infection and the diagnosis of AIDS. Now, with advances in treatment, this time lag may even be lengthened. Once symptoms begin to develop, they may include:

  • An unexplained loss of weight lasting at least one month
  • Diarrhea for several weeks or more
  • A white coating on the tongue
  • Enlarged or sore glands in the neck, armpit, and/or other parts of the body
  • A cough that persists for more than one month
  • Persistent fever and/or nightsweats
  • Persistent vaginal yeast infections

Since these symptoms may be caused by other diseases, a test must be done to confirm the presence of HIV.

Can infection with HIV lead to other health problems?

HIV weakens the immune system making a person infected with HIV susceptible to many infections that the body is normally able to fight off. These are often referred to as opportunistic infections or AIDS-defining illnesses. Many conditions may be especially severe, difficult to treat, and recurrent in individuals with HIV infection.

What is the impact of HIV infection on pregnancy?

Babies born to mothers with HIV infection can contract the HIV virus during pregnancy, labor, delivery, and breastfeeding. About 20% of the newborns of untreated mothers in the United States will get HIV infection; percentages of transmission are higher in some parts of the world.

There are now some treatment options (HIV antiviral drugs) that can greatly reduce the rate of transmission of HIV from mother to child. If you are a pregnant woman infected with HIV, you should talk to your health care provider about options for preventing transmission.

Because the HIV virus can also be transmitted through breast milk, HIV-positive mothers are advised not to breastfeed their newborns. However, in areas of the world where infant and childhood infections are common and can be fatal, the risk of HIV transmission must be weighed against the risks associated with not breastfeeding.

How is HIV infection diagnosed?

There are blood tests to determine if a person is infected with HIV. Diagnosis of HIV infection is made by detection of antibodies to HIV on the same blood sample by a test called an ELISA and confirmation by another test--the Western Blot. Because these tests look for antibodies rather than the actual virus, it is possible that during the time between when infection occurs and when antibody levels are high enough to be detected, an HIV test will be negative even if the person is actually infected with HIV. This "window period" varies from one person to the next. Therefore, persons who think that they might be infected should wait 2-6 months since their last possible exposure before getting tested.

There are other blood tests that can look for the actual presence and amount of virus in the blood. However, these tests are very expensive and used primarily in treatment decisions for persons already known to be HIV-infected.

Is there a treatment or cure for HIV infection or AIDS?

Currently, there is no cure for HIV infection or AIDS. However, with the combined use of new antiviral drugs (known as combination therapy) as well as drugs to prevent opportunistic infections, many people with HIV infection and AIDS have extended and improved the quality of their lives and delayed the progression of HIV infection to AIDS. These drugs can cause a number of side effects that may require that a person switch to other drugs or stop taking them. In addition, combination therapy requires taking a large number of pills on a complicated schedule. These drugs are also very costly and unavailable to many people in industrialized countries as well as in many parts of the world, where the majority of individuals with HIV infection and AIDS live.



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