HIV: The Causes, Signs, Symptoms, and How to Diagnose HIV

What is HIV?

Human immunodeficiency virus (HIV) is a virus that attacks the cells in the body that fight infection. As it affects the immune system, you become vulnerable to other diseases and conditions.

Untreated HIV affects and kills CD4 cells, also known as T cells. This makes individuals with HIV more likely to get cancers and other kinds of conditions.

This disease is often spread by contacting the bodily fluids of a person with HIV.

What is AIDS?

Acquired immunodeficiency syndrome (AIDS) is a type of disease that develops in people who have HIV. This is one of the most advanced stages of HIV, but it doesn't mean that everyone with HIV develops AIDS. An individual with HIV whose CD4 count falls below 200 per cubic millimetre millimetre is diagnosed with AIDS.

What's the difference between HIV and AIDS?

The main difference between HIV and AIDS is that HIV is the virus that weakens the immune system. AIDS, on the other hand, happens due to an HIV infection when your immune system is severely weakened.

What does HIV do to a person?

HIV infects the CD4 cells or helper T cells in the immune system. As the CD4 cells get destroyed, it can cause the white blood cell count to drop. A compromised immune system prevents you from fighting off infections even if these things do not usually make you sick.

The initial HIV symptoms are similar to that of a common flu. It can then stay within your body long without showing any noticeable signs. It takes this time to destroy the T-cells slowly. As the number of these cells reduces, HIV progresses to AIDS.

AIDS can cause symptoms like rapid weight loss, extreme tiredness, mount or genital ulcers, fevers, night sweats, and skin discolouration. These are usually the first signs and symptoms of HIV that most people notice.

What's a retrovirus?

A retrovirus is a virus that does the opposite of what human cells do. The DNA in human cells sends messages through the RNA to the body's building blocks (proteins). On the other hand, a retrovirus has its own set of instructions written on its RNA. When these retroviruses invade your cells, they alter their RNA to look like your cell's DNA and insert themselves into your cells. Due to this, your cell believes that the virus' instructions are its own.

HIV is a retrovirus that invades your cells and uses the cell's replication mechanism to make replicas of itself. Along with this, it also alters your DNA.

Who does HIV affect?

Anyone who is exposed to HIV may start to show HIV symptoms. Things like having unprotected sex or sharing a needle with someone with HIV help spread the disease. However, a few groups of individuals are statistically more likely to be affected by HIV. This includes:

• People who are bisexual, homosexual, and men who prefer sex with men.
• Some races, like Hispanics and Blacks
• Sex workers and others who exchange sex for money or other items.

Most of these groups face unique barriers to testing, preventive care, and treatment. Factors like homophobia, poverty, social stigma around HIV, and homophobia prevent people from getting the treatment they need.

How common is HIV?

Although the number of individuals showing signs of HIV has decreased, it remains a global public health issue. According to the WHO, around 39 million people live with HIV.

What are the symptoms of HIV?

As mentioned, you can live a long life without any signs and symptoms of HIV. This is why everyone who thinks they may be at risk of this disease needs to get tested, even if they are not sick.

When you first get infected, you may experience flu-like HIV symptoms, including:

• Fever
• Chills
• Sore throat
• Fatigue
• Rash
• Muscle ache
• Night sweats
• Mouth sores
• Swollen lymph nodes

Other HIV symptoms after six months of infection could include a weakened immune system and frequent infections.

What are the stages of HIV?

Differentiating HIV into stages helps healthcare professionals understand the kind of treatment and disease management approach you need to be able to live with this condition. Although HIV cannot be cured, you would need continuous treatment to ensure it doesn't reach a severe stage. The advanced HIV treatment options available today can slow down the progression of HIV to Stage 3 (AIDS), making it a less common disease as compared to the early years.

These are the stages of HIV that you need to keep in mind to be able to recognize and get the required treatment.

Stage I

This stage of HIV is the stage of acute HIV infection. At this stage, the person has a large amount of HIV in their blood, making them highly contagious. Most people display the known flu-like HIV symptoms. If you have developed these flu-like HIV symptoms and think you may have been exposed to the virus, it is best to get tested and receive treatment immediately.

Stage II

At this stage of HIV, you may not experience any HIV symptoms, but the HIV is still active and continues to reproduce in your body. This is the stage of chronic HIV infection, also known as asymptomatic HIV infection or clinical latency. Although the individuals do not show signs of sickness at this stage, they can still transmit the disease.

This stage of HIV can last for a long time, and in some cases, with the proper medication, you may never move into stage III of HIV. However, this stage lasts a decade or a little longer without treatment before progressing into Stage III, AIDS.

Stage III

Acquired Immunodeficiency Syndrome (AIDS) is the most severe stage of HIV infection; during this stage, the individuals have a very high viral load and can easily transmit this to others. People with AIDS have a highly damaged immune system and can acquire more opportunistic infections or other severe illnesses like cancer. People who reach this stage can survive for about three years without treatment.

What are the symptoms of AIDS?

Most of the symptoms of AIDS are related to those illness that has taken advantage of your compromised immune system.

How is HIV/AIDS caused?

You must want to know how is HIV/AIDS caused. HIV is caused by the human immunodeficiency virus, which attacks the helper T-cells of your immune system, leaving it weak. When you have few immune cells left to fight off illnesses, it can cause AIDS.

How does HIV spread?

HIV is spread through bodily fluids like semen, blood, vaginal fluids, rectal fluids, and breast milk of an infected individual.

Can you get HIV from kissing?

As HIV cannot be spread through spit, kissing is not a common way this infection spreads. However, in cases where both individuals have open sores or bleeding gums, there is a slight chance the infection can spread with open-mouth kissing.

HIV is also not spread by:

• Hugging or touching someone with HIV
• Using a swimming pool or public bathroom
• Sharing cups, telephones, and utensils with individuals who have HIV/AIDS
• Donating blood
• Bug bites

How can I know if I have HIV?

An HIV infection is not evident by just looking at the individual. 1 out of 7 infected people do not even know they have HIV. Since there are few identifiable signs and symptoms of HIV, the only way to see if you are infected is to take an HIV test. The Centers for Disease Control and Prevention recommends that all individuals between the ages of 13 and 64 need to get tested for HIV at least once as part of their routine healthcare. This is a voluntary test; most diagnostic centres keep the results confidential.

How is HIV diagnosed?

A blood or saliva test is used to diagnose HIV. You can take the test at home, at a healthcare provider clinic, or at a testing facility near your locality. You do not need to get tested again if:

• You haven't been exposed to the virus three months before testing
• You haven't had any possible exposure within the window period for a test done with a blood draw. Talk to your doctor if you are unsure of the window period of the test you took.

If you were possibly exposed to the virus within three months of the test, consider taking another to confirm your negative results. In case, your preliminary test comes positive, you must do a few follow-up tests to confirm your results.

What tests diagnose HIV?

Three types of follow-up tests are done to confirm a positive HIV test result.

Antigen/antibody test

The antigen tests you for antigen markers on the surface of HIV, known as p24. The antibody part of the test checks for the chemicals your body makes when it reacts to the p24 markers. This (p24 test)antigen/antibody test checks for both these components.

During this test, your healthcare provider will take a small sample of your blood and send it to the lab to test for p24 and its antibodies. This test can detect HIV after 18 to 45 days of exposure.

You can also do a rapid antigen/antibody test requiring a finger prick to draw blood. This test also needs to be done 18 days after exposure for the test to detect the virus. However, you may also need to repeat the test after 90 days for accurate results.

Antibody test

This test looks for antibodies to HIV present in your blood or saliva. For this test, a blood sample is collected from your arm or with a finger prick, or a small stick is rubbed across your gums for a saliva sample.

For an antibody test to detect HIV, it needs to be done after 23 to 90 days of exposure. Antibody tests done with blood samples can test HIV quicker than those done with finger pricks or saliva samples.

Nucleic acid tests (NATs)

This test looks for the HIV in your blood. A small blood sample is collected through your arm and sent to the lab for testing. A NAT can detect HIV around 10 to 33 days after exposure to the virus. This test is only used in cases where you have had high-risk exposure.

If your test comes back positive, your doctor may suggest other tests that help to assess your health. These may include a complete blood count (CBC), along with:

• Viral hepatitis screening
• Chest X-ray
• Pap smear
• CD4 count
• Tuberculosis

Are there at-home tests for HIV?

You can get at-home HIV test kits, some of which are rapid tests where you would need to use a swab (a stick with a soft, flexible tip) to collect a saliva sample from your gums. You would then need to put the stick in a unique solution that gives you the results within 15 to 20 minutes.

Some other at-home tests use a simple device to prick your finger and draw blood. This drop of blood then needs to be put on a card and sent via mail to get your results.

If any of these tests come positive, you must contact your healthcare provider for further testing and confirm your results.

Is there a cure for HIV?

Currently, there is no known cure for HIV. However, several treatment options help to slow down the progression of the condition significantly.

How is HIV treated?

HIV can be treated by combining oral medications known as antiretroviral therapy (ART).

Using a combination of pills rather than just one is considered the most effective way to stop HIV from multiplying and destroying your cells. You can also find combination pills containing several medications within a single pill. Your doctor will look at your condition and prescribe the best combination.

ART works towards reducing the viral load of HIV in your blood to one that is not detected by an HIV test while slowing HIV's effect on your immune system.

Medications used to treat HIV

Every type of pill in ART has its own way of delaying HIV from replicating and infecting healthy cells. While there can be various brand names, the basic types of drug remains the same.

These include:

• Nucleoside reverse transcriptase inhibitors (NRTIs)
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
• Fusion inhibitors
• Integrase strand transfer inhibitors (INSTIs)
• Protease inhibitors
• CCR5 antagonists
• Attachment inhibitors
• Post attachment inhibitors
• Combination of HIV medicines
• Pharmacokinetic enhancers

If you take the pills on time, you will have an undetectable viral load that allows you to stay healthy and keep others safe from the disease. However, not taking the drugs on time can lead to drug resistance, reducing your chances of successful HIV treatment.

How can I take care of myself while living with HIV?

Not missing out on your doctor's appointments and taking your medication on time is the best way to care for yourself while living with HIV. If your schedule interferes with the same, talk to your doctor and try to find viable alternatives, if possible.

How can I reduce my risk of getting HIV?

Awareness is one of the best ways of reducing your risk of getting HIV. Knowing the signs of HIV and how it spreads allows you to protect yourself in the most risky situations. Having unprotected sex and sharing needles are the most common reasons for catching this disease. Here are some ways to reduce this risk.

• Use a condom whenever you have sex, whether anal, oral, or vaginal.
• Avoid using condoms made from animal products.
• Only use water-based lubricants.
• Never share needles.
• Get tested and treated for STIs immediately, as other STIs increase your risk of an HIV infection.
• If you are at a high risk of HIV exposure, speak to your healthcare provider about pre-exposure prophylaxis.
• If you have been exposed to HIV, talk to your doctor about post-exposure prophylaxis.
• Get tested for HIV often to avoid spreading it to others.

Using a condom ensures you protect yourself against HIV. Use a condom for any sexual act. Dental dams or internal condoms help you preserve your vagina or anus. A dental dam is a flat piece of polyurethane or latex put in your vagina or naus during oral sex. An internal condom, also known as a female condom, is inserted into the vagina or anus. Male and female condoms should not be used together.

Can medications prevent HIV?

If you are at high risk of being exposed to HIV or have already been exposed to HIV, a few medications can help you prevent this disease. This includes:

Pre-exposure prophylaxis (PrEP)

You will need to take this pill every day if you are at high risk of getting infected by HIV but haven't been infected yet. This is specifically recommended to individuals who do not have HIV but have had anal or vaginal sex in the past six months, and at least one of the following is true.

• Your sexual partner has HIV.
• You haven't been consistent while using a condom.
• You have been diagnosed with a sexually transmitted infection (STI) in the past six months.

It is also recommended for those who don't have HIV but inject drugs and at least one of the following conditions is true.

• You share needles and other tools used to inject drugs.
• You inject drugs with a partner who has HIV.

Even while taking PrEP, it is essential to maintain preventative measures like using a condom and not sharing needles to do drugs.

Post-exposure prophylaxis (PEP)

This is used to try and prevent HIV after you have been exposed to the virus. This treatment is used for someone who doesn't have HIV or if you don't know if you have HIV and think you must have been exposed. Either due to consensual sex, sexual assault, shared needles, or work.

PEP must be started within 72 hours of exposure to the virus and taken daily for 28 days. This is only for emergency use and cannot replace preventative measures.

What can I expect if I have HIV?

After receiving a positive result of an HIV test, it is essential to know that you can live a full and fulfilling life if you follow your doctor's treatment guidelines. If you have a high CD4 count and undetectable viral load within a year of starting your HIV treatment, you will have the best outcome if you continue the treatment.

Here are a few ways to improve your overall outlook:

• Getting tested regularly and if you think you may have been exposed to the virus.
• Starting ART as soon as you are diagnosed
• Taking your pills every day
• Don't miss your appointments with your healthcare team.

As ART is only responsible for keeping your blood levels undetectable, it does not eliminate the virus from your body. Not being regular with your medication can cause the virus to multiply and mutate, making the drug ineffective.

If an HIV infection is left untreated, it can take around ten years to advance to AIDS. If the condition has progressed to AIDS and still goes untreated, the life expectancy is around three years.

Those on treatment and with a high CD4 count and undetectable viral load within a year of starting your treatment can expect to live almost as long as someone without HIV. Those with a low CD4 count or a detectable load within the first year of starting treatment have a life expectancy of around 10 to 20 years less than someone without HIV.

Does HIV go away?

HIV can never go away for good or on its own. It is a retrovirus that inserts itself into your DNA so that your cells think it's a part of their own. Many individuals have lived with HIV for many years without showing any symptoms. However, the virus still damages your cells even when you don't feel sick.

HIV can also hide in your body undetected for specific periods while you are on medication. However, stopping the medication or missing a few doses can destroy your cells all over again.

This is why it is essential to continue taking your HIV medication on time.

How do I take care of myself with HIV?

One of the best ways to care for yourself while infected with HIV is to follow your treatment plan.

• Take your medication as prescribed by your doctor and on time.
• Show up to all your appointments and monitor your feelings to know if your treatment plan needs to be adjusted.
• Listen to your healthcare provider's instructions on how to avoid additional illnesses.

If I have HIV, how can I keep from spreading it to others?

Preventing the spread of HIV is very similar to protecting yourself from it. Here are a few points to remember to avoid the spread to others.

• Informing sexual partners that you have HIV is the start of ensuring they take suitable precautions to avoid the spread of HIV. Also, avoid sharing the needles injected into you.
• Talk to your sexual partner about getting themselves a PrEP prescription.
• Follow your treatment plan without missing any dose. Individuals with an undetectable viral load significantly reduce the risk of transmitting HIV to someone else through sex.
• Always wear a condom when having sex (oral, vaginal, or anal)
• Limit your sexual partners
• Dont share needles or other drug-injecting equipment
• If you are pregnant and have HIV, follow your treatment plan and ART to reduce the risk of transmitting the virus to your fetus.

Can I get pregnant if I have HIV?

Women living with HIV who want to start a family can talk to their healthcare provider about the available options. You can devise a plan together that helps you keep your future child and your partner safe from the virus.

You risk spreading HIV to your partner during unprotected sex and to your baby during pregnancy, childbirth, and breastfeeding. Following your ART medications can help reduce the risk of transmitting HIV to your baby, especially if you maintain an undetectable viral load. In some cases, your doctor may suggest using formula instead of breastfeeding.

Conclusion

HIV is a global health risk that does not have a cure. However, technological advances and drug combinations can effectively manage this disease. Getting tested often, especially if you are at high risk of exposure, ensures you get timely treatment and can live a long and fulfilled life. Diagnostic centres like Metropolis Labs offer home sample collection and confidential results to ensure your privacy is retained. Check out the list of services offered.