What is an HIV infection?Human immunodeficiency virus (HIV) is a retrovirus. An untreated HIV infection leads to AIDS after a mostly multi-year, symptom-free phase. Click to enlarge.
The human immunodeficiency virus is known in English as human deficiency virus, or HIV for short. Infection with such viruses is not immediately referred to as an AIDS disease because AIDS first describes the onset of the first symptoms and not the infection with this pathogen itself.
Recognizable symptoms of an infection describe the final stage of HIV, it is now called a disease, the acquired immunodeficiency syndrome - AIDS. HIV infection was first described in the US in the 1980s and is still a treatable, yet incurable and mostly fatal disease.
The most common transmission pathway for HIV infection is unprotected sexual intercourse. About the slightest mucosal injury, the partners get infected unnoticed. The risk of HIV infection is also very high in the transmission of HIV-infected blood, often in the drug milieu when dependent people use syringes and needles from other addicts. A very small proportion of the infected were infected during pregnancy or breastfeeding a sick mother.
In general, a certain amount of viral material is needed for a transfer and this is done via body fluids such as blood, semen, vaginal secretions and breast milk. A droplet infection is not possible. Inadequate education of the population about this disease and a low level of knowledge about the risks of contagion prevent this infectious disease from being contained, especially in South Africa where prevalence is particularly high.
Symptoms, complaints & signs
HIV infection often shows symptoms in the acute phase after infection. These occur within a few days or weeks. They include rash on the upper body, heavy night sweats, mouth sores, fever, fatigue and head and neck pain. In addition, joint pain, swollen lymph nodes and swollen tonsils also occur. Overall, the symptom picture can be very similar to that of flu.
Occasionally it happens that infected people show no symptoms at all. Also almost all symptoms do not occur at the same time, but only some or only one of them. The fact that most of the symptoms are rather unspecific, can not be deduced from this HIV infection.
If the acute phase of HIV infection is over and the body has made antibodies, the symptoms will fade. It comes to a long and symtomlosen latency phase. Finally, if the immune system is sufficiently harmed by HIV, opportunistic infections may occur, the type and amount of which also determines whether AIDS is eventually diagnosed. The transition from HIV infection with serious symptoms to AIDS is fluent in this case. The opportunistic infections include fungal infections, bacterial and viral infections, as well as various other conditions that can occur in immunocompromised individuals.
HIV is one of the retroviruses and it needs the nucleus of a host cell to propagate. Within the disease process of HIV infection, different stages of the disease can be distinguished. After the infection, symptoms that are very similar to a flu and often go unnoticed a few weeks later may appear: fever, diarrhea, headache, swelling of the lymph nodes, body aches.
In the following years, HIV antibodies are detectable in the patient, but the infected can live without symptoms. In the so-called lymphadenopathy syndrome lymph node swelling can occur over several months at various parts of the body and in the AIDS-related complex, a decrease in weight, night sweats and fever can be seen. However, the average life expectancy is only two years at the onset of the full-blown AIDS program; it leads to opportunistic infections and malignant tumors can arise.
HIV infection is associated with many complications. On the one hand, the idea of suffering from an HIV infection is a heavy burden for the person concerned, as it is not curable after the current medical status. This can develop depression. This in turn can cause a weakened self-esteem and associated with sleep disorders, fatigue and loss of performance.
In some cases addictive behavior is compounded with regard to alcohol and drugs, which can have serious consequences. In the worst cases, those affected may have a thought of suicide, which they then subsequently execute. Furthermore, HIV infection can spread untreated and end-stage AIDS can develop.
Those affected are very susceptible to infections and other diseases, so they get sick faster. Even more unusual diseases such as a fungal disease (for example, Candidasoor) or atypical pneumonia now occur frequently. Harmless infections that usually heal spontaneously in healthy people are life-threatening for the AIDS patient.
Rare tumors such as Kaposi's sarcoma can occur especially in AIDS patients. Life expectancy is also lower. AIDS sufferers have a further life expectancy of ten years with therapy, without therapy of only one year. In addition, there is a risk that people infected with HIV can infect other people if they engage in unprotected sexual intercourse.
When should you go to the doctor?
Since an HIV infection in the worst case can lead to the death of the person affected, this disease must always be examined by a doctor. Although a direct treatment is not possible, visits and regular check-ups with a doctor are very useful. In general, permanent fatigue and fatigue may indicate HIV infection. Even severe headaches or body aches occur and are accompanied by diarrhea or vomiting.
Many patients also suffer from fever or loss of appetite due to the HIV infection. If these symptoms therefore occur over a longer period, a visit to a doctor is necessary. Furthermore, many sufferers also suffer from severe itching or a rash on the skin. The susceptibility to infections also increases significantly as a result of the HIV infection, so that those affected suffer more frequently from inflammation and infections.
Restrictions and discomfort to the nerves can also be a sign of HIV infection. If a suspicion exists, the HIV infection can be examined by a general practitioner. The further treatment of the disease depends on the symptoms.
Treatment & Therapy
Basically, the disease with AIDS is not curable, the course of HIV infection can be delayed at best. An effective therapy is the highly active antiretroviral therapy, short HAART. It combines at least three different antiretroviral drugs that are designed to inhibit HI virus replication, thereby strengthening the immune system and relieving the onset of symptoms.
This therapy requires good cooperation from the patient. The intake of these inhibitory drugs, however, leads to enormous side effects. Lifelong treatment can cause serious damage to the intestine, liver, nerves or cardiovascular system.
This combination therapy sometimes needs to be altered or even stopped because of the undesirable effects that occur. It is important that the drugs in the combination therapy for the treatment of HIV infection do not lead to a resistance and thus can no longer be inhibitory effect.
AIDS is a multi-system disease, which means that in addition to medical treatment and counseling, psychosocial care is also very important. The social system of a patient is affected, necessary changes may be made professionally, and social withdrawal is often the result of persistent depression, anxiety, or guilt feelings of an infected person.
Outlook & Forecast
The prognosis for HIV infection depends on the time of initiation of post-infection drug treatment. Furthermore, the occurrence of other chronic diseases plays a role in the prognosis.
If left untreated, it can be expected that within 8 to 15 years, the immune system of those affected will be destroyed to such an extent that it will lead to the onset of AIDS and death will occur as a result of the diseases that occur. This prognosis can be very different from one individual case to another. In a few cases, the virus also remains lifelong inactive and those affected have a barely suppressed immune system.
The prognosis for a consistent antiretroviral treatment, however, is significantly better. Thus, the outbreak of AIDS can be prevented in most cases thanks to the drug combination therapy. The life expectancy of people who are 25 years or younger at the time the treatment is started and who do not have any other illnesses is considered not to be reduced.
The situation is different in cases in which other diseases, such as hepatitis C or an addiction disease, limit the lives of those affected. Life expectancy can be shortened by several years.
In addition, the drugs can lead to long-term damage to, for example, the kidneys or in terms of fat distribution. However, these consequences can be well controlled by a timely change of medication. Overall, the prognosis for HIV infection is good, however, and it can be expected that the side effects will be less pronounced due to new drugs.
HIV is not curable according to the current state of science. Those affected must therefore be able to cope with the consequences for a lifetime. Aftercare aims to prevent the passage to AIDS and alleviate any discomfort. In addition to a personal responsibility, which is protected inter alia by protected sexual intercourse, a medical accompaniment is necessary.
Because of a combination of agents, regular follow-up visits are advised. The current status is mainly determined by blood tests. Changes in medication are not uncommon. Not infrequently patients report side effects. The active substances inhibit the docking of the viruses to the immune cells, block certain virus enzymes or interfere with another enzyme.
Suitable are, for example, entry inhibitors, integrase inhibitors, protease inhibitors and reverse transcriptase inhibitors. It seems problematic that after some time the HI virus mutates. This requires a close-meshed control. Patients should strictly follow the suggested rhythm of the treating physician.
If acute symptoms occur, a general practitioner should be consulted immediately in the face of permanent weakening of the body. In the social field, the closest environment should be informed about the disease. Collusion for the outbreak of AIDS is important. Sometimes an HIV infection also leads to existential fears. If necessary, a psychological or pastoral accompaniment is necessary.
You can do that yourself
The infection with HIV usually represents a mental burden for those affected, which is particularly felt immediately after a diagnosis. The possibilities for those affected to live better with their illness in everyday life - ie the actual infection - are nevertheless superfluous due to the drug therapy. HIV-positive people do not have to make a drastic change in their lives if they are well medicated.
The self-help measures are concerned with learning everything about the disease, understanding the therapy and the effects of it, and thus regaining the feeling of control. After all, infection with HIV is no longer a death sentence. In many cities, self-help groups, AIDS relief and similar organizations are available to gather information and exchange information.
Those affected often have to rebuild their good attitude to life. The environment should also be included, with HIV-positive people having to decide for themselves who learns about the infection and who does not. It can not be ruled out that in everyday life unpleasant situations can be triggered by ignorance or prejudice of others. Enlightenment and self-confidently dealing with the situation can help.
Nevertheless, a healthy and balanced diet should always be used to strengthen the immune system, especially if minor illnesses are common. Sport also strengthens and can be positive for the psyche at the same time.