HIV infection is not the same as AIDS. Initially, an infection caused by the HIV virus (HIV) is only the infection caused by the virus that causes it, which can subsequently lead to AIDS.
What is HIV infection?
Human immunodeficiency virus (HIV) is a retrovirus. Untreated HIV infection leads to AIDS after a symptom-free period that usually lasts several years. Click to enlarge. The human immunodeficiency virus is known in English as human immunodeficiency virus, or HIV. When infected with such viruses, one does not immediately speak of an AIDS disease, because AIDS describes only the appearance of the first symptoms and not the infection with this pathogen per se. Recognizable symptoms due to an infection describe the final stage of HIV, one speaks now of a disease, the acquired immune deficiency syndrome – AIDS. HIV infection was first described in the 1980s in the United States and is still a treatable, but not curable and usually fatal disease.
Causes
The most common route of transmission in HIV infection is unprotected sexual intercourse. Over smallest mucous membrane injuries the partners infect themselves thereby unnoticed. The risk of HIV infection is also very high with the transmission of HIV-infected blood, often in the drug environment, when addicted people use syringes and needles of other addicts. A very small proportion of infected people became infected during pregnancy or by breastfeeding a sick mother. Generally, a certain amount of viral material is required for transmission and this occurs through body fluids such as blood, semen, vaginal secretions and breast milk. However, droplet infection is not possible. Insufficient education of the population about this disease and low knowledge about the risks of infection prevent the containment of this infectious disease, especially in South Africa the prevalence is particularly high.
Symptoms, complaints, and signs
HIV infection often presents symptoms in the acute phase after infection. These then appear within a few days or weeks. They include rash on the upper body, profuse 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 influenza. Occasionally, infected individuals show no symptoms at all. Also, almost never all symptoms occur at the same time, but only some or only one of them. Because most of the symptoms are rather unspecific, it is not yet possible to deduce an HIV infection from them. Once the acute phase of the HIV infection is over and the body has produced antibodies, the symptoms subside. There is a long and symptomless latency phase. Eventually, when the immune system is sufficiently damaged by HIV, opportunistic infections may occur, the type and amount of which also determine whether AIDS is eventually diagnosed. The transition from HIV infection with serious symptoms to AIDS is smooth in this case. Opportunistic infections include fungal infections, bacterial and viral infections, and various other ailments that can occur in immunocompromised individuals.
Course
HIV belongs to the retroviruses, and it requires the nucleus of a host cell to replicate. Within the disease course of an HIV infection, different stages of the disease can be distinguished. After infection, symptoms often appear a few weeks later that are very similar to the flu and can therefore go unnoticed: Fever, diarrhea, headache, swelling of the lymph nodes, aching limbs. In the following years, HIV antibodies are detectable in the patient, but infected persons can live without developing symptoms. In the so-called lymphadenopathy syndrome, lymph node swelling can occur in various parts of the body over several months, and in the AIDS-relatet complex, weight loss, night sweats and fever can be seen. However, the average life expectancy at the onset of full-blown AIDS is only two years; opportunistic infections occur and malignant tumors may develop.
Complications
HIV infection is associated with many complications.On the one hand, the thought of suffering from an HIV infection is a heavy burden for the person concerned, since according to the current state of medical knowledge it is not curable. This can lead to the development of depression. This in turn can cause a weakened self-esteem and be accompanied by sleep disturbances, fatigue and a drop in performance. In some cases, addictive behavior is increased with regard to alcohol and drugs, which can have serious consequences. In the worst cases, sufferers may have thoughts of suicide, which they subsequently carry out. Furthermore, if left untreated, HIV infection can spread and the final stage of AIDS can develop. Affected people are very susceptible to infections and other diseases, so they get sick faster. Even rather unusual diseases such as a fungal disease (for example Candidasoor) or atypical pneumonia now occur more frequently. Harmless infections that normally heal spontaneously in healthy people are life-threatening for the AIDS patient. Rare tumor diseases such as Kaposi’s sarcoma can occur especially in AIDS patients. Life expectancy is also lower. AIDS patients have a further life expectancy of ten years with therapy, and only one year without therapy. In addition, there is also a risk that HIV-infected people can infect other people if they engage in unprotected sexual intercourse.
When should you go to the doctor?
Because HIV infection can lead to the death of the affected person in the worst case, this disease must always be examined by a doctor. Although direct treatment is not possible, visits and regular checkups with a doctor are very useful. As a rule, permanent tiredness and fatigue can indicate HIV infection. Severe headaches or aching limbs also occur and are accompanied by diarrhea or vomiting. Many patients also suffer from fever or loss of appetite due to HIV infection. Therefore, if these complaints occur over a longer period of time, a visit to a doctor is necessary. Furthermore, many affected persons also suffer from severe itching or a rash on the skin. The susceptibility to infections also increases significantly due to the HIV infection, so that those affected suffer more frequently from inflammations and infections. Restrictions and complaints of the nerves can also refer to the HIV infection. If there is a suspicion, the HIV infection can be examined by a general practitioner. Further treatment of the disease depends on the symptoms.
Treatment and therapy
Basically, the disease with AIDS is not yet curable, the course of HIV infection can be delayed at best. One effective method of therapy is highly active antiretroviral therapy, or HAART. At least three different antiretroviral drugs are combined to inhibit HIV replication, which strengthens the immune system and reduces symptoms. This therapy requires good cooperation from the patient. However, taking these inhibitory drugs leads to enormous side effects. With lifelong treatment, serious damage to the intestines, liver, nerves or cardiovascular system is possible. This combination therapy must sometimes be modified or even discontinued due to the adverse effects that occur. It is important that the drugs in combination therapy for the treatment of HIV infection do not lead to resistance and thus can no longer have an inhibitory effect. AIDS is a multi-system disease, which means that in addition to medical treatment and counseling, psychosocial care is very important. A patient’s social system is affected, necessary changes in occupational status may result, and social withdrawal is often the result of persistent depression, anxiety, or guilt in an infected person.
Outlook and prognosis
The prognosis for HIV infection depends on the timing of initiation of postinfection drug treatment. Furthermore, the occurrence of other chronic diseases plays a role in the prognosis. If left untreated after an HIV infection, it is to be expected that within 8 to 15 years the immune system of the affected person will be destroyed to such an extent that AIDS will break out and death will occur due to the diseases that occur. This prognosis can vary greatly from case to case.In a few cases, the virus also remains inactive for life and those affected have a barely suppressed immune system. The prognosis with consistent antiretroviral treatment, on the other hand, is significantly better. Thus, the outbreak of AIDS can be prevented in the vast majority of cases thanks to drug combination therapy. The life expectancy of people who are 25 years old or younger at the time of starting therapy and do not suffer from any other diseases is not considered to be reduced. The situation is different in cases where other diseases, such as hepatitis C or an addictive disorder, also limit the lives of those affected. In these cases, life expectancy can be shortened by several years. In addition, the drugs can lead to long-term damage to the kidneys, for example, or with regard to fat distribution. However, these consequences can be well controlled by a timely change of medication. Overall, however, the prognosis for HIV infection is good and it is also to be expected that the side effects will be less severe due to new drugs.
Follow-up care
HIV is not curable according to the current state of science. Affected individuals must therefore cope with the consequences for the rest of their lives. Aftercare aims to prevent the transition to AIDS and to alleviate any symptoms. In addition to personal responsibility, which is maintained among other things through protected sexual intercourse, drug support is necessary. Since there is a combination of agents, regular follow-up examinations are indicated. The current status is determined primarily by blood tests. Changes in medication are not uncommon. It is not uncommon for patients to report side effects. The active ingredients inhibit the docking of viruses to immune cells, block certain viral enzymes or interfere with another enzyme. Suitable drugs include entry inhibitors, integrase inhibitors, protease inhibitors and reverse transcriptase inhibitors. It appears problematic that the HI virus mutates after some time. This requires close monitoring. Patients should absolutely adhere to the rhythm suggested by the treating physician. If acute complaints occur, a general practitioner should be consulted immediately in view of the permanent weakening of the body. In the social sphere, the closest environment should be informed about the disease. Arrangements for the outbreak of AIDS are important. Sometimes an HIV infection also leads to existential fears. If necessary, psychological or pastoral support becomes necessary.
What you can do yourself
Infection with HIV usually places a psychological burden on those affected, which is particularly noticeable immediately after a diagnosis. The possibilities for affected persons to live better in everyday life with their disease – that is, the actual infection – nevertheless become unnecessary due to the drug therapy. HIV-positive people do not have to make any drastic changes in their lives if they are well medicated. The self-help measures are rather concerned with learning everything there is to know about the disease, understanding the therapy and its effects, and thus also regaining a sense of control. After all, infection with HIV is no longer a death sentence. For the purpose of obtaining information and exchanging ideas, self-help groups, AIDS help centers and similar organizations are available in many cities. Affected people often have to rebuild their positive attitude towards life. In this process, the environment must also be involved, whereby HIV-positive people must decide for themselves who learns about the infection and who does not. It cannot be ruled out that this may trigger unpleasant situations in everyday life, caused by ignorance or prejudice of others. Educating people and dealing with the situation confidently can help. For the general strengthening of the immune system, a healthy and balanced diet should nevertheless be followed – especially if minor illnesses occur frequently. Sport also strengthens and can be positive for the psyche at the same time.
