Human immunodeficiency virus (Hi virus) is a virus in the retrovirus family. People infected with the HI virus develop the disease AIDS after an incubation period that usually lasts several years. The virus is transmitted through unprotected sexual contact, through a blood transfusion or through contaminated syringes. To date, HIV infection or AIDS is treatable but not curable.
What is human immunodeficiency virus?
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 the causative agent of the immunodeficiency disease AIDS. A person is called HIV-positive if antibodies against the virus can be detected in the blood. The human body produces antibodies whenever it needs to fight off a viral infection. If a person has been infected with the HI virus, in most cases he or she shows a clinical picture similar to a flu-like infection in the first three months after the infection. The symptoms subside quite quickly, and the patient remains symptom-free for years.
Symptoms, complaints, and signs
Symptoms of HIV infection can manifest differently in different individuals. In some cases, the infection is asymptomatic for years, often going unnoticed. In other infected individuals, mild or even serious infections occur early on. A few days to weeks after infection with the virus, many affected persons experience an acute HIV phase with non-specific symptoms that can resemble those of a flu-like infection or influenza. Common symptoms include fever lasting several days, heavy night sweats, listlessness, headache, joint and muscle pain, and swollen lymph nodes, for example in the armpits or neck. About half of those infected with HIV also develop a small-spotted, itchy rash on the back, abdomen or chest that can last for several days. Characteristically, this occurs in combination with fever. However, this need not be the case. Significantly, there is also often loss of weight and appetite. Other possible symptoms include open sores in the mouth, tonsillitis, inflammation of the throat, recurrent episodes of fever, and diarrhea. Early HIV infection is also often confused with glandular fever because of the pronounced symptoms.
Significance and course
Immediately after an HIV infection, affected individuals do not initially notice the infection. During this phase of the disease, physicians refer to it as “stage A, new infection without symptoms.” During this phase, there is only an acute HIV infection, which can easily be mistaken for a flu-like infection due to the symptoms that occur. Symptoms include swollen lymph nodes, headache and aching limbs, fatigue, fever and loss of appetite. Apart from this episode, a patient with HIV infection can usually live completely symptom-free for years. If the infection is not noticed, the patient will enter stage B of HIV infection. For the first time, the patient will show symptoms that are part of the AIDS comorbidities. These include fevers of over 38.5 degrees for which no other cause can be identified, repeated diarrhea, shingles, various infections, and fungal infections of the mouth and throat. In stage B, the patient will steadily perceive losses in his quality of life, and his body will increasingly degrade in its function. If the infection progresses even further, the patient will show symptoms of stage C – also called full-blown AIDS. The patient will show significant weight loss due to severe diarrhea. In addition, the immunocompromised body can no longer fight off any pathogens, so the patient shows numerous, rather rare infections, such as pneumonia, salmonella, toxoplasmosis, or increased fungal infestation of the esophagus, trachea, bronchi, and lungs. Many stage C patients present with malignancies, such as cervical cancer, Kaposi’s sarcoma, or non-Hodgkin’s lymphoma.
Complications
In the case that human immunodeficiency virus infection is not treated, the number of helper cells in the body continuously decreases.A severe immunodeficiency then occurs on average after about ten years and is determined by the AIDS-defining diseases. Untreated, an outbreak of AIDS after infection with HIV leads to the death of the affected person after some time. Even if HIV is treated with an anti-retroviral combination therapy, complications can still occur. Due to the high mutation rate of the virus itself, the efforts of the still existing immune system of the patient in combination with a suitable therapy can achieve an improvement for the time being, but can be cancelled out again by a development of resistance of the HIV. A readjustment of the medication is then necessary. In almost all cases, mild and moderate side effects can be expected. Some active substances are toxic for the internal organs in the long run and therefore lead to serious damage only after a long time. A further complication is the occurrence of a so-called superinfection with HIV: the person already infected becomes infected with another strain of the human immunodeficiency virus. This provides an additional burden on the immune system and complicates therapy.
When should you see a doctor?
People who have alternating sexual contacts should generally have a control test regarding sexually transmitted diseases at regular intervals. If contraception does not take place with a condom, there is an increased risk of infection with sexually transmitted diseases. Since the first symptoms of the human immunodeficiency virus often do not appear until an advanced stage, the affected person should develop a good feeling for changes in his or her health. If there are swollen lymph nodes, an untraceable loss of weight or a persistent loss of appetite, there is cause for concern. If symptoms persist for several weeks or months or spread, a check-up with a doctor is recommended. A gradual process of increasing discomfort is a warning sign. If there are disturbances in digestion, unpleasant flatulence or diarrhea, a visit to the doctor is necessary. If there is a persistent listlessness, tiredness or fatigue despite good sleep hygiene, a doctor should be consulted. If there is a fungal infection in the mouth or throat, breathing problems or joint pain, a doctor should be consulted. Respiratory disorders or cessation of breathing should be investigated and treated immediately. Life-threatening situations or secondary illnesses may result. A visit to the doctor is recommended in case of a diffuse feeling of illness, malaise or general weakness.
Treatment and therapy
If there is a suspicion of having been infected with the HI virus, it is advisable to have a test done immediately. All public health departments offer free and anonymous testing. Such a test determines antibodies against the virus – if no antibodies are detectable, the test is negative, i.e. there is no infection. In the opposite case, the test shows a positive result. Since in the past the test often showed a false positive result, a positive test is always repeated. If an HIV infection is detected early, it is easily treatable. Although the infection itself cannot be treated – the patient will remain “HIV-positive” for the rest of his or her life – the onset of the immunodeficiency disease AIDS can nevertheless be delayed for a long time. There are various drugs available that aim to inhibit certain processes in the cells. So-called entry inhibitors, which prevent the HI virus from entering the human cell and multiplying, achieve good results. Protease inhibitors prevent the formation of proteins, which in turn form new HI viruses. In addition to the health restrictions, people infected with HIV are still at the mercy of the dangers of social exclusion. Although infection with the virus is only possible through unprotected sexual intercourse, through sharing infected and uncleaned syringes or through a blood transfusion, many people avoid socializing with HIV-infected people. Help can be found by HIV-positive people with in self-help groups or with psychological support.
Aftercare
In the case of the immunodeficiency virus, very few or no aftercare measures are available to the affected person in most cases. However, the affected person should make sure to see a doctor at the first symptoms and signs of the disease to avoid further complications or discomfort.The disease itself cannot be completely cured, so that there are usually no special aftercare measures. First and foremost, the infection or the transmission of this disease should be prevented. Therefore, a condom should always be used during sexual intercourse. The immunodeficiency virus can be alleviated in many cases if it is recognized gladly. In this case, those affected are usually dependent on taking medication, whereby care must be taken to ensure that it is taken regularly and also in the correct dosage. It is not uncommon for affected patients to need psychological support, which can be provided by their own family or by parents and friends. Whether it comes through the disease to a reduced life expectancy, can not be predicted in general.
Outlook and prognosis
According to current scientific knowledge, there is no possibility of a complete cure; infection with human immunodeficiency virus persists throughout life. However, the prognosis has improved greatly in recent years. Before the development of modern treatment methods, HIV-infected persons in industrialized countries could expect a further life expectancy of 8 to 15 years after infection; today this is significantly higher. Thanks to antiretroviral therapy, those affected generally do not have to accept any significant loss in their quality of life for years if treatment is started early. The prognosis is worse if the disease is only discovered at an advanced stage. An already massively weakened immune system responds less well to therapy, and the prospect of being free of symptoms for many years is much lower in this case. In addition, the success of treatment is strongly influenced by the patient’s cooperation. The medications prescribed by the physician must be taken regularly, permanently and exactly as prescribed in order to achieve positive results. With consistent therapy, the life expectancy of young HIV-infected persons without other underlying diseases is now approximately the same as that of healthy people. Patients who first become infected with the virus at an older age or suffer from other chronic diseases must expect a shorter life expectancy in comparison.
Here’s what you can do yourself
Self-help measures in the event of infection with the human immunodeficiency virus are particularly useful in connection with drug therapy. In this context, they are primarily concerned with how the affected person himself deals with his infection and with possible psychological support, which is particularly relevant shortly after diagnosis. In many places, for example, there are self-help groups and counseling services for those affected. Here, intensive education is provided on the subject of “Living with HIV”. In addition, knowledge about the infection itself can be deepened here. The mere fact that an infection with HIV no longer means a death sentence is a relief for many. A self-confident way of dealing with it, which ideally also extends to informing relatives and sexual partners, makes life easier for those affected. However, depending on the environment, resistance can arise in the form of discrimination and ignorance. This makes a trustworthy social environment all the more important. The knowledge and communication of the fact that an HIV-positive person does not represent a risk for other people with appropriate therapy and behavior is all the more important. Furthermore, there are many possibilities for those affected to improve their quality of life with regard to their health. A healthy diet and exercise protect against other diseases. Maintaining work and social contacts enables an ordinary life without restrictions. A developing psychological burden can be communicated on the part of the affected person with friends and relatives. Discovering new perspectives (hobbies, change of job, etc.) also enables the rediscovery of lost joy of life.
