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HIV

 

What is H.I.V.?

HIV stands for Human Immunodeficiency Virus it is a virus that attacks the cells in your immune system. As the immune system weakens your body loses its ability to fight infection.  At the end of 2015 there was around 101,200 people in the UK living with HIV.Once a person becomes infected with HIV they will remain infected for life as there is currently no cure but it can be managed effectively with drugs.

What causes H.I.V. to develop?

Blood is made up of a fluid called plasma and three types of cells. Red blood cells, which give blood it’s colour, platelets, which help the blood to clot and white blood cells. It is the white blood cells which defend the body from germs and fight infections. One of the most important white blood cells is called a T-helper cell (commonly called a CD4 cell) and this is the main cell that HIV infects.

Like all viruses, the HIV virus only wants to do one thing, multiply. Once it has attacked the CD4 cell, it takes it over and reproduces itself. During this process (which takes a couple of days) the infected cell dies and the virus seeks out other CD4 cells to infect.

The CD4 cells of someone infected with HIV will battle against the invading infection and so it may be years before you notice any symptoms. However, the virus is not completely destroyed or eradicated from the body, and will continue to attack the CD4 cells. Eventually as your CD4 cell count goes down you might start having symptoms of HIV.

What is A.I.D.S.?

AIDS stands for Acquired Immune Deficiency Syndrome it is the name given when people with HIV go on to develop one of a number of rare illnesses or cancers because their immune system is weakened. Before effective treatments AIDS was a state someone infected with HIV almost inevitably entered, as HIV attacked their immune system. This is no longer the case.

How is HIV passed on?

HIV is present in sexual fluids and blood of infected people, it may also be in the breast-milk of infected women. Because of the way in which HIV is spread the 2 most common ways of contracting the virus is through unprotected penetrative sex (where the penis enters the vagina or anus) and the use of infected needles and syringes. HIV can also be passed on to an unborn baby either before or during birth. There is a small risk of you contracting HIV through oral sex but this is very rare.

HIV is not a strong virus and so doesn’t survive outside the body for long, this is why it is not possible for HIV to be contracted through touching, hugging, sharing cutlery, insect bites, toilet seats or eating food that has been prepared by a person with H.I.V.

How likely am I to have HIV?

As HIV is linked to sexual behviour, people who have had a high number of different partners and unprotected sex are at a higher risk of catching HIV. Gay and bisexual men in the UK also have high rates of HIV and people who have lived or travelled to Africa. If you use drugs and share equipment you are also putting yourself at a higher risk.

How do I avoid catching H.I.V.?

You can avoid catching HIV by practicing safe sex, this refers to any sexual activities which does not involve any sexual fluid from one person getting into another person’s body. Safe sex activities include kissing, touching and mutual masturbation. A condom when used properly and consistently acts as a physical barrier, making it hard for the virus to pass between people.

If you inject drugs make sure you only use your own syringe or needles and always sterilize them before and after use.

What are the symptoms of H.I.V.?

Most people who are infected with HIV will experience a short flu like illness, this occurs around 2-6 weeks after infection and can last for 1-2 weeks. Symptoms inculde fever, headache, blotchy red rash, fatigue and muscle pain. After these intial symptoms, HIV may cause no symptoms for years though the virus continues to cause damage to your immune system and as people are often unaware they have the infection they may be spreading the infection to others. It can take up to 15 years before the immune system becomes severely damaged and more serious symptoms develop, these can include:

You are also at risk of serious illness or disease, these are known as opportunistic infection and may include any of the following;

  • Toxoplasmosis – parasite that causes lung and brain infections.
  • Cytomegalovirus (C.M.V.) – a virus that causes pneumonia, bowel infections and severe eye infections that may end in blindness.
  • Tuberculosis  this is the most common infection in people with HIV.
  • Pneumocystis Carinii Pneumonia (P.C.P.) – a infection that can cause a deadly form of pneumonia.
  • Kaposi’s sarcoma – a cancer that causes purple-coloured spots or lesions on the skin or lining of the mouth.

What are the stages of H.I.V. infection?

HIV can usually be broken down into 3 stages: –

Stage 1– Primary stage, this stage of infection lasts a few weeks and will often be accompanied by a flu like illness which occurs just after infection. A HIV test at this time may not yet prove positive.

Stage 2Asymptomatic stage, this stage can last for an average of 10-15 years and as its name suggests usually has no symptoms, although there may be swollen glands. HIV remains infectious and will now show up positive in a test.

Stage 3 – Symptomatic HIV infection, the immune system loses the struggle to contain HIV, lymph nodes and tissues have become damaged because of activity over the years’s. You may get infections and cancers (see symptoms above) that normally the immune system would prevent causing ‘symptomatic HIV infection’. If these symptoms are left untreated then HIV can develop into AIDS. As the immune system becomes more and more damaged the illnesses that occur become more and more severe leading to an AIDS diagnosis. People can be very ill with HIV but not have an AIDS diagnosis.

How is H.I.V. diagnosed? 

HIV is diagnosed with a blood test, if your first test suggests you have HIV a second test will be required to confirm the diagnosis. If you have any concerns talk to your doctor or a trained counsellor at a G.U.M. clinic and they can help you decide whether to have a HIV test or not, though the final decision will be left up to you.

There are no specific symptoms which can tell whether a person is infected or not, the only way to know for certain is by having a HIV antibody test. The test looks for HIV antibodies in a person’s blood. Remember, it can take 3 months for HIV antibodies to develop to a level where they will show up on a test result.

The results of a HIV test can take anything from a few hours to a week or more to come back, you may have to book up in advance if you want the result the same day.

If you have a test at a clinic it should be strictly confidential to you and the staff concerned, staff will advise you to tell your doctor but no one will be told without your permission.

Anyone in the U.K. can have a free HIV test, they are available from your doctor and local G.U.M. clinic.

If you test positive you will be referred to a HIV clinic for further tests and to discuss your treatment.

Tests are also now available online.

What treatment is available for H.I.V.?

There is no cure for HIV and so the earlier HIV is diagnosed the better your chance of avoiding any serious infections from developing. If you think you have been exposed to HIV then there is now a drug available that may stop you becoming infected. This drug is called PEP (Post Exposure Prophylaxis) and must be taken within 72 hours of coming into contact with the virus. The drug has to be taken every day for one month. PEP is available from GUM clinics and hospitals.

There are a wide range of treatments now available which can slow down the damaging effect of HIV on the immune system and allow it to restore itself over a period of years. The aim of treatment is have an undetectabel viral load meaning that the level of the virus is so low it can no longer be detected by a HIV test. Since the introduction of these drugs very few people go on to develop AIDS.

A combination of drugs are usually recommended as HIV can quickly adapt and become resistant, the type you are given will be individual to you. The treatment of HIV is changing all the time as more research and knowledge of the virus is known.

 

Living with H.I.V.

People living with HIV will need to have 2 tests regularly to monitor the infection and to see how well the treatment is working.

A CD4 (T-helper) count – this measures the number of CD4 cells in the blood, this will give you and your doctor an idea of how the infection is progressing. The lower the amount of CD4 cells (usually below 200) the more prone you are to infections. Healthy people have between 800 and 1,500 CD4 cells in a millilitre of blood.

A viral load test – this measures the amount of HIV in the blood. The higher the viral load the more virus there is in your blood. This test is used along with the CD4 cell count to help your doctor decide when to start or change your treatment.

Your doctor will also advise you to get immunizations to prevent infections such as pneumonia and influenza.

If you are a smoker or use drugs not prescribed by your doctor you should quit. Try to maintain a healthy diet, exercise regularly (if you are able) and find time to relax and ensure you get enough sleep.

What happens if I have H.I.V.?

Living with the knowledge of a life threatening condition is very stressful, you will need to look at ways of taking particular care of your own health. It also means you can pass the virus on to others. You will be offered a referral on to a HIV specialist, to discuss whether to start treatment.

Remember, you are at no risk of getting the infection from normal everyday contact with a person infected with HIV or AIDS.

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