HIV AND AIDS LECTURE NOTE

INTRODUCTION

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV
is not treated, it can lead to AIDS (acquired immunodeficiency syndrome).There is currently no
effective cure. Once people get HIV, they have it for life. But with proper medical care, HIV can
be controlled. People with HIV who get effective HIV treatment can live long, healthy lives and
protect their partners.

DEFINITION OF TERMS

a. HIV: stand for human immune deficiency virus.

b. HIV 1: retrovirus isolated and recognized as the etiologic agent of HIV disease.
c. HIV 2: retrovirus identified in 1986 in patients with AIDS in western Africa.
d. AIDS – stands for acquired immune deficiency syndromes.
e. Alpha interferon – it is a protein substance that the human body produces in response to
infection.
f. B-cell lymphoma – this is a common malignancy in patients with HIV and AIDS.
g. Candidiasis – defines as yeast infection of skin or mucous membrane.
h. EIA (enzyme immuno-assay): a blood test that can determine the presence of antibodies
to HIV in the blood or saliva.
i. HIV encephalopathy: seen as a degenerative neurologic condition that is characterised
by a group of clinical presentations including loss of coordination, mood swings, loss of
inhibition and cognitive dysfunction refers to as AIDS dementia complex (ADC).
j. Kaposi’s sarcoma: it is a malignancy that involves the epithelial layer or blood and
lymphatic vessels.
k. Opportunistic infection: it is an illness caused by organisms, some of which usually do
not cause disease in people with normal immune systems.
l. Polymerase chain reaction (PCR): a sensitive laboratory technique that can detect and
qualify HIV in a person’s blood or lymph nodes.

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 m. Primary infection: it is 4 to 7-week period of rapid viral replication immediately
following infection, it is also known as acute HIV infection.
n. Protease inhibitor: medication that inhibits the function of protease (an enzyme needed
for viral replication).
o. Reverse transcriptase: an enzyme that transform single stranded RNA into a double-
stranded DNA.
p. Retrovirus: a virus that carries genetic material in RNA instead of DNA and contains
reverse transcriptase.
q. Viral load test: it is a measure of the quality of HIV RNA in the blood.
r. Wasting syndrome: this is an involuntary weight loss consisting of both lean and fat
body mass.
s. Western blot assay (WBS): a blood test that identifies antibodies to HIV and is used to
confirm the results of an EIA test.

DEFINITION

HIV is a virus that damages the immune system. Untreated HIV affects and kills CD4 cells,
which are a type of immune cell called T cell. Over time, as HIV kills more CD4 cells, the body
is more likely to get various types of conditions and cancers.

MODE OF TRANSMISSION

HIV is transmitted through bodily fluids that include:

 blood
 semen
 vaginal and rectal fluids
 breast milk

Some of the ways HIV is transferred from person to person include:

 through vaginal or anal sex — the most common route of transmission

 by sharing needles, syringes, and other items for injection drug use

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  by sharing tattoo equipment without sterilizing it between uses
 during pregnancy, labor, or delivery from a pregnant person to their baby
 during breastfeeding
 through “premastication,” or chewing a baby’s food before feeding it to them
 through exposure to the blood, semen, vaginal and rectal fluids, and breast milk of
someone living with HIV, such as through a needle stick

SIGNS AND SYMPTOMS OF HIV

The first few weeks after someone contracts HIV is called the acute infection stage.

During this time, the virus reproduces rapidly. The person’s immune system responds by
producing HIV antibodies, which are proteins that take measures to respond against infection.

During this stage, some people have no symptoms at first. However, many people experience
symptoms in the first month or so after contracting the virus, but they often don’t realize HIV
causes those symptoms.

This is because symptoms of the acute stage can be very similar to those of the flu or other
seasonal viruses, such as:

 they may be mild to severe

 they may come and go
 they may last anywhere from a few days to several weeks

Early symptoms of HIV can include:

 fever
 chills
 swollen lymph nodes
 general aches and pains
 skin rash
 sore throat
 headache

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  nausea
 upset stomach

LATE SYMPTOMS OF HIV

After the first month or so, HIV enters the clinical latency stage. This stage can last from a few
years to a few decades.

Some people don’t have any symptoms during this time, while others may have minimal or
nonspecific symptoms. A nonspecific symptom is a symptom that doesn’t pertain to one specific
disease or condition.

These nonspecific symptoms may include:

 headaches and other aches and pains

 swollen lymph nodes
 recurrent fevers
 night sweats
 fatigue
 nausea
 vomiting
 diarrhea
 weight loss
 skin rashes
 recurrent oral or vaginal yeast infections
 pneumonia
 shingles

SIGNS AND SYMPTOMS OF AIDS

AIDS refers to acquired immunodeficiency syndrome. With this condition, the immune system is
weakened due to HIV that’s typically gone untreated for many years.

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If HIV is found and treated early with antiretroviral therapy, a person will usually not develop
AIDS.

People with HIV may develop AIDS if their HIV is not diagnosed until late or if they know they
have HIV but don’t consistently take their antiretroviral therapy. They may also develop AIDS if
they have a type of HIV that’s resistant to (doesn’t respond to) the antiretroviral treatment.

Without proper and consistent treatment, people living with HIV can develop AIDS sooner. By
that time, the immune system is quite damaged and has a harder time generating a response to
infection and disease. With the use of antiretroviral therapy, a person can maintain a chronic HIV
diagnosis without developing AIDS for decades.

Symptoms of AIDS can include:

 recurrent fever
 chronic swollen lymph glands, especially of the armpits, neck, and groin
 chronic fatigue
 night sweats
 dark splotches under the skin or inside the mouth, nose, or eyelids
 sores, spots, or lesions of the mouth and tongue, genitals, or anus
 bumps, lesions, or rashes of the skin
 recurrent or chronic diarrhea
 rapid weight loss
 neurologic problems such as trouble concentrating, memory loss, and confusion
 anxiety and depression

DIAGNOSIS OF HIV

Antibody/antigen tests

Antibody/antigen tests are the most commonly used tests. They can show positive results
typically within 18–45 days after someone initially contracts HIV.

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These tests check the blood for antibodies and antigens. An antibody is a type of protein the body
makes to respond to an infection. An antigen, on the other hand, is the part of the virus that
activates the immune system.

Antibody tests

These tests check the blood solely for antibodies. Between 23 and 90 days after transmission,
most people will develop detectable HIV antibodies, which can be found in the blood or saliva.
These tests are done using blood tests or mouth swabs, and there’s no preparation necessary.
Some tests provide results in 30 minutes or less and can be performed in a healthcare provider’s
office or clinic.

Other antibody tests can be done at home:

 OraQuick HIV Test. An oral swab provides results in as little as 20 minutes.

 Home Access HIV-1 Test System. After the person pricks their finger, they send a blood
sample to a licensed laboratory. They can remain anonymous and call for results the next
business day.

If someone suspects they’ve been exposed to HIV but tested negative in a home test, they should
repeat the test in 3 months. If they have a positive result, they should follow up with their
healthcare provider to confirm.

Nucleic acid test (NAT)

This expensive test isn’t used for general screening. It’s for people who have early symptoms of
HIV or have a known risk factor. This test doesn’t look for antibodies; it looks for the virus
itself. It takes from 5 to 21 days for HIV to be detectable in the blood. This test is usually
accompanied or confirmed by an antibody test.

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 STAGES OF HIV

STAGE 1 (ACUTE HIV INFECTION)

 People have a large amount of HIV in their blood and are very contagious.
 Many people have flu-like symptoms.
 If you have flu-like symptoms and think you may have been exposed to HIV, get tested.

STAGE 2 (CHRONIC STAGE HIV)

 This stage is also called asymptomatic HIV infection or clinical latency.

 HIV is still active and continues to reproduce in the body.
 People may not have any symptoms or get sick during this phase but can transmit HIV.
 People who take HIV treatment as prescribed may never move into Stage 3 (AIDS).
 Without HIV treatment, this stage may last a decade or longer, or may progress faster. At
the end of this stage, the amount of HIV in the blood (viral load) goes up and the person
may move into Stage 3 (AIDS).

STAGE 3 (ACQUIRED IMMUNE DEFICIENCY SYNDROME)

 The most severe stage of HIV infection.

 People with AIDS can have a high viral load and may easily transmit HIV to others.
 People with AIDS have badly damaged immune systems. They can get an increasing
number of opportunistic infections or other serious illnesses.
 Without HIV treatment, people with AIDS typically survive about three years.

TREATMENT OF HIV

Many antiretroviral therapy medications are approved to treat HIV. They work to prevent HIV
from reproducing and destroying CD4 cells, which help the immune system generate a response
to infection. This helps reduce the risk of developing complications related to HIV, as well as
transmitting the virus to others.

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These antiretroviral medications are grouped into seven classes:

 Nucleoside reverse transcriptase inhibitors (NRTIs)

 Non-nucleoside reverse transcriptase inhibitors (NNRTIs)
 Protease inhibitors
 Fusion inhibitors
 CCR5 antagonists, also known as entry inhibitors
 Integrase strand transfer inhibitors
 Attachment inhibitors

WAYS TO PREVENT HIV

Although many researchers are working to develop one, there’s currently no vaccine available to
prevent the transmission of HIV. However, taking certain steps can help prevent the transmission
of HIV.

Safer sex

The most common way for HIV to be transferred is through anal or vaginal sex without a
condom or other barrier method. This risk can’t be completely eliminated unless sex is avoided
entirely, but the risk can be lowered considerably by taking a few precautions.

A person concerned about their risk for HIV should:

 Get tested for HIV. It’s important they learn their status and that of their partner.
 Get tested for other sexually transmitted infections (STIs). If they test positive for
one, they should get it treated, because having an STI increases the risk of contracting
HIV.
 Use condoms. They should learn the correct way to use condoms and use them every
time they have sex, whether it’s through vaginal or anal intercourse. It’s important to
keep in mind that pre-seminal fluids (which come out before male ejaculation) can
contain HIV.

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  Take their medications as directed if they have HIV. This lowers the risk of
transmitting the virus to their sexual partner.

Other prevention methods

Other steps to help prevent the spread of HIV include:

 Avoid sharing needles or other paraphernalia. HIV is transmitted through blood and
can be contracted by using materials that have come in contact with the blood of someone
who has HIV.
 Consider PEP. A person who has been exposed to HIV should contact their healthcare
provider about obtaining post-exposure prophylaxis (PEP). PEP can reduce the risk of
contracting HIV. It consists of three antiretroviral medications given for 28 days. PEP
should be started as soon as possible after exposure but before 36 to 72 hours have
passed.
 Consider PrEP. A person has a higher chance of contracting HIV should talk to their
healthcare provider about pre-exposure prophylaxis (PrEP). If taken consistently, it can
lower the risk of acquiring HIV. PrEP is a combination of two drugs available in pill
form.

LIVING WITH HIV

The most important thing is to start antiretroviral treatment as soon as possible. By taking
medications exactly as prescribed, people living with HIV can keep their viral load low and their
immune system strong.

It’s also important to follow up with a healthcare provider regularly.

Other ways people living with HIV can improve their health include:

 Make their health their top priority. Steps to help people living with HIV feel their
best include:
o fueling their body with a well-balanced diet
o exercising regularly

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 o getting plenty of rest
o avoiding tobacco and other drugs
o reporting any new symptoms to their healthcare provider right away
 Focus on their mental health. They could consider seeing a licensed therapist who is
experienced in treating people with HIV.
 Use safer sex practices.
 Talk to their sexual partner(s). Get tested for other STIs. And use condoms and other
barrier methods every time they have vaginal or anal sex.
 Talk to their healthcare provider about PrEP and PEP.

When used consistently by a person without HIV, pre-exposure prophylaxis (PrEP) and
post-exposure prophylaxis (PEP) can lower the chances of transmission. PrEP is most
often recommended for people without HIV in relationships with people with HIV, but it
can be used in other situations as well. Online sources for finding a PrEP provider include
PrEP Locator and Please PrEP Me.

 Surround themselves with loved ones. When first telling people about their diagnosis,
they can start slow by telling someone who can maintain their confidence. They may
want to choose someone who won’t judge them and who will support them in caring for
their health.
 Get support. They can join an HIV support group, either in person or online, so they can
meet with others who face the same concerns they have. Their healthcare provider can
also steer them toward a variety of resources in their area.

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