AIDS is a chronic and mostly fatal transmissible sexually transmitted disease caused by the human immunodeficiency virus (HIV).
HIV impairs the body’s ability to fight those organisms that cause this disease because the virus damages the immune system.
AIDS is the final stage of HIV infection, when the body is no longer able to fight the deadly infections.
There is no cure for HIV, but there are treatments that allow most people with the virus to live long and healthy lives.
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How does HIV work in the body?
The virus attacks special lymphocytes, the so-called T-helper cells (lymphocytes are white blood cells), penetrates the DNA of the cell and multiplies there.
The virus destroys the T cells and thus the body’s ability to fight germs and diseases.
If the number of T cells drops too much, people with HIV become more susceptible to other infections and can develop some forms of cancer that a healthy body would normally fight.
The weakened immune system (or immunodeficiency) is known as AIDS and can cause serious fatal infections, some forms of cancer, and impairment of the nervous system.
Although AIDS is always caused by HIV infection, not all people infected with HIV have AIDS. In fact, some adults with HIV infection can be healthy for years before they develop AIDS.
Both types of HIV damage a person’s body by destroying specific cells in the blood called CD4+ T cells, which are very important for fighting disease.
Within a few weeks of being infected with HIV, some people develop flu-like symptoms that last a week or two, while others have no symptoms.
People living with HIV may feel healthy for a few years.
But even if there are no symptoms, HIV is still in the body.
Symptoms of HIV infection
The incubation period is over the first 3-4 weeks, the person does not perceive any symptoms.
After that, the infection passes into the acute phase for 20-25 days, provoking typical symptoms of influenza:
- Fever
- Lymph node enlargement
- Pharyngitis (sore throat)
- Rashes
- Muscle
- Headache
- Sores in the mouth and esophagus.
The third stage is asymptomatic, is of varying duration and ends in the phase of AIDS, which leads to the development of infections and tumors.
AIDS can cause the following symptoms:
- Weight loss
- Fever
- Weakness
- Lymph node enlargement
- Diarrhoea
- Restlessness and night sweating
- Tremble
- Pneumonia.
At this point, the following infections are life-threatening: opportunistic infections such as pneumonia, various tumor forms such as Kaposi’s sarcoma, brain tumors and lymphomas.
Symptoms in newborns
Symptoms may appear 2 or 3 months after the child is born. Children born with HIV can develop infections such as pneumocystis carinii pneumonia due to the impaired immune system.
Other possible infections include infections caused by the Epstein-Barr virus or tuberculosis.
When do you get AIDS?
AIDS is the final phase of HIV infection. At this stage, a person’s immune system is severely damaged and has difficulty fighting diseases and some tumors.
Before the development of appropriate drugs, people with HIV could get AIDS in a few years.
Currently, people can live with HIV much longer before they develop the state of AIDS, even for several decades.
This is made possible by the action of combinations of “highly active” drugs introduced in the mid-nineties.
While today’s drugs can significantly improve the health of people infected with HIV, the slow progression from HIV to AIDS requires daily treatments throughout their lives.
Treatment must be closely monitored to avoid possible side effects. Currently, there is no definitive cure for HIV infection.
Complications
HIV infection weakens the immune system, which can no longer fight infections and some types of tumors.
Common infections affecting patients with HIV/AIDS:
Tuberculosis
In poorer countries, tuberculosis is the most common HIV-associated opportunistic infection and one of the leading causes of death in people living with AIDS.
Millions of people today are seropositive (with HIV) and also have tuberculosis.
Salmonellosis
This bacterial infection is caused by contaminated water or food.
Symptoms include severe diarrhea, fever, chills, abdominal pain and, less frequently, vomiting.
Anyone exposed to salmonella can contract it. However, salmonellosis is much more common in people who are HIV positive.
Cytomegalovirus
This is a herpes virus that is transmitted through bodily fluids such as saliva, blood, urine, semen and breast milk.
A healthy immune system inactivates the virus, but it remains latent in the body. When the immune system is weakened, the virus recurs and causes damage to the eyes, digestive system, lungs or other organs.
Candidiasis
Candidiasis is an infection often accompanied by the HIV virus.
It causes inflammation and a thick white coating in the mouth, tongue, esophagus or vagina.
Children may have particularly severe symptoms in the mouth or esophagus, eating can become painful and difficult.
Cryptococcal meningitis
Meningitis is an inflammation of the membranes (meninges) and fluid surrounding the brain and spinal cord.
Cryptococcal meningitis is a common infection of the central nervous system associated with HIV and caused by a fungus present in the soil.
It may also be associated with the excretions of birds or bats.
Toxoplasmosis
This mostly fatal infection is caused by Toxoplasma gondii, a parasite spread especially by cats.
Infected cats transfer the parasites to their stool, through which they can be transmitted to other animals.
Cryptosporidiosis
This infection is caused by an intestinal parasite that is usually found in animals.
You can get cryptosporidiosis if you ingest contaminated water or food.
The parasite grows in the intestines and bile ducts, causing severe and chronic diarrhea in people with AIDS.
Common tumors in HIV/AIDS
Kaposi’s sarcoma
Kaposi’s sarcoma is a tumor of the blood vessel walls.
This neoplasm rarely occurs in people not infected with HIV, but often in HIV-positive people.
Kaposi’s sarcoma usually presents with pink or pinkish-purple patches on the skin and mouth. In dark-skinned people, the lesions may be dark brown or black.
Kaposi’s sarcoma can also affect internal organs, including the digestive tract and lungs.
Lymphomas
This type of tumor has its origin in white blood cells.
Lymphomas usually begin in the lymph nodes. The most common sign is painless swelling of the lymph nodes on the neck, armpits or groin.
Other complications
Wasting syndrome
Weight loss syndrome in AIDS (wasting syndrome) is defined as a weight loss of at least 10 percent of body weight and is often accompanied by diarrhea, chronic weakness and fever.
Aggressive therapies have reduced the number of cases of weight loss syndrome, but it still affects many individuals with AIDS.
Neurological complications
Although AIDS is not infectious to nerve cells, neurological symptoms such as confusion, forgetfulness, depression, anxiety, and gait difficulties may occur.
One of the most common neurological complications is HIV-correlated dementia, which leads to behavioral disorders and mental impairment.
Kidney disease
HIV-associated nephropathy is an inflammation of the small kidney filters that filter excess fluid and waste products from the blood and release it into the urine.
Due to genetic predisposition, the risk of developing nephropathy is highest in African-Americans.
Regardless of the amount of CD4 lymphocytes, antiretroviral therapy should begin in individuals diagnosed with HIV nephropathy who are not yet receiving treatment.
How is HIV transmitted?
HIV is present to varying degrees in blood and genital secretions in almost all infected individuals, regardless of whether they have symptoms. The spread of HIV can occur when these secretions come into contact with another mucosa, such as the vagina, anus, mouth, eyes, or a skin wound, for example after an injection.
The most common processes in which HIV is transmitted worldwide are sexual intercourse, sharing infected syringes or mother-to-child transmission during pregnancy, childbirth or breastfeeding.
Experience has shown that sexual transmission of HIV can take place from man to man, from man to woman and vice versa.
The HIV virus and thus AIDS is transmitted through sexual intercourse.
At the beginning of the HIV epidemic, many people got this infection through a blood transfusion, as used in hemophilia.
Because blood is currently tested for HIV antibodies and the virus itself before transfusions, the risk of contracting HIV through a blood transfusion in the United States is extremely low and is considered insignificant.
There is little evidence that HIV is transmitted by chance, as it might be in the home setting.
For example, a kiss is not a risk factor for transmission of the HIV virus unless there are open sores or bleeding in the mouth.
The reason for this is that lower amounts of HIV are present in saliva than in genital secretions.
There are theoretical transmission risks when using a toothbrush and razor together, because these can cause bleeding and blood can contain a large amount of HIV.
These items should therefore not be shared with infected persons.
Likewise, without sexual contact or direct blood contact, there are no risks of HIV
infection at work or school.
HIV does not develop via:
- fleeting contact, such as hugging and shaking hands
- Drinking glasses
- Sneeze
- Cough
- Mosquitoes or other insects
- Towels
- Toilet bowl
- Doorknobs.
How can infection with HIV be prevented?
The best way to avoid sexual transmission is sexual abstinence until both partners are sure they are in a monogamous relationship and not infected with HIV.
Since months can pass after HIV infection before the test for detecting HIV antibodies becomes positive, both partners should check whether the test is negative 24 weeks or 6 months after the last possible HIV exposure.
If abstinence is not possible, the best method is to use a latex barrier.
The condom should be applied to the penis immediately as soon as an erection is achieved to avoid contact with pre-ejaculate and sperm containing the HIV virus.
During oral sex with fellatio (oral contact with the penis), condoms should be used.
The spread of the HIV virus through infected blood occurs with the joint use of hypodermic needles, such as those used in some drugs (for example, heroin).
HIV can also be spread by exchanging needles for anabolic steroid injections that serve to increase muscle.
HIV can also be transmitted through tattooing and piercing.
To avoid the spread of HIV and other diseases, such as hepatitis, hypodermic needles should never be used together.
