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HIV and AIDs

HIV and AIDS conditions and Treatment in London

Human immunodeficiency virus (HIV) is a very common viral infection and is responsible for causing acquired immune deficiency syndrome (AIDS). This virus fights and destroys your T-cells until your immune system is too weak to fight off minor illnesses. You may be infected with this virus and show no symptoms. Early detection of this virus can help you begin treatment and take proactive steps to increase your chances of living a long life.

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What is HIV?

Human immunodeficiency virus weakens the immune system by infecting and destroying the cells, making it difficult to fight diseases. Once this viral infection has seriously weakened your immune system, it can result in AIDS (acquired immunodeficiency syndrome). HIV is referred to as a retrovirus because it contains reverse transcriptase.

What is AIDS?

AIDS stands for acquired immunodeficiency syndrome and is the final and most serious stage of HIV infection. People diagnosed with AIDs have very low white blood cell counts, and their immune system is mostly damaged. Alongside this condition, they might also have other illnesses showing that the viral infection has progressed to AIDs. If you don't get treated for HIV, it can develop into AIDS within 10 years.

Is there any difference between HIV and AIDS?

The primary difference between AIDS and HIV is that HIV is the virus that weakens your immune system, while AIDS is the condition that occurs as a result of HIV infection – a severely weakened immune system. You need to be infected with HIV before you can get AIDS. There are several treatments available for HIV to reduce and slow down the viral effect. With treatment, your HIV infection may not progress to AIDS. However, almost everyone who has HIV and doesn't get treatment will progress to AIDS.

What happens to people with HIV?

HIV operates by infecting the white blood cells of your immune system, known as the helper T cells or CD4 cells. The virus destroys helper T cells, leading to a drop in your white blood cell count. After this, your immune system gets weakened and can't fight away things that your immune system will normally resist or other infections.

The virus causes flu-like symptoms and makes you feel sick. You may be infected with this virus for a long time without showing any symptoms. During the symptomatic phase, your CD4 cells are destroyed slowly. After your immune system has been weakened, and you begin to fall ill or have several illnesses that other people with a healthy immune system don't have, the virus has developed into AIDS. AIDS can cause fevers, skin discolourations, extreme tiredness, rapid weight loss, genital or mouth ulcers and night sweats.

People living with AIDS may also experience other symptoms, illnesses or even cancer.

Why is HIV a retrovirus?

A retrovirus is a virus that functions in reverse to how regular human cells do. Human cells comprise DNA and RNA; DNA and RNA work by taking instructions and sending messages to create proteins, which are the body's building blocks. When the cells are invaded by a retrovirus, it changes its RNA to look similar to your body's DNA. It then intercepts your DNA and inserts its instructions on it. Your cell now acts with the instruction of the retrovirus. HIV invades human cells and uses them to replicate itself. Apart from rapid replication, the instructions for the retrovirus are inserted into your DNA.

Who gets affected by HIV?

A common myth about HIV is that it only affects a specific group of people. Anybody who gets exposed to this virus is at risk of contracting HIV. There are so many ways by which people can get HIV, but sharing needles used in injecting drugs and having sex without protection(condoms) are the most common.

Certain communities are at higher risk of being affected by HIV. They include:

  • Black and Hispanic race
  • Bisexual, gay and men who have sex with other men (MSM)
  • People who have sex in exchange for money

These communities are not the only people at risk of contracting HIV, but you should consider that specific barriers are causing this, including access to frequent testing, receiving proper treatment and access to preventive care. Things like racism, homophobia, social stigmas and poverty continue to increase prejudice and prevent people from access to high-quality medical care.

Is HIV common?

There has been a decline in the number of new HIV infections. It is essential to get tested routinely for HIV, as about 13% of people who have this virus show no symptoms and have no idea they are infected.

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What are the symptoms of HIV?

It is possible to be infected with this virus and show no symptoms. This is why getting routinely tested is very important, even when you don't feel ill. You may notice some of these flu-like symptoms, including:

  • Chills
  • Fatigue
  • Mouth sores
  • Sore throat
  • Rash
  • Swollen lymph nodes
  • Fever
  • Muscle Aches
  • Night sweats

The stages of HIV infection

There are 3 stages of this viral infection.

  • Acute HIV infection

    This is the first stage of this viral infection. In this phase, you may notice flu-like symptoms within one or two months after getting infected with HIV. These symptoms don't last for a long time and may clear off within 1 to 4 weeks.

  • Latent or chronic stage

    At the Latent stage, you may have this viral infection for several years without showing more symptoms or falling sick. However, getting tested is very important as you can transmit this virus at this stage even if you do not feel sick.

  • AIDS – Stage 3

    This is the most chronic stage of this viral infection. At this point, HIV has weakened your immune system severely, and several other opportunistic infections are likely to make you sick. Opportunistic infections can easily be fought off in people with a healthy immune system. After the viral replication and HIV has developed into AIDS, these infections will exploit your immune system, and you fall ill easily.

    You have a very high chance of having some types of cancer if you have AIDS. Opportunistic infections and these cancers are referred to as AIDS-defining illnesses. For you to be diagnosed with AIDS, you must test positive for HIV and have one of these:

    • AIDS-defining illness
    • Lesser than 200 CD4 cells in every cubic millimetre of blood (200 cells/mm3)

AIDS-defining illnesses

These are opportunistic infections, illnesses, certain cancers, and other neurological conditions. Some of them include:

  • Encephalopathy cryptococcosis
  • Burkitt lymphoma
  • Cytomegalovirus retinitis (comes with loss of eyesight)
  • Candidiasis of trachea, bronchi, lungs or oesophagus
  • Cytomegalovirus diseases of the spleen, lymph nodes or liver
  • Chronic intestinal isosporiais – when it lasts over a month
  • Coccidioidomycosis spreads outside your lungs
  • HIV wasting syndrome
  • Extrapulmonarycryptococcosis
  • Invasive cervical cancer
  • Chronic intestinal cryptosporidiosis
  • Histoplasmosis spreading outside the lungs
  • Herpes simplex ulcer extending past a month
  • Herpes simplex bronchitis, oesophagitis, pneumonitis
  • Toxoplasmosis of the brain
  • Immunoblastic Lymphoma
  • Kaposi sarcoma
  • Recurrent salmonella septicema
  • Primary lymphoma of the brain
  • Recurrent pneumonia
  • Progressive multifocal leukoencephalopathy
  • Multiple or recurrent bacterial infections
  • Mycobacterium kansasii spreading outside the lungs
  • Mycobacterium avium complex outside of the lungs
  • Mycobacterium tuberculosis of any site
  • Pneumocystis jirovecii pneumonia

Symptoms of AIDS

The HIV infection commonly causes symptoms of AIDS, but you may also notice symptoms resulting from the illnesses taking advantage of your weakened immune system.

How does HIV spread to people?

This viral infection can be spread through breast milk, semen, blood or vaginal fluid of an infected individual. People of all sexual orientations and genders can spread this virus and also get infected. The point of entry of this virus may differ, and it may be from your mouth, vagina, penis, anus, or broken skin. You can only get this virus through the skin if the infected individual has an open sore, cut or wound. Mothers are also capable of passing it on to their babies.

Practising safe sex and avoiding the sharing of sharp objects like needles can go a long way in preventing this viral infection. The best way to know your status is to get tested, as you might be asymptomatic.

Can people contract HIV from kissing?

HIV is not transmitted through saliva, so getting infected while kissing is uncommon. However, if both people kissing have bleeding gums or mouth sores, then there is a possibility of getting infected through deep kissing.

You can't get infected with HIV from:

  • Donating blood
  • Swimming pools and public bathrooms
  • Hugging or touching an infected person
  • Bug bites
  • Sharing eating utensils or phones with infected people

How would I know if I have HIV/AIDS?

There is no written word on the faces of infected people, and they may not have or show symptoms associated with this viral infection. The best and only way to know is if you undergo an HIV test. According to statistics by the Centre for Disease Control & Prevention, 1 out of 7 people infected with HIV are not aware they are infected. Regular testing can help you to know your status.

How is HIV/AIDS diagnosed?

For your HIV diagnosis, your healthcare practitioner will either collect a blood or saliva sample. This test can be done at the medical practitioner's office, or you can do a home test and follow the provided instructions to get accurate results.

If your result is negative, you won't need to undergo further testing if the following are correct.

  • You have not had any exposure during the window period from when the sample was collected. During your test, make sure you ask about your window period if you are unsure.
  • You have not been previously exposed in the past 3 months prior to your test.

If you might have been exposed to this infection within 3 months of testing, you should get tested again to confirm your result is accurate. If your test results are positive, your healthcare practitioner may do a follow-up test to confirm the results.

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What test can be used to diagnose HIV?

Basically, we have 3 HV tests to diagnose the virus: Nucleic acid tests, antibody tests and antigen/antibody tests:

  • Antibody tests

    This test is done to check for HIV antibodies in your saliva or blood. It can be done by collecting blood through a finger prick, from your arm or by rubbing a stick on your gums to collect saliva. This test may take between 23 and 90 days after exposure to see the virus. Antibody tests done with blood from a finger prick or saliva will take longer to detect than those done with blood drawn from the arm.

  • Antigen/antibody tests

    Antibody tests screen for chemicals which your body produces due to reaction to p24 markers. Antigen tests search for markers called p24 found on the surface of HIV. With an HIV antigen/antibody test, you get screened for both. Your healthcare professional will collect a blood sample from your arm. The blood sample is sent to a laboratory to test for antibodies and p24. This test can detect HIV within 18 to 45 days after potential exposure.

    A rapid antibody/antigen test will be done using a finger prick. This test takes around 18 days post-exposure to detect HIV. To get the best results, you might need to take the test around 90 days after exposure for increased accuracy. Rapid antibody/antigen test does not refer to the period of exposure and time taken to detect the virus but rather the time taken to receive your results.

  • Nucleic acid tests (NATs)

    Nucleic acid tests screen for virus in the blood of an infected person. Your healthcare professional will collect a blood sample from your arm using a needle. The collected blood sample is sent to a laboratory and screened for HIV. A NAT test can detect HIV within 10 – 33 days post-exposure to the virus. However, this test is commonly used if you have had a high-risk exposure.

    If your test result returns positive, you will likely be recommended to carry out other tests to check your health. These tests include:

    • Complete blood count (CBC)
    • Pap smear
    • Tuberculosis
    • Chest X-ray
    • Viral hepatitis screening
    • CD4 count

Can I get tested at home?

There are in-house HIV test kits. Some of these test kits are rapid tests, and you can use a stick with a flexible and soft tip to rub your gums. The stick is placed in a tube with a solution and left for 15-20mins to get your results. Other than this option, you may prick your finger with a small needle, and the drop of blood will be placed on the provided card. This test kit is sent back to the lab via mail to get your results.

If your result is positive, you should reach out to your healthcare professional for additional testing to ensure your result is accurate.

Does HIV have a cure?

As of now, there is no cure for HIV, but there is an array of treatment options to slow down the infection from developing into AIDS.

What are the available treatment options?

There are several treatment options available for HIV. You can treat HIV with a combination of medications taken orally each day. This medication combination is known as antiretroviral therapy (ART). Taking this antiretroviral therapy rather than just one medication has proven very effective in preventing HIV replication and destroying your white blood cells. Some pills combine several medications in a single tablet. Your healthcare professional will decide on a suitable course of treatment.

Antiretroviral therapy aims at reducing the viral load of HIV in your blood to a level where it can not be detected by a test and reducing the weakening of your immune system.

HIV medications

Every pill used in antiretroviral therapy has its form of working to prevent replication of this viral infection. There are a couple of brand names for HIV treatments providing the same medication.

  • Combination of HIV medicines
  • Fusion inhibitors
  • Nucleoside reverse transcriptase inhibitors (NRTIs)
  • Protease inhibitors (PIs)
  • CCR5 antagonists
  • Non-nucleoside reverse transcriptase inhibitors (NRTIs)
  • Attachment inhibitors
  • Pharmacokinetic enhancers
  • Integrase strand transfer inhibitors (INSTIs)
  • Post attachment inhibitors

How can people living with HIV care for themselves?

Most important is strictly following your healthcare practitioner's instructions regarding your medications and never missing your scheduled appointments – treatment adherence. Even by accident, missing medications can affect how the viral infection affects your cells and make your medications ineffective. If you have a tight schedule and are at risk of skipping medications or showing up late to appointments, you should speak to your healthcare practitioner.

What can be done to prevent this viral infection?

There are a couple of ways to prevent yourself from getting HIV, but you must first know how the virus spreads to know what to avoid. The most common ways of getting infected with HIV are through unprotected sex (no condom) and sharing of needles used in taking drugs.

You can practise the following to lower your risk of infection:

  • Use water-based lubricants
  • Use latex condoms for anal, vaginal, or oral sex
  • Do not share needles used to take drugs
  • Avoid the use of condoms made from animal products like lambskin
  • Get tested for other STIs and get treated if you test positive. Testing positive for other STIs increases your risk of contracting HIV.
  • Get tested for HIV and know if you can spread it to others.
  • If you think you might have recently been exposed to HIV, reach out to your healthcare professional for post-exposure prophylaxis (PEP)
  • If you think you are at risk of exposure to HIV, reach out to your healthcare professional for pre-exposure prophylaxis (PrEP)

Apart from using condoms for sex, you can also use dental dams or internal condoms (female condoms). Avoid using multiple condoms at a time to secure yourself against protection– use only one type of condom at a time.

Will taking medications prevent getting HIV?

If you are at a high risk of exposure or feel you might have been recently exposed to HIV, some medications can be taken to help prevent infection. Your healthcare practitioner may suggest a pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP).

Pre-exposure prophylaxis

This pill is usually administered if you are at a high risk of getting infected and you need to take it daily. PrEP is recommended if you are not yet infected with HIV, have had vaginal or anal sex within the last six months, and one of the following is true:

  • You have had sex without the use of protection (condoms)
  • Your sexual partner has HIV
  • If you have had an STI within the last six months

Your healthcare practitioner might also suggest this treatment option if you don't have HIV but use needles to inject drugs and one of the following is true:

  • You share needles or other instruments used to inject drugs
  • You inject drugs alongside your infected (HIV) partner

PrEP does not guarantee 100% protection and should be used alongside other preventive measures.

Post-exposure prophylaxis

PEP uses HIV medications to prevent this viral infection if you recently got exposed to HIV. This medication is mainly given to those who don't know if they have been infected or don't have HIV or might be exposed through shared needles, sexual assault, or work or consensual sex. You must take this PEP medication at most 72 hours after exposure, and it is taken daily for 28 days. Note that PEP does not eliminate preventive measures like the use of condoms and dental dams.

What should I do if I have HIV?

Having HIV is not a death sentence and those who have HIV need to follow strict treatment regimens all their lives to live a normal life. If you have a very high CD4 count within your first year of treatment, there is a high chance of getting a good outcome as long as you maintain your treatment.

You can enhance your chances by:

  • Getting tested routinely if you are at risk of exposure
  • Begin your Antiretroviral therapy (ART) immediately after diagnosis
  • Keeping up with your medical appointments
  • Taking your medications daily

ART can make your viral load undetectable but won't completely eliminate the virus from your system. If you skip medications, you are at risk of triggering the virus to mutate and multiply, and this can hinder your medicines from working. If you don't get tested, you may not show symptoms, and it can take as long as 10 years for HIV to progress into AIDS. If you remain untreated when you have AIDS, your life span can be reduced drastically, usually giving you 3 more years to live.

However, people who begin treatment early on and have an undetectable viral load within the first year can expect to live as long as people without HIV. On the other hand, people who have a detectable viral load or low CD4 count within their first year of treatment may live 10 – 20 years less than people with HIV.

Does HIV self-resolve?

No, this viral infection does not self-resolve. You may show mild to no symptoms, but this does not mean your immune system is not being damaged during this period, even if you don't get sick. If you have been diagnosed with HIV, ensure you always take your medications to lower your viral load, whether you feel sick or not. If you aren't treated for HIV, your immune system will be weakened after a couple of years, and this infection will advance to AIDS.

How do you take care of yourself if you are living with HIV?

You can do the following if you are living with HIV to take care of yourself.

  • Adhere strictly to the instructions of your medical practitioner on how to avoid other illnesses.
  • Take your medications according to the given prescriptions and at the right time.
  • Always show up to your medical appointments and let your healthcare practitioner know if you might not make it or if you miss a medication.

What can I do to avoid spreading this virus to others?

You can practise the following to avoid spreading HIV to your partner and others.

  • Inform your partner or sexual partners that you have HIV
  • Talk to your sexual partner about getting PrEP
  • Inform your healthcare professional if you are pregnant and use your antiretroviral therapy to avoid transmitting the infection to your baby.
  • Don't miss a medication, and follow your treatment plan.
  • Limit the number of sexual partners you have sexual intercourse with
  • Always use protection (condoms) when having sex, even if your healthcare practitioner confirms that you have an undetectable viral load
  • Don't share needles or instruments used to take drugs

How does HIV affect my chances of being pregnant?

HIV does not affect your chances of being pregnant. All you need to do is speak to your healthcare professional, and you will be advised on things to do and how you can protect your partner and child from getting infected and stay healthy.

Taking your ART medications will prevent you from transmitting this infection to your child or partner. Note that you always have to make use of condoms when having sex to protect your partner. Speak to your medical professional if you will be able to breastfeed your baby or if you will need baby formula.

What questions should I ask during my appointment?

  • Do I need to get vaccinated?
  • Am I at risk of getting infected?
  • What does my blood count mean?
  • What can be done to reduce my risk of getting HIV?
  • How can I prevent the transmission of HIV?
  • How can I ensure I take my medications appropriately?
  • What does my test result mean?
  • How can I protect myself from getting other illnesses?

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Getting to know your status is an essential step in preventing HIV. If you feel you might be at risk or might have been recently exposed to HIV, kindly call us today to book an appointment and get tested. AT STI Clinic UK, you can be guaranteed confidential, discreet and accurate test results. We are just a call away!