What Is AIDS?
Acquired Immune Deficiency Syndrome (AIDS) is caused by HIV (Human Immunodeficiency Virus).
AIDS is the end stage form of HIV (Stage 4 HIV). Patients are first diagnosed with HIV, and then the disease may later progress to AIDS, although not all patients who have HIV will end up with AIDS.
HIV is a virus that attacks the body's immune system and thus breaks down its ability to fight and prevent infections. HIV specifically attacks the white blood cells in the immune system called the CD4 cells. These cells are critical in our body's defense against diseases.
HIV is spread by contact with contaminated body fluids.
HIV is diagnosed with a blood test. In infancy, an HIV PCR test is done (assesses DNA to find HIV present). In patients older than 18monts, a test called HIV ELISA is done. Nowadays, there are many rapid finger prick tests available for HIV that have a sensitivity of 90-95%.
Blood tests used to monitor the disease are CD4 counts and the HIV viral load in the blood. Initially, as HIV multiplies in the body, the number of viral cells in the blood will be high- thus the patient will have a high viral load. Inversely the CD4 count of the immune system will be very low, as the HIV is actively destroying the cells.
When a patient starts treatment, the reverse should be seen in blood tests- The HIV viral load should come down, and the number of CD4 cells in the body should increase.
There has been a dramatic change in HIV/AIDS medicine over the past decade. HIV is no longer a death sentence. AIDS is now on the road to become a chronic medical condition, that can be managed life-long, in the same way as diabetes or high blood pressure. Patients who are on HIV treatment can have a normal lifespan and be healthy throughout.
What Are The Symptoms Of AIDS?
During the initial period of infection with HIV, patients may experience flu-like symptoms such as fatigue, runny nose, chills and body aches. Swollen lymph nodes over the body may also be present.
As the immune system weakens, the patient may present with recurrent episodes of infections.
The hallmark of infections in HIV is that patients usually experience infections by "opportunistic" organisms. These are bacteria, fungi or parasites that under normal circumstances in a healthy immune system would not cause disease.
These include tuberculosis, fungal infections of the lungs and meninges in the brain (pneumocystis pneumonia and cryptococcal meningitis). Often the patient may also present with recurrent yeast infections in the mouth- oral Candida or vaginal thrush.
AIDS is defined as stage 4 HIV, or when certain opportunistic infections are present. These include HIV wasting syndrome (wasting and loss of weight), HIV encephalopathy (degeneration of brain function due to HIV) and oesophageal candida (yeast infection in the esophagus).
What Are The Causes Of AIDS?
AIDS is caused by HIV.
HIV is spread by contact with infected body fluids. This includes blood and semen. Tears and saliva cannot carry HIV.
HIV cannot survive outside the body and cannot be spread via droplets or air routes. When blood containing HIV is exposed to air, the virus dies. You cannot get HIV from contact with dried blood.
For HIV transmission to occur, there has to contact with mucous membranes or open wounds on the skin. HIV cannot be spread through intact skin.
The most common ways of transmission are sharing of contaminated or contact with hypodermic needles (health care professionals), unprotected sexual activity, mother to child transmission (during delivery and breastfeeding) and contact with blood products.
What Are The Things One Should Do To Manage AIDS?
- If you are sexually active, make sure that you and your partner get HIV tests done at least six months.
- Use barrier methods when engaging in sexual activities. This is the only means of preventing the spread of the virus during intercourse.
- Practice safe sex.
What Are The Things One Should Avoid To Manage AIDS?
- Do not smoke, as this weakens your immune system.
- Avoid alcohol or use with moderation.
- Don't engage in unsafe sexual practices.
- Don't engage illicit drug use, particularly in the sharing of needles.
What Are The Best Foods For AIDS?
- A healthy balanced diet, high in fresh fruits and vegetables
- Vitamin C to boost your immune system as well as vitamin B for energy and metabolism.
What Are The Worst Foods For AIDS?
- No specific foods have been shown to worsen HIV.
- In general, any food that puts increased strain on the body will exacerbate the effect that HIV already has on the immune system.
- Processed food and refined carbohydrates, as well as sugars, increase inflammation in the body.
- Alcohol also increases inflammation and overburden the body's detoxification system.
What Are The Medicines For AIDS?
There have been rapid changes in the treatment of HIV and AIDS over the past decade, especially in Sub-Saharan African which has the highest rate of HIV in the world.
The WHO advocates that all patients who are diagnosed with HIV should be started on treatment, regardless of their CD4 count or HIV staging.
Anti-retrovirals (ARVs) are the drugs used to treat HIV and AIDS. These drugs work on different mechanisms of the HIV virus’ implantation and reproduction in the body. HAART- Highly Active Retroviral Therapy is now the mainstay of treatment. This means a minimum of three different drugs, that all work on different pathways to fight HIV.
NNRTIs (No- Nuclease Reverse Transcriptase Inhibitor) and NRTIs (Nucleoside Reverse Transcriptase Inhibitors) are the backbones of HAART. NRTIs include Lamivudine, Emtricitabine, Stavudine, Tenofovir. NNRTIs include Efavirenz and Nevirapine.
PIs (Protease Inhibitors) are added on if there is a problem or resistance to above-mentioned drugs. Lopinavir, Ritonavir, and Atazanavir are commonly used.
There is currently no vaccine available for HIV, although many trials are in progress.
What Are The Tips To Manage AIDS?
Although HIV is no longer a death sentence, prevention is always better than cure. HIV has a high mortality rate. Use caution and safe practices to avoid exposure to possible HIV.