Human Immunodeficiency Virus (HIV) is a retrovirus that targets the body’s immune system, specifically the CD4 cells (T cells), leading to a progressive decline in immune function. If untreated, HIV can advance to Acquired Immunodeficiency Syndrome (AIDS), the most severe phase of HIV infection. Understanding the intricacies of HIV infection is crucial for effective prevention, diagnosis, and management.
Stages of HIV Infection
HIV infection progresses through three distinct stages:
- Acute HIV Infection: Occurs 2 to 4 weeks post-exposure, characterized by rapid viral replication and a high viral load. Symptoms may include fever, headache, rash, and sore throat.
- Chronic HIV Infection: Also known as asymptomatic or clinical latency stage, where the virus continues to replicate at low levels. Individuals may remain asymptomatic, but without treatment, this stage can last a decade or longer.
- AIDS: The final stage marked by a severely compromised immune system, leading to opportunistic infections and certain cancers. A CD4 count below 200 cells/mm³ or the presence of specific illnesses defines this stage.
Transmission Routes
HIV is transmitted through contact with certain body fluids from an infected person:
- Unprotected Sexual Contact: The most common route, involving vaginal, anal, or oral sex without protection.
- Mother-to-Child Transmission: Can occur during pregnancy, childbirth, or breastfeeding.
- Blood Transfusions: Receiving contaminated blood or blood products.
- Sharing Needles: Among individuals who inject drugs.
It’s important to note that HIV is not transmitted through casual contact, such as hugging, shaking hands, or sharing utensils.
Symptoms
The manifestation of HIV symptoms varies depending on the infection stage:
- Acute Stage: Flu-like symptoms, including fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and mouth ulcers.
- Chronic Stage: Often asymptomatic, but some may experience generalized lymphadenopathy.
- AIDS: Symptoms include rapid weight loss, recurring fever, prolonged swelling of lymph glands, diarrhea lasting more than a week, sores, pneumonia, and neurologic disorders.
Diagnosis
Early detection of HIV is vital for effective management:
- HIV Testing: Involves rapid diagnostic tests providing same-day results, including self-tests. Confirmatory laboratory tests are required for a definitive diagnosis.
- CD4 Count: Measures the number of CD4 cells in the blood to assess immune function. A declining count indicates disease progression.
- Viral Load Test: Determines the amount of HIV in the blood, guiding treatment efficacy.
Treatment
While there is no cure for HIV, Antiretroviral Therapy (ART) has transformed HIV into a manageable chronic condition:
- ART: Involves the daily use of HIV medicines to reduce the viral load to undetectable levels, preserving immune function and preventing transmission.
- Treatment Initiation: WHO recommends that individuals diagnosed with HIV start ART as soon as possible, regardless of CD4 count.
Prevention Strategies
Preventing HIV transmission encompasses various strategies:
- Condom Use: Consistent and correct use of male and female condoms during sexual intercourse.
- Pre-Exposure Prophylaxis (PrEP): Daily medication for HIV-negative individuals at high risk, significantly reducing the chance of infection.
- Post-Exposure Prophylaxis (PEP): Antiretroviral medicines taken within 72 hours after potential HIV exposure to prevent infection.
- Harm Reduction: For people who inject drugs, access to sterile needles and opioid substitution therapy.
- Mother-to-Child Transmission Prevention: ART during pregnancy, delivery, and breastfeeding to reduce transmission risk.
Global and Regional Context
HIV remains a significant public health issue globally:
- Global Statistics: As of 2021, approximately 38 million people worldwide were living with HIV.
- India’s Scenario: The National AIDS Control Organisation (NACO) leads HIV/AIDS control programs, focusing on prevention, testing, and treatment services.
Understanding HIV infection is fundamental to combating its spread and impact. Through early diagnosis, effective treatment, and comprehensive prevention strategies, individuals and communities can work towards reducing HIV transmission and improving the quality of life for those affected.
