HIV

HIV infection comes in three stages.

The Symptoms of HIV/AIDS – the First Stage

The first stage is called acute infection or seroconversion, and it typically happens within two to six weeks after exposure or becoming infected. This is when the body fights against HIV. The symptoms of acute infection look similar to those of the flu. The symptoms may last a week or two and then completely go away as the virus goes into a non-symptomatic stage.

The initial symptoms of acute HIV infection may include:

• Headache
• Diarrhea
• Nausea and vomiting
• Fatigue
• Aching muscles
• Sore throat
• Red rash that doesn’t itch, usually on the torso.
• Fever

Call your doctor about HIV infection if you think you have come in contact with HIV. You may be tested for HIV using highly sensitive tests that detect both HIV antigen and HIV antibodies. You may also be given anti-HIV drugs to take for a prescribed period of time. There may be unpleasant side effects to these drugs, but they may stop HIV from infecting you.

Most people don’t know they’ve been infected with HIV, but weeks later they may experience the symptoms of seroconversion. These symptoms mean the body is trying to fight HIV.

The Period Without Symptoms of HIV – the Second Stage

The asymptomatic (or latent ) period, a long period without symptoms, is the second stage because the body loses the battle with HIV. This is when people may not know they are infected and can pass HIV on to others. This period can last 10 or more years. During this period without symptoms, HIV is slowly destroying the immune system.

HIV Infection and AIDS – the Third Stage

AIDS (acquired immune deficiency syndrome) is the advanced stage of HIV infection and diagnosed when the CD4 T-cell number drops below 200.

Someone infected with HIV that has “AIDS defining illness” such as Kaposi’s sarcoma (a form of skin cancer) or pneumocystis pneumonia (a lung disease) can be diagnosed as AIDS regardless of the CD4 T-cell number.

Some people don’t know they were infected with HIV, and only discover their HIV infection after experiencing some of these HIV-related symptoms:

• Being tired all of the time
• Swollen lymph nodes in the neck or groin
• Fever lasting for more than 10 days
• Night sweats
• Unexplained weight loss
• Purplish spots on the skin that don’t go away
• Shortness of breath
• Severe, long-lasting diarrhea
• Yeast infections in the mouth, throat, or vagina
• Easy bruising or unexplained bleeding

DIAGNOSIS

There are blood tests used for HIV testing. These tests determine if you have antigens of HIV or antibodies against HIV.

Your doctor may recommend counseling before and after HIV testing, and it is usually available at the hospital or clinic where you will be tested. This will give you an opportunity to:

• Discuss your fears about being tested.
• Learn how to reduce your risk of becoming infected if your test is negative.
• Learn how to keep from spreading HIV to others if your test is positive.
• Think about personal issues, such as how having HIV will affect you socially, emotionally, professionally, and financially.
• Learn what you need to do to stay healthy as long as possible.

RECOMMENDED MEDICATIONS

Medicines used to treat HIV are called antiretrovirals. Several of these are combined for treatment called antiretroviral therapy, or ART.

Medicine choices

• Nucleoside/nucleotide reverse transcriptase inhibitors, such as abacavir, emtricitabine, and tenofovir.
• Nonnucleoside reverse transcriptase inhibitors (NNRTIs), such as efavirenz, etravirine, and nevirapine.
• Protease inhibitors (PIs), such as atazanavir, darunavir, and ritonavir.
• Entry inhibitors, such as enfuvirtide and maraviroc.
• Integrase inhibitors, such as dolutegravir and raltegravir.

Drug resistance

Resistance to HIV medicines can occur when:

• There is a change in the way your body absorbs the medicine.
• There are interactions between two or more medicines you are taking.
• The virus changes and no longer responds to the medicines you are taking.
• You have been infected with a drug-resistant strain of the virus.
• You have not taken your medicines as prescribed by your doctor.

Treatment failure

If your viral load doesn’t drop as expected, or if your CD4+ cell count starts to fall, your doctor will try to find out why the treatment didn’t work.

There are two main reasons that treatment fails:

• The virus that causes HIV has become resistant. The medicine no longer works to control virus multiplication or protect your immune system. Tests can show if resistance has occurred. You may need a different combination of medicines.
• You did not take your medicine as prescribed. If you have trouble taking the medicines exactly as prescribed, talk with your doctor.