1. When was HIV discovered?
The Human Immunodeficiency Virus (HIV) was discovered in 1981 by American doctors, who documented the appearance of uncommon opportunistic infections in a particular group of patients. These individuals showed immunosuppression without any apparent reason. After some studies, it was found that this syndrome, until then unknown, caused the reduction of CD4+ T lymphocytes in peripheral blood.
After 3 years of study, there came the discovery of the agent causing the disease, HIV.
2. Can someone die from AIDS?
Ironically, no. People with AIDS do not die because of the virus. They die because their defences are very low, in a state of immunosuppression, and the appearance of opportunistic infections. While these infections do not cause any major complications in healthy people, they kill those infected with the virus.
3. What are the symptoms caused by this disease?
During the acute stage, which occurs within four weeks after infection, some people exhibit symptoms similar to those of the flu, such as fever, headaches, stomach and muscle pains, sweats, fatigue, and enlarged lymph nodes.
This acute stage lasts about one to three weeks, and people recover naturally due to the response of the immune system. The symptoms disappear and individuals with HIV show no symptoms for several years.
Next comes a symptomatic stage of the infection, in which patients begin to show characteristic symptoms of immunosuppression of the immune system. The patient may suffer from night sweats, weight loss, diarrhea, loss of appetite, hair loss, dry skin, among other symptoms.
The following stage is the Human Immunodeficiency Syndrome (AIDS), in which there is an immunodeficiency deterioration, enabling the appearance of opportunistic infections.
4. How does HIV work?
HIV is a virus from the Retroviridae family and causes AIDS (Acquired Immunodeficiency Syndrome). Once settled in the organism, this virus develops and reproduces by invading and destroying a certain type of cells from the immune system, the CD4 T lymphocytes, which are primarily responsible for defending the body against pathogens, tumours and infections.
The virus attaches itself to the receptors in the walls of the T lymphocytes and merges with them. Next, the virus uses the person’s DNA, reproducing their viral DNA, forming new HIVs that are released into the bloodstream and will infect new cells.
In its the final stage, the disease decreases the organism’s ability to resist any sort of infection, even the most simple, making them so severe and difficult to treat, ultimately leading to death.
5. What is the window period for HIV?
The window period is the period between acquiring the infection and receiving positive laboratory tests (antibody screening). This period lasts, on average, 3 to 6 weeks. However, since everyone is different, some people may take longer than normal to develop antibodies against the virus.
The window period for HIV can last between 3 weeks and 3 months. However, doctors recommend repeating the screening after six months of possible contagion, to make sure that there is no infection.
6. How is HIV transmitted?
HIV is not transmitted by the normal direct contact with people infected with the virus, nor by air. The virus can only infect through a gateway. HIV is not very resistant outside the human body, it can only survive up to one hour on the outside, once exposed to environmental conditions.
It can be spread in three ways:
- Sexual intercourse;
- Contact with infected blood;
- From mother to child, during pregnancy, childbirth or breastfeeding.
HIV can be transmitted through several bodily fluids, such as blood, semen, vaginal fluids and breast milk.
The virus gateways can be through sharing contaminated syringes, accidental needle stick injuries, unprotected sex, breastfeeding, direct contact with the blood of an infected person with an open wound or the possibility of infecting the fetus at childbirth or during pregnancy.
Even though the virus can eventually be transmitted through blood or blood products transfusions, this route shows few associated risks, since it is mandatory to screen all donors for these kinds of issues.
7. What can I do to protect myself against HIV?
Since there is still no cure or vaccine to prevent HIV infection, the best solution is to avoid certain risk behaviours. You should always wear a condom during sexual intercourse, do not share needles or syringes, do not share materials used to prepare injectable drugs and piercing objects, such as the items used in tattooing or body piercing, in hairdressing, in manicures and in acupuncture.
You should also be aware of objects that have been in contact with blood, semen and vaginal fluids, which may contain the virus.
There are also other products, not sold in common locations, which can be used for protection during a wide variety of sexual practices.
8. Who should get tested for HIV?
Everyone should be tested for HIV, not just those who engage in risky behaviours. This is a silent disease that only manifests its presence after many years. Just as we should take care to protect ourselves from HIV, we must also take care to prevent others when infected with this disease, so that HIV does not keep spreading to the entire population.
AIDS has long since surpassed the barriers that mainly encompassed homosexuals and drug addicts. It is now a disease that anyone can contract. There are no longer stated risk groups, only risk behaviours that should be avoided or, knowingly carried out with the utmost caution.
Protect yourself, protect others, for the great respect we owe to the right of life, to health, to tranquillity. Consult with your conscience; then, with your doctor at aidsportugal.com
9. What are the potential risk groups for HIV?
The potential risk groups are drug addicts, due to syringe sharing, sexually promiscuous individuals, due to not using condoms, and health care professionals, who are always subject to accidents, such as needle stick injuries. However, nowadays, there are no risk groups, only risk behaviours that should be avoided or minimized.
10. How is the laboratory diagnosis of HIV done?
The laboratory diagnosis of HIV is done through tests that screen for the presence of the antibody and/or antigen of the virus in peripheral blood. Nowadays there are already 4th generation tests, which enable early detection of individuals infected with HIV, reducing the window period to a minimum of two weeks by screening for a core antigen in the HIV nucleus, the antigen p24.
However, the most commonly used tests for screening HIV are the ELISA tests (Enzyme-Linked Immuno-Sorbent Assay), detect antibodies in the blood. These 3rd generation tests enable virus detection 3 to 4 weeks after you have been infected with HIV. Still, due to individual differences, there can be no absolute certainty about the negative results in the first three months after infection.
11. How is a positive result confirmed?
If an HIV screening comes back positive, this result has to be confirmed before the result is delivered to the user. The patient’s serum is first confirmed in the laboratory and is then forwarded to the Faculty of Pharmacy, where confirmatory tests are performed. The most common test is the Western Blot, which is a Molecular Biology test.
12. What is the difference between being HIV Positive and having AIDS?
A person carrying the HIV virus, meaning someone who, through laboratory screening, tested positive for HIV, is called HIV Positive or Seropositive. For a period of 10 to 15 years, depending on the person, the virus continues to replicate, although the person does not exhibit symptoms at this stage, and the organism can replenish the amount of CD4+ T lymphocytes destroyed by the virus.
When the infected subject is no longer able to restore the balance between the destroyed CD4+ T lymphocytes and those replaced in circulation, the cell count starts to drop, leading to Acquired Immunodeficiency Syndrome (AIDS), where there is a considerable decline in the host’s defences and opportunistic diseases begin to emerge.
In laboratory terms, it is considered that a healthy individual has between 500 and 1500 CD4+ T lymphocytes per millilitre of blood. Seropositivity becomes AIDS when the CD4+ T lymphocytes fall below 200 per millilitre of blood, leaving the organism unprotected against infections or opportunistic diseases.
13. Which tests are used in the diagnosis and monitoring of HIV?
There are several kinds of tests to diagnose and monitor HIV. The most commonly used tests for diagnosing HIV are the detection of HIV antibodies and the determination of the p24 antigen.
The tests used for monitoring HIV are viral load testing and quantification of CD4+ T lymphocytes, which determine when to initiate treatment, monitoring it and the progression of the virus. These tests should be repeated every three months.
14. How can you know if newborn children of HIV positive mothers are also infected?
In the case of newborn children of HIV positive mothers, testing for antibodies has a peculiarity: since newborns cannot produce them, they receive immunization from the mother’s antibodies. The antibodies are only valid after a period of 18 months, after which the antibodies from the mother disappear.
Following this period, if the child does not show HIV antibodies, they are not infected. In these cases, it is also possible to test for the presence of genetic material from the virus, which clarifies whether the newborn is infected with HIV.
15. How is it treated?
Nowadays there is still no real and effective treatment for this disease. Moreover, there is no medical treatment for diseases caused by the virus. Ideally, we could kill the causative agent, as in the case of infections caused by bacteria.
In diseases caused by the virus, the medical course of action is to create in the patient-specific defences against the disease, through the preventive administration of vaccines, so that, should an infection emerge, the disease does not. At this time, the vaccine for AIDS prevention has not yet been discovered.
There is however a group of medications that helps reduce the spread of the virus, although it does not cure or destroy the virus, it simply slows its development by inhibiting certain enzymes responsible for the virus’ multiplication. These medications help to prolong a person’s life, containing the infection before it reaches the Immunodeficiency Syndrome, in which the patients no longer have any defences against the simplest infections.
16. Can I remain in a Seropositive state, without it evolving into AIDS if I don’t receive the proper treatment?
No. If you are HIV positive and do not receive the proper treatment, you will, sooner or later, develop AIDS. HIV infection has a natural evolution before reaching AIDS. This period can last up to 10 years without treatment.
With currently available treatments, it is possible to modify the natural course of the disease, increasing its asymptomatic period, thus preventing the surfacing of opportunistic infections and tumours that arise with the onset of AIDS.
In order to increase this period and preserve the quality of life, all HIV-positive individuals should start a course of treatment with the appropriate medical monitoring.
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