HIV infection (“HIV positive”) and AIDS

HIV infection (“HIV positive”) and AIDS

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

What is AIDS?

• AIDS stands for acquired immunodeficiency syndrome.
• It is the final stage of the infection of the Human Immunodeficiency Virus (HIV).

How can I be infected with HIV?

• Non protected sexual intercourse with an infected individual
• Sharing of syringes and infected needles (between intraveinous drug users…)
• Mother-to-child transmission during pregnancy, at birth or while breastfeeding.
• Transfusion of contaminated blood
• More than 80% of infections worldwide are transmitted sexually, that proportion being even higher in industrialised countries.
• At one time, it was thought that the infection only affected certain risk groups (drug addicts, homosexuals…). To say the truth, nowadays, any individual adopting a risky sexual behaviour can be infected with HIV.

What is the incubation period of AIDS?

• This is defined as the time between exposure (infection) of an individual up to the moment where the first signs of AIDS appear.
• This time amounts in average to 8 to 10 years.

What is the difference between AIDS and an HIV infection?

• An infection with HIV (seropositivity) includes all the stages of infection by the virus.
• AIDS is the final stage of infection with HIV, that is when the individual does not resist to infections otherwise resisted by normal people (=opportunistic infections: tuberculosis, Pneumocystis carinii pneumonia, Kaposi’s sarcoma).
• An individual infected by HIV (seropositive) but not having reached the stage of AIDS feels well and is perfectly health (asymptomatic carrier).

What are the signs and symptoms of an HIV infection (seropositivity) and AIDS?

• The majority of seropositive individuals are asymptomatic.

There are 4 stages of the infection:

• (A). Acute infection (Primary) with HIV

-This happens quickly after HIV infection, and looks like the flu where lymphonodes swell, fever, asthenia and a cutaneous rash are present. The episode lasts from 2 to 3 weeks.

• (B). Asymptomatic stage

-There are no signs nor symptoms.

-This stage lasts many years.

• (C). Generalized persistent adenopathies

-This stage is caracterized by swollen lymphonodes in the neck, armpits and inguinal folds. The cause is unknown and the signs are present for more than three months.

• (D). AIDS and associated problems

-It is the most advanced stage of the infection and the patients passes away to to infection by unusual organisms, against which non infected individuals would resist.

-The affected organs include the lungs, eyes, digestive tract, nervous system and the skin.

-Systemic symptoms like fever, weight loss, diarrhea are frequent.Des symptômes systémiques comme fièvre, perte de poids et diarhées sont fréquentes.

-Rare cancers (lymphomas and Kaposi’s sarcoma) may also occurDes cancers rares (lymphomes et sarcomes de Kaposi).

Can I be infected with the virus during casual contacts?

• No. The virus cannot be transmitted by non-sexual contacts at home or elsewhere.
• The is no danger to:

1. Share toilets, launderettes with infected individuals (seropositive).
2. Eat together or share cutlery with infected individuals (seropositive).
3. Go to the same swimming pools as infected individuals (seropositive),
4. Live with infected individuals (seropositive).
5. Work with infected individuals (seropositive).
6. Go to school with infected individuals (seropositive).
7. Insect bites cannot transmit the virus.

Can the virus be detected (screening test)?

• The antibody to HIV only appears after a certain period following the infection.
• Almost all individuals develop antibodies 3 months after the infection. In rare cases, antibodies will only be developped 6 months after infection with the virus.
• A negative result only means that the antibody was not present at the time of the test.
• The presence of antidodies in the case of HIV doesn’t mean that the infection may be fought against effectively.
• The test may need to be done again if a first negative test was done shortly after the infection.
• A positive screening test means that one is infected by HIV virus.
• A positive screening test to HIV does NOT mean that one has AIDS. AIDS is only the final stage of the infection and diagnosis is only made when certain infections, cancers… additionally to a seropositive person are made.

Can I be infected if I give my blood?

• No. There is no risk in giving blood; all the equipment used for blood donation is sterile and only used once (it is discarded after use).

Is a cure available for HIV infection or AIDS?

• Until now, this disease cannot be cured.
• Antiviral drugs (NRT, AZT, ddl, ddC, 3TC, d4T, NNRTI, protease inhibitors) are available. These drugs are used in combination and can slow down the progression of the disease, and the health of the patient is often restored.
• Again, the drugs available do not bring a cure.
• There are many drugs under trial which may be useful in the future.

What precautions can I take to prevent being infected?

• Favor a monogamous relationship with a non-infected partner.
• Enhance a safer sex attitude (male or female condoms…) when having intercourse with prostitutes or casual acquaintances.
• Do not use injectable drugs, otherwise do not share syringes and needles.
• Only accept blood from trustworthy sources.
• Ensure that the instruments used for ear pearcing, tatooing and acupuncture treatments are sterilized.

What does “safer sex attitude” mean?

• It is a sexual intercourse with no contact between the secretion fluids (vaginal secretions, sperm).
• Use condoms (male or female available) for each sexual intercourse.
• Do not consume alcohol before or during the sex act as it could impair your judgement.

What to do if I think I may be infected?

• Get the advice of an HIV counsellor (or medical doctor) and do a screening test.
• Adopt a “safer sex attitude” (see before).
• Do not give your blood or organs.
• Do not get pregnant.

Contributors

Dr Husain Ali Mahdi Juma  (دكتورحسين علي جمعه) – dermatologist. Manama, Bahrain

Dr Christophe HSU – dermatologist. Geneva, Switzerland

National Skin Centre. Singapore

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