What is HIV/AIDS from a Medical Perspective?
- Types: HIV-1 (dominant globally) and HIV-2 (less common, primarily in West Africa)
- Transmission Routes:
- Unprotected sexual contact (vaginal, anal, oral)
- Contaminated blood exposure (transfusions, needle sharing)
- Perinatal transmission (mother-to-child during pregnancy/birth/breastfeeding)
- Non-transmission: Casual contact (hugging, sharing utensils), saliva, insects
Signs and Symptoms of HIV/AIDS
Stage-Specific Symptoms:
- Acute Infection (2-4 weeks post-exposure):
- Flu-like symptoms: Fever, night sweats, muscle aches
- Rash (most common on torso/chest)
- Swollen lymph nodes
- Headache, sore throat
- Clinical Latency (Chronic Infection):
- No symptoms for 10+ years without treatment
- Asymptomatic but still contagious
- AIDS Stage Symptoms:
- Unexplained weight loss (>10% body weight)
- Persistent diarrhea (weeks/months)
- Prolonged fever (>1 month)
- Recurrent fungal/bacterial infections
- Opportunistic infections:
- Pneumocystis pneumonia (PCP)
- Toxoplasmosis
- Cryptococcal meningitis
- Cancers: Kaposi’s sarcoma, non-Hodgkin lymphoma
HIV Testing Methods
Diagnostic options include:
- Antibody/Antigen Tests (4th generation):
- Combines HIV antigen (p24) and antibody detection
- Window period: 2-6 weeks post-exposure
- Nucleic Acid Tests (NAT):
- Direct detection of viral RNA
- Earliest detection (10 days post-exposure)
- Gold standard for acute infection confirmation
- Rapid Tests:
- Point-of-care testing (15-30 minute results)
- Used in high-risk populations
- Western Blot: Confirmatory test for antibody specificity
Testing guidelines recommend:
- Annual screening for sexually active individuals
- Pregnancy testing at first prenatal visit
- Post-exposure testing (PEP initiation within 72 hours)
Current HIV Treatment Protocols
Antiretroviral Therapy (ART):
- Combination therapy with 3+ drugs from different classes
- Goals:
- Suppress viral load to undetectable levels
- Prevent progression to AIDS
- Reduce transmission risk (U=U principle)
Common Regimens:
- First-line:
- Truvada (TDF/FTC) + Dolutegravir
- Descovy (TAF/FTC) + Bictegravir
- Important Considerations:
- Lifelong adherence critical
- Regular viral load monitoring
- Drug resistance testing before regimen change
Frequently Asked Questions (FAQ)
Can HIV be cured?
Currently incurable, but remission has been achieved in rare cases (e.g., Berlin Patient, London Patient). ART keeps viral load undetectable but doesn’t eliminate latent reservoirs.
How long does it take to show symptoms?
Acute symptoms appear 2-4 weeks post-infection. Latency period averages 8-10 years without treatment.
Is pre-exposure prophylaxis (PrEP) effective?
Truvada PrEP reduces HIV risk by 92-99% when taken consistently. Requires regular medical monitoring.
Can I transmit HIV if my viral load is undetectable?
Undetectable = Untransmittable (U=U). No documented cases of sexual transmission when viral load <200 copies/mL for 6+ months.
What’s the difference between HIV and AIDS?
HIV is the virus causing infection. AIDS is the advanced stage where immune system damage meets specific clinical criteria.
Preventing HIV Transmission
Strategies by Transmission Route:
- Sexual Transmission:
- Use condoms consistently
- Pre-exposure prophylaxis (PrEP)
- Post-exposure prophylaxis (PEP)
- Bloodborne Prevention:
- Avoid sharing needles/syringes
- Sterile equipment for tattoos/piercings
- Perinatal Prevention:
- Antiretroviral treatment during pregnancy
- Cesarean delivery for high viral loads
- Formula feeding instead of breastfeeding
- Public Health Measures:
- Universal precautions in healthcare settings
- Needle exchange programs
