Human immunodeficiency virus infection (HIV)

Definition

HIV infection is a disease caused by the human immunodeficiency virus (HIV). The condition gradually destroys the immune system, which makes it harder for the body to fight off infections.

This article provides a general overview. For more detailed information, see:
AIDS
Acute HIV infection
Asymptomatic HIV infection
Early symptomatic HIV infection

Causes

The human immunodeficiency virus (HIV) may be spread by the following:
Intimate sexual contact
The use of contaminated needles and syringes
Contaminated blood transfusions and blood products

The virus may also spread through the placenta from the mother to her developing baby. It is rarely spread through breastfeeding.

People who become infected with HIV may have no symptoms for up to 10 years, but they can still pass the infection to others. After being exposed to the virus, blood tests results change from HIV negative to HIV positive usually within 3 months.

HIV has spread throughout the United States. Higher concentrations of the disease are found in inner cities.

Symptoms

HIV can cause any symptoms of illness, since infections can occur throughout the body. Special symptoms relating to HIV infection include:
Diarrhea
Fatigue
Fever
Frequent vaginal yeast infections
Headache
Mouth sores, including candidal infection
Muscular stiffness or aching
Rash of various types, including seborrheic dermatitis
Sore throat
Swollen lymph glands

Note: At the time of diagnosis with HIV infection, many people have not experienced any symptoms.

Exams and Tests

The HIV ELISA/Western blot test may be positive HIV antibodies. If it is negative and you have definite risk factors for HIV infection, you should be retested in 3 months.

Other blood tests can be done to determine how much HIV is in your bloodstream. Blood differential may show abnormalities.

A lower-than-normal CD4 cell count is a sign that the virus is suppressing the immune system.

Treatment

Doctors often recommend drug therapy for patients who are committed to taking all their medications and have a CD4 count below 350 (indicating immune system suppression).

It is extremely important that patients take all doses of their medications, otherwise the virus will quickly become resistant to the drugs. Therapy always involves a combination of antiviral drugs.

People with HIV infection need to become educated about the disease and treatment so that they can be active partners in making decisions with their health care provider.



Outlook (Prognosis)

HIV is a chronic medical condition that can be treated, but not yet cured. There are effective ways to prevent complications and delaying, but not preventing, progression to AIDS.

Most people infected with HIV will progress to AIDS if not treated. However, there is a tiny group of people who develop AIDS very slowly, or never at all. These patients are called long-term non-progressors.

Possible Complications

Cancers
Chronic wasting from HIV infection
HIV dementia
HIV lipodystrophy
Opportunistic infections
Bacillary angiomatosis
Candidiasis
Cytomegalovirus infection
Cryptococcus
Cryptosporidium enterocolitis (or other protozoal infections)
Mycobacterium avium complex (MAC)
Pneumocystis carinii pneumonia
Salmonella infection in the bloodstream
Toxoplasmosis
Tuberculosis
Viral infection of the brain (progressive multifocal leukoencephalopathy)

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have had a possible or actual exposure to AIDS or HIV infection.

Prevention
Avoid intravenous (IV) drugs. If you use IV drugs, avoid sharing needles or syringes. Always use new needles. (Boiling or cleaning them with alcohol does not guarantee that they're sterile.)
Avoid oral, vaginal, or anal contact with semen from HIV-infected people.
Avoid unprotected anal intercourse, since it causes small tears in the rectal tissues, through which HIV in an infected partner's semen may enter directly into the other partner's blood.
If you have sex with people who use IV drugs, always use protection.
If you have sex with many people or with people who have multiple partners, always use protection.
People with AIDS or who have had positive HIV antibody tests can pass the disease on to others. They should not donate blood, plasma, body organs, or sperm. They should not exchange genital fluids during sexual activity.
Safer sex behaviors may reduce the risk of getting the infection. There is still a slight risk of getting the infection even if you practice "safe sex" with the use of condoms, due to the possibility of the condom breaking. Abstinence is the only sure way to prevent sexual transmission of the virus.
Use protection when having sexual contact with people you know or suspect of being infected with HIV.

Sources : www.nlm.nih.gov