Content: Courtesy of Centers for Disease Control (CDC) and BBC
HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus is passed from one person to another through
People with HIV are described as HIV-positive (HIV +ve). They have what is called HIV infection. Most of these people will develop AIDS as a result of their HIV infection, several years after being infected.
What body fluids transmit HIV?
The body fluids proven to spread HIV are:
There are additional body fluids that may transmit the virus that health care workers may come into contact with:
What is AIDS? What causes AIDS?
AIDS stands for acquired immunodeficiency syndrome. An HIV-infected person receives a diagnosis of AIDS after developing one of the AIDS indicator illnesses defined by CDC. An HIV-positive person who has not had any serious illnesses also can receive an AIDS diagnosis on the basis of certain blood tests (CD4+ counts and viral load).
A positive HIV test result does not mean that a person has AIDS. A diagnosis of AIDS is made by a physician using certain clinical criteria (e.g., AIDS indicator illnesses).
Infection with HIV can weaken the immune system to the point that it has difficulty fighting off certain infections. These types of infections are known as "opportunistic" infections because they take the opportunity a weakened immune system gives to cause illness.
Many of the infections that cause problems or may be life-threatening for people with AIDS are usually controlled by a healthy immune system. The immune system of a person with AIDS is weakened to the point that medical intervention may be necessary to prevent or treat serious illness.
Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS. As with other diseases, early detection offers more options for treatment and preventative care.
Where did HIV come from?
Scientists have different theories about the origin of HIV, but none have been proven. The earliest known case of HIV was from a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggests that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s.
We do know that the virus has existed in the United States since at least the mid- to late 1970s. From 1979-1981 rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of gay male patients. These were conditions not usually found in people with healthy immune systems.
In 1982 public health officials began to use the term "acquired immunodeficiency syndrome," or AIDS, to describe the occurrences of opportunistic infections, Kaposi's sarcoma, and Pneumocystis carinii pneumonia in previously healthy men. Formal tracking (surveillance) of AIDS cases began that year in the United States.
The cause of AIDS is a virus that scientists isolated in 1983. The virus was at first named HTLV-III/LAV (human T-cell lymphotropic virus-type III/lymphadenopathy- associated virus) by an international scientific committee. This name was later changed to HIV (human immunodeficiency virus).
Where can I get tested for HIV infection?
Many places provide testing for HIV infection. Common testing locations include local health departments, private clinics and nursing homes, hospitals, and sites specifically set up to provide HIV testing. In India several District Hospitals are offering HIV testing coupled with pre-test and post-test counselling, for a nominal price of Rs.10 (about 20 cents).
It is important to seek testing at a place that also provides counseling about HIV and AIDS. Counselors can answer any questions you might have about risky behavior and ways you can protect yourself and others in the future. In addition, they can help you understand the meaning of the test results and describe what AIDS-related resources are available in the local area.
Many countriles have hotlines and helplines run by the State or NGOs. In India the AIDS helpline responds at phone Nos.1097. In the US, The CDC National AIDS Hotline can answer questions about testing and can refer you to testing sites in your area.
Home Test Kits
Consumer-controlled test kits (popularly known as "home test kits") were first licensed in 1997 in the USA. Although home HIV tests are sometimes advertised through the Internet, currently only the Home Access test is approved by the Food and Drug Administration. (The accuracy of home test kits other than Home Access cannot be verified.) The Home Access test kit can be found at most local drug stores. The testing procedure involves pricking your finger with a special device, placing drops of blood on a specially treated card, then mailing the card in to be tested at a licensed laboratory. Customers are given an identification number to use when phoning for the test results. Callers may speak to a counselor before taking the test, while waiting for the test result, and when getting the result.
What are rapid HIV tests?
A rapid test for detecting antibody to human immunodeficiency virus (HIV) is a screening test that produces very quick results, in 30 minutes or less. In comparison, results from the commonly used HIV antibody screening test, the enzyme immunoassay (EIA), are not available for 1-2 weeks.
Two rapid HIV tests have been approved by the Food and Drug Administration (FDA) for use in the United States. OraQuick Rapid HIV-1 Antibody Test (OraSure Technologies, Inc., Bethlehem, Pennsylvania) was approved for use by trained personnel as a point-of-care test to aid in the diagnosis of HIV infection. OraQuick is a simple, rapid test that can detect antibodies to HIV in finger-stick whole-blood specimens and provide results in as little as 20 minutes.
A second FDA-approved moderate-complexity rapid HIV test, Single Use Diagnostic System for HIV-1 (SUDS) (Murex-Abbott Inc., Norcross, Georgia), remains available in the United States for use with serum or plasma specimens and can produce results in 30 minutes or less. Both tests have been categorized as moderate complexity under the Clinical Laboratory Improvement Amendments of 1988. Both rapid tests are considered to be just as accurate as the EIA.
Both the rapid test and the EIA look for the presence of antibodies to HIV. As is true for all screening tests (including the EIA), a reactive rapid HIV test result must be confirmed before a final diagnosis of infection can be given.
Are there other tests available?
The EIA (enzyme immunoassay) is the standard screening test used to detect the presence of antibodies to HIV. The EIA should be used with a confirmatory test such as the Western blot. Tests that detect other signs of HIV are available for special purposes, such as for additional testing of the blood supply and conducting research. Because some tests are expensive or require sophisticated equipment and specialized training, their use is limited. In addition to the EIA, other tests now available include:
Rapid latex agglutination assay: A simplified, inexpensive blood test that may prove useful in medically disadvantaged areas where there is a high prevalence of HIV infection.
Dot-blot immunobinding assay: A rapid-screening blood test that is cost-effective and that may become an alternative to conventional EIA and Western blot testing.
p24 antigen capture assay: Also known as the HIV-1 antigen capture assay. This blood test was added as an interim measure by the Food and Drug Administration (FDA) in 1996 to HIV-antibody testing to protect the blood supply further until other tests become available to detect early HIV infection before antibodies are fully developed. Because some activity of p24 antigen is unpredictable, this test is not useful for helping people find out if they have HIV.
Polymerase chain reaction (PCR): A specialized blood test that looks for HIV genetic information. Although expensive and labor-intensive, the test can detect the virus even in someone only recently infected. To further protect the blood supply, the FDA has indicated that the development and implementation of tests for HIV genetic material such as PCR is warranted.
How long after a possible exposure should one wait to get tested for HIV?
The tests commonly used to detect HIV infection actually look for antibodies produced by your body to fight HIV. Most people will develop detectable antibodies within 3 months after infection, the average being 25 days. In rare cases, it can take up to 6 months.
How long does it take for HIV to cause AIDS?
Since 1992, scientists have estimated that about half the people with HIV develop AIDS within 10 years after becoming infected. This time varies greatly from person to person and can depend on many factors, including a person's health status and their health-related behaviors.
Today there are medical treatments that can slow down the rate at which HIV weakens the immune system. There are other treatments that can prevent or cure some of the illnesses associated with AIDS, though the treatments do not cure AIDS itself. As with other diseases, early detection offers more options for treatment and preventative health care.
How can I tell if I'm infected
The only way to determine for sure whether you are infected is to be tested for HIV infection. You cannot rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV do not have any symptoms at all for many years.
The following may be warning signs of infection with HIV:
However, no one should assume they are infected if they have any of these symptoms. Each of these symptoms can be related to other illnesses. Again, the only way to determine whether you are infected is to be tested for HIV infection.
Similarly, you cannot rely on symptoms to establish that a person has AIDS. The symptoms of AIDS are similar to the symptoms of many other illnesses. AIDS is a medical diagnosis made by a doctor based on specific criteria established by the CDC.
If I test HIV negative, does that mean that my partner is HIV negative also?
No. Your HIV test result reveals only your HIV status. Your negative test result does not tell you whether your partner has HIV.
HIV is not necessarily transmitted every time there is an exposure. Therefore, your taking an HIV test should not be seen as a method to find out if your partner is infected. Testing should never take the place of protecting yourself from HIV infection. If your behaviors are putting you at risk for exposure to HIV, it is important to reduce your risks.
What if I test positive for HIV?
If you test positive for HIV, the sooner you take steps to protect your health, the better. Early medical treatment and a healthy lifestyle can help you stay well. Prompt medical care may delay the onset of AIDS and prevent some life-threatening conditions. There are a number of important steps you can take immediately to protect your health:
Have a TB (tuberculosis) test done. You may be infected with TB and not know it. Undetected TB can cause serious illness, but it can be successfully treated if caught early.
Smoking cigarettes, drinking too much alcohol, or using
illegal drugs (such as cocaine) can weaken your immune system. There are
programs available that can help you reduce or stop using these substances.
How does HIV cause AIDS?
HIV destroys a certain kind of blood cells--CD4+ T cells (helper cells)--which are crucial to the normal function of the human immune system. In fact, loss of these cells in people with HIV is an extremely powerful predictor of the development of AIDS. Studies of thousands of people have revealed that most people infected with HIV carry the virus for years before enough damage is done to the immune system for AIDS to develop. However, recently developed sensitive tests have shown a strong connection between the amount of HIV in the blood and the decline in CD4+ T cell numbers and the development of AIDS. Reducing the amount of virus in the body with anti-HIV drugs can slow this immune destruction.
An author indicated in a recently published book that AIDS is caused by HHV-6 rather than HIV. Is this true?
No, this is not true. Both HHV-6 and HIV infect the same kind of cells in a person's body. These cells are called CD4+ T cells (helper cells). However, AIDS will not develop in someone who is not infected with HIV. Infection with HHV-6 does not lead to infection with HIV. HHV-6, one of the eight known human herpesviruses, is common throughout the world, with over 90% of adults in many populations being infected. Most people are infected with HHV-6 between the ages of 6 months and 2 years old, soon after they lose their mother's antibodies. HHV-6 is the cause of roseola [ro ZEE o la], a usually mild childhood disease that is also called exanthem subitum [eg ZAN them SUBI tum] or sixth disease. Approximately 30% of all children get roseola, usually before 2 years of age.
Why do some people make statements that HIV does not cause AIDS?
The epidemic of HIV and AIDS has attracted much attention both within and outside the medical and scientific communities. Much of this attention comes from the many social issues--homosexuality, drug use, poverty--related to this disease. Although the scientific evidence is overwhelming and compelling that HIV is the cause of AIDS, the disease process is not yet completely understood.. This incomplete understanding has led some persons to make statements that AIDS is not caused by an infectious agent or is caused by a virus that is not HIV. This is not only misleading, but may have dangerous consequences. Before the discovery of HIV, evidence from epidemiologic studies involving tracing of patientsí sex partners and cases occurring in persons receiving transfusions of blood or blood clotting products had clearly indicated that the underlying cause of the condition was an infectious agent. Infection with HIV has been the sole common factor shared by AIDS cases throughout the world among homosexual men, transfusion recipients, persons with hemophilia, sex partners of infected persons, children born to infected women, and occupationally exposed health care workers. Recommendations to prevent HIV involve guidance to avoid or modify behaviors that pose a risk of transmitting the virus as well as the use of tests to screen donors of blood and organs.
The inescapable conclusion of more than 15 years of scientific research is that people, if exposed to HIV through sexual contact or injecting drug use, may become infected with HIV. If they become infected, most will eventually develop AIDS.
Precaution for First Aiders
Because it is not possible to tell if someone has HIV, it is important that a first aid worker covers up any sores, cuts or scratches on their own hands or body, with waterproof plasters.
Then when they are helping someone who has cut themselves or who has had an accident causing blood, menstrual fluid, pus or semen to be released, these fluids will not get into their own bodies.
Any splashes should be washed off immediately with soap and water, and any spilled fluids mopped up at once, and then everything wiped over with diluted bleach (sodium hypochiorite, eau de Javel).
All the cleaning clothes should either be burnt, or be boiled for 20 minutes before being reused. In this way First Aid workers will be protected. (BBC)
Do I get HIV from Oral Sex?