HIV
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The human immunodeficiency virus (HIV) is known to have been present in the United States since 1978, though some people believe it may have arrived as much as two decades earlier. It is a type of virus known as a retrovirus. All viruses can multiply only after entering the cells of a living being, but retroviruses actually take over the genetic material of the cells they invade, causing the cells to create additional copies of the virus.
In the case of HIV, the particular cells the virus invades are called T-lymphocytes (T-cells), a type of white blood cell that is a key component of the immune system. T-cells recognize infections invaders and mobilize the immune response against them. As HIV uses T-cells to manufacture copies of it, the copies invade other T-cells. This process is repeated over and over, destroying more and more. T-cells and seriously weakening the body's ability to fight off infection and disease.
A healthy person has a T-cell count of between 1000 and 1500 per micro liter of blood. After infection with HIV, the T-cell count begins to fall, usually in a slow, steady decline punctuated by occasional sudden, sharp drops. People with acquired immunodeficiency syndrome (AIDS), the severest stage of HIV disease, generally have a T-cell count of 200 or less.
The incubation period for this illness is both long and variable. Some people experience a brief flulike illness soon after infection, but most feel perfectly healthy and are likely to be unaware they have contracted HIV. After a period of several weeks, the body begins to make antibodies to the virus. Unfortunately, because of the way retroviruses operate, these antibodies cannot protect the body against HIV and its effects, but they are useful for diagnosis. If a person is found to have HIV antibodies in his or her blood, this is proof that he or she has been infected. Such a person is said to be HIV-positive.
At some point after becoming HIV-positive, the infected individual may begin to suffer such symptoms as chronically enlarged lymph nodes, weight loss, fatigue, diarrhea, unexplained fevers, and night sweats. This phase of the disease is called AIDs-Related Complex (ARC), although the term is being used less frequently than in the past since the symptoms are so variable and it does not assist with the treatment. ARC may develop anywhere from several months to many years after the initial infections.
As the person's T-cell count continues to fall, he or she becomes susceptible to a wide array of infections and other illnesses, many of which are otherwise quite rare. These include, but are hardly limited to, Pneumocystis carinii pneumonia (PCP), persistent and systemic candida (yeast) infection, Kaposi's sarcoma, toxoplasmic encephalitis, and cytomegalovirus (CMV) infection. PCP is a kind of fungal pneumonia. A systemic candida infection may manifest in many different ways. Oral thrush and persistent vaginitis are two of the most common. Kaposi's sarcoma is a form of skin cancer that once affected primarily older men of Mediterranean ancestry, but has now become closely associated with AIDS. It is characterized by the appearance on the body of spots or nodules that may be pink, red, purple, or brown in color. Toxoplasmic encephalitis is an infection of the brain caused by the parasite Toxoplasma gondii. This disease can result in severe headache, partial paralysis, seizures, confusion, and other symptoms. CMV is a common virus that many people carry in their systems without knowing it, but in persons with HIV it can infect the kidneys, the central nervous system, and, especially, the eyes, leading to blindness.
Virtually all infectious diseases are more common, and more dangerous, in people who have HIV. For example, tuberculosis is both more common and more difficult to treat in people with HIV. Chronic fever, diarrhea, anemia, fatigue, severe weight loss, and other symptoms may develop and/or worsen as the body becomes unable to defend itself against the effects of organisms that normally are related harmless. If HIV infects the brain, it can cause dementia, deterioration in mental functioning. If a person's T-cell count falls below 200 or certain characteristic infections or cancer develop, he or she diagnosed with AIDs.
The time between infection with HIV and the development of AIDS varies greatly. Today, it is generally believed that an otherwise healthy person who contracts HIV can expect eight to twelve years of continuing health before the onset of AIDS. This is just a statistic, however. Every person is an individual, and there are many different factors that affect an individual's experience. Your overall state of health when you become infected, how well you care for yourself, the level of stress in your life, how early you begin treatment and how well you respond to it-all of these are important considerations in determining how well your immune system will continue to function despite the presence of HIV. Then, too, there are some people who show no signs of impaired immunity and remain healthy for many years after contracting the virus. These individuals, known as long-term nonprogressors, are naturally the subject of considerable interest among those involved in HIV and AIDS research.
HIV is contracted principally through sexual or blood-to-blood contact, such as occurs during blood transfusions or the sharing of needles by intravenous drug users. Women who are HIV-positive can transmit the virus to a developing fetus during pregnancy or to an infant during childbirth or through breastfeeding. HIV cannot be transmitted from one person to another through coughing and sneezing, as cold as, nor through normal everyday interactions at home or work, including hugs and dry kisses. Similarly, you should understand that it is not possible to contract the virus by donating blood. It is also important to know that exposure to HIV does not always result in infection, but, in general, the greater and more frequent the exposure, the more likely it is that a person will become infected. Persons with one or more other sexually transmitted diseases appear to be more likely to contract HIV through sexual contact.
In the early years of the AIDS epidemic in the United States, HIV primarily affected men who had sex with other men. This has changed over time, however. The number of people acquiring HIV through heterosexual sex is rising, as is the incidence of new cases currently can be attributed to intravenous drug use with sharing of syringes and/or needles. A very small percentage of cases occur among health-care workers who are exposed to infected body fluids through accidental needle sticks and similar incidents. One alarming trend is that the infection rate among young people is rising. As estimated one out of every four new cases of HIV infection occurs in a person under the age of twenty-one.
HIV has had a devastating impact on the portion of the population who have hemophilia, an inherited blood-clotting disorder. Treatment for hemophilia involves the use of blood products and transfusions. Donated blood is now screened for HIV, and the clotting factors used by hemophiliacs contracted the virus through the very treatments they depended on to remain healthy.
If you are HIV-positive, whether you have AIDS or not, your goal should be to avoid secondary infections, if possible; to treat any health problems promptly and aggressively; and to do everything you can to support your immune system.
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