What Is HIV?: The Route of Infection in Adults

1
What is HIV?
HIV stands for human immunodeficiency virus, which attacks and destroys certain white
blood cells that are essential to the body's immune system. When HIV infects a cell, it
combines with that cell's genetic material and may lie inactive for years. Most people
infected with HIV are still healthy and can live for years with no symptoms or only minor
illnesses. They are infected with HIV, but they do not have AIDS. After a variable period
of time, the virus becomes activated and then leads progressively to the serious infections
and other conditions that characterize AIDS. Although there are treatments that can
extend life, AIDS is a fatal disease. Research continues on possible vaccines and,
ultimately, a cure. For the moment, however, prevention of transmission remains the only
method of control.
Route of infection:
The route of infection in adults
HIV targets two groups of white blood cells called CD4+ lymphocytes and monocytes/
macrophages. Normally, CD4+ cells and macrophages help recognize and destroy
bacteria, viruses or other infectious agents that invade a cell and cause disease. In an
HIV-infected person, the CD4+ lymphocytes are killed by the virus, while the
macrophages act as reservoirs, carrying HIV to a number of vital organs.
The route of infection in infants and children
Most HIV-infected infants and children acquired the infection from their mothers before,
during or shortly after birth, or during breastfeeding. Only a small proportion are
infected through HIV-contaminated blood transfusions or injections. There are two
patterns of disease progression in children infected from birth. About half these children
2
progress rapidly to AIDS, but others remain symptom free for years, as adults do. Studies
show that, in developed countries, approximately two-thirds of infected children are still
alive at age 5 years. In developing countries, the figure ranges between 30 and 65
percent.
How HIV is transmitted

Sexual intercourse
HIV can be transmitted through unprotected sexual intercourse—that is, any penetrative
sexual act in which a condom is not used. Anal and vaginal intercourse can transmit the
virus from an HIV-infected man to a woman or to another man, or from an infected
woman to a man.
The probability of HIV infection in the partner
The prevalence of HIV infection among sexually active men and women varies according
to geographical area or population subgroup, such as heterosexuals, men who have sex
with men (MSM), sex workers, or injecting drug users (see page 36). Generally, the
likelihood of becoming infected with HIV sexually is related to the number of sexual
partners and unprotected sex acts you have. In other words, the more sexual partners you
have, the greater your chance of becoming infected.
The type of sex act

All unprotected acts of sexual penetration (anal, vaginal, oral) carry a risk of HIV
transmission because they bring body fluids secreted during sex directly into contact with
exposed mucous membranes (the lining of the rectum, the vagina, the urethra and the
mouth).
 Men and women who engage in unprotected receptive anal intercourse with an
HIV-infected partner run the highest risk of becoming infected.
 The next highest risk is that associated with unprotected vaginal intercourse.
 Unprotected oral intercourse involves some risk as well, particularly if there are
mouth or throat injuries present such as bleeding gums, lesions, sores, abscessed
teeth, throat infections, oral gonorrhea or other STDs present. This risk is
reduced, although not entirely eliminated, by the proper use of condoms. Injury to
the mucous membrane of the rectum, vagina or mouth may help the virus enter the
bloodstream. However, HIV can be transmitted even through unbroken mucous
membrane. Kissing has not been shown to transmit HIV, as saliva contains very
little of the virus. Nevertheless, there is a theoretical risk of HIV transmission
during deep or "wet" kissing (tongue kissing) if blood from gum or mouth sores is
present in the saliva.
The amount of virus present in the infected partner
3
HIV-infected individuals become more infectious as they progress to HIV-related disease

and AIDS. There is also an early one- to two-week period of infectiousness around the
time of seroconversion—that is, when antibodies first develop.
Contaminated blood or blood products, tissues and organs
Blood transfusions save millions of lives each year, but in places where a safe blood
supply is not guaranteed, those receiving transfused blood have an increased risk of being
infected with HIV. In most industrialized countries, the risk of acquiring HIV infection
from transfusions is extremely low. This is due in large part to effective recruitment of
regular, volunteer blood donors; improved donor testing procedures; universal screening
of blood and blood products with highly sensitive and specific tests for the antibody to
HIV; and the appropriate use of blood. In the developing world, however, the risk is much
higher. One estimate is that up to 5 percent of HIV infections may be caused by
transfusions in high-prevalence areas such as sub-Saharan Africa. The lack of
coordinated national blood transfusion systems, the absence of non-remunerated
volunteer blood donors, lack of testing, and inappropriate use of blood products
compound the problem (4-6).
Contaminated needles, syringes or other piercing instruments
HIV can be transmitted through the use of HIV-contaminated needles or other invasive
instruments. The sharing of syringes and needles by injecting drug users is responsible
for the very rapid rise in HIV infection among these persons in many parts of the world.
A risk is also attached to non-medical procedures if the instruments used are not properly
sterilized. Such procedures include ear- and body-piercing, tattooing, acupuncture, male
and female circumcision, and traditional scarification. The actual risk depends on the
local prevalence of HIV infection. HIV transmission by means of injection equipment can
also occur in health care settings where syringes, needles and other instruments, such as
dental equipment, are not properly sterilized, or through injury by needles and other
sharps.
Mother-to-child transmission (MTCT)
Mother-to-child transmission (MTCT) is the overwhelming source of HIV infection in
young children. The virus may be transmitted during pregnancy, labor, and delivery or
after the child's birth during breastfeeding. Among infected infants who are not
breastfed, most MTCT occurs around the time of delivery (just before or during lab our
and delivery). In populations where breastfeeding is the norm, breastfeeding may account
for more than one-third of all cases of MTCT transmission (7,8)
How HIV is not transmitted
These activities will not transmit the virus:
 ■ Shaking hands, hugging or kissing (see paragraph on deep kissing, page 14)
 ■ coughing or sneezing
4
 ■ using a public phone

 ■ visiting a hospital
 ■ opening a door
 ■ sharing food, eating or drinking utensils ■ using drinking fountains
 ■ using toilets or showers
 ■ using public swimming pools
 ■ getting a mosquito or insect bite.
HIV and work

For the vast majority of occupations, the workplace does not pose a risk of acquiring
HIV. The exceptions include laboratory workers, health care workers, persons dealing
with hospital waste products, emergency medical response personnel and any other
occupation where there is a possibility of exposure to blood. Their risk is very low, but
real. Among the hazards to which these persons may be exposed are needle stick injuries
and other skin piercing accidents, and blood splashing into the eyes while they are
administering treatment or otherwise performing their duties.
REFERENCES:
BOOKS
 Comprehensive Review of Infectious Diseases. ...
 Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. ...
 Netter's Infectious Diseases, 2nd Edition. ...
 Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 8th Edition. ...
 Graphic Guide to Infectious Disease.
WEBSITES
 AIDSinfo. ...
5
 aidsmap. ...
 The Body. ...
 Centers for Disease Control and Prevention. ...
 Henry J. ...
 Medscape HIV/AIDS

What Is HIV?: The Route of Infection in Adults

Uploaded by

Copyright:

Available Formats

What Is HIV?: The Route of Infection in Adults

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

What Is HIV?: The Route of Infection in Adults

Uploaded by

Copyright:

Available Formats

1

How HIV is transmitted

The type of sex act

HIV-infected individuals become more infectious as they progress to HIV-related disease

 ■ using a public phone

HIV and work

You might also like