HIV and AIDS

Overview
Acquired immunodeficiency syndrome (AIDS) is a chronic,

potentially life-threatening condition caused by the human
immunodeficiency virus (HIV). By damaging your immune
system, HIV interferes with your body's ability to fight the
organisms that cause disease.
HIV is a sexually transmitted infection (STI). It can also be

spread by contact with infected blood or from mother to child
during pregnancy, childbirth or breast-feeding. Without
medication, it may take years before HIV weakens your
immune system to the point that you have AIDS.
There's no cure for HIV/AIDS, but there are medications that

can dramatically slow the progression of the disease. These
drugs have reduced AIDS deaths in many developed nations.
Symptoms
The symptoms of HIV and AIDS vary, depending on the phase
of infection.
Primary infection (Acute HIV)

Most people infected by HIV develop a flu-like illness within a
month or two after the virus enters the body. This illness,
known as primary or acute HIV infection, may last for a few
weeks. Possible signs and symptoms include:
 Fever
 Headache
 Muscle aches and joint pain
 Rash
 Sore throat and painful mouth sores
 Swollen lymph glands, mainly on the neck
These symptoms can be so mild that you might not even

notice them. However, the amount of virus in your bloodstream
(viral load) is quite high at this time. As a result, the infection
spreads more easily during primary infection than during the
next stage.
Clinical latent infection (Chronic HIV)

In some people, persistent swelling of lymph nodes occurs
during this stage. Otherwise, there are no specific signs and
symptoms. HIV remains in the body and in infected white
blood cells.
This stage of HIV infection generally lasts around 10 years if

you're not receiving antiretroviral therapy. But sometimes,
even with this treatment, it lasts for decades. Some people
develop more severe disease much sooner.
Symptomatic HIV infection

As the virus continues to multiply and destroy your immune
cells — the cells in your body that help fight off germs — you
may develop mild infections or chronic signs and symptoms
such as:
 Fever
 Fatigue
 Swollen lymph nodes — often one of the first signs of HIV
infection
 Diarrhea
 Weight loss
 Oral yeast infection (thrush)
 Shingles (herpes zoster)
Progression to AIDS
Thanks to better antiviral treatments, most people with HIV in
the U. S. today don't develop AIDS. Untreated, HIV typically
turns into AIDS in about 10 years.
When AIDS occurs, your immune system has been severely
damaged. You'll be more likely to develop opportunistic
infections or opportunistic cancers — diseases that wouldn't
usually trouble a person with a healthy immune system.
The signs and symptoms of some of these infections may

include:
 Soaking night sweats

 Recurring fever
 Chronic diarrhea
 Persistent white spots or unusual lesions on your tongue or
in your mouth
 Persistent, unexplained fatigue
 Weight loss
 Skin rashes or bumps
When to see a doctor

If you think you may have been infected with HIV or are at risk
of contracting the virus, see a health care provider as soon as
possible.
Causes
HIV is caused by a virus. It can spread through sexual contact
or blood, or from mother to child during pregnancy, childbirth
or breast-feeding.
How does HIV become AIDS?

HIV destroys CD4 T cells — white blood cells that play a large
role in helping your body fight disease. The fewer CD4 T cells
you have, the weaker your immune system becomes.
You can have an HIV infection for years before it turns into
AIDS. AIDS is diagnosed when the CD4 T cell count falls below
200 or you have an AIDS-defining complication.
How HIV spreads
To become infected with HIV, infected blood, semen or vaginal
secretions must enter your body. This can happen in several
ways:
 By having sex. You may become infected if you have

vaginal, anal or oral sex with an infected partner whose
blood, semen or vaginal secretions enter your body. The
virus can enter your body through mouth sores or small
tears that sometimes develop in the rectum or vagina
during sexual activity.
 From blood transfusions. In some cases, the virus may be
transmitted through blood transfusions. American hospitals
and blood banks now screen the blood supply for HIV
antibodies, so this risk is very small.
 By sharing needles. Sharing contaminated intravenous drug
paraphernalia (needles and syringes) puts you at high risk
of HIV and other infectious diseases, such as hepatitis.
 During pregnancy or delivery or through breast-
feeding. Infected mothers can pass the virus on to their
babies. HIV-positive mothers who get treatment for the
infection during pregnancy can significantly lower the risk
to their babies.
How HIV doesn't spread

You can't become infected with HIV through ordinary contact.
That means you can't catch HIV or AIDS by hugging, kissing,
dancing or shaking hands with someone who has the infection.
HIV isn't spread through the air, water or insect bites.
Risk factors
When HIV/AIDS first appeared in the United States, it mainly
affected men who had sex with men. However, now it's clear
that HIV also spreads through heterosexual sex.
Anyone of any age, race, sex or sexual orientation can be
infected. However, you're at greatest risk of HIV/AIDS if you:
 Have unprotected sex. Use a new latex or polyurethane

condom every time you have sex. Anal sex is more risky
than is vaginal sex. Your risk of HIV increases if you have
multiple sexual partners.
 Have an STI. Many STIs produce open sores on your
genitals. These sores act as doorways for HIV to enter your
body.
 Use intravenous drugs. People who use intravenous drugs
often share needles and syringes. This exposes them to
droplets of other people's blood.
 Are an uncircumcised man. Studies suggest that lack of
circumcision increases the risk of heterosexual
transmission of HIV.
Complications
HIV infection weakens your immune system, making you much
more likely to develop numerous infections and certain types
of cancers.
Infections common to HIV/AIDS

 Tuberculosis (TB). In resource-limited nations, TB is the
most common opportunistic infection associated with HIV.
It's a leading cause of death among people with AIDS.
 Cytomegalovirus. This common herpes virus is transmitted
in body fluids such as saliva, blood, urine, semen and breast
milk. A healthy immune system inactivates the virus, and it
remains dormant in your body. If your immune system
weakens, the virus resurfaces — causing damage to your
eyes, digestive tract, lungs or other organs.
 Candidiasis. Candidiasis is a common HIV-related infection.
It causes inflammation and a thick, white coating on the
mucous membranes of your mouth, tongue, esophagus or
vagina.
 Cryptococcal meningitis. Meningitis is an inflammation of
the membranes and fluid surrounding your brain and spinal
cord (meninges). Cryptococcal meningitis is a common
central nervous system infection associated with HIV,
caused by a fungus found in soil.
 Toxoplasmosis. This potentially deadly infection is caused
by Toxoplasma gondii, a parasite spread primarily by cats.
Infected cats pass the parasites in their stools, which may
then spread to other animals and humans. Seizures occur
when it spreads to the brain.
 Cryptosporidiosis. This infection is caused by an intestinal
parasite that's commonly found in animals. You get it when
you eat or drink contaminated food or water. The parasite
grows in your intestines and bile ducts, leading to severe,
chronic diarrhea in people with AIDS.
Cancers common to HIV/AIDS

 Kaposi's sarcoma. A tumor of the blood vessel walls, this
cancer is rare in people not infected with HIV, but common
in HIV-positive people. It usually appears as pink, red or
purple lesions on the skin and mouth. In people with darker
skin, the lesions may look dark brown or black. Kaposi's
sarcoma can also affect the internal organs, including the
digestive tract and lungs.
 Lymphoma. This cancer starts in the white blood cells. The
most common early sign is painless swelling of the lymph
nodes in your neck, armpit or groin.
Other complications
 Wasting syndrome. Aggressive treatment approaches have
reduced the number of cases of wasting syndrome, but it
still affects many people with AIDS. It's defined as a loss of
at least 10 percent of body weight, often accompanied by
diarrhea, chronic weakness and fever.
 Neurological complications. Although AIDS doesn't appear
to infect the nerve cells, it can cause neurological
symptoms such as confusion, forgetfulness, depression,
anxiety and difficulty walking. One of the most common
neurological complications is AIDS dementia complex,
which leads to behavioral changes and reduced mental
functioning.
 Kidney disease. HIV-associated nephropathy (HIVAN) is an
inflammation of the tiny filters in your kidneys that remove
excess fluid and wastes from your blood and pass them to
your urine. It most often affects blacks or Hispanics.
Anyone with this complication should be started on
antiretroviral therapy.
Prevention
There's no vaccine to prevent HIV infection and no cure for
AIDS. But you can protect yourself and others from infection.
To help prevent the spread of HIV:
 Use a new condom every time you have sex. Use a new
condom every time you have anal or vaginal sex. Women
can use a female condom. If using lubricant, make sure it's
water-based. Oil-based lubricants can weaken condoms and
cause them to break. During oral sex use a nonlubricated,
cut-open condom or a dental dam — a piece of medical-
grade latex.
 Consider the drug Truvada. The drug emtricitabine-
tenofovir (Truvada) can reduce the risk of sexually
transmitted HIV infection in people at very high risk. You
need to take it every day. It doesn't prevent other STIs, so
you'll still need to practice safe sex. If you have hepatitis B
you should be evaluated by an infectious disease or liver
specialist before beginning therapy. You will need a blood
test to check your kidney function before taking this drug.
 Tell your sexual partners if you have HIV. It's important to
tell all your current and past sexual partners that you're
HIV-positive. They'll need to be tested.
 Use a clean needle. If you use a needle to inject drugs,
make sure it's sterile and don't share it. Take advantage of
needle-exchange programs in your community and consider
seeking help for your drug use.
 If you're pregnant, get medical care right away. If you're
HIV-positive, you may pass the infection to your baby. But if
you receive treatment during pregnancy, you can cut your
baby's risk significantly.
 Consider male circumcision. There's evidence that male
circumcision can help reduce a man's risk of getting HIV
infection.

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Overview

Acquired immunodeficiency syndrome (AIDS) is a chronic,

HIV is a sexually transmitted infection (STI). It can also be

There's no cure for HIV/AIDS, but there are medications that

Primary infection (Acute HIV)

These symptoms can be so mild that you might not even

Clinical latent infection (Chronic HIV)

This stage of HIV infection generally lasts around 10 years if

Symptomatic HIV infection

The signs and symptoms of some of these infections may

 Soaking night sweats

When to see a doctor

How does HIV become AIDS?

 By having sex. You may become infected if you have

How HIV doesn't spread

HIV isn't spread through the air, water or insect bites.

 Have unprotected sex. Use a new latex or polyurethane

Infections common to HIV/AIDS

Cancers common to HIV/AIDS

To help prevent the spread of HIV:

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