Symptoms And Treatment Of HIV

Human immunodeficiency virus (HIV) is an infection that attacks the immune system, specifically targeting CD4 cells, a type of white blood cell.

As HIV destroys these cells, it weakens the immune system, making the body more susceptible to opportunistic infections like tuberculosis, fungal infections, severe bacterial infections, and certain cancers.

The World Health Organization (WHO) advises that everyone at risk of HIV should have access to testing. Individuals at higher risk should seek comprehensive prevention, testing, and treatment services.

HIV can be diagnosed using simple, low-cost rapid diagnostic tests or self-tests.

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It’s important that HIV testing services adhere to the “5 Cs” principles: consent, confidentiality, counseling, correct results, and connecting patients to treatment and other necessary services.

Once diagnosed, individuals with HIV should begin antiretroviral treatment (ART) as soon as possible and have regular clinical and laboratory check-ups, including viral load tests, to track the virus in their blood.

Consistent ART not only helps manage the infection but also prevents transmission to others.

A CD4 count should be done at diagnosis or shortly after starting ART to evaluate immune function.

This test helps assess HIV progression and the risk of opportunistic infections. A normal CD4 count ranges from 500 to 1500 cells per mm³ of blood, but it decreases in those not receiving or not responding to ART.

If a CD4 count falls below 200, the immune system is significantly weakened, making the person vulnerable to serious infections and considered to have advanced HIV disease (AHD).

Viral load testing measures the amount of HIV in the blood and is used to monitor ART effectiveness.

The goal of treatment is to reduce the viral load to undetectable levels (below 50 copies/ml). A viral load over 1,000 copies/ml in someone on ART suggests that treatment needs to be adjusted.

Symptoms

In the initial months after contracting HIV, many people may not show any symptoms and may not realize they are infected.

Others might experience flu-like symptoms such as fever, headache, rash, and sore throat, but this early stage is also when the virus is most contagious.

As HIV progresses, more noticeable symptoms may appear, including swollen lymph nodes, weight loss, fever, diarrhea, and coughing.

The virus weakens the immune system, increasing susceptibility to serious infections and diseases such as tuberculosis, cryptococcal meningitis, bacterial infections, and certain cancers like lymphomas and Kaposi’s sarcoma.

HIV can be detected through rapid tests that offer same-day results, and these can even be done at home.

However, a confirmatory laboratory test is needed to confirm the infection.

Early detection is vital as it opens up more treatment options and helps reduce the risk of spreading the virus to others, including sexual and needle-sharing partners.

Treatment

HIV is preventable, and effective antiretroviral therapy (ART) can prevent mother-to-child transmission during pregnancy, childbirth, and breastfeeding. Individuals on ART with suppressed viral loads cannot transmit HIV to their sexual partners.

Condoms offer protection against HIV and other sexually transmitted infections, and pre-exposure prophylaxis (PrEP), which involves antiretroviral drugs, can prevent HIV infection.

In areas with high HIV prevalence, such as parts of eastern and southern Africa, male circumcision is recommended.

Harm reduction strategies, like needle exchange programs and opioid substitution therapy, are also effective in preventing HIV and other blood-borne infections among people who inject drugs.

HIV treatment consists of antiretroviral therapy, usually involving one or more medications.

While ART does not cure HIV, it significantly reduces the virus’s ability to replicate, bringing the viral load to undetectable levels.

ART allows people with HIV to live healthy, productive lives and significantly reduces the risk of transmission by 96%.

Adherence to ART is crucial for maintaining these benefits. If ART becomes less effective—due to missed doses or drug shortages—HIV drug resistance may develop, requiring a switch to different treatments to maintain health.

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