HIV specialist and information on infection and AIDS

Worldwide incidence of HIV infections and AIDS

AIDS is an immunodeficiency disease that emerged in the early 1980s. Since then, AIDS and the HIV infection that causes it have developed into a global pandemic.

These are estimates by the organization UNAIDS (United Nations Programme on HIV/AIDS). 25 million people have died of AIDS to date. Around 33.4 million people worldwide are currently infected with HIV. In 2008, around two million people died of AIDS. A further 2.7 million were newly infected with HIV. In Germany, around 67,000 people are affected by HIV infection. In 2009, 11,300 of them already had AIDS.

Causes of HIV infection and AIDS

The cause of the immunodeficiency disease AIDS is the human immunodeficiency virus (HIV), which represents the late stage of HIV infection.

Infection with HIV occurs through direct contact with an HIV-infected person. Transmission occurs via bodily fluids such as blood, semen, vaginal or anal secretions. The concentration of HI viruses is particularly high here.

Various transmission routes are possible, with sexual contact being the most common cause of infection in Germany. Unprotected sexual intercourse is responsible for 90 percent of HIV infections.

In 8 percent of cases, HIV infection is transmitted through needles and syringes. This occurs when a drug addict injects drugs into their vein with a contaminated injection needle.

If a pregnant woman is infected with HIV, she can transmit the infection to her unborn child. However, this happens in less than 1 percent of cases, as doctors take preventive measures.

Other now rather rare transmission routes are

• Transfusions of HIV-infected blood
• Organ transplants
• Non-disinfected medical devices
• Pricks with an infected needle

Symptoms and stages of HIV infection

The disease stages of AIDS are divided into three stages according to the 1993 Center for Disease Control and Prevention classification:

1. Stage A describes the acute symptomatic initial infection with HIV and the subsequent symptom-free latency phase.
2. In stage B of the HIV infection, the first (non-AIDS-specific) signs of an impaired immune system appear.
3. Finally,stage C describes the outbreak of the AIDS disease

In this stage, half of those affected develop acute HIV disease a few days to weeks after the initial infection.

This so-called acute symptomatic HIV infection manifests itself through

• Flu-like symptoms
• fever
• Headache and sore throat
• fatigue
• tiredness
• Loss of appetite
• Swollen lymph nodes
• Skin rashes that subside after a few days to weeks

This is followed by a symptom-free latency phase (asymptomatic HIV infection), which can last from several years to decades. On average, it lasts ten years. Nevertheless, the HIV viruses continue to multiply during this time and increasingly damage certain cells of the immune system.

In stage B of the HIV infection, there is an increase in symptoms that are the result of the attacked immune system. As the body can no longer fight bacteria, viruses and fungi, HIV patients are susceptible to infections and diseases.

These include

• Fungal infections in the mouth and throat or in the genital area
• Herpes infections,
• Repeated bouts of fever,
• shingles
• Bacterial infections of blood vessels
• Other symptoms that can occur at this stage of HIV infection are
• Chronic diarrhea
• Nerve disorders in the arms and legs
• Persistent swelling of the lymph nodes

Shingles (herpes zoster) is often a side effect of HIV infection @ ryanking999 /AdobeStock

In stage C of HIV infection, the body's own immune defenses finally break down completely and AIDS breaks out.

The body can no longer defend itself against bacteria, viruses and fungi. This results in severe infections, illnesses and symptoms.

These include, among others

• Severe weight loss
• Prolonged diarrhea
• Fungal diseases
• Herpes infections
• Pneumonia
• Viral infections of various organs
• Chronic intestinal infections
• Malignant lymphomas and tumors

Many of these infections would usually be harmless in healthy people, but are life-threatening for AIDS patients.

Diagnosis of an HIV infection

HIV infection is diagnosed on the basis of a blood test. Experts examine the blood for antibodies against the HIV virus. If antibodies against HIV can be detected in the blood, it can be assumed that the HIV viruses themselves are also present in the body. The person affected is therefore HIV-positive.

An HIV test is only reliable three months after infection. This is because the body needs up to twelve weeks to form antibodies. If there are no antibodies in the blood after three to six months, an HIV infection can be ruled out.

An HIV test is a blood test that is used to confirm or rule out an HIV infection@ jes2uphoto /AdobeStock

Treatment of an HIV infection

The aim of treatment is to inhibit the multiplication of the HI viruses and delay the transition to stage C for a long time.

The therapy is primarily directed against the HI virus itself. However, if the AIDS disease has already broken out with the typical accompanying illnesses, doctors must also treat these.

Nowadays, so-called highly active antiretroviral therapy (HAART) is used to treat HIV infection. This consists of a combination of different drugs:

• Entry inhibitors
• reverse transcriptase inhibitors
• integrase inhibitors
• protease inhibitors

These are designed to inhibit the growth and multiplication of the HI virus in various phases of life.

Prognosis and prospects of cure

Since the first occurrence of HIV infections and AIDS cases in the 1980s, experts have developed numerous new drugs. As a result, theprognosis for AIDS patients hasimproved significantly.

HAART therapy delays the onset of AIDS, improves life expectancy and quality of life and reduces the risk of opportunistic infections.

However, HIV infection and AIDS cannot be cured. It is therefore still important to use condoms during sexual intercourse to prevent HIV infection.