HIV Specialist and Information on HIV Infection and AIDS

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

These are estimates from UNAIDS (United Nations Program on HIV/AIDS). To date, 25 million people have died of AIDS. Approximately 33.4 million people worldwide are currently living with HIV. In 2008, approximately two million people died of AIDS. Another 2.7 million became newly infected with HIV. In Germany, about 67,000 people are living with HIV. Of these, 11,300 were already living with AIDS in 2009.

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

HIV infection occurs through direct contact with a person who is already infected with HIV. Transmission occurs via bodily fluids such as blood, semen, vaginal fluid, or anal secretions, where the concentration of HIV is particularly high.

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

In 8 percent of cases, HIV is transmitted through the sharing of needles and syringes. This occurs when a drug user injects drugs into a vein using a contaminated needle.

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

Other routes of transmission, which are now relatively rare, include:

• Transfusions of HIV-infected blood
• Organ transplants
• Non-sterilized medical equipment
• Injections with an infected needle

The 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 as well as the subsequent asymptomatic latent phase.
2. In Stage B of HIV infection, the first (non-AIDS-specific) signs of a compromised immune system appear.
3. Stage C, finally, refers to the onset of AIDS

In half of those affected, acute HIV disease develops within a few days to weeks after initial infection.

This so-called acute symptomatic HIV infection manifests as:

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

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

In Stage B of HIV infection, symptoms become more frequent as a result of the compromised immune system. Since the body can no longer fight off bacteria, viruses, and fungi, people with HIV are susceptible to infections and diseases.

These include:

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

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

In Stage C of HIV infection, the body’s immune system eventually collapses completely, leading to the onset of AIDS.

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 infections
• 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 they are life-threatening for people with AIDS.

HIV infection is diagnosed through a blood test. During this test, experts examine the blood for antibodies against the HIV virus. If antibodies against HIV are detected in the blood, it can be assumed that the HIV viruses themselves are also present in the body. The person is therefore HIV-positive.

An HIV test is not reliable until three months after infection. The reason: It takes the body up to twelve weeks to produce antibodies. If no antibodies are detected in the blood after three to six months, an HIV infection can be ruled out.

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

The goal of treatment is to inhibit the replication of HIV and to delay the progression to Stage C for as long as possible.

Treatment is primarily directed against the HIV virus itself. However, if AIDS has already developed along with its typical associated conditions, doctors must treat those as well.

Today, the treatment of choice for HIV infection is high-activity antiretroviral therapy (HAART). It consists of a combination of different medications:

• Entry inhibitors
• Reverse transcriptase inhibitors
• Integrase inhibitors
• Protease inhibitors

These are designed to inhibit the growth and replication of the HIV virus at various stages of its life cycle.

Since the first appearance of HIV infections and AIDS cases in the 1980s, experts have developed numerous new medications. As a result, the prognosis for AIDS patients has improved 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 are not curable. Therefore, it is still important to use condoms during sexual intercourse to prevent HIV infection.