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AIDS (aquired immunodeficiency syndrome) is caused by by a virus. The virus is named HIV - human immunodeficiency virus.
People who get infected with HIV will eventually get AIDS, although there are a few people infected with HIV that have not progressed to AIDS yet (despite these people not even taking any type of medication), who are being studied by scientists to work out how their immune system works.
When the immune system becomes seriously damaged, then HIV infection has become AIDS. The way the immune system is damaged is when the HIV virus multiplies in the body and the white blood cells (CD4+ or helper T cells) responsible for stimulating the activity of other cells, become depleted. With less of these helper T cells in the blood, the body becomes even more vulnerable to the virus allowing it to replicate and take over.
In addition to this, less immunity means that other bacterial, virual and fungal infections can take this as the perfect opportunity to invade the body and cause a serious infection, which, if the person was otherwise healthy, would not have any serious impacts.
AIDS is basically when the body's immunity is badly compromised due to the initial infection with the human immunodeficiency virus (HIV) that allows other, opportunistic infection to seriously debilitate the body with often fatal results.
The only way to prevent AIDS is to not get a HIV infection in the first place by not engaging in risky behaviour :
- Do not have unsafe sex with untested partners - always use a condom for vaginal or anal sex or use other methods of safe sex (such as cuddling, kissing, mutual masturbation, touching, massage)
- Do not share needles with others
- Do not have unprotected oral sex with a new and untested partner - while this is a less common way to get a HIV infection, it still does occur
Most people who get infected with the HIV may not experience any symptoms when they are first infected. People who do have symptoms, will notice flu-like symptoms (within the first month or two after infection) such as:
- Aches
- Enlarged lymph nodes (found in the neck and groin)
- Fatigue
- Fever
- Headache
Most people will not realise they have been infected by HIV and will just think it is another flu infection. People are extremely infectious at this time, with a great deal of HIV in the genital fluid, so if they have unprotected sex (vaginal, oral, rectal) at this time, they can infect everyone they have sex with!
As the immune system deteriorates, the following symptoms will be displayed:
- Children who grow slowly or get sick a lot
- Cold sores (herpes simplex 1)
- Fatigue
- Frequent fevers (or sweats)
- Genital herpes (herpes simplex 2)
- Loss of appetite
- Shingles
- Short-term memory loss
- Weight loss
- Yeast infections such as candida (in the mouth or genitals)
When the infection become AIDS, the following symptoms can be experienced (which are caused by opportunistic infections):
- Cancer - various types of cancers
- Cognitive dysfunction - forgetfulness, confusion
- Coma - usually at the climax of illness, just before death
- Conjunctivitis
- Coughing and shortness of breath
- Difficult or painful swallowing
- Fatigue - extreme
- Fever
- Nausea, abdominal cramps, and vomiting
- Seizures and lack of coordination
- Severe and persistent diarrhea
- Severe headaches
- Vision loss
- Weight loss
The Centre for Disease Control has a definition of AIDS - all HIV-infected people who have less than 200 CD4+ T cells per cubic millimeter of blood (healthy adults have counts over 1,000). In addition to this, the definition also includes 26 health conditions which are opportunistic, meaning they would not cause the same severity of symptoms in healthy people as in the HIV-infected people who have a much lowered immune system that can fight off the bacteria, viruses, fungi, parasites, and other microbes as easily.
A small number of people have remained asymptomatic (have no symptoms) from HIV or AIDS for a very long time (over 10 years), even without taking any type of medications. Scientists are trying to work out how these people stay healthy and why their immune system is not being depleted by HIV like most other people are and why they are not getting sick.
AIDS is caused by the human immunodeficiency virus (HIV), which can be caught by any of the following ways:
- Unprotected sex - anal, vaginal, oral (less common)
- Sharing needles - using a needle that has already been used by someone else either to inject drugs or to draw out blood
- Mother to child - HIV can be passed onto an unborn child from the mother through the placenta.
Diagnosis
AIDS is detected through a blood test that tests for HIV antibodies. People with HIV antibodies are HIV-positive, which those without the antibodies are HIV-negative. It is thought that the body produces HIV antibodies by the immune system when it becomes infected with HIV and people who have not been infected with HIV should not produce these antibodies.
Antibodies to HIV usually develop within 6 weeks to 12 months after exposure to the virus. Early testing is advised, as that means risky behaviours (unprotected sex, sharing needles) should then be avoided to ensure this disease is not passed onto others.
The most common blood tests that will be done on a regular basis are the following:
- T-cell count - normal levels are 500-1500 in cubic mm of blood, abnormal levels are when it falls to less than 200
- Viral load count - measures the amount of HIV in the amount of blood being tested to determine how much of the virus is infecting the cells; a low viral count (less than 200 copies of the virus) is excellent , while a high viral count (more than 5,000 copies of the virus) is not so good
- Complete blood count - to test the levels of all the different blood cells (red cell, white cells and platelets)
- Chem-screen test - measures a number of important chemicals produced by your body to help it function properly; while this test won't give much information about HIV or how the immune system is functioning, it can determine if other infections are present or if there are side effects to any drug (or other) treatments
There is no cure for AIDS at present (2007), although there are ways to control and manage this illness before it becomes AIDS.
Conventional treatments
Scientists have developed many anti-retroviral drugs to fight both HIV infection (and prevent replication of the virus) to stop its associated opportunistic infections and cancers.
These drugs (many of which are taken in combination with each other), are listed here:
- Cellular inhibitors - these types of drug is used as an antineoplastic, which means they are used to treat various types of cancers associated with AIDS; this type of drug targets the T cells themselves and not the virus; this drug should only be used under medical supervision as it can have very serious (even fatal) side effects
- Entry inhibitors (including fusion inhibitors) - these class of drugs prevent the virus from entering healthy CD4+ cells (T cells) and replicating, which means they are different to many other anti-HIV drugs (which work on the virus after it has entered the CD4+ cell)
- Immune based therapies - these are a type of anti-viral medications that control HIV infection by preventing HIV from replicating in the body; various approaches are being used and large clinical trials are being investigated - these drugs are still in the experimental stage and have not yet been officially approved as a HIV/AIDS treatment
- Integrase inhibitors - an experimental drug showing promise in clinical trials and which may offer hope for those people who have become resistant to the other drugs normally prescribed in anti-HIV treatment; stops HIV from further replicating through the DNA
- Maturation inhibitors - these type of drugs that specifically block a late step in processing of the HIV protein to stop HIV-infected cells from becoming infectious and to terminate virus replication; an experimental class of drugs currently in clinical trials to investigate their use in people with HIV infection resistant to the current class of drugs
- Multi-class combination drugs - these are single drug doses which have a combination of a few types of anti-HIV drugs to simplify drug dosage to be administered in a single dose
- Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs) - these class of drugs are a type of anti-HIV drug and prevent healthy T cells (CD4+ cells) from becoming infected with HIV; one NNRTI is used in combination with 3 other anti-HIV drugs
- Nucleoside/Nucleotide reverse transcriptase inhibitors (NRTI) - these are a class of anti-HIV drugs, used in together with other anti-HIV drugs; these drugs prevent the T cells from being infected with HIV
- Protease inhibitors - these are another class of anti-HIV drugs; when one of these drugs is used in combination with 3 other anti-HIV drugs, they can block the replication of HIV in infected T (CD4+) cells
Drug combinations are used to really supress the virus' action of replication and is used on people with AIDS and also those with a new or existing HIV infection.
All drugs have some associated side-effects (from minor ones to those which could be life-threatening), which must be considered by the doctor when choosing the right medication for the patient. Often, medications are swapped for others if the side effects have a strongly detrimental effect on the infected person. In addition to this, there may be some dietary restrictions with some of these drugs. Your doctor will also advise on the interaction of these drugs with other medications.
Alternative / complementary treatments
A small number of people have reported decrease in symptoms by using alternative practices and no conventional treatments (this are rare cases - ensure you consider all your options and take medical advice before embarking on any type of treatment, conventional or alternative, or combination of both). While alternative / complementary treatments may work on the HIV infection, it is not yet determined if any people with AIDS have used any therapies successfully.
Before trying any type of alternative / complementary treatments, you must advise your doctor, as they may cause serious complications or side effects with any other medications you are taking, including death. Plus there may be serious implications, including death, from not taking any conventional anti-HIV drugs. You should determine your risks with advice from medical specialists.
The following are some alternative / completmentary treatments, some are highly recommended while many alternative practitioners will advise a combination of therapies for greatest effect:
- Chinese medicine - this includes the application of the following
- Accupuncture - people report that it helps with improving energy levels and helps the body deal better with side effects of medications
- Herbs - several scientific journals present research on the health benefits of Chinese herbs to strengthen the immune system
- Moxibustion - this is a heat-drawing therapy to draw toxins out of the body
- Exercise - people infected with HIV / AIDS are recmmended to exercise as much as their illness allows (at least 30 minutes most days of the week); some people can exercise for longer, it depends on the individual
- Herbs - certain herbs have been reported to have some anti-HIV effects
- Echinacea - this herb has known anti-viral activity (improving immunity), but there is some controversy with its use in people with HIV infections
- St John's Wort - hypericum has shown in vitro anti-viral activities and in particular, it has shown anti-HIV activity
- St Mary's Thistle - silymarin, the active component in the herb St Mary's Thistle has been shown in many studies to have a beneficial effect on the liver, protecting the liver from damage; this herb could be especially beneficial for people with AIDS as some of the medication prescribed may damage their liver over the long term
- Meditation - many people report this has a very beneficial effect on their symptoms and quality of life; studies are in progress to determine how and if meditation has any effects on the immune system of people infected with HIV
- Nutrition - people with HIV are advised to take a better look at their nutrition and dietary intake to ensure they are eating in a really healthy manner
- 3 meals a day plus 2 snacks in between
- at least 2 servings of fruit with 5 servings of vegetables a day
- fish 3 times a week
- less red meat
- yoghurt that has been enhaced with probiotics
- little or no added sugar
- little or no preservatives, additives, colours or flavours
- little or no processed foods
- Supplements
- many alternative health care providers recommend extra supplementation of the following nutrients for those infected with HIV
- Antioxidants - studies have shown these supplements may reduce some symptoms (betacarotene, vitamin C, selenium)
- Bioflavonoids - foods high in bioflavonoids have shown to have some anti-HIV activity
- Yoga - many people report reduction in symptoms and better quality of life from all forms of this fitness and meditation technique from the East
- Since May 1985, all blood donations in Australia have been tested for HIV virus (the same screening procedures were also set up in other countries around the same time), with more types of screen testing in place after that
- HIV infections are predominantly found in Africa (in 2007), although they are not eradicated in other countries around the world
- HIV is the most common sexual disease in Australia, which is spread by having intercourse without a condom or by sharing needles
- A person with HIV may no even display any symptoms of the disease, but they can still transfer the virus to another person through their body fluids (semen, blood)
- Drugs for HIV are used to delay AIDS-related illnesses, which invariably lead to death
- People with HIV who get opportunistic infections are classified as having AIDS
- There is a great deal of research on developing a vaccine for HIV and thus preventing AIDS
- AIDS was first reported in the USA in 1981
- The only way to prevent HIV infection and therefore AIDS is to not participate in risky behaviour - no unprotected sex, no sharing of needles
references
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- Constans J, Seigneur M, Blann A et al. Effect of the antioxidants selenium and beta-carotene on HIV-related endothelium dysfunction. Thromb Haemost 1998; 80:1015-17
- Gulick RM, McAuliffe V, Holden-Wiltse J, Crumpacker C, Liebes L, Stein DS, Meehan P, Hussey S, Forcht J, Valentine FT. Phase I studies of hypericin, the active compound in St. John’s wort, as an antiretroviral agent in HIV-infected adults. Annals of Internal Medicine 1999; 130(6): 510-514
- Shahat A, Ismail S, Hammouda F, et al. Anti-HIV activity of flavonoids and proanthocyanidins from Crataegus sinaica. Phytomedicine 1998; 5(2):133-136
To learn more, visit the following reliable sources:
- Centre for Disease Control USA
- Australian Federation of AIDS Organisations
- People Living with AIDS, NSW (Australia)
- National Association of People Living with AIDS, Australia
- AIDS Info (Dept Health & Human Service USA)
