HIV - AIDS

HIV “Human Immunodeficiency Virus”

AIDS “Acquired Immunodeficiency Syndrome”

HIV life cycle:

  1. Attachment: GP120 protein projections binds with CD4 receptors, while also binding with co-receptors called CCR5 or CXCR4 to enter into the cell.

  2. Fusion: Virus unites with cell, viral RNA & viral enzymes unpack contents.

  3. Reverse transcription: viral RNA and viral enzyme (reverse transcriptase) turn into viral DNA & move into nucleus.

  4. Integrate: HIV DNA release integrase (enzyme that can take over cell’s DNA) & integrates into cell’s DNA.

  5. Replicate: HIV DNA makes long chains of virus.

  6. Budding: assembled parts start to grow off cell wall.

  7. Maturity: Pops off cell surface and starts cycle all over.

HIV can turn into AIDS once the body loses enough T cells & its ability to fight off infection & virus.

Transmission of HIV:

  • Sex without a condom

  • Pregnancy (birthing process, breastmilk)

  • Infected injection equipment

  • blood transfusions

  • non-sterile tools

  • HIV can only be transmitted through blood, semen, vaginal fluid, or breastmilk.

HIV Stages:

  • Acute stage

    • Can be spread to others

    • viral load very high in the blood

    • Signs and symptoms: flu-like (aches, joint pain, fever, fatigue, sore throat, swollen lymph nodes, GI upset, rash)

    • Begins a couple weeks to months after being infected

  • Chronic Stage:

    • may be asymptomatic

    • can last a decade or more

    • taking ART (antiretroviral therapy) can keep you here forever and not progress to AIDS

    • can still transmit to others

    • low viral load

    • CD4 count is more than 200 to about 500

    • no opportunistic infections at this time

    • When stage ends: viral count increasing, CD4 drops less than 200, signs and symptoms appear, along with opportunistic infections

  • AIDS

    • last stage

    • immune system completely destroyed by virus

    • without meds, survival is only a few years

Diagnostic Testing for HIV:

  • Acute stage:

    • Window period: time when infected to when a test can deliver a positive result (not enough time for virus to get picked up by test)

      • If the person is suspected to have HIV, they need to abstain from sex until confirmation.

      • No test can show immediate infection

    • Combination test - antigen and antibodies of HIV as early as 2 weeks.

    • Antibody HIV test - not as early as combination test and only tests for the antigen

    • Nucleic acid test (NAT) - used for high risk exposure patients; can show amount of virus in blood; earliest around 10 days

    • CD4 count - measure helper T cells

  • AIDS

    • CD4 count drops less than 200 cells per millimeter

    • Opportunistic disease is present

How to avoid opportunistic infections:

  • Avoid water that is not treated

  • Do not eat foods that are raw or uncooked

  • avoid risky sexual activities

  • Keep up with vaccines

  • Avoid exposure to animal feces

  • Need to take ART therapy as prescribed