Acquired Immune Deficiency Syndrome (AIDS): Causes, Complications, cost and Treatment
What is AIDS?
Acquired immunodeficiency syndrome (AIDS) is a term which applies to the most advanced stages of HIV infection. It is defined by the occurrence of any of more than 20 opportunistic infections or HIV-related cancers. This disease modifies and corrupts the immune system, making people susceptible to infections and diseases. The susceptibility worsens as the syndrome progresses.
The human immunodeficiency virus (HIV) infects cells of the immune system, destroying or impairing their function. Infection with the virus results in progressive deterioration of the immune system, leading to "immune deficiency." The immune system is considered deficient when it can no longer fulfill its role of fighting infection and disease. Infections associated with severe immunodeficiency are known as "opportunistic infections", because they take advantage of a weakened immune system.
The names HIV and AIDS can be confusing because both terms describe the same disease.
However, people who are HIV-positive need not necessarily have AIDS.
An HIV-positive person becomes an AIDS patient when his or her immune system becomes extremely weak and non-resistant to various infections and diseases such as tuberculosis, candidiasis, meningitis, Toxoplasma gondii, PCP (a type of pneumonia ,herpes simplex and herpes zoster. An AIDS patient can also be susceptible to cancers such as Kaposi?s sarcoma, lymphoma, and cervical cancer. They are also prone to wasting syndrome (involuntary weight loss), and memory impairment.
Most people with HIV however, can prevent AIDS by starting treatment (with medicines called antiretroviral therapy or ART) soon after becoming infected with the virus.
How does AIDS occur?
AIDS is the most advanced stage of HIV-positive infection that occurs when your immune system is irreparably damaged and you become vulnerable to what is known as opportunistic infections. Opportunistic infections are infections caused by pathogens (bacteria, viruses, fungi, or protozoa) and occur more often in people with weakened immune systems.
AIDs gets transmitted from an infected person to another through direct contact with bodily fluids such as:
- blood (including menstrual blood)
- semen / cum / precum / ejaculate
- vaginal secretions
- breast milk
The highest concentration of the virus is found in blood, followed by semen, followed by vaginal fluids, and then by breast milk.
AIDS gets transmitted through:
- any form of sexual contact that involves semen, pre-cum, vaginal fluids or blood.
- contact with infected blood, especially through sharing infected injections, or through blood transfusions.
- mother to baby during or before birth or while breastfeeding the baby, through breast milk.
The count of CD4 cells in a human body shows the immunity level of the person. A person with a healthy immune system has CD4 counts between 500 and 1,600 cells per cubic millimetre. When the number of CD4 cells fall below 200 cells per cubic millimetre of blood, then the person is said to have AIDS.
Once a person has been diagnosed with AIDS, she or he is always considered to be an AIDS patient even if that person's CD4 count goes up again or they recover from the disease that defined their AIDS diagnosis.
Who is prone to AIDS?
Anyone of any age, race, sex or sexual orientation can be infected, but you're at greatest risk of HIV/AIDS if you:
- have unprotected sex without using a condom
- have anal sex
- have multiple sexual partners.
- suffer from sexually transmitted infection which may cause sores in your genital area through which the HIV virus may enter your body.
- share needles and syringes for intravenous drugs
- an uncircumcised man
What are the causes of AIDS?
The causes of AIDS include:
- having unprotected sex with an HIV infected partner
- sharing drug needles with someone who is infected by HIV
- the virus passing on from an expectant mother to her baby, during or before birth or while breastfeeding the baby, through breast milk.
- blood transfusion of infected blood
What are the symptoms of AIDS? How is AIDS diagnosed?
As the virus continues to multiply and destroy your immune cells ? the cells in your body that help fight off germs ? you may develop mild infections or chronic signs and symptoms such as:
- skin rash
- muscle aches and joint pains
- a sore throat
- weight loss (anorexia)
- oral ulcers
- genital or anal ulcers
- weight loss
- night sweats
- a persistent cough
- enlarged lymph nodes in the neck, armpits, and groin.
- persistent nausea
People are diagnosed with AIDS when they have certain signs or symptoms defined by the U.S. Centers for Disease Control and Prevention (CDC). The CDC's definition of AIDS includes:
- Less than 200 CD4+ T cells per cubic millimeter of blood, compared with about 1,000 CD4+ T cells for healthy people. CD4+T cells are white blood cells that play an important role in the body's immune system. These cells are destroyed by HIV. Even when a HIV-positive person feels well and is not experiencing any symptoms of the disease, CD4+ T cells are being infected by HIV.
- CD4+ T cells accounting for less than 14 percent of all lymphocytes, a type of white blood cell.
One of more of the illnesses listed below:
- Candidiasis of bronchi, esophagus, trachea or lungs
- Cervical cancer that is invasive
- Coccidioidomycosis that has spread
- Cryptococcosis that is affecting the body outside the lungs
- Cryptosporidiosis affecting the intestines and lasting more than a month
- Cytomegalovirus disease outside of the liver, spleen or lymph nodes
- Cytomegalovirus retinitis that occurs with vision loss
- Encephalopathy that is HIV-related
- Herpes simplex including ulcers lasting more than a month or bronchitis, pneumonitis or esophagitis
- Histoplasmosis that has spread
- Isosporiasis affecting the intestines and lasting more than a month
- Kaposi's sarcoma
- Lymphoma that is Burkitt type, immunoblastic or that is primary and affects the brain or central nervous system
- Mycobacterium avium complex or disease caused by M kansasii
- Mycobacterium tuberculosis in or outside the lungs
- Other species of mycobacterium that has spread
- Pneumocystis jiroveci, formerly called carinii, pneumonia
- Pneumonia that is recurrent
- Progressive multifocal leukoencephalopathy
- Salmonella septicemia that is recurrent
- Toxoplasmosis of the brain, also called encephalitis
- Wasting syndrome caused by HIV infection
Symptoms also may include anxiety, dementia, depression and insomnia.
Tests for HIV and AIDS
Blood tests are the most common way to diagnose the human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS). These tests look for antibodies to the virus that are present in the blood of infected individuals. People exposed to the virus should get tested immediately.
The primery tests for diagnosing HIV/AIDs includes: ELISA Test- ELISA, which stands for enzyme-linked immunosorbent assay, is used to detect HIV infection. If an ELISA test is positive, the Western blot test is usually administered to confirm the diagnosis. If an ELISA test is negative, but you think you may have HIV, you should be tested again in one to three months. Western Blot- This is a very sensitive blood test used to confirm a positive ELISA test result. Home Tests- The only home test approved by the U.S. Food and Drug Administration is called the Home Access Express Test, which is sold in pharmacies. Saliva Tests- A cotton pad is used to obtain saliva from the inside of your cheek. The pad is placed in a vial and submitted to a laboratory for testing. Viral Load Test- This test measures the amount of HIV in your blood. Generally, it's used to monitor treatment progress or detect early HIV infection. Reverse transcription polymerase chain reaction (RT-PCR), branched DNA (bDNA) and nucleic acid sequence-based amplification assay (NASBA).These are the three technologies measures HIV viral in blood.
- a confirmed, positive test for HIV i.e. results showing HIV-positive.
- evidence of an AIDS-defining condition or severely depleted CD4 cells.
Testing for HIV involves:
- a screening test
- a confirmatory test
For the screening test, either blood is obtained from a finger or a vein, or a urine sample or oral swab is taken. The results can be obtained on the same day or may take a few days.
If the result of the screening test is positive, the results are again confirmed by Western blot test or indirect immunofluorescence assay test. The confirmatory test is necessary because the screening test is not considered to be very accurate.
The first step is usually a screening test that looks for antibodies against the HIV. Specimens for testing come from blood obtained from a vein or a finger stick, an oral swab, or a urine sample. Results can come back in minutes (rapid tests) or can take several days, depending on the method that is used. If the screening HIV test is positive, the results are confirmed by a special test called a Western blot or indirect immunofluorescence assay test.
A Western blot detects antibodies to specific components of the virus. The confirmatory test is necessary because the screening test is less accurate and occasionally will be positive in those who do not have HIV.
If the confirmatory test results come back as positive, the person has a 99% likelihood of being infected with HIV.
These tests detect RNA, DNA, or viral antigens. However, these tests are more commonly used for guiding treatment rather than for diagnosis.
What are the complications of AIDS?
HIV complications may include:
- Tuberculosis: Causes, Symptoms, and Treatment"")
- Cryptococcal meningitis
- Wasting syndrome
- Neurological complications
- Kidney diseases
- Memory impairment
Some cancers which are common among AIDS patients are:
- Kaposi's sarcoma
- Cervical cancer in women
What is the treatment of AIDS?
There's no cure for HIV/AIDS,but medications have been highly effective in fighting HIV and its complications. Drug treatments help reduce the HIV virus in your body, keep your immune system as healthy as possible and decrease the complications you may develop.
A few health issues that are a part of the natural ageing process, occurs earlier if you suffer from AIDS and may be more difficult to manage.
Medications may be prescribed for these conditions. However, some medications such as those for cardiovascular, metabolic and bone conditions, may not interact well with anti-HIV medications. You will need to discuss your conditions in detail with your doctor so that he/she can make sure your medicines do not react with each other.
You will be monitored every two to three months especially for your CD4 counts and viral load.
HIV treatment should reduce your viral load to the point that it's undetectable. Though, this does not mean you are free of HIV or that you will not transmit it to others.
Staying Healthy with AIDS
With a few precautions, you can lead a normal life even if you suffer from AIDS.
Ask your doctor about vaccination so that you can get vaccinated if you have AIDS.
Use condoms while having sex with your partner to avoid transmitting the disease and avoiding exposure to sexually transmitted infections.
Avoid illicit drug use and needle sharing.
Religiously take the medicines prescribed by your doctor to avoid any kind of AIDS-related complications.
Take extra precautions when working or visiting hospitals or any other health care facilities so that you do not contract any infection.
Avoid raw or undercooked products and unpasteurized dairy products.
Wash your hands frequently when preparing foods.
Drink filtered water.
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