HIV/AIDS

Possible Cause

Scientists believe a virus similar to HIV first occurred in some populations of chimps and monkeys in Africa, where they're hunted for food. Contact with an infected monkey's blood during butchering or cooking may have allowed the virus to cross into humans and become HIV.

How does HIV become AIDS?

HIV destroys CD4 cells — a specific type of white blood cell that plays a large role in helping your body fight disease. Your immune system weakens as more CD4 cells are killed. You can have an HIV infection for years before it progresses to AIDS. People infected with HIV progress to AIDS when their CD4 count falls below 200 or they experience an AIDS-defining complication, such as:

• Pneumocystis pneumonia
• Cytomegalovirus
• Tuberculosis
• Toxoplasmosis
• Cryptosporidiosis

How HIV is transmitted

To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. You can't become infected through ordinary contact — hugging, kissing, dancing or shaking hands — with someone who has HIV or AIDS. HIV can't be transmitted through the air, water or via insect bites.You can become infected with HIV in several ways, including:

• By having sex You may become infected if you have vaginal, anal or oral sex with an infected partner whose blood, semen or vaginal secretions enter your body. The virus can enter your body through mouth sores or small tears that sometimes develop in the rectum or vagina during sexual activity.
• From blood transfusions In some cases, the virus may be transmitted through blood transfusions. Indian hospitals and blood banks now screen the blood supply for HIV antibodies, so this risk is very small.
• By sharing needles HIV can be transmitted through needles and syringes contaminated with infected blood. Sharing intravenous drug paraphernalia puts you at high risk of HIV and other infectious diseases, such as hepatitis.
• During pregnancy or delivery or through breast-feeding Infected mothers can infect their babies. But receiving treatment for HIV infection during pregnancy, mothers significantly lower the risk to their babies.

Risk Factors

When HIV/AIDS first surfaced in the United States, it mainly affected men who had sex with men. However, now it's clear that HIV is also spread through heterosexual sex.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 sexual Unprotected sex means having sex without using a new latex or polyurethane condom every time. Anal sex is more risky than is vaginal sex. The risk increases if you have multiple sexual partners.
• Have another STI Many sexually transmitted infections (STIs) produce open sores on your genitals. These sores act as doorways for HIV to enter your body.
• Use intravenous drugs Use intravenous drugs
• Are an uncircumcised man Studies indicate that lack of circumcision increases the risk of heterosexual transmission of HIV.

Complications

HIV infection weakens your immune system, making you highly susceptible to numerous infections and certain types of cancers.

Infections common to HIV/AIDS

• Tuberculosis (TB). In resource-poor nations, TB is the most common opportunistic infection associated with HIV and a leading cause of death among people with AIDS. Millions of people are currently infected with both HIV and tuberculosis, and many experts consider the two diseases to be twin epidemics.
• Salmonellosis You contract this bacterial infection from contaminated food or water. Signs and symptoms include severe diarrhea, fever, chills, abdominal pain and, occasionally, vomiting. Although anyone exposed to salmonella bacteria can become sick, salmonellosis is far more common in HIV-positive people.
• Cytomegalovirus This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.
• Candidiasis Candidiasis is a common HIV-related infection. It causes inflammation and a thick, white coating on the mucous membranes of your mouth, tongue, esophagus or vagina. Children may have especially severe symptoms in the mouth or esophagus, which can make eating painful.
• Cryptococcal meningitis Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus found in soil. The disease may also be associated with bird or bat droppings.
• Toxoplasmosis This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasites in their stools, and the parasites may then spread to other animals and humans.
• Cryptosporidiosis This infection is caused by an intestinal parasite that's commonly found in animals. You contract cryptosporidiosis when you ingest contaminated food or water. The parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhea in people with AIDS.

Cancers common to HIV/AIDS

• Kaposi's sarcoma A tumor of the blood vessel walls, this cancer is rare in people not infected with HIV, but common in HIV-positive people. Kaposi's sarcoma usually appears as pink, red or purple lesions on the skin and mouth. In people with darker skin, the lesions may look dark brown or black. Kaposi's sarcoma can also affect the internal organs, including the digestive tract and lungs.
• Lymphomas This type of cancer originates in your white blood cells and usually first appears in your lymph nodes. The most common early sign is painless swelling of the lymph nodes in your neck, armpit or groin.

Care and Treatment

There's no vaccine to prevent HIV infection and no cure for AIDS. But it's possible to protect yourself and others from infection. That means educating yourself about HIV and avoiding any behavior that allows HIV-infected fluids — blood, semen, vaginal secretions and breast milk — into your body.To help prevent the spread of HIV:

• Use a new condom every time you have sex If you don't know the HIV status of your partner, use a new condom every time you have anal or vaginal sex. Women can use a female condom. Use only water-based lubricants. Oil-based lubricants can weaken condoms and cause them to break. During oral sex use a condom, dental dam — a piece of medical-grade latex — or plastic wrap.
• Consider the drug Truvada In July 2012, the Food and Drug Administration approved the use of the combination drug emtricitabine-tenofovir (Truvada) to reduce the risk of sexually transmitted HIV infection in those who are at high risk. Truvada is also used as an HIV treatment along with other medications.When used to help prevent HIV infection, Truvada is only appropriate if your doctor is certain you don't already have an HIV infection. Your doctor should also test for hepatitis B infection. If you have hepatitis B, your doctor should test your kidney function before prescribing Truvada.

Truvada must be taken daily, exactly as prescribed, and you'll need follow-up HIV and kidney function testing every few months. Truvada should only be used along with other prevention strategies such as condom use every time you have sex.

• Tell your sexual partners if you have HIV It's important to tell anyone with whom you've had sex that you're HIV-positive. Your partners need to be tested and to receive medical care if they have the virus. They also need to know their HIV status so that they don't infect others.
• Use a clean needle If you use a needle to inject drugs, make sure it's sterile and don't share it. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
• If you're pregnant get medical care right away. If you're HIV-positive, you may pass the infection to your baby. But if you receive treatment during pregnancy, you can cut your baby's risk by as much as two-thirds.
• Consider male circumcision There's evidence that male circumcision can help reduce a man's risk of acquiring HIV.

When to Call the Doctor

If you think you may have been infected with HIV or are at risk of contracting the virus, see a health care provider as soon as possible.