HIV/AIDS
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        Overview
        Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening
        condition caused by the human immunodeficiency virus (HIV). By damaging your
        immune system, HIV interferes with your body's ability to fight infection and disease.
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        HIV is a sexually transmitted infection (STI). It can also be spread by contact with
        infected blood or from mother to child during pregnancy, childbirth or breast-feeding.
        Without medication, it may take years before HIV weakens your immune system to the
        point that you have AIDS.
        There's no cure for HIV/AIDS, but medications can dramatically slow the progression of
        the disease. These drugs have reduced AIDS deaths in many developed nations.
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        Symptoms
        The symptoms of HIV and AIDS vary, depending on the phase of infection.
        Primary infection (Acute HIV)
        Some people infected by HIV develop a flu-like illness within two to four weeks after the
        virus enters the body. This illness, known as primary (acute) HIV infection, may last for
        a few weeks. Possible signs and symptoms include:
               Fever
      Headache
      Muscle aches and joint pain
      Rash
      Sore throat and painful mouth sores
      Swollen lymph glands, mainly on the neck
      Diarrhea
      Weight loss
      Cough
      Night sweats
These symptoms can be so mild that you might not even notice them. However, the
amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the
infection spreads more easily during primary infection than during the next stage.
Clinical latent infection (Chronic HIV)
In this stage of infection, HIV is still present in the body and in white blood cells.
However, many people may not have any symptoms or infections during this time.
This stage can last for many years if you're not receiving antiretroviral therapy (ART).
Some people develop more severe disease much sooner.
Symptomatic HIV infection
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:
      Fever
      Fatigue
      Swollen lymph nodes — often one of the first signs of HIV infection
      Diarrhea
      Weight loss
          Oral yeast infection (thrush)
          Shingles (herpes zoster)
          Pneumonia
    Progression to AIDS
    Thanks to better antiviral treatments, most people with HIV in the U.S. today don't
    develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.
    When AIDS occurs, your immune system has been severely damaged. You'll be more
    likely to develop opportunistic infections or opportunistic cancers — diseases that
    wouldn't usually cause illness in a person with a healthy immune system.
    The signs and symptoms of some of these infections may include:
          Sweats
          Chills
          Recurring fever
          Chronic diarrhea
          Swollen lymph glands
          Persistent white spots or unusual lesions on your tongue or in your mouth
          Persistent, unexplained fatigue
          Weakness
          Weight loss
          Skin rashes or bumps
    When to see a doctor
    If you think you may have been infected with HIV or are at risk of contracting the virus,
    see a doctor as soon as possible.
    More Information
          Early HIV symptoms: What are they?
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Causes
HIV is caused by a virus. It can spread through sexual contact or blood, or from mother
to child during pregnancy, childbirth or breast-feeding.
How does HIV become AIDS?
HIV destroys CD4 T cells — white blood cells that play a large role in helping your body
fight disease. The fewer CD4 T cells you have, the weaker your immune system
becomes.
You can have an HIV infection, with few or no symptoms, for years before it turns
into AIDS. AIDS is diagnosed when the CD4 T cell count falls below 200 or you have
an AIDS-defining complication, such as a serious infection or cancer.
How HIV spreads
To become infected with HIV, infected blood, semen or vaginal secretions must enter
your body. This can happen in several ways:
      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.
      By sharing needles. Sharing contaminated IV drug paraphernalia (needles and
       syringes) puts you at high risk of HIV and other infectious diseases, such as hepatitis.
      From blood transfusions. In some cases, the virus may be transmitted through blood
       transfusions. American hospitals and blood banks now screen the blood supply
       for HIV antibodies, so this risk is very small.
      During pregnancy or delivery or through breast-feeding. Infected mothers can pass
       the virus on to their babies. Mothers who are HIV-positive and get treatment for the
       infection during pregnancy can significantly lower the risk to their babies.
How HIV doesn't spread
You can't become infected with HIV through ordinary contact. That means you can't
catch HIV or AIDS by hugging, kissing, dancing or shaking hands with someone who
has the infection.
HIV isn't spread through the air, water or insect bites.
Risk factors
Anyone of any age, race, sex or sexual orientation can be infected with HIV/AIDS.
However, you're at greatest risk of HIV/AIDS if you:
     Have unprotected sex. Use a new latex or polyurethane condom every time you have
      sex. Anal sex is more risky than is vaginal sex. Your risk of HIV increases if you have
      multiple sexual partners.
     Have an STI. Many STIs produce open sores on your genitals. These sores act as
      doorways for HIV to enter your body.
     Use IV drugs. People who use IV drugs often share needles and syringes. This exposes
      them to droplets of other people's blood.
Complications
HIV infection weakens your immune system, making you much more likely to develop
many infections and certain types of cancers.
Infections common to HIV/AIDS
     Pneumocystis pneumonia (PCP). This fungal infection can cause severe illness.
      Although it's declined significantly with current treatments for HIV/AIDS, in the
      U.S. PCP is still the most common cause of pneumonia in people infected with HIV.
     Candidiasis (thrush). Candidiasis is a common HIV-related infection. It causes
      inflammation and a thick, white coating on your mouth, tongue, esophagus or vagina.
     Tuberculosis (TB). In resource-limited nations, TB is the most common opportunistic
      infection associated with HIV. It's a leading cause of death among people with AIDS.
     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.
     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.
     Toxoplasmosis. This potentially deadly infection is caused by Toxoplasma gondii, a
      parasite spread primarily by cats. Infected cats pass the parasites in their stools, which
      may then spread to other animals and humans. Toxoplasmosis can cause heart disease,
      and seizures occur when it spreads to the brain.
Cancers common to HIV/AIDS
     Lymphoma. This cancer starts in the white blood cells. The most common early sign is
      painless swelling of the lymph nodes in your neck, armpit or groin.
     Kaposi's sarcoma. A tumor of the blood vessel walls, 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.
Other complications
     Wasting syndrome. Untreated HIV/AIDS can cause significant weight loss, often
      accompanied by diarrhea, chronic weakness and fever.
     Neurological complications. HIV can cause neurological symptoms such as confusion,
      forgetfulness, depression, anxiety and difficulty walking. HIV-associated neurocognitive
      disorders (HAND) can range from mild symptoms of behavioral changes and reduced
      mental functioning to severe dementia causing weakness and inability to function.
     Kidney disease. HIV-associated nephropathy (HIVAN) is an inflammation of the tiny
      filters in your kidneys that remove excess fluid and wastes from your blood and pass
      them to your urine. It most often affects black or Hispanic people.
     Liver disease. Liver disease is also a major complication, especially in people who also
      have hepatitis B or hepatitis C.
Prevention
There's no vaccine to prevent HIV infection and no cure for AIDS. But you can protect
yourself and others from infection.
To help prevent the spread of HIV:
     Use treatment as prevention (TasP). If you're living with HIV, taking HIV medication
      can keep your partner from becoming infected with the virus. If you make sure your viral
      load stays undetectable — a blood test doesn't show any virus — you won't transmit the
      virus to anyone else. Using TasP means taking your medication exactly as prescribed
      and getting regular checkups.
   Use post-exposure prophylaxis (PEP) if you've been exposed to HIV. If you think
    you've been exposed through sex, needles or in the workplace, contact your doctor or go
    to the emergency department. Taking PEP as soon as possible within the first 72 hours
    can greatly reduce your risk of becoming infected with HIV. You will need to take
    medication for 28 days.
   Use a new condom every time you have sex. Use a new condom every time you have
    anal or vaginal sex. Women can use a female condom. If using a lubricant, make sure it's
    water-based. Oil-based lubricants can weaken condoms and cause them to break.
    During oral sex use a nonlubricated, cut-open condom or a dental dam — a piece of
    medical-grade latex.
   Consider preexposure prophylaxis (PrEP). The combination drugs emtricitabine plus
    tenofovir (Truvada) and emtricitabine plus tenofovir alafenamide (Descovy) can reduce
    the risk of sexually transmitted HIV infection in people at very high risk. PrEP can reduce
    your risk of getting HIV from sex by more than 90% and from injection drug use by more
    than 70%, according to the Centers for Disease Control and Prevention. Descovy hasn't
    been studied in people who have receptive vaginal sex.
    Your doctor will prescribe these drugs for HIV prevention only if you don't already
    have HIV infection. You will need an HIV test before you start taking PrEP and
    then every three months as long as you're taking it. Your doctor will also test your
    kidney function before prescribing Truvada and continue to test it every six
    months.
    You need to take the drugs every day. They don't prevent other STIs, so you'll still
    need to practice safe sex. If you have hepatitis B, you should be evaluated by an
    infectious disease or liver specialist before beginning therapy.
   Tell your sexual partners if you have HIV. It's important to tell all your current and past
    sexual partners that you're HIV-positive. They'll need to be tested.
   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. 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
    significantly cut your baby's risk.
   Consider male circumcision. There's evidence that male circumcision can help reduce
    the risk of getting HIV infection.