Hiv B
Hiv B
What is HIV?
HIV is a virus that damages the immune system. Untreated HIV affects and kills CD4 cells, which are a
type of immune cell called T cell.
Over time, as HIV kills more CD4 cells, the body is more likely to get various types of conditions and
cancers.
blood
semen
breast milk
Because HIV inserts itself into the DNA of cells, it’s a lifelong condition and currently there’s no drug
that eliminates HIV from the body, although many scientists are working to find one.
However, with medical care, including treatment called antiretroviral therapy, it’s possible to manage
HIV and live with the virus for many years.
Without treatment, a person with HIV is likely to develop a serious condition called the Acquired
Immunodeficiency Syndrome, known as AIDS.
At that point, the immune system is too weak to successfully respond against other diseases,
infections, and conditions.
Untreated, life expectancy with end stage AIDS is about 3 yearsTrusted Source. With antiretroviral
therapy, HIV can be well-managed, and life expectancy can be nearly the same as someone who has
not contracted HIV.
It’s estimated that 1.2 million Americans are currently living with HIV. Of those people, 1 in 7 don’t
know they have the virus.
Learn about the effects of HIV on the different systems in the body.
What is AIDS?
AIDS is a disease that can develop in people with HIV. It’s the most advanced stage of HIV. But just
because a person has HIV doesn’t mean AIDS will develop.
HIV kills CD4 cells. Healthy adults generally have a CD4 count of 500 to 1,600 per cubic millimeter. A
person with HIV whose CD4 count falls below 200 per cubic millimeter will be diagnosed with AIDS.
A person can also be diagnosed with AIDS if they have HIV and develop an opportunistic infection or
cancer that’s rare in people who don’t have HIV.
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An opportunistic infection such as Pneumocystis jiroveci pneumonia is one that only occurs in a
severely immunocompromised person, such as someone with advanced HIV infection (AIDS).
Untreated, HIV can progress to AIDS within a decade. There’s currently no cure for AIDS, and without
treatment, life expectancy after diagnosis is about 3 yearsTrusted Source.
This may be shorter if the person develops a severe opportunistic illness. However, treatment with
antiretroviral drugs can prevent AIDS from developing.
If AIDS does develop, it means that the immune system is severely compromised, that is, weakened
to the point where it can no longer successfully respond against most diseases and infections.
That makes the person living with AIDS vulnerable to a wide range of illnesses, including:
pneumonia
tuberculosis
The shortened life expectancy linked with untreated AIDS isn’t a direct result of the syndrome itself.
Rather, it’s a result of the diseases and complications that arise from having an immune system
weakened by AIDS.
Learn more about possible complications that can arise from HIV and AIDS.
During this time, the virus reproduces rapidly. The person’s immune system responds by producing
HIV antibodies, which are proteins that take measures to respond against infection.
During this stage, some people have no symptoms at first. However, many people experience
symptoms in the first month or so after contracting the virus, but they often don’t realize HIV causes
those symptoms.
This is because symptoms of the acute stage can be very similar to those of the flu or other seasonal
viruses, such as:
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fever
chills
skin rash
sore throat
headache
nausea
upset stomach
Because these symptoms are similar to common illnesses like the flu, the person who has them
might not think they need to see a healthcare provider.
And even if they do, their healthcare provider might suspect the flu or mononucleosis and might not
even consider HIV.
Whether a person has symptoms or not, during this period their viral load is very high. The viral load
is the amount of HIV found in the bloodstream.
A high viral load means that HIV can be easily transmitted to someone else during this time.
Initial HIV symptoms usually resolve within a few months as the person enters the chronic, or clinical
latency, stage of HIV. This stage can last many years or even decades with treatment.
After the first month or so, HIV enters the clinical latency stage. This stage can last from a few years
to a few decades.
Some people don’t have any symptoms during this time, while others may have minimal or
nonspecific symptoms. A nonspecific symptom is a symptom that doesn’t pertain to one specific
disease or condition.
recurrent fevers
night sweats
fatigue
nausea
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vomiting
diarrhea
weight loss
skin rashes
pneumonia
shingles
As with the early stage, HIV is still transferable during this time even without symptoms and can be
transmitted to another person.
However, a person won’t know they have HIV unless they get tested. If someone has these
symptoms and thinks they may have been exposed to HIV, it’s important that they get tested.
HIV symptoms at this stage may come and go, or they may progress rapidly. This progression can be
slowed substantially with treatment.
With the consistent use of this antiretroviral therapy, chronic HIV can last for decades and will likely
not develop into AIDS, if treatment was started early enough.
Learn more about how HIV symptoms can progress over time.
molluscum contagiosum
herpes simplex
shingles
how it looks
This type of rash usually appears within a week or 2 weeks of starting a new medication. Sometimes
the rash will clear up on its own. If it doesn’t, a change in medications may be needed.
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Rash due to an allergic reaction to medication can be serious.
dizziness
fever
Stevens-Johnson syndrome (SJS) is a rare allergic reaction to HIV medication. Symptoms include fever
and swelling of the face and tongue. A blistering rash, which can involve the skin and mucous
membranes, appears and spreads quickly.
When 30 percentTrusted Source of the skin is affected, it’s called toxic epidermal necrolysis, which is
a life threatening condition. If this develops, emergency medical care is needed.
While rash can be linked with HIV or HIV medications, it’s important to keep in mind that rashes are
common and can have many other causes.
If a person has been exposed to HIV, they may also have been exposed to other sexually transmitted
infections (STIs). These include:
gonorrhea
chlamydia
syphilis
trichomoniasis
Men, and those with a penis, may be more likely than women to notice symptoms of STIs such as
sores on their genitals. However, men typically don’t seek medical care as often as women.
Both men and women with HIV are at increased risk for STIs. However, women, and those with a
vagina, may be less likely than men to notice small spots or other changes to their genitals.
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human papillomavirus (HPV), which can cause genital warts and lead to cervical cancer
While not related to HIV symptoms, another risk for women with HIV is that the virus can be
transmitted to a baby during pregnancy. However, antiretroviral therapy is considered safe during
pregnancy.
Women who are treated with antiretroviral therapy are at very low risk for transmitting HIV to their
baby during pregnancy and delivery. Breastfeeding is also affected in women with HIV. The virus can
be transferred to a baby through breast milk.
In the United States and other settings where formula is accessible and safe, it’s recommended that
women with HIV not breastfeed their babies. For these women, use of formula is encouraged.
For women who may have been exposed to HIV, it’s important to know what symptoms to look for.
If HIV is found and treated early with antiretroviral therapy, a person will usually not develop AIDS.
People with HIV may develop AIDS if their HIV is not diagnosed until late or if they know they have
HIV but don’t consistently take their antiretroviral therapy.
They may also develop AIDS if they have a type of HIV that’s resistant to (doesn’t respond to) the
antiretroviral treatment.
Without proper and consistent treatment, people living with HIV can develop AIDS sooner. By that
time, the immune system is quite damaged and has a harder time generating a response to infection
and disease.
With the use of antiretroviral therapy, a person can maintain a chronic HIV diagnosis without
developing AIDS for decades.
recurrent fever
chronic swollen lymph glands, especially of the armpits, neck, and groin
chronic fatigue
night sweats
dark splotches under the skin or inside the mouth, nose, or eyelids
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neurologic problems such as trouble concentrating, memory loss, and confusion
Antiretroviral therapy controls the virus and usually prevents progression to AIDS. Other infections
and complications of AIDS can also be treated. That treatment must be tailored to the individual
needs of the person.
blood
semen
breast milk
by sharing needles, syringes, and other items for injection drug use
during breastfeeding
through exposure to the blood, semen, vaginal and rectal fluids, and breast milk of someone
living with HIV, such as through a needle stick
The virus can also be transmitted through a blood transfusion or organ and tissue transplant.
However, rigorous testing for HIV among blood, organ, and tissue donors ensures that this is very
rare in the United States.
It’s theoretically possible, but considered extremely rare, for HIV to be transmitted through:
oral sex (only if there are bleeding gums or open sores in the person’s mouth)
being bitten by a person with HIV (only if the saliva is bloody or there are open sores in the
person’s mouth)
contact between broken skin, wounds, or mucous membranes and the blood of someone
living with HIV
skin-to-skin contact
air or water
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sharing food or drinks, including drinking fountains
saliva, tears, or sweat (unless mixed with the blood of a person with HIV)
It’s important to note that if a person living with HIV is being treated and has a persistently
undetectable viral load, it’s virtually impossible to transmit the virus to another person.
Causes of HIV
HIV is a variation of a virus that can be transmitted to African chimpanzees. Scientists suspect the
simian immunodeficiency virus (SIV) jumped from chimps to humans when people consumed
chimpanzee meat containing the virus.
Once inside the human population, the virus mutated into what we now know as HIV. This likely
occurred as long ago as the 1920s.
HIV spread from person to person throughout Africa over the course of several decades. Eventually,
the virus migrated to other parts of the world. Scientists first discovered HIV in a human blood
sample in 1959.
It’s thought that HIV has existed in the United States since the 1970s, but it didn’t start to hit public
consciousness until the 1980s.
Learn more about the history of HIV and AIDS in the United States.
The main treatment for HIV is antiretroviral therapy, a combination of daily medications that stop the
virus from reproducing. This helps protect CD4 cells, keeping the immune system strong enough to
take measures against disease.
Antiretroviral therapy helps keep HIV from progressing to AIDS. It also helps reduce the risk of
transmitting HIV to others.
When treatment is effective, the viral load will be “undetectable.” The person still has HIV, but the
virus is not visible in test results.
However, the virus is still in the body. And if that person stops taking antiretroviral therapy, the viral
load will increase again, and the HIV can again start attacking CD4 cells.
HIV medications
Many antiretroviral therapy medications are approved to treat HIV. They work to prevent HIV from
reproducing and destroying CD4 cells, which help the immune system generate a response to
infection.
This helps reduce the risk of developing complications related to HIV, as well as transmitting the virus
to others.
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These antiretroviral medications are grouped into seven classes:
protease inhibitors
fusion inhibitors
attachment inhibitors
Treatment regimens
The U.S. Department of Health and Human Services (HHS) generally recommends a starting regimen
of three HIV medications from at least two of these drug classes.
This combination helps prevent HIV from forming resistance to medications. (Resistance means the
drug no longer works to treat the virus.)
Many of the antiretroviral medications are combined with others so that a person with HIV typically
takes only one or two pills a day.
A healthcare provider will help a person with HIV choose a regimen based on their overall health and
personal circumstances.
These medications must be taken every day, exactly as prescribed. If they’re not taken appropriately,
viral resistance can develop, and a new regimen may be needed.
Blood testing will help determine if the regimen is working to keep the viral load down and the CD4
count up. If an antiretroviral therapy regimen isn’t working, the person’s healthcare provider will
switch them to a different regimen that’s more effective.
Serious side effects can include swelling of the mouth and tongue and liver or kidney damage. If side
effects are severe, the medications can be adjusted.
Costs for antiretroviral therapy vary according to geographic location and type of insurance coverage.
Some pharmaceutical companies have assistance programs to help lower the cost.
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stage 2: clinical latency, or chronic stage
stage 3: AIDS
As HIV lowers the CD4 cell count, the immune system weakens. A typical adult’s CD4 count is 500 to
1,500 per cubic millimeter. A person with a count below 200 is considered to have AIDS.
How quickly a case of HIV progresses through the chronic stage varies significantly from person to
person. Without treatment, it can last up to a decade before advancing to AIDS. With treatment, it
can last indefinitely.
There’s currently no cure for HIV, but it can be managed. People with HIV often have a near-normal
lifespan with early treatment with antiretroviral therapy.
Along those same lines, there’s technically no cure for AIDS currently. However, treatment can
increase a person’s CD4 count to the point where they’re considered to no longer have AIDS. (This
point is a count of 200 or higher.)
HIV and AIDS are related, but they’re not the same thing.
Causes of AIDS
AIDS is caused by HIV. A person can’t get AIDS if they haven’t contracted HIV.
Healthy individuals have a CD4 count of 500 to 1,500 per cubic millimeter. Without treatment, HIV
continues to multiply and destroy CD4 cells. If a person’s CD4 count falls below 200, they have AIDS.
Also, if someone with HIV develops an opportunistic infection associated with HIV, they can still be
diagnosed with AIDS, even if their CD4 count is above 200.
Antibody/antigen tests
Antibody/antigen tests are the most commonly used tests. They can show positive results typically
within 18–45 daysTrusted Source after someone initially contracts HIV.
These tests check the blood for antibodies and antigens. An antibody is a type of protein the body
makes to respond to an infection. An antigen, on the other hand, is the part of the virus that
activates the immune system.
Antibody tests
These tests check the blood solely for antibodies. Between 23 and 90 daysTrusted Source after
transmission, most people will develop detectable HIV antibodies, which can be found in the blood
or saliva.
These tests are done using blood tests or mouth swabs, and there’s no preparation necessary. Some
tests provide results in 30 minutes or less and can be performed in a healthcare provider’s office or
clinic.
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OraQuick HIV Test. An oral swab provides results in as little as 20 minutes.
Home Access HIV-1 Test System. After the person pricks their finger, they send a blood
sample to a licensed laboratory. They can remain anonymous and call for results the next
business day.
If someone suspects they’ve been exposed to HIV but tested negative in a home test, they should
repeat the test in 3 months. If they have a positive result, they should follow up with their healthcare
provider to confirm.
It takes from 5 to 21 days for HIV to be detectable in the blood. This test is usually accompanied or
confirmed by an antibody test.
The time between exposure to HIV and when it becomes detectable in the blood is called the HIV
window period. Most people develop detectable HIV antibodies within 23 to 90 days after
transmission.
If a person takes an HIV test during the window period, it’s likely they’ll receive a negative result.
However, they can still transmit the virus to others during this time.
If someone thinks they may have been exposed to HIV but tested negative during this time, they
should repeat the test in a few months to confirm (the timing depends on the test used). And during
that time, they need to use condoms or other barrier methods to prevent possibly spreading HIV.
Someone who tests negative during the window might benefit from post-exposure prophylaxis (PEP).
This is medication taken after an exposure to prevent getting HIV.
PEP needs to be taken as soon as possible after the exposure; it should be taken no later than 72
hours after exposure but ideally before then.
Another way to prevent getting HIV is pre-exposure prophylaxis (PrEP). A combination of HIV drugs
taken before potential exposure to HIV, PrEP can lower the risk of contracting or transmitting HIV
when taken consistently.
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HIV prevention
Although many researchers are working to develop one, there’s currently no vaccine available to
prevent the transmission of HIV. However, taking certain steps can help prevent the transmission of
HIV.
Safer sex
The most common way for HIV to be transferred is through anal or vaginal sex without a condom or
other barrier method. This risk can’t be completely eliminated unless sex is avoided entirely, but the
risk can be lowered considerably by taking a few precautions.
Get tested for HIV. It’s important they learn their status and that of their partner.
Get tested for other sexually transmitted infections (STIs). If they test positive for one, they
should get it treated, because having an STI increases the risk of contracting HIV.
Use condoms. They should learn the correct way to use condoms and use them every time
they have sex, whether it’s through vaginal or anal intercourse. It’s important to keep in mind
that pre-seminal fluids (which come out before male ejaculation) can contain HIV.
Take their medications as directed if they have HIV. This lowers the risk of transmitting the
virus to their sexual partner.
Avoid sharing needles or other paraphernalia. HIV is transmitted through blood and can be
contracted by using materials that have come in contact with the blood of someone who has
HIV.
Consider PEP. A person who has been exposed to HIV should contact their healthcare
provider about obtaining post-exposure prophylaxis (PEP). PEP can reduce the risk of
contracting HIV. It consists of three antiretroviral medications given for 28 days. PEP should
be started as soon as possible after exposure but before 36 to 72 hours have passed.
Consider PrEP. A person has a higher chance of contracting HIV should talk to their
healthcare provider about pre-exposure prophylaxis (PrEP). If taken consistently, it can lower
the risk of acquiring HIV. PrEP is a combination of two drugs available in pill form.
Healthcare providers can offer more information on these and other ways to prevent the spread of
HIV.
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The most important thing is to start antiretroviral treatment as soon as possible. By taking
medications exactly as prescribed, people living with HIV can keep their viral load low and their
immune system strong.
Other ways people living with HIV can improve their health include:
Make their health their top priority. Steps to help people living with HIV feel their best
include:
o exercising regularly
Focus on their mental health. They could consider seeing a licensed therapist who is
experienced in treating people with HIV.
Use safer sex practices. Talk to their sexual partner(s). Get tested for other STIs. And use
condoms and other barrier methods every time they have vaginal or anal sex.
Talk to their healthcare provider about PrEP and PEP. When used consistently by a person
without HIV, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) can lower
the chances of transmission. PrEP is most often recommended for people without HIV in
relationships with people with HIV, but it can be used in other situations as well. Online
sources for finding a PrEP provider include PrEP Locator and PleasePrEPMe.
Surround themselves with loved ones. When first telling people about their diagnosis, they
can start slow by telling someone who can maintain their confidence. They may want to
choose someone who won’t judge them and who will support them in caring for their health.
Get support. They can join an HIV support group, either in person or online, so they can
meet with others who face the same concerns they have. Their healthcare provider can also
steer them toward a variety of resources in their area.
There are many ways to get the most out of life when living with HIV.
It’s a dramatic improvement, due in large part to antiretroviral therapy. With proper treatment, many
people with HIV can expect a normal or near- normal lifespan.
Of course, many things affect life expectancy for a person with HIV. Among them are:
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viral load
misusing drugs
smoking
age
Where a person lives also matters. People in the United States and other developed countries may
be more likely to have access to antiretroviral therapy.
Consistent use of these drugs helps prevent HIV from progressing to AIDS. When HIV advances to
AIDS, life expectancy without treatment is about 3 yearsTrusted Source.
In 2017, about 20.9 million peopleTrusted Source living with HIV were using antiretroviral therapy.
Life expectancy statistics are just general guidelines. People living with HIV should talk to their
healthcare provider to learn more about what they can expect.
Learn more about life expectancy and long-term outlook with HIV.
HIV is a complicated virus. It mutates (changes) rapidly and is often able to fend off immune system
responses. Only a small number of people who have HIV develop broadly neutralizing antibodies, the
kind of antibodies that can respond to a range of HIV strains.
The first HIV vaccine efficacy study in 7 years was underway in South Africa in 2016. The
experimental vaccine is an updated version of one used in a 2009 trial that took place in Thailand.
A 3.5-year follow-up after vaccination showed the vaccine was 31.2 percent effective in preventing
HIV transmission.
The study involves 5,400 men and women from South Africa. In 2016 in South Africa, about 270,000
peopleTrusted Source contracted HIV. The results of the study are expected in 2021.
Other late-stage, multinational vaccine clinical trials are also currently underway.
While there’s still no vaccine to prevent HIV, people with HIV can benefit from other vaccines to
prevent HIV-related illnesses. Here are the CDC recommendations:
pneumonia: recommendedTrusted Source for all children younger than 2 and all adults 65
and older
influenza: recommendedTrusted Source for all people over 6 months old annually with rare
exceptions
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hepatitis A and B: ask your doctor if you should get vaccinated for hepatitis A and B,
especially if you are in a higher risk groupTrusted Source
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