HIV and AIDS

AIDS (Acquired Immunodeficiency Syndrome)

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Kiran Anaparthi

Published on Apr 11, 2019   -  4 min read

Abstract

Abstract

AIDS (Acquired Immunodeficiency Syndrome) is the most advanced stage of HIV infection. AIDS is defined by the presence of at least one major and two minor infections and not related to CD4 count. Human Immunodeficiency Virus (HIV) causes HIV and AIDS.

AIDS (Acquired Immunodeficiency Syndrome)

AIDS (Acquired Immunodeficiency Syndrome) is the most advanced stage of HIV infection. AIDS is defined by the presence of at least one major and two minor infections and not related to CD4 count. Human Immunodeficiency Virus (HIV) causes HIV and AIDS.

There are two types of HIV, which are HIV-1 and HIV-2, both of which can cause AIDS. The only difference being HIV-2 cannot be transmitted easily and once infected, it takes time for HIV infection to lead to AIDS. If HIV infection is left untreated, it gradually affects the immune system, which results in AIDS as the body becomes susceptible to infections. Without treatment, 50 % of people with HIV develop AIDS within 10 years.

Since the first documented case of AIDS in 1981, nearly 35 million people have died due to conditions resulting from this disease. But now with the help of combination antiretroviral drugs, HIV infection has been converted into a chronic disease that people live with.

With proper treatment and care, people with HIV infection can expect a near-normal life expectancy. Once an HIV patient progresses to AIDS, he or she typically survive for about 3 years without treatment. But if the patient is infected with some dangerous opportunistic infection, then life-expectancy falls to about a year.

What Are the Factors Responsible for the Rapid Progression of HIV to AIDS?

The progression of HIV to AIDS depends on a lot of factors like:

  1. Age of the patient.

  2. The condition of the immune system to fight against HIV.

  3. Availability of high-quality healthcare.

  4. The presence of other diseases and infections.

  5. Strains of HIV that are resistant to drugs.

  6. The patient's genetic resistance to some of the HIV strains.

What Are the Symptoms of AIDS?

The symptoms of AIDS are:

  • Persistent and chronic diarrhea.

  • Blurred vision.

  • Dry cough.

  • Long lasting fever.

  • Night sweats.

  • Dyspnea.

  • Swollen lymph nodes.

  • Weight loss.

  • Persistent white spots on the tongue and mouth.

  • Extreme tiredness.

  • Opportunistic infections.

  • Skin rashes.

What Are Opportunistic Infections of HIV?

As HIV weakens the immune system, the normal flora of our body and commensal organisms (organisms that help our body in our day to day life) become overactive and attack our body causing opportunistic infections. That is it takes the opportunity and feeds on our body causing multiple infections. Some of the commonly seen infections are:

  • Candidiasis - Candidiasis is a fungal infection that is caused by the fungi Candida. It usually causes white patches in the tongue, skin, mouth, vagina, and mail. In HIV patients, it causes lesions in the esophagus, bronchi, trachea, and lungs.

  • Cryptococcosis - Cryptococcal meningitis is the inflammation of the membranes around the brain and spinal cord that results from inhalation of the fungus Cryptococcus. This fungus is found in soil, bird droppings, and areas surrounding trees. This fungus when inhaled enters the lungs and causes pneumonia.

  • Coccidioidomycosis - It is a fungal disease caused due to the inhalation of fungus Coccidioides immitis.

  • Cryptosporidiosis - It is a parasitic infection caused by the protozoan Cryptosporidium, which results in severe watery diarrhea and stomach cramps.

  • Cytomegalovirus (CMV) Disease - Cytomegalovirus causes infections like pneumonia, gastroenteritis, and brain infection (encephalitis). In HIV patients, it causes infection of the retina called CMV retinitis, which can cause blindness and is a medical emergency.

  • Herpes Simplex Virus (HSV) Infection - In HIV patients, HSV infection causes painful cold sores in the mouth, vagina, and anus, which does not resolve. This virus also infects the breathing tube, lungs, and esophagus of HIV patients.

  • Pneumocystis jiroveci pneumonia (PJP) - The fungus Pneumocystis jiroveci causes pneumonia and symptoms like dry cough, fever, and breathlessness. It can be fatal.

  • Tuberculosis - The bacteria Mycobacterium tuberculosis causes a severe lung infection and gets transferred in droplets when the infected person sneezes or coughs or speaks. Tuberculosis can cause tiredness, weight loss, persistent cough, and can also spread to the lymph nodes, bones, brain, and kidneys.

  • Mycobacterium Infections - Mycobacteria occurs naturally in the environment and does not affect healthy individuals that much. But in HIV patients, it causes symptoms like fever and diarrhea and is generally not fatal.

  • Toxoplasmosis - Toxoplasmosis is caused by the parasite Toxoplasma gondii, which is found in the feces of cats and rodents. It enters the human body through contaminated food and dust. This parasite causes severe infections in the retina, lungs, colon, pancreas, testes, and brain.

  • Salmonella Septicemia - The bacteria Salmonella enters the body through contaminated food and water and causes infection of the intestines. It can spread to other organs through the blood.

How Can Opportunistic Infections Be Prevented?

HIV patients can prevent the disease from progressing to AIDS by preventing opportunistic infections by:

  • Take antiretroviral medicines as suggested by your doctor.

  • Take preventive medicines and get vaccinations on time.

  • Always use condoms during sex.

  • Avoid getting infected with cats and other animal feces.

  • Avoid contact with people who are sick.

  • Do not consume contaminated food and water.

  • Maintain good hygiene.

  • Wash hands properly after touching raw meat.

How Can AIDS Be Treated?

Once the disease has progressed to AIDS, only symptomatic treatment is given. Depending on the cause and type of opportunistic infection, antibiotics and antiviral medicines are used. By adhering to a strict antiretroviral regimen, most HIV patients lead a near normal life. Avoid getting infected by taking some precautionary measures. Patients with AIDS can revert the condition to HIV by sticking to proper treatment.

There is no permanent cure for HIV infection currently. HAART (highly active antiretroviral therapy) will stop replication of the virus, so further damage to CD4 cells will be stopped. This can be seen as “target not found” in plasma viral load, which is used to monitor treatment. HIV once positive will remain positive lifelong.

Last reviewed at:
11 Apr 2019  -  4 min read

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