We’re Here to Help
At Alegria, compassion, understanding and education are the keys to ensuring optimal treatment outcomes for patients with HIV/Aids. Our outreach programs help patients understand how and why different therapies work, and our clinical initiatives help providers monitor and improve therapy adherence. This, combined with our close management of each patient’s individual circumstances, means more support and better quality of care.
What is HIV/Aids?
AIDS (acquired immunodeficiency syndrome) 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 the organisms that cause disease.
HIV is a sexually transmitted infection. It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. It can take years before HIV weakens your immune system to the point that you have AIDS.
There’s no cure for HIV/AIDS, but there are medications that can dramatically slow disease progression. These drugs have reduced AIDS deaths in many developed nations. But HIV continues to decimate populations in Africa, Haiti and parts of Asia.
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
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. American 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.
The following are risk factors of HIV/Aids:
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 sex. 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. People who use intravenous drugs often share needles and syringes. This exposes them to droplets of other people’s blood.
- Are an uncircumcised man. Studies indicate that lack of circumcision increases the risk of heterosexual transmission of HIV.
The symptoms of HIV and AIDS vary, depending on the phase of infection.
The majority of people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible signs and symptoms include:
- Muscle aches
- Sore throat
- Mouth or genital ulcers
- Swollen lymph glands, mainly on the neck
- Joint pain
- Night sweats
Although the symptoms of primary HIV infection may be mild enough to go unnoticed, the amount of virus in the bloodstream (viral load) is particularly high at this time. As a result, HIV infection spreads more efficiently during primary infection than during the next stage of infection.
Clinical latent infection
In some people, persistent swelling of lymph nodes occurs during clinical latent HIV. Otherwise, there are no specific signs and symptoms. HIV remains in the body, however, and in infected white blood cells.
Clinical latent infection typically lasts eight to 10 years. A few people stay in this stage even longer, but others progress to more severe disease much sooner.
Early symptomatic HIV infection
As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic signs and symptoms such as:
- Swollen lymph nodes — often one of the first signs of HIV infection
- Weight loss
- Shortness of breath
Progression to AIDS
If you receive no treatment for your HIV infection, the disease typically progresses to AIDS in about 10 years. By the time AIDS develops, your immune system has been severely damaged, making you susceptible to opportunistic infections — diseases that wouldn’t trouble a person with a healthy immune system.
The signs and symptoms of some of these infections may include:
- Soaking night sweats
- Shaking chills or fever higher than 100 F (38 C) for several weeks
- Shortness of breath
- Chronic diarrhea
- Persistent white spots or unusual lesions on your tongue or in your mouth
- Persistent, unexplained fatigue
- Blurred and distorted vision
- Weight loss
- Skin rashes or bumps
Tests and Diagnosis
HIV is most commonly diagnosed by testing your blood or saliva for antibodies to the virus. Unfortunately, it takes time for your body to develop these antibodies — usually up to 12 weeks. In rare cases, it can take up to six months for an HIV antibody test to become positive.
A newer type of test that checks for HIV antigen, a protein produced by the virus immediately after infection, can confirm a diagnosis within days of infection. An earlier diagnosis may prompt people to take extra precautions to prevent transmission of the virus to others. There is also increasing evidence that early treatment may be of benefit.
Tests to tailor treatment
If you receive a diagnosis of HIV/AIDS, several types of tests can help your doctor determine what stage of the disease you have. These tests include:
- CD4 count. CD4 cells are a type of white blood cell that’s specifically targeted and destroyed by HIV. A healthy person’s CD4 count can vary from 500 to more than 1,000. Even if you have no symptoms, HIV infection progresses to AIDS when your CD4 count dips below 200.
- Viral load. This test measures the amount of virus in your blood. Studies have shown that people with higher viral loads generally fare more poorly than do those with a lower viral load.
- Drug resistance. This blood test determines whether the strain of HIV you have will be resistant to certain anti-HIV medications.
Tests for complications
Your doctor might also order lab tests to check for other infections or complications, including:
- Sexually transmitted infections
- Liver or kidney damage
- Urinary tract infection
Treatment & Drugs
There’s no cure for HIV/AIDS, but a variety of drugs can be used in combination to control the virus. Each class of anti-HIV drugs blocks the virus in different ways. It’s best to combine at least three drugs from two classes to avoid creating strains of HIV that are immune to single drugs.
The classes of anti-HIV drugs include:
- Non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs disable a protein needed by HIV to make copies of itself. Examples include efavirenz (Sustiva), etravirine (Intelence) and nevirapine (Viramune).
- Nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are faulty versions of building blocks that HIV needs to make copies of itself. Examples include Abacavir (Ziagen), and the combination drugs emtricitabine and tenofovir (Truvada), and lamivudine and zidovudine (Combivir).
- Protease inhibitors (PIs). PIs disable protease, another protein that HIV needs to make copies of itself. Examples include atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva) and ritonavir (Norvir).
Entry or fusion inhibitors. These drugs block HIV’s entry into CD4 cells. Examples include enfuvirtide (Fuzeon) and maraviroc (Selzentry).
- Integrase inhibitors. Raltegravir (Isentress) works by disabling integrase, a protein that HIV uses to insert its genetic material into CD4 cells.
These organizations offer more information on HIV/AIDS and related services.
Centers for Disease Control
The federal agency serves as the national public health institute of the United States.
Gay Men’s Health Crisis
A New York-based non-profit, AIDS service organization.
National HIV and STD Testing Resources
Find HIV and STD testing sites near you.
Test Positive Aware Network
This Chicago-based organization offers peer-led support programs and collaborative wellness services.