There is life with HIV

HIV / AIDS well explained

https://soropositivo.org/2019/03/16/ciclo-de-vida-do-hiv/

HIV/AIDS bem explicados, Blog Soropositivo.Org HIV and AIDS still inhabit the collective unconscious as death sentences, divine punishments, punishments. IF I set out to write about everything I learned over two decades of work in the HIV / AIDS field, from personal understanding of it to what I learned, after learning, about how people see, see themselves and often me see inside my work, I would certainly end up setting fire to this room in which I work!

In a single stroke, quoting a brief stretch of conversation with a person who firmly and obstinately believed that she was HIV positive, despite repeated, repeated and repeated non-reactive tests (I have to write about this term) the statement was as follows:

-"It's fine by me! I did the ***! I am a FDP who cheated on my wife and now all I fear is for their health! I f *** me! ”

Not every day I am "sanctified enough" to have a petard like this on my face and not react in a heated way! And that was one of the reasons why I ended up stopping my personal work with people on WhatsApp! 

I chose to leave the ball with Beto Volpe, who likes, and enjoys doing this job, who asked me for this job and, yes, has a little more extensive patience than mine for these unfortunate placements.

By yes, by no, aware of all the darkness that still exists around the theme and of all the light that still definitely lacks in me, I determined to translate another text, and very broad, that has as a goal to make …

… HIV and AIDS are better explained

Good reading Cláudio Souza

  • Symptoms
  • Causes
  • Diagnosis
  • Treatment
  • Prevention
  • HIV infection: Signs and symptoms to watch for

The human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). HIV is transmitted through blood, semen and vaginal fluids and causes a series of symptoms that manifest shortly after infection, including fever and mouth ulcers. After a latent period - during which HIV progresses to AIDS (HIV / AIDS), the third and last stage of the disease caused by the virus, when the infected face more serious concerns, including extreme weight loss and the manifestation of opportunistic infections, with a right and immediate risk to their own survival and, at least, with serious damages to the quality of life of the person living with HIV!

When AIDS first appeared in 1981, the overwhelming majority of cases were fatal. After the researchers determined that HIV was the cause of AIDS and how the virus spreads, they were able to develop ways to test for the presence of the virus and develop effective treatments to prevent its replication in the body - a protocol called antiretroviral therapy ( ART).1

Now, many people who are HIV positive, HIV positive, can start taking medication and can continue to live, otherwise, long and healthy lives.

HIV / AIDS in numbers Excuses I don't care

  • Deaths related to HIV since the identification of the virus (worldwide): More than 30 million
  • people living with HIV today (worldwide): More than 35 million, 69% of which are in sub-Saharan Africa.
  • People in the USA infected with HIV: About 1,2 million
  • infected people in the US who have not been diagnosed (estimate): 20% to 25% A

AIDS is still considered a rare disease in the United States: less than 200.000 HIV-positive people develop AIDS.

Symptoms of HIV / AIDS Infection 

The symptoms of HIV / AIDS can be divided into two categories: symptoms which appear when the body is first infected (stage 1, the acute phase) and those that can occur after years if the virus is not treated and the infection can progress to AIDS (stage 3 of HIV).2

Stage 2 - chronic HIV infection - is usually asymptomatic. With treatment, an HIV-positive person can remain in this phase for decades. Without treatment, the virus usually progresses in eight to 12 years.

Primary HIV infection

A few weeks after entering the body, HIV triggers flu-like symptoms and, in some cases, some other telling symptoms:

  • Fever
  • Chills
  • Headache
  • Night sweats
  • Pharyngitis (sore throat)
  • Myalgia (muscle pain)
  • Arthralgia (joint pain)
  • Fatigue
  • Lymphadenopathy (swollen lymph nodes, mainly in the neck)
  • Mouth ulcers

Some people will also experience nausea, diarrhea or vomiting, and one in five will develop an “HIV rash”, a maculopapular skin condition characterized by a bump, pink / red areas covered by small pimple-like bumps that often fuse into only one. 

From HIV to AIDS, clinical latency

Risco de pegar HIV!

After the latent period, signs that the virus is beginning to outperform the immune system include:

  • Swollen lymph nodes - Note that this is a sign of advanced HIV disease, AIDS, and not a clear phasea HIV infection during the immune window period.
  • Candidiasis (thrush), a fungal infection that usually affects the mouth and or vagina - Amarilis
  • Skin problems: spots, lesions and wounds - Kaposi's sarcoma it is an example
  • Night sweats (sleep hyperhidrosis) - a possible sign of TB active
  • Extreme weight loss 
  • This is also the point at which a person can become ill with opportunistic infections, so called because they are caused by pathogens that a healthy immune system would normally be able to fight and quell easily. Candidiasis and pneumonia are two of the most common.3

 HIV infection: signs and symptoms a be observed

The virus that causes HIV / AIDS is classified by scientists as a retrovirus. In most living organisms, a cell's genetic material is encoded from DNA to RNA. A retrovirus is the only one that uses its RNA encoding to produce DNA within an infected cell, a reversal of the normal process.

When this occurs, the newly produced DNA is inserted into the host cell's nucleus, effectively sequestering its genetic machinery to create multiple copies of itself, each of which is capable of infecting and killing an infinity of other host cells. In this case, the host cells are white blood cells called “helper” T cells - in particular, T CD4 that trigger the body's immune response.

By systematically depleting these cells, HIV decreases the body's ability to identify and neutralize invading viruses, as well as a number of other agents (viral, bacterial, parasitic) against which it could defend itself.

During the initial infection, HIV replicates vigorously, infecting and destroying a substantial number of CD4 T cells. As soon as it becomes latent, the virus continues to replicate silently, generating, on average, the annual loss of eighty CD4 T cells.

In addition to HIV, a subset of the virus called provirus is incorporated into cells and tissues called latent reservoirs, where they cannot be easily detected by the immune system. Even if HIV is controlled with antiretroviral drugs, these proviruses can persist, ready to re-emerge as fully formed HIV the moment treatment fails or the immune system collapses. This provirus forms the so-called viral reservoirs.

How HIV spreads 

HIV spreads in the following ways:

  • Unprotected sexual contact
  • Sharing needles between users of injecting drugs
  • Accidental blood exposure
  • Mother-to-child transmission During the pregnancy 
  • HIV cannot be transmitted through sweat, tears, saliva, feces or urine.4
Why is testing for HIV so important?

Often it is only when an opportunistic infection first appears that a person can suspect that he or she is infected with HIV. 

At this point, the immune system is usually severely impaired, sometimes severely. I have seen this process many times and have seen people lose loved ones in this way, amid total surprise and perplexity.

Because the opportunistic manifestation was serious, powerful and devastating, not giving doctors the possibility to revert the situation, bringing the perfectly avoidable fatality to the bosom of that family.

The best way to prevent this from happening is to get an HIV test at least once; people at high risk of HIV should be tested two to four times a year.

Cause and risk factors of HIV / AIDS - in translation

How is the diagnosis of HIV infection made?

The prognosis of HIV / AIDS has been, for many, a strong impediment to testing. But the positive HIV test is no longer a death sentence in developed parts of the world: Studies published in 2014 found that patients who start ART while the amount of virus in their bodies is relatively low have the same life expectancy as the general population.5

There are five ways to test for the presence of human immunodeficiency viruses:

  • Outpatient pattern, in which a blood sample is taken at a doctor's office or clinic and examined for the presence of antibodies against HIV; the results are returned in five to 10 days.
  • Rapid on-site test, which can generate a result in 20 minutes by measuring both antigens (virus surface proteins) as well as antibodies in a blood sample taken from a finger bite, a sample of saliva taken from the gums, or a urine sample
  • Nucleic acid test: a blood test that measures HIV RNA in the blood and is reserved for people at high risk of exposure
  • Home testing who use a saliva sample and deliver the results in about 20 minutes
  • Home collection kits that detect antibodies in a blood sample that you collect and send to a laboratory for testing
When HIV infection turns to AIDS

For someone whose HIV infection has not been controlled, AIDS is diagnosed in two ways:

  • For the diagnosis of an AIDS-defining disease
  • For a CD4 count of less than 200 cells per microliter (µL).

Normal CD4 counts vary on average between 800 and 1600 cells per µL. A newly diagnosed HIV-positive person will be monitored regularly to monitor any changes in their CD4 count.6

If the CD4 count> 500 and they have suppressed viral load for at least two years, monitoring the CD4 cell count is no longer necessary.

 How is HIV / AIDS diagnosed?

Treatment Against HIV Infection and AIDS

Managing the symptoms of HIV infection in the acute stage is usually a matter of getting plenty of rest and sleeping well, drinking plenty of fluids, eating well and taking OTC pain relievers to relieve headaches or body pain if necessary.

However, once the HIV test result is positive, it is vital that he start taking antiretroviral drugs to control the virus and prevent it from replicating, causing serious and irreversible damage to the immune system.7

There is no cure for AIDS, but strict adherence to antiretroviral therapy (ART) can dramatically slow the progress of the disease, prevent infections and secondary complications, and prolong life.

As a rule, antiretroviral therapy depends on three different drug molecules, a strategy known as highly active antiretroviral therapy (HAART). However, this standard triple therapy can be replaced by therapies with two drugs, such as Juluca (dolutegravir + rilpivirine).

Antiretroviral drugs are organized into six classes based on the stage of the HIV life cycle they affect. In 2019, there were 28 individual drug molecules and 13 fixed dose combination (FDC) drugs composed of two or more molecules each. Eight of the FDCs can be used as a single pill, a daily therapy.8

 How HIV / AIDS is treated
How Preventing HIV Infection Can Be Ugly

Although HIV is a highly contagious virus, there is a positive side: the forms of transmission are well understood and also highly preventable if specific precautions are taken.

To reduce the risk of becoming infected with the virus, the Centers for Disease Control and Prevention (CDC) recommends taking certain precautions: 9

  • Limit the number of sexual partners you have and make sure someone you are intimate with has been tested and is HIV-negative
  • Always use a barrier, such as a condom, during sex, including oral sex.
  • Use new, sterile needles and syringes if you are an intravenous drug user.
  • Take a daily medication to help protect yourself from the infection, which is known as pre-exposure prophylaxis (PrEP)

 How HIV / AIDS can be prevented

Dealing with HIV Infection

HIV infection is a chronic disease, which means that it must be treated daily. Nevertheless, minimizing any disease and saying that it is easy to treat is to lack responsibility to humanity and, going further, to try to make any disease “easy to manage” and then minimize HIV infection as well. like the other pathology, it is disrespecting those who face the compared pathology and irresponsibility those who know nothing in the face of “illusory facilities”.

The most obvious aspects of dealing with being HIV positive include doing everything necessary to stay healthy and that it requires diligence and daily effort, seeking to maintain a healthy lifestyle that will support the health of the immune system; comply with medication; and follow the doctor's orders about regular check-ups to keep track of any changes in viral load and overall health.

However, the stigma that persists in relation to HIV and the continuos misunderstandings about how it is transmitted means that dealing with the situation extends to how you behave towards others and also how you feel about yourself. 

For this reason, being frank with trusted friends and family about your HIV status can or not,  help a lot to feel supported and cared for; so think, and think well before choosing who to talk to

Just as important, it can be finding a community of other people who are also HIV-positive, which can be an important lifeline and source of advice for dealing with all aspects of being HIV-positive.

You can obtain this support by participating in local support groups for people with your diagnosis and / or by joining the online versions. If you are having trouble finding one, there are several resources to which you can appeal.

While receiving an HIV diagnosis can be disruptive, current treatments and an improved understanding of the disease have made it a manageable chronic disease for many people. If you have HIV, it is important to talk to your doctor, who can advise you on what you need to do to stay healthy.

 Facing and living well with HIV / AIDS

Keep in mind that when I say that there is life with HIV, I do nothing more than tell the truth and, nevertheless, it is much better, simpler, wise and advisable to try to keep away from HIV, not allowing him to come be part of your life by taking over your body, inhabiting your bloodstream. 

Although much is said, for more than twenty years Mara and I have kept HIV out of other people's lives based on our monogamous relationship, and meanwhile, in our diagnoses, in our search for each other, let us protect everyone who we find the condom on our way and, therefore, we consider it, the condom, the best and most efficient protection.

Love, live, be happy, treat yourself! But don't leave condoms out of your life.

Thanks for reading

Translated by Cláudio souza do Original in What Is HIV / AIDSwritten by James Myhre and Dennis Sifris, MD 

Reviewed by Mara T. Mac

We suggest, by analogy, this reading:

The primary HIV infection. How to detect it and how to act?

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