Just one careless act sometimes has dire consequences in the form of an HIV diagnosis. Is this a verdict? During the 30 years that the infection has been known to mankind, it has not been possible to find an effective cure for it. The most important thing in treatment is to start it on time, for which it is necessary to know the first symptoms of HIV and immediately seek help.
Some success in the treatment of HIV has been achieved: there are drugs that can inhibit the multiplication of viral particles for a long time.
The reasons
A small RNA virus causes HIV infection. Infection occurs from a sick person in one of the ways:
- Sexual - during unprotected intercourse, since the pathogen is contained in vaginal mucus and semen.
- Through the blood - these are injections and any invasive procedures during which the integrity of the tissues is violated. Dangerous contact can also occur during a fight, for example, when the blood of a sick person gets into the abrasions and cuts of a healthy person.
- From mother to child during pregnancy and childbirth - the virus is able to cross the placenta into the fetal bloodstream.
The virus lives and multiplies in precisely those cells that are created to protect against infections - T-lymphocytes. Its genetic information is embedded in the cells of the immune system, which begin to produce new viral particles.
As a result, we get a paradoxical situation: protective cells serve as an incubator for an aggressive invader. It is currently impossible to extract the virus from T-lymphocytes without destroying them, which is why the disease is considered incurable.
In addition, the virus is incredibly changeable - each new generation has a slightly changed "appearance".
Some people do not have receptors for the HIV virus on the T-helpers, that is, it cannot penetrate them. This means that the risk of infection is minimal. Most often, this feature is found among the population of northern latitudes.
Symptoms and stages
HIV infection proceeds cyclically, that is, it has certain stages in its development:
- incubation;
- sharp;
- latent;
- secondary manifestations;
- AIDS.
Incubation period AND acute infection
It starts from the moment of infection and lasts on average 2-4 weeks, although it can last up to six months. During this period, there are no symptoms of HIV, and the tests will also be negative.
The virus is contained in the blood in minimal quantities, but has already penetrated into the T-helpers and is actively multiplying.
Treatment
At the moment, there are various HIV treatment regimens. They include 1 to 4-5 antiviral drugs that inhibit the multiplication of the virus and prevent the infection of new T-helpers. The scheme is prescribed by the district infectious disease doctor or the doctor of the AIDS center, if there is one in the village.
Once every few months, a person is tested for HIV viral load and immunogram to monitor treatment and the course of the disease.
General rules of therapy:
- it should be started as early as possible (pronounced symptoms of the acute stage of HIV are one of the indications for the appointment);
- you need to take drugs strictly by the hour according to the prescribed scheme;
- you can change the scheme only in cases of extreme necessity.
All drugs are prescribed for life, patients can receive them free of charge at the AIDS center, or buy them on their own.
Prevention of AIDS disease - regular intake of antiviral drugs.
Prevention
Prevention of HIV disease is mandatory use of condoms for all sexual intercourse. In the case of intravenous drug use, injections should only be done with your own disposable syringe. During pregnancy, an HIV-infected woman should take antiviral drugs to protect her baby from infection.
Life does not end with the diagnosis of HIV; it only introduces some limitations. A healthy lifestyle, regular check-ups and taking antiviral drugs will keep you healthy for decades to come.
HIV is an abbreviation that stands for Human Immunodeficiency Virus, which affects the human immune system, causing HIV infection.
The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome).
HIV infection and AIDS: what is the fundamental difference between these two conditions?
HIV infection
An incurable infectious disease. It belongs to a group of slow viral infections with a long-term course that affects the immune system.
That is, a virus, having entered the body of a healthy person from a sick person, may not manifest itself in any way for many years.
However, HIV gradually destroys the cells of the immune system, which is designed to protect the human body from all kinds of infections and negative influences.
Therefore, over time, immunity "gives up its positions."
AIDS (AIDS)
A condition in which the human immune system is practically unable to fight infections, resist the development of cancer cells and various harmful environmental factors. At this stage, any infection, even the most harmless one, can lead to the development of a serious illness, and subsequently to the death of the patient from complications, encephalitis or a tumor.
Disease facts
Perhaps now there is not a single adult who has never heard of HIV infection. It is not for nothing that it is called the "plague of the 20th century." And in the XI century it is moving forward with "leaps and bounds", taking about 5,000 human lives every day all over the world. Though, as a disease of HIV has a not so long history.
It is believed that HIV infection began its "triumphant march" across the planet back in the 70s of the last century, when the first massive cases of infection were described in terms of symptoms similar to AIDS.
However, they started talking about HIV officially only in the early 80s of the last century:
- In 1981, two articles were published that described the development of unusual Pneumocystis pneumonia (caused by a yeast-like fungus) and Kaposi's sarcoma (a malignant tumor of the skin) in homosexual men.
- In July 1982, the term AIDS was coined to denote a new disease.
- The human immunodeficiency virus was discovered in 1983 in two independent laboratories simultaneously:
- In France at the Institute. Louis Pasteur under the direction of Luc Montagnier
- In the USA at the National Cancer Institute under the direction of Robert Gallo
- In 1985, a method was developed that determined the presence of antibodies to HIV in the blood of patients - enzyme immunoassay.
- In 1987, the first case of HIV infection was diagnosed in the USSR. The patient is a homosexual man who worked as a translator in African countries.
- In 1988, the World Health Organization declared International AIDS Day - December 1.
Where did HIV come from? There is no definite answer to this question. However, there are several hypotheses.
The most common theory is that humans were infected by a monkey. It is based on the fact that the great apes (chimpanzees) living in Central Africa (Congo) have isolated a virus from their blood that can cause the development of AIDS in humans. Probably, the infection of a person occurred during an accidental injury while cutting a monkey carcass or a person biting a monkey.
However, monkey HIV is a weak virus and the human body copes with it within one week. But for the virus to harm the immune system, it must be transmitted from one person to another within a short time. Then the virus mutates (changes), acquiring properties characteristic of human HIV.
There is also an assumption that HIV has existed for a long time among the tribes of Central Africa. However, it was only with the onset of increased migration in the 20th century that the virus spread throughout the world.
Statistics
A huge number of people around the world are infected with HIV every year.
Number of HIV-infected
- Worldwide as of 01.01.2013 amounted to 35.3 million people
- In Russia at the end of 2013 - about 780,000 people, and 51,190 thousand were identified in the period from 01/01/13 to 08/31/13
- By CIS countries(data at the end of 2013):
- Ukraine - about 350,000
- Kazakhstan - about 16,000
- Belarus - 15,711
- Moldova - 7 800
- Georgia - 4,094
- Armenia - 3,500
- Tajikistan - 4,700
- Azerbaijan - 4,171
- Kyrgyzstan - about 5,000
- Turkmenistan - Officials say there is no HIV infection in the country
- Uzbekistan - about 7 800
Mortality
Since the beginning of the epidemic, AIDS has killed about 36 million people. Moreover, the mortality rate of patients is decreasing from year to year - thanks to the successful highly active antiretroviral therapy (HAART or ART).
Celebrities who passed away from AIDS
- Gia Carangi is an American supermodel. She died in 1986. She suffered from a severe form of drug addiction.
- Freddie Mercury - the lead singer of the legendary rock band Queen. He died in 1991.
- Michael Wastfall - a famous tennis player. He died at the age of 26.
- Rudolf Nureyev - the legend of world ballet. He died in 1993.
- Ryne White - the first and most famous child with HIV infection. He suffered from hemophilia and contracted HIV through a blood transfusion at age 13. The boy, together with his mother, fought all his life for the rights of HIV-infected people. Ryan White died of AIDS in 1990 at the age of 18, but he did not lose: he proved to the whole world that HIV-infected people do not pose a threat when taking basic precautions, having the right to an ordinary life.
AIDS virus
Perhaps there is no other virus that is so thoroughly studied and at the same time remains a big mystery for scientists, claiming thousands of lives every year, including children. This is due to the fact that the human immunodeficiency virus is changing very quickly: 1000 mutations per gene. Therefore, an effective drug against it has not yet been found and a vaccine has not been developed. Whereas, for example, the flu virus mutates 30 (!) Less often.In addition, there are several varieties of the virus itself.
HIV: structure
There are two main types of HIV:- HIV-1 or HIV-1 (opened in 1983) - the main causative agent of infection. He is quite aggressive, causing the typical manifestations of the disease. Most often found in Western Europe and Asia, South and North America, Central Africa.
- HIV-2 or HIV-2 (opened in 1986) - a less aggressive analogue of HIV-1, so the disease is milder. Not so widespread: found in West Africa, Germany, France, Portugal.
Structure
HIV- a spherical (spherical) particle with a size of 100 to 120 nanometers. The envelope of the virus is dense, formed by a double lipid (fat-like substance) layer with "thorns", and under it is a protein layer (p-24-Capsid).
Below the capsule are:
- two strands of viral RNA (ribonucleic acid) - a carrier of genetic information
- viral enzymes: protease, intergrase and transcriptase
- p7 protein
The most important feature of retroviruses is the presence of a special enzyme: reverse transcriptase. Thanks to this enzyme, the virus converts its RNA into DNA (a molecule that provides storage and transmission of genetic information to future generations), which is then inserted into the host's cells.
HIV: properties
HIV in the external environment is unstable:- quickly dies under the influence of 5% hydrogen peroxide solution, ether, chloramine solution, 70 ° C alcohol, acetone
- outside the body in the open air dies within a few minutes
- at +56 0 С - 30 minutes
- when boiling - instantly
HIV: features of the life cycle
HIV has a special tropism (prefers) to some cells of the immune system - T-helper lymphocytes, monocytes, macrophages, as well as cells of the nervous system, in the membrane of which there are special receptors - CD4 cells. However, there is speculation that HIV infects other cells as well.What are the cells of the immune system responsible for?
T-lymphocytes-helpers activate the work of almost all cells of the immune system, and also produce special substances that fight against foreign agents: viruses, microbes, fungi, allergens. That is, in fact, they control the work of almost the entire immune system.
Monocytes and macrophages -cells that absorb foreign particles, viruses and microbes, digesting them.
The life cycle of HIV includes several phases
Let us consider them using the example of a helper T-lymphocyte:- Once in the body, the virus binds to special receptors on the surface of the T lymphocyte - CD4 cells. Then it enters the host cell and sheds the outer shell.
- Using reverse transcriptase a DNA copy (one strand) is synthesized on viral RNA (matrix).Then the copy is completed into double-stranded DNA.
- Double-stranded DNA travels to the nucleus of the T-lymphocyte, where it is incorporated into the host cell's DNA. At this stage, the acting enzyme is integrase.
- The DNA copy is stored in the host cell from several months to several years, so to speak, "sleeps". At this stage, the presence of the virus in the human body can be detected using tests with specific antibodies.
- Any secondary infection provokes the transfer of information from the DNA copy to the matrix (viral) RNA, which leads to further multiplication of the virus.
- Further, the ribosomes of the host cell (particles that produce protein) on viral RNA synthesize viral proteins.
- Then from viral RNA and newly synthesized viral proteins assembling new parts of viruses that leave the cell, destroying it.
- New viruses attach to receptors on the surface of other T lymphocytes - and the cycle begins again.
General scheme of HIV division along with a photograph taken under an electron microscope.
HIV infection
Gone are the days when it was believed that HIV infection is a disease that only drug addicts, sex workers and homosexuals suffer.Anyone can get infected, regardless of social status, financial wealth, gender, age and sexual orientation. The source of infection is an HIV-infected person at any stage of the infectious process.
It's just that HIV doesn't fly through the air. It is found in biological fluids of the body: blood, semen, vaginal secretions, breast milk, cerebrospinal fluid. For infection, it is necessary that an infectious dose - about 10,000 viral particles - enter the bloodstream.
Routes of HIV transmission
- Heterosexual contact - unprotected vaginal sex.
The risk of infection after one sexual contact with ejaculation is from 0.1 to 0.32% for the passive partner ("receiving" side), and 0.01-0.1% for the active ("entering" side).
However, infection can occur after one sexual contact, if there is any other sexually transmitted disease (STD): syphilis, gonorrhea, trichomoniasis and others. Since the number of T-helper lymphocytes and other cells of the immune system increases in the inflammatory focus. And then HIV "enters the human body on a white horse."
In addition, with all STDs, the mucous membrane is prone to injury, so its integrity is often violated: cracks, ulcers, erosion appear. As a result, infection occurs much faster.
The likelihood of infection increases with prolonged sexual intercourse: if the husband is sick, then within three years in 45-50% of cases the wife becomes infected, if the wife is sick - in 35-45% of the husband. The risk of infection in a woman is higher, since a large amount of infected sperm enters the vagina, it contacts the mucous membrane longer, and the contact area is larger.
- Intravenous drug use
Since intravenous drug addicts often use shared non-sterile medical syringes or common utensils for solution preparation. The probability of infection is 30-35%.
In addition, drug addicts often engage in promiscuous sexual intercourse, which several times increases the likelihood of infection, both themselves and others.
- Unprotected anal sex regardless of sexual orientation
- Unprotected oral sex
However, the risk of infection increases if there are seizures in the corners of the mouth, and wounds and ulcers in the cavity.
- Children born to HIV-infected mothers
It is possible for a healthy mother to become infected while breastfeeding a sick child, if the woman has cracks in her nipples, and the baby's gums are bleeding.
- Accidental injuries with medical instruments, subcutaneous and intramuscular injections
- Blood transfusion and organ transplants
On a note
The likelihood of infection depends on the initial state of the human immune system: the weaker it is, the faster the infection occurs, and the disease is more severe. In addition, it matters what the viral load of an HIV-infected person is, if it is high, then the risk of infection increases several times.
Diagnosis of HIV infection
Quite difficult, since its symptoms appear long after infection and are similar to other diseases. therefore the main method of early diagnosis is testing for HIV infection.Methods for diagnosing HIV infection
They have been developed for a long time and are constantly being improved, reducing the risk of both false negative and false positive results to a minimum. Most often blood is used for diagnosis. However, there are test systems for determining HIV in saliva (scraping from the oral mucosa) and in urine, but they have not yet found widespread use.There are three main stages of diagnosis HIV infections in adults:
- Preliminary- screening (sorting), which serves to select suspected infected persons
- Reference
- Confirming- expert
Some concepts in the context of HIV diagnosis:
- Antigen- the virus itself or its particles (proteins, fats, enzymes, capsule particles, and so on).
- Antibody- cells produced by the immune system in response to HIV entering the body.
- Seroconversion- immune response. Once in the body, HIV multiplies intensively. In response, the immune system begins to produce antibodies, the concentration of which increases over the next few weeks. And only when their number reaches a certain level (seroconversion), they are detected by special test systems. Further, the level of the virus drops, and the immune system calms down.
- "Window period"- the interval from the moment of infection to the appearance of seroconversion (on average, from 6-12 weeks). This is the most dangerous period, since the risk of HIV transmission is high, and the test system gives a false negative result
Screening stage
Definition common antibodiesto HIV-1 and HIV-2 using enzyme immunoassay - ELISA (ELISA) . It is informative usually 3-6 months after infection. However, sometimes he detects antibodies a little earlier: three to five weeks after a dangerous contact.It is preferable to use test systems of the fourth generation. They have one feature - in addition to antibodies, they also determine the HIV antigen - p-24-Capsid, which makes it possible to detect the virus even before the development of a sufficient level of antibodies, reducing the "window period".
However, in most countries, outdated third or even second generation test systems (only detect antibodies) are still used, since they are cheaper.
However, they are more often give false positive results:if there is an infectious disease during pregnancy, autoimmune processes (rheumatism, systemic lupus erythematosus, psoriasis), the presence of the Epstein-Bar virus in the body, and in some other diseases.
If the ELISA result is positive, then the diagnosis of HIV infection is not made, but proceeds to the next stage of diagnosis.
Reference stage
It is carried out with more sensitive test systems 2-3 times. In case of two positive results, proceed to the third stage.Expert stage - immunoblotting
A method in which antibodies to specific HIV proteins are determined.Consists of several stages:
- HIV is destroyed by electrophoresis into antigens.
- by blotting (in a special chamber) they are transferred to special strips, on which the proteins characteristic of HIV are already applied.
- the patient's blood is applied to the strips, if it contains antibodies to antigens, a reaction occurs that is visible on the test strips.
Therefore there are two options for the expert stagelaboratory diagnosis of HIV infection:
| First option | Second option |
There is another sensitive diagnostic method HIV infection - polymerase chain reaction (PCR) - determination of the DNA and RNA of the virus. However, it has a significant drawback - a high percentage of false positives. Therefore, it is used in combination with other methods.
Diagnosis in children born to HIV-infected mothers
It has its own characteristics, since maternal antibodies to HIV, which cross the placenta, may be present in the child's blood. They are available from the moment of birth, remaining up to 15-18 months of life. However, the absence of antibodies is not an indication that the child is not infected.Diagnostic tactics
- up to 1 month - PCR, since the virus does not multiply intensively during this period
- over a month - determination of p24-Capsid antigen
- laboratory diagnostic examination and observation from the moment of birth to 36 months
Symptoms and signs of HIV in men and women
Diagnosis is difficult because the clinical manifestations are similar to those of other infections and diseases. In addition, HIV infection proceeds differently in different people.Stages of HIV infection
According to the Russian clinical classification of HIV infection (V.I. Pokrovsky)HIV infection symptoms
- First stage - incubation
The virus is actively multiplying. Duration - from the moment of infection to 3-6 weeks (sometimes up to one year). With weakened immunity - up to two weeks.
Symptoms
None. You can suspect if there was a dangerous situation: unprotected casual sexual contact, blood transfusion, and so on. Test systems do not detect antibodies in the blood. - Second stage - primary manifestations
The body's immune response to the introduction, reproduction and massive spread of HIV. The first symptoms appear within the first three months after infection and may outpace seroconversion. Duration - usually 2-3 weeks (rarely several months).
Flow options
- 2A - AsymptomaticThere are no manifestations of the disease. Only antibody production is present.
- 2B - Acute infection without secondary diseases It is observed in 15-30% of patients. It proceeds as an acute viral infection or infectious mononucleosis.
- Increased body temperature 38.8C and above is the response to the introduction of the virus. The body begins to produce an active biological substance - interleukin, which "gives a signal" to the hypothalamus (located in the brain) that there is an "alien" in the body. Therefore, energy production is increased and heat output is reduced.
- Swollen lymph nodes- the reaction of the immune system. In the lymph nodes, the production of antibodies by lymphocytes against HIV increases, which leads to working hypertophia (enlargement) of the lymph nodes.
- Skin rashesin the form of red spots and seals, small hemorrhages up to 10 mm in diameter, prone to merging with each other. The rash is located symmetrically mainly on the skin on the trunk, but sometimes on the face and neck. It is a consequence of direct damage by the virus to T-lymphocytes and macrophages in the skin, which leads to a violation of local immunity. Therefore, in the future, there is an increased susceptibility to various pathogens.
- Diarrhea (frequent loose stools) develops due to the direct effect of HIV on the intestinal mucosa, which causes changes in the local immune system and also interferes with absorption.
- Sore throat (tonsillitis, pharyngitis) and the oral cavity is associated with the fact that HIV affects the mucous membranes of the mouth and nose, as well as lymphoid tissue (tonsils). As a result, swelling of the mucous membrane appears, the tonsils increase, which causes a sore throat, painful swallowing and other symptoms characteristic of a viral infection.
- Enlargement of the liver and spleen associated with the response of the immune system to the introduction of HIV into the body.
- Sometimes autoimmune diseases develop (psoriasis, seborrheic dermatitis and others). The reason and mechanism of formation are still unclear. However, most often these diseases occur at a later stage.
- 2B - Acute infection with secondary diseases
It is observed in 50-90% of patients. It proceeds against the background of a temporary decrease in CD4-lymphocytes, therefore the immune system is weakened and cannot fully resist "outsiders".
There are secondary diseases caused by microbes, fungi, viruses: candidiasis, herpes, respiratory tract infections, stomatitis, dermatitis, tonsillitis and others. They usually respond well to treatment. Further, the state of the immune system is stabilized, and the disease moves on to the next stage.
- Stage three - long-term widespread enlargement of the lymph nodes
Duration - from 2 to 15-20 years, since the immune system inhibits the multiplication of the virus. During this period, the level of CD4-lymphocytes gradually decreases: approximately at a rate of 0.05-0.07x109 / l per year.
There is only an increase in at least two groups of lymph nodes (LN), not connected to each other for three months, with the exception of the inguinal. LU size in adults is more than 1 cm, in children - more than 0.5 cm. They are painless and elastic. LNs gradually decrease in size, remaining in this state for a long time. But sometimes they can increase again, and then decrease - and so on for several years.
- Stage Four - Secondary Diseases (pre-AIDS)
It develops when the immune system is depleted: the level of CD4 lymphocytes, macrophages, and other cells of the immune system drops significantly.
Therefore, HIV, practically not meeting a response from the immune system, begins to multiply intensively. It affects more and more healthy cells, leading to the development of tumors and severe infectious diseases - opurtonic infections (under normal conditions, the body easily copes with them). Some of them are found only in HIV-infected, and some - in ordinary people, only in HIV-positive they are much more severe.
The disease can be suspected if there are at least 2-3 diseases or conditions listed at each stage.
Has three stages
- 4A. Develops 6-10 years after infectionwhen the level of CD4 lymphocytes is 350-500 CD4 / mm3 (in healthy people, it ranges from 600-1900 CD4 / mm3).
- Weight loss up to 10% of baseline weight in less than 6 months. The reason is that the proteins of the virus are introduced into the cells of the body, suppressing protein synthesis in them. Therefore, the patient literally “dries up before our eyes,” and the absorption of nutrients in the intestine is also impaired.
- Repeated damage to the skin and mucous membranes by bacteria (abscesses, boils), fungi (candidiasis, lichen), viruses (herpes zoster)
- Pharyngitis and sinusitis (more than three times a year).
- 4A. Develops 6-10 years after infectionwhen the level of CD4 lymphocytes is 350-500 CD4 / mm3 (in healthy people, it ranges from 600-1900 CD4 / mm3).
- 4B. Occurs 7-10 years after infectionwhen the level of CD4 lymphocytes is 350-200 CD4 / mm3.
It is characterized by diseases and conditions:
- Weight loss of more than 10% in 6 months. There is weakness.
- An increase in body temperature to 38.0-38.5 0 С for more than 1 month.
- Chronic diarrhea (diarrhea) for more than 1 month develops as a result of both direct infection by the virus of the intestinal mucosa, and the addition of a secondary infection, usually mixed.
- Leukoplakia is a proliferation of the papillary layer of the tongue: white threadlike formations appear on its lateral surface, sometimes on the mucous membrane of the cheeks. Its occurrence is a bad sign for the prognosis of the disease.
- Deep lesions of the skin and mucous membranes (candidiasis, simple blister lichen, molluscum contagiosum, rubrophytosis, versicolor versicolor and others) with a protracted course.
- Repeated and persistent bacterial (tonsillitis, pneumonia), viral (cytomegalovirus, Epstein-Bar virus, herpes simplex virus) infections.
- Recurrent or widespread shingles caused by the varicella-zoster virus.
- Localized (non-widespread) Kaposi's sarcoma is a malignant skin tumor that develops from the vessels of the lymphatic and circulatory system.
- Pulmonary tuberculosis.
- 4B. Develops 10-12 years after infectionwhen the level of CD4 lymphocytes is less than 200 CD4 / mm3. Life-threatening diseases develop.
It is characterized by diseases and conditions:
- Extreme emaciation, lack of appetite, and severe weakness. Patients have to spend more than a month in bed.
- Pneumocystis pneumonia (caused by a yeast-like fungus) is a marker of HIV infection.
- Often recurrent herpes, manifested by non-healing erosions and ulcers on the mucous membranes.
- Protozoal diseases: cryptosporidiosis and isosporosis (affecting the intestines), toxoplasmosis (focal and diffuse brain lesions, pneumonia) are markers of HIV infection.
- Candidiasis of the skin and internal organs: esophagus, respiratory tract and so on
- Extrapulmonary tuberculosis: bones, meninges, intestines and other organs.
- Common Kaposi's sarcoma.
- Mycobacteriosis affecting the skin, lungs, gastrointestinal tract, central nervous system and other internal organs. Mycobacteria are present in water, soil, dust. They cause illness only in HIV-infected people.
- Cryptococcal meningitis is caused by a fungus that is present in the soil. It usually does not occur in a healthy body.
- Diseases of the central nervous system: dementia, movement disorders, forgetfulness, decreased ability to concentrate, slowed thinking, gait disturbance, personality changes, awkwardness in the hands. It develops both due to the direct effect of HIV on nerve cells for a long time, and as a result of complications developed after the transferred diseases.
- Malignant tumors of any location.
- Kidney and heart damage due to HIV infection.
- Fifth stage - terminal
It develops when the number of CD4 cells is below 50-100 CD4 / mm3. At this stage, all existing diseases progress, the treatment of secondary infections is ineffective. The patient's life depends on the HAART being performed, but, unfortunately, it, as well as the treatment of secondary diseases, is ineffective. Therefore, patients usually die within a few months.
There is a WHO classification of HIV infection, but it is less structured, therefore, mainly specialists prefer to work according to the Pokrovsky classification.
The given data on the stages and their manifestations of HIV infection are of an average nature. Not all patients pass sequentially through the stages, sometimes "jumping" over them or staying at a certain stage for a long time.
Therefore, the course of the disease can be quite long (up to 20 years) or short (there are cases of a fulminant course, when patients died within 7-9 months from the moment of infection). This is associated with the characteristics of the patient's immune system (for example, some have few CD4 lymphocytes or initially reduced immunity), as well as the type of HIV.
HIV infection in men
Symptoms fit into the usual clinic, without specific manifestations.HIV infection in women
As a rule, they have menstrual irregularities (irregular periods with the presence of intermenstrual bleeding), and the menstruation itself is painful.Women have a slightly higher risk of developing malignant tumors on the cervix.
In addition, they have inflammation of the female genital organs more often (more than three times a year) than in healthy women, and are more severe.
HIV infection in children
The course does not differ from that of adults, but there is a difference - they are somewhat behind in physical and mental development from their peers.
Treatment of HIV infection
Unfortunately, there is no drug yet that would completely cure this disease. However, there are drugs that significantly reduce the multiplication of the virus, prolonging the life of patients.Moreover, these drugs are so effective that with proper treatment, CD4 cells grow, and even the most sensitive methods of HIV itself are hardly detected in the body.
To achieve this u the patient must have self-discipline:
- taking the medicine at the same time
- adherence to dosage and diet
- continuity of treatment
The main directions of treatment
- Prevent and delay the development of life-threatening conditions
- Ensure a longer preservation of the quality of life of infected patients
- With the help of HAART and the prevention of secondary diseases, achieve remission (no clinical symptoms)
- Emotional and practical support for patients
- Provision of free drugs
First stage
No treatment is prescribed. However, if there was contact with an HIV-infected person, then chemoprophylaxis is recommended in the first three days after it.
Stage two
2A. No treatment unless CD4 count is less than 200 CD4 / mm3
2B. Treatment is prescribed, but if the CD4 count is more than 350 CD4 / mm3, then refrain from it.
2B. Treatment is prescribed if the patient has manifestations characteristic of stage 4, but with the exception of cases when the level of CD4 lymphocytes is more than 350 CD4 / mm3.
Third stage
HAART is prescribed if the CD4-lymphocyte count is less than 200 CD4 / mm3, and the HIV RNA level is more than 100,000 copies, or the patient actively wants to start therapy.
Fourth stage
Treatment is prescribed if the CD4 lymphocyte count is less than 350 CD4 / mm3 or the HIV RNA count is more than 100,000 copies.
Fifth stage
Treatment is always prescribed.
On a note
Children are prescribed HAART regardless of the stage of the disease.
These are the existing standards for the treatment of HIV infection today. But recent studies have shown that earlier initiation of HAART produces better results. Therefore, most likely, these recommendations will soon be revised.
Drugs Used to Treat HIV
- Nucleoside viral reverse transcriptase inhibitors (Didanosine, Lamivudine, Zidovudine, Abakovir, Stavudine, Zalcitabine)
- Non-nucleoside reverse transcriptase inhibitors (Nevirapine, Efavirenz, Delavirdine)
- Virus protease (enzyme) inhibitors (Saquinavir, Indinavir, Nelfinavir, Ritonavir, Nelfinavir)
However, a new drug will soon enter the market - Quad, which promises to radically change the lives of people living with HIV. Since it works faster, it has fewer side effects. In addition, it solves the problem of HIV drug resistance. And patients no longer have to swallow handfuls of pills. Because the new drug combines the effects of several drugs to treat HIV infection, and is taken once a day.
Prevention of HIV infection
"Any disease is easier to prevent than to cure later."Perhaps there is no person who does not agree with this statement. It also applies to HIV / AIDS. Therefore, most countries are implementing various programs to reduce the spread of this infection.
However, we'll talk about what everyone can do. After all, not so much effort is needed to protect yourself and your loved ones from this plague.
Prevention of HIV / AIDS among people at higher risk
Heterosexual and homosexual contacts- The surest way is to have one sexual partner whose HIV status is known.
- Have casual sex (vaginal, anal) only with a condom. The most reliable are latex with standard lubrication.
But the likelihood of infection is still reduced to almost zero if you use the condom correctly: you need to put it on before intercourse, make sure that there is no air between the latex and the penis (there is a risk of rupture), always use a condom in accordance with the size.
Almost all condoms made from other materials do not protect against HIV at all.
Intravenous drug use
Drug addiction and HIV often go “hand in hand”, so the most reliable way is to stop taking intravenous drugs.
However, if this path is nevertheless chosen, precautions must be taken:
- Individual and single use of sterile medical syringes
- Preparation of a solution for injection in a sterile individual container
- using a self-insemination kit (HIV negative parterre)
- sperm cleaning followed by insemination (both partners are HIV positive)
- in vitro fertilization
Taking medications:
- HAART (if necessary) with therapeutic or prophylactic purposes, depending on the duration of pregnancy
- multivitamins
- iron preparations and others
It is important to pass all the necessary tests on time: determine the viral load, the level of CD4 cells, smears, and so on.
Medical staff
Risk of infection if the activity is associated with penetration through natural barriers (skin, mucous membranes) and manipulations during which they come into contact with biological fluids.
Prevention of infection
- use of protective equipment: goggles, gloves, mask and protective clothing
- promptly throw the used needle into a special non-puncture-resistant container
- contact with HIV-infected biological fluid - chemoprophylaxis - taking complex HAART according to the scheme
- contact with a suspected infected body fluid:
- skin damage (puncture or cut) - the blood does not need to be stopped for a few seconds, then treat the injury site with 700C alcohol
- contact with biological fluid on intact parts of the body - rinse with running water and soap, then wipe with 700C alcohol
- eye contact - rinse with running water
- into the oral cavity - rinse 700C with alcohol
- on clothes - remove it and soak it in one of the disinfectants (chloramine and others), and wipe the skin under it with 70% alcohol
- on shoes - wiping twice with a rag soaked in one of the disinfectants
- on walls, floors, tiles - pour disinfectant solution for 30 minutes, then wipe
How is HIV transmitted?
A healthy person becomes infected from an HIV-infected person at any stage of the disease when an infectious dose enters the bloodstream.Virus transmission methods
- Unprotected sexual intercourse with an HIV-infected person (heterosexual and homosexual contacts). Most often - in persons leading a promiscuous sex life. The risk is increased with anal sex regardless of sexual orientation.
- When using intravenous drugs: using a non-sterile syringe or utensils for solution preparation together with an HIV-infected person.
- From HIV-infected woman to baby during pregnancy, childbirth and breastfeeding.
- When health workers come into contact with contaminated biological fluid: contact with mucous membranes, injections or cuts.
- Blood transfusion or organ transplant from HIV-infected. Of course, the donor organ or blood is tested before medical manipulations. However, if it falls within the "window period", the test gives a false negative result.
Where can you donate blood for HIV?
Thanks to special programs, as well as the adopted laws to protect HIV-infected people, information is not disclosed or transferred to third parties. Therefore, you should not be afraid of disclosure of status or discrimination in case of a positive result.There are two ways to donate blood for HIV infection:
- Anonymous A person does not give his name, but he is assigned a number by which you can find out the result (for many, this is more comfortable).
- Confidential The laboratory staff becomes aware of the person's first and last name, but they keep medical confidentiality.
- at any regional AIDS center
- in the city, regional or district polyclinic in the rooms of anonymous and voluntary testing, where blood is taken to detect HIV infection.
In addition, you can take the analysis at a private medical center, which is equipped with special equipment, but, most likely, for a fee.
Depending on the capabilities of the laboratory, the result can be obtained on the same day, after 2-3 days or after 2 weeks. Given that testing is stressful for many people, it is best to clarify the timing in advance.
What to eat if the HIV test is positive?
Usually when you get a positive HIV test result doctor anonymously invites the patient to her place and explains:- the course of the disease itself
- what research still needs to be done
- how to live with this diagnosis
- what treatment to take if necessary, and so on
Necessarily defined:
- cD4 cell count
- the presence of viral hepatitis (B, C, D)
- in some cases p-24-Capsid antigen
How can you not get infected with HIV?
- when coughing or sneezing
- with insect or animal bites
- through shared tableware and cutlery
- during medical examinations
- when swimming in a pool or pond
- in the sauna, steam room
- through a handshake, hug and kiss
- when using a shared toilet
- in public places
Who are HIV dissidents?
People who deny the existence of HIV infection.Their beliefs are based on the fact that:
- HIV has not been identified unequivocally and indisputably
In fact, there are plenty of photos taken under an electron microscope
- Patients die faster from treatment with antiviral drugsthan from illness
This is partly true, since the very first drugs did cause a lot of side effects. However, modern medicines are much more effective and safer. In addition, science is not standing still, inventing more effective and safe means.
- Considered a worldwide conspiracy of pharmaceutical companies
If this were the case, then pharmaceutical companies would disseminate information not about the disease itself and its treatment, but about some kind of miraculous vaccine, which, by the way, does not exist to this day.
- AIDS is said to be a disease of the immune system, not caused by a virus
They say that it is a consequence of immunodeficiency that has developed as a result of stress, after strong radiation, exposure to poison or strong drugs, and some other reasons.
This can be contrasted with the fact that as soon as an HIV-infected patient starts taking HAART, his condition improves significantly.
All these statements mislead patients, so they refuse treatment. Whereas HAART started on time slows down the course of the disease, prolonging life and allowing HIV-infected people to be full members of society: work, give birth to healthy children, live in a normal rhythm, and so on. Therefore, it is so important to detect HIV on time, and, if necessary, start HAART.
Acquired Deficiency Syndrome (AIDS) is one of the worst killer diseases that, along with cancer, diabetes or cardiovascular diseases, takes a lot of human lives. In almost half of the patients, the first signs of AIDS proceed without pronounced symptoms, as a result of which the patient does not seek medical help in a timely manner and becomes a hidden carrier of the infection, posing a danger to the people around him.
AIDS and HIV: What's the Difference?
Many do not share these concepts, believing that they denote the name of the disease. Doctors explain that the term "HIV" refers to the human immunodeficiency virus, which is the causative agent of a terrible disease.
After infection with a virus, HIV infection develops in stages and AIDS becomes its last stage - a condition in which the human body can no longer resist any diseases caused by viruses or pathogenic bacteria.
For the first time, symptoms of an unknown disease associated with immunodeficiency were diagnosed in several patients in the United States and Sweden back in the 80s of the last century. Since then, HIV infection has become an epidemic and spread throughout the world. Today, there are already more than 50 million people with AIDS, but a cure for the deadly disease has not yet been found. According to inexorable statistics, the percentage of deaths from AIDS remains extremely high - in the first year, up to 40% of patients die, after 2 years from the onset of the disease - 80%, after 3 years - 100%.
The first signs of infection with a dangerous virus most often go unnoticed, a person feels absolutely healthy, and no examinations or sampling of biomaterials for analysis will be able to reveal the presence of an infection. The incubation period can last from several weeks to three months, but sometimes the symptoms of pathology do not appear in any way for a longer period.
If a person has strong immunity, the virus simply goes into "sleep" mode, waiting for the right moment to activate and begin its destructive work. A person simply attributes some of the implicit signs and ailments to extreme fatigue or exacerbation of chronic diseases, not knowing what is the "incubator" of the disease and can become a source of infection for other people.
Ways of transmission
Many years of research have established the main pathways by which infection is transmitted:
- transmission of the virus with blood (blood transfusion pathway) during medical procedures or transfusion of blood, plasma, etc.
- infection of the fetus from the mother during intrauterine development or from the newborn during breastfeeding.
At the same time, a mother with HIV infection can give birth to a child absolutely healthy, the risk of the disease in this case is only about 13%. But with breastfeeding, the likelihood of transmission of the infection increases many times over, therefore, such babies are fed with artificial mixtures immediately after birth.
Often, the virus enters the body through transfusion of contaminated blood or its components, injections with a non-sterile syringe, in the process of diagnostic or therapeutic manipulations, in case of violations of the rules for sterilization and processing of instruments.
But the most common route of transmission is sexual, and most often the transmission of infection is a man. This is explained by the fact that the highest concentration of the virus accumulates in the semen. The risk of infection increases many times over during unprotected sexual intercourse with unfamiliar partners, homosexual relationships, in the presence of infectious diseases, accompanied by damage to the mucous membrane of the genital organs. The maximum likelihood of infection is observed during homosexual contacts, since when the rectal mucosa is injured, the virus very quickly enters the bloodstream.
Thus, human immunodeficiency virus is only found in blood, semen, vaginal secretions, or breast milk. It is impossible to get infected with it by airborne droplets or by household means. The virus cannot be obtained through insect or animal bites, while visiting a bathhouse or sauna. The infection is not transmitted by shaking hands, touching, through dishes, bedding or household items. The virus cannot exist outside the body and dies within a few minutes. However, in a used syringe, it can persist for several days.
Who is at risk?
The main risk group for AIDS, first of all, includes persons of non-traditional sexual orientation, drug addicts and asocial personalities. But it is impossible to completely exclude the likelihood of infection of any person leading a healthy lifestyle.
None of us is immune from an accident, accident, injury or serious illness that can lead to a hospital bed. Unfortunately, among the HIV-infected there are many who contracted the infection in the walls of a medical institution through a blood transfusion. Of course, all donated blood is tested, but there is a special "blind" period during which no laboratory research methods can detect the virus.
Signs of AIDS
After infection with a virus, the infection develops gradually, its course includes 4 stages:
- incubation period;
- primary symptoms;
- the progression of the disease, accompanied by opportunistic infections and the development of secondary diseases;
- terminal stage (AIDS).
From the moment of infection, to the first manifestations of the disease, it can take quite a long time. AIDS does not develop immediately after infection, but is already the last stage of HIV infection. Scientists still have not found an answer to the question of why some people develop severe symptoms within a year after infection, while others do not have them for a decade.
What are the first signs of AIDS?
This question is often asked by patients to their doctor. A person cannot know about a virus infection until the incubation period ends and the infection goes into attack. Most often, the first signs of the disease appear 2-6 weeks after infection. In this case, the infection is disguised as a common cold disease and in the acute period manifests itself with symptoms similar to ARVI, influenza or mononucleosis. A person has the following symptoms:
- an increase in temperature to subfebrile values \u200b\u200b(37-37.5 ° C);
- feverish condition, chills;
- aching joints;
- enlarged lymph nodes (more often cervical, inguinal);
- inflammation of the tonsils;
- headaches, lack of appetite;
- weakness, apathy;
- profuse night sweats, insomnia, or daytime sleepiness.
The patient may complain of pain in the right hypochondrium, diarrhea, which cannot be relieved even by drugs and dietary adjustments. Sometimes rashes appear on the skin in the form of pink spots without clear boundaries. On examination, the patient shows an enlarged liver and spleen.
Such symptoms are determined in about 30% of patients. In another part of patients, this period is almost asymptomatic, as a result of which the malaise is attributed to a common cold and the person does not go to the doctor. In some infected people, the acute stage of the disease is severe, with the development of serous meningitis or encephalitis and is accompanied by a sharp rise in temperature to critical levels, intense headache, nausea, and vomiting.
At this stage of the disease, an increased number of leukocytes, lymphocytes and mononuclear cells of an atypical type already appears in the blood. And if immediately after infection laboratory tests do not confirm the presence of the virus, then at this stage modern diagnostic methods (PCR and HIV test) make it possible to make the correct diagnosis.
The first signs of AIDS in women
They appear several weeks after infection with an unreasonable appearance of temperature. A febrile condition can last from 2 to 10 days and be accompanied by catarrhal symptoms - sore throat, dry cough and symptoms of general intoxication of the body. The condition is complicated by general weakness, severe sweating at night, headaches and muscle pains, menstruation becomes painful, and abundant vaginal discharge appears.
There is an increase in lymph nodes in the neck, armpits, groin, severe vomiting opens, and rapid weight loss is observed. At the first stage of the disease, women often develop vaginal infections (candidiasis), infectious diseases of the pelvic organs, which are difficult to treat, and an abnormal smear of the cervix is \u200b\u200brevealed during examination. If the nervous system is damaged, the patient may complain of pain in the eye area and tension in the occipital muscles.
The first signs of AIDS in men
More pronounced and accompanied by fever, sore throat, migraines, indigestion, enlargement of the cervical and inguinal lymph nodes. Abundant eruptions of a papular or urticarial nature appear throughout the body. Even with the preservation of appetite, there is significant weight loss, weakness, fatigue, constant drowsiness, photophobia, persistent diarrhea, which is difficult to treat. Examination reveals an enlarged liver and spleen.
After the acute stage, there is a latency period when all symptoms subside. But even without visible manifestations, the development of immunodeficiency continues and, in the absence of treatment, leads to the further development of a terrible disease. The asymptomatic stage in some patients can last for several years, in others the disease develops rapidly and after 4-5 weeks characteristic complications arise.
Further development of the disease is accompanied by opportunistic infections and the development of secondary diseases:
- Pneumocystis pneumonia. It develops against the background of a sharp increase in temperature and a rapid deterioration in the condition. The patient develops a dry, painful cough, severe shortness of breath even with minimal physical exertion. At the same time, traditional antibiotic therapy does not give a positive effect.
- Generalized infections - herpes, candidiasis, cytomegalovirus, tuberculosis, which are very difficult against the background of immunodeficiency.
- The pulmonary form of the disease is manifested by severe pneumonia, intestinal - prolonged diarrhea, dehydration and anorexia.
- Damage to the central nervous system - at the initial stage, there is a decrease in concentration, memory problems. In the future, the disease leads to the development of encephalitis, meningitis and brain tumors. The progression of infection and the multiplication of the virus provoke epileptic seizures, in advanced cases, brain atrophy and dementia develop.
- Kaposi's sarcoma. Multiple neoplasms of a characteristic red color develop from the lymphatic vessels and most often appear in men. Tumors are localized on the head, body, or form in the mouth.
- At this stage, women are often diagnosed with an inflammatory process in the pelvic organs (salpingitis), carcinoma or dysplasia of the cervix.
The last stage of HIV
The last, terminal stage of the disease is acquired immunodeficiency syndrome (AIDS). If the disease is diagnosed on time, when the first signs appear, the patient can live quite a long time. According to medical estimates, the average life expectancy of HIV-infected patients is 12 years. But in some cases, death can occur within a year after infection. Most often, such an outcome occurs with an asymptomatic course of the disease, when the infected person does not even suspect that he is sick.
Even with the slightest suspicion of HIV infection, a test should be taken to detect the presence of a virus in the body. With a timely diagnosis, it is possible with the help of modern medicines to stop the progression of the disease and prolong the patient's life.
Human immunodeficiency virus is the scourge of the XXI century. Doctors are looking for a way to diagnose the disease in a timely manner, since so far it is possible to recognize HIV symptoms at an already advanced stage of the disease. A universal cure for this disease has not yet been invented, although scientists around the world are working on this problem.
Development of infection
From the moment the virus enters the human body, 5 stages of the development of the disease can be distinguished:
- Incubation period.
- The period of primary symptomatology, which in turn can occur in 3 different forms.
- Latent (latent) period.
- Stage of secondary diseases.
- Terminal stage.
The incubation period of infection lasts from the first day of infection until the body begins to develop antibodies to the immunodeficiency virus or until symptoms of an acute infection appear, which will be discussed below.
The incubation phase of the virus can last from 3 weeks to 3 months, however, there are cases when this stage lasted for several months. In the early stages of the disease, the virus actively multiplies in the human body, but this happens without any signs and the formation of antibodies.
The presence of infection at this stage is diagnosed based on the data of the epidemiological survey. The virus, its antigens and residues of nucleic sequences should be detected in the patient's blood serum.
At the next stage, the first symptoms of HIV infection begin to appear. The virus continues to actively multiply in the body of an infected person. This period is also known as early HIV infection, and can develop in 3 forms:
- Without any pronounced symptoms, when an ailment can be detected only by detecting antibodies to the virus.
- Acute form of the disease without secondary infections. In this case, the first signs of HIV infection in the body can be very diverse (weakness, fever, fever, rash, swollen lymph nodes, diarrhea). It is very easy to confuse HIV with the influenza virus based on primary symptoms. The immunodeficiency virus can be recognized both by specific antibodies and by the presence of special lymphocytes in the blood (mononuclear cells). This form is observed in most patients in the first 3 months of the development of the disease.
- The acute form of the disease with the addition of concomitant infections. In 10-15% of patients, secondary infectious diseases develop, such as pneumonia, tonsillitis, herpes, etc. In this form, HIV lasts from 2 to 3 weeks.
An early infection is replaced by a latent period, which is characterized by a gradual progression of immunodeficiency. HIV can be recognized by an enlarged pair (or more) of lymph nodes. They are elastic to the touch, do not cause pain in the patient.
The latent stage can last from 2 to 20 years. In most cases from 6 to 7 years old.
At the stage of secondary diseases, concomitant ailments join HIV infection. In this phase, a period of disease progression and a period of remission are distinguished.
The final stage (terminal) is characterized by the irreversibility of the progression of concomitant infections. Antiviral treatment does not give a positive result, the patient's death occurs after a few months.
First signs
HIV infection attacks almost all organs and systems of the body. This is done in one of the following ways:
- The virus directly infects one or another part of the body.
- The infection causes a weakening of the protective function of the immune system, which makes it possible for other infections to infect the patient's body.
HIV infection chooses the central nervous system, intestinal cells and blood as the main targets.
As a result, a person's mental health is disturbed, his head hurts, he can feel numbness of the limbs, anemia develops, digestive upset and general weakness are possible.
How long does it take for HIV to appear? At the first stages of the progression of the disease, a person may be pestered by aching muscle pains, profuse night sweats, and nausea. These signs often don't last more than 15 days. With HIV at an early stage, there is a likelihood of developing malignant formations in the brain and / or its membrane. The patient has a severe headache with HIV, neck swelling, fever (which cannot be brought down for several days), possibly falling into a coma. The enlarged lymph nodes can remain as such for several months or even years.
There are some features of the symptomatology of the disease in the male and female organisms. It is believed that HIV infects a man's body faster than a woman.
However, due to the anatomical features of the genitourinary system of women, they become ill more often than men, which increases the likelihood of contracting HIV. Infected women have swelling of the inguinal lymph nodes, pain during menstruation, unhealthy vaginal discharge, pelvic pain, chronic fatigue, weakness, and mood swings.
Then there comes a period when a person does not suffer from any alarming symptoms. He continues to lead his usual life, unaware of the spread of the virus in his body. This can take up to 10 years before it is possible to determine HIV in the body.
When the next stage of the disease comes, the person begins to dramatically lose weight. This is the stage when the patient develops manifestations of acquired immunodeficiency syndrome. Because of the dramatic weight loss, AIDS is known as the disease of thinness in parts of Africa.
As you can see, it is very difficult to recognize HIV infection in the early stages. A person can attribute the symptoms to ARVI, and over time forget about any ailment. Meanwhile, the virus will actively poison the body of the infected. Take care of your health, do HIV prevention and get tested from time to time to detect antibodies to the virus.
The human immunodeficiency virus belongs to the group of retroviruses, provoking the development of HIV infection. This disease can proceed in several stages, each of which differs in the clinical picture, the intensity of manifestations.
Stages of HIV
Stages of development of HIV infection:
- incubation period;
- primary manifestations are acute infection, asymptomatic and generalized lymphadenopathy;
- secondary manifestations - damage to internal organs of a persistent nature, damage to the skin and mucous membranes, diseases of the generalized type;
- terminal stage.
According to statistics, HIV infection is most often diagnosed at the stage of secondary manifestations and this is due to the fact that the symptoms of HIV become pronounced and begin to bother the patient precisely during this period of the course of the disease.
At the first stage of the development of HIV infection, certain symptoms may also be present, but they, as a rule, are mild, the clinical picture is blurred, and the patients themselves do not turn to doctors for such "trifles". But there is one more nuance - even if a patient seeks qualified medical care at the first stage of the course of HIV infection, specialists may not diagnose the pathology. Moreover, at this stage of the development of the disease in question, the symptoms will be the same in men and women - this often confuses doctors. And only at the secondary stage it is quite realistic to hear the diagnosis of HIV infection, and the symptoms will be individual for men and women.
How long does it take to manifest HIV
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The first signs of HIV infection go unnoticed, but they are there. And they appear on average in the period from 3 weeks to 3 months after infection. A longer period is also possible.
Signs of secondary manifestations of the disease in question can also appear only many years after infection with HIV, but manifestations can also occur within 4-6 months from the moment of infection.
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After a person has contracted HIV infection, no symptoms and even small hints of the development of any pathology are observed for a long time. It is precisely this period that is called the incubation period, it can last, in accordance with the classification of V.I. Pokrovsky, from 3 weeks to 3 months.
No examinations and laboratory tests of biomaterials (serological, immunological, hematological tests) will help to identify HIV infection, and the infected person himself does not look sick at all. But it is the incubation period, without any manifestations, that poses a particular danger - a person serves as a source of infection.
Some time after infection, the patient begins the acute phase of the disease - the clinical picture during this period may become a reason for the diagnosis of HIV infection "in question."
The first manifestations of HIV infection in the acute phase of the course strongly resemble the symptoms of mononucleosis. They appear on average in the period from 3 weeks to 3 months from the moment of infection. These include:
When examining a patient, a doctor can determine a slight increase in the size of the spleen and liver - the patient, by the way, may complain of recurrent pain in the right hypochondrium. The patient's skin may be covered with a small rash - pale pink spots that do not have clear boundaries. Often there are complaints from infected people and about prolonged stool disturbance - they are tormented by diarrhea, which is not relieved even by specific medications and a change in diet.
Please note: with this course of the acute phase of HIV infection, lymphocytes / leukocytes in an increased amount and mononuclear cells of an atypical type will be detected in the blood.
The above signs of the acute phase of the disease in question can be observed in 30% of patients. Another 30-40% of patients live an acute phase in the development of serous meningitis or encephalitis - the symptoms will be radically different from those already described: nausea, vomiting, an increase in body temperature to critical levels, a powerful headache.
Often, the first symptom of HIV infection is esophagitis, an inflammatory process in the esophagus, characterized by swallowing problems and chest pain.
In whatever form the acute phase of HIV infection proceeds, after 30-60 days all symptoms disappear - often the patient thinks that he is completely cured, especially if this period of pathology was almost asymptomatic or their intensity was low (and this can also be ).
During the course of this stage of the disease in question, there are no symptoms - the patient feels great, does not consider it necessary to appear in a medical institution for a preventive examination. But it is at the stage of asymptomatic course that antibodies to HIV can be detected in the blood! This makes it possible to diagnose pathology at one of the early stages of development and begin adequate, effective treatment.
The asymptomatic stage of HIV infection can last for several years, but only if the patient's immune system has not been significantly affected. The statistics are quite contradictory - only in 30% of patients within 5 years after the asymptomatic course of HIV infection, symptoms of the following stages begin to appear, but in some infected people the asymptomatic stage of the course proceeds rapidly, lasts no more than 30 days.
This stage is characterized by an increase in almost all groups of lymph nodes, this process does not affect only the inguinal lymph nodes. It is noteworthy that it is generalized lymphadenopathy that can become the main symptom of HIV infection, if all the previous stages of the development of the disease in question proceeded without any manifestations.
Lymphosules increase by 1-5 cm, remain mobile and painless, and the surface of the skin above them has absolutely no signs of a pathological process. But with such a pronounced symptom as an increase in lymph node groups, the standard causes of this phenomenon are excluded. And here, too, lies the danger - some doctors classify lymphadenopathy as difficult to explain.
The stage of generalized lymphadenopathy lasts 3 months, about 2 months after the onset of the stage, the patient begins to lose weight.
Secondary manifestations
It often happens that it is the secondary manifestations of HIV infection that serve as the basis for a high-quality diagnosis. Secondary manifestations include:
The patient notes a sudden increase in body temperature, he has a dry, obsessive cough, which eventually turns into a wet one. The patient develops intense shortness of breath with minimal physical exertion, and the patient's general condition deteriorates rapidly. The therapy carried out with the use of antibacterial drugs (antibiotics) does not give a positive effect.
Generalized infection
These include herpes, tuberculosis, cytomegalovirus infection, candidiasis. Most often, women are ill with these infections, and against the background of the human immunodeficiency virus, they are extremely difficult.
Kaposi's sarcoma
It is a neoplasm / tumor that develops from the lymphatic vessels. More often diagnosed in men, it has the appearance of multiple tumors of a characteristic cherry color, located on the head, trunk and in the mouth.
Damage to the central nervous system
At first, this manifests itself only with minor memory problems, decreased concentration. But in the course of the development of pathology, the patient develops dementia.
Features of the first signs of HIV infection in women
If infection with the human immunodeficiency virus occurs in a woman, then secondary symptoms will most likely manifest themselves in the form of development, progression of generalized infections - herpes, candidiasis, cytomegalovirus infection, tuberculosis.
Often, secondary manifestations of HIV infection begin with a banal menstrual irregularity, inflammatory processes in the pelvic organs, for example, salpingitis, can develop. Often diagnosed and oncological diseases of the cervix - carcinoma or dysplasia.
Features of HIV infection in children
Children who were infected with the human immunodeficiency virus during pregnancy (in utero from the mother) have some peculiarities during the course of the disease. First, the disease begins to develop at 4-6 months of age. Secondly, the earliest and main symptom of HIV infection during intrauterine infection is considered a disorder of the central nervous system - the baby lags behind his peers in physical and mental development. Thirdly, children with human immunodeficiency virus are susceptible to the progression of disorders of the digestive system and the appearance of purulent diseases.
The human immunodeficiency virus is still an unexplored disease - too many questions arise in both diagnosis and treatment. But doctors say that only the patients themselves can detect HIV infection at an early stage - they must carefully monitor their health and undergo periodic preventive examinations. Even if the symptoms of HIV infection are hidden, the disease develops - only a timely test analysis will help save the patient's life for several years.
Answers to popular questions about HIV
Due to the large number of requests from our readers, we decided to group the most common questions and answers to them in one section.
Signs of HIV infection appear approximately 3 weeks to 3 months after exposure. Fever, sore throat and swollen lymph nodes in the first days after infection can indicate any pathology, except for the human immunodeficiency virus. During this period (doctors call it incubation), not only are there no symptoms of HIV, but deep laboratory blood tests will not give a positive result.
Yes, unfortunately, this is rare, but it happens (in about 30% of cases): a person does not notice any characteristic symptoms during the acute phase, and then the disease goes into a latent phase (this is, in fact, an asymptomatic course for about 8-10 years ).
Most modern screening tests are based on enzyme-linked immunosorbent assay (ELISA) - this is the "gold standard" of diagnostics, and an accurate result can be expected no earlier than 3-6 months after infection. Therefore, the analysis must be taken twice: 3 months after a possible infection and then another 3 months later.
First, you need to take into account the period that has passed after a potentially dangerous contact - if less than 3 weeks have passed, then these symptoms may indicate a banal cold.
Secondly, if more than 3 weeks have already passed after a possible infection, then you should not make yourself nervous - just wait and 3 months after a dangerous contact to undergo a specific examination.
Third, fever and swollen lymph nodes are not “classic” signs of HIV infection! Often, the first manifestations of the disease are expressed by pain in the chest and a burning sensation in the esophagus, a violation of the stool (a person is worried about frequent diarrhea), a pale pink rash on the skin.
The risk of contracting HIV through oral sex is minimized. The fact is that the virus does not survive in the environment, so for oral infection it is necessary that two conditions come together: there are wounds / abrasions on the partner's penis and wounds / abrasions in the partner's oral cavity. But even these circumstances do not in every case lead to HIV infection. For your own peace of mind, you need to pass a specific test for HIV 3 months after a dangerous contact and pass a "control" examination after another 3 months.
There are a number of medications that are used for HIV postexposure prophylaxis. Unfortunately, they are not available for sale, so you have to go to an appointment with a therapist and explain the situation. There is no guarantee that such measures will prevent the development of HIV infection by 100%, but experts say that taking such drugs is quite advisable - the risk of developing the human immunodeficiency virus is reduced by 70-75%.
If there is no opportunity (or courage) to see a doctor with a similar problem, then there is only one thing to do - wait. You will need to wait 3 months, then get tested for HIV, and even if the result is negative, it is worth taking a control test after another 3 months.
No you can not! The human immunodeficiency virus does not survive in the environment, therefore, with people who are HIV-positive, you can without hesitation use shared dishes, bed linen, visit the pool and bathhouse.
There are risks of infection, but they are quite small. So, with a single vaginal intercourse without a condom, the risk is 0.01 - 0.15%. With oral sex, the risks range from 0.005 to 0.01%, with anal sex - from 0.065 to 0.5%. Such statistics are provided in the clinical protocols for the WHO European Region on HIV / AIDS treatment and care (p. 523).
In medicine, cases are described when married couples, where one of the spouses was HIV-infected, had sex life without using condoms for several years, and the second spouse remained healthy.
If during intercourse a condom was used, it was used according to the instructions and remained intact, then the risk of HIV infection is minimized. If, after 3 or more months after a dubious contact, symptoms resembling HIV infection appear, then you just need to contact a therapist. An increase in temperature, an increase in lymph nodes may indicate the development of ARVI and other diseases. For your own reassurance, it is worth taking an HIV test.
To answer this question, you need to know at what time and how many times such an analysis was submitted:
- a negative result in the first 3 months after a dangerous contact cannot be accurate, doctors talk about a false negative result;
- negative response to HIV testing after 3 months from the moment of dangerous contact - most likely the subject is not infected, but it is imperative to do another test 3 months after the first for control;
- negative response to HIV analysis 6 months or more after dangerous contact - the subject is not infected.
The risks in this case are extremely small - the virus quickly dies in the environment, therefore, even if the blood of an infected person remains on the needle, it is almost impossible to become infected with HIV by wounding with such a needle. There can be no virus in the dried biological fluid (blood). However, after 3 months, and then again - after another 3 months - it is still worth getting tested for HIV.
Tsygankova Yana Alexandrovna, medical commentator, therapist of the highest qualification category.