Symptoms Of Hiv

Other articles in this series have discussed how HIV attacks the CD4 helper T-cells, white blood cells that do the heavy lifting in the immune system.   Uninfected and healthy people have an average of 1000 CD4 T cells in every cubic millimeter of their blood, while AIDS victims have less than 200.  In the most advanced stages of the disease, the CD4 T-cells may be almost completely wiped out. 

The death of the immune system proceeds gradually.   Most infected people live for years without any symptoms, because the body continues to manufacture new helper cells.  But it's losing the race with the virus, which never stops doing its dirty work.  As HIV destroys more and more CD4 cells, and uses their reproductive machinery to make more copies of itself, it slowly erodes the body's capacity to regenerate the immune system.   In otherwise healthy individuals, untreated HIV will lead to AIDS within a decade.   Ultimately, most people with AIDS die not of the syndrome itself, but of other diseases such as pneumonia or Karposi's sarcoma,   "opportunistic infections" that invade the body in the absence of strong immunity. 

Antiretroviral medications are the only treatment currently available for HIV infection.  They impair HIV's capacity to reproduce.  However, HIV evolves quickly, and can often develop resistance to anti-retroviral treatments, so an HIV patient must keep changing doses of the antiretroviral drugs in order to stay ahead of the virus.   When the medication works properly, it drives down the levels of HIV in the blood while increasing the quantity of CD4 T-cells.   At its most effective, in particular with otherwise healthy patients who take the right doses at the right times, anti-retroviral treatment can double the healthy lifespan of HIV-infected people and allow them to live more or less normal lives, albeit with a slightly reduced capacity to fight off disease.   

Since its discovery in 1981, HIV has spread relentlessly around the globe.   Out of the close to 40 million people now infected, it has claimed 25 million victims, and numbers of deaths and infections are still climbing.  In parts of Africa, AIDS has decimated the working-age population and created an economic and cultural crisis.    The virus kills undercover over many years, and it is transmitted almost entirely through unprotected sex.  This makes it extremely difficult for public health care officials to prevent.  

Individuals with a deep awareness of HIV, and a clear understanding of how it is transmitted, can easily protect themselves by practicing safe sex and/or choosing their sexual partners carefully.   In many countries with an AIDS epidemic, however, the health care system does not have the capacity to educate citizens about the disease, or to push for the necessary changes in social mores.  In some of the hardest-hit places, men have most of the power in the society.  They also take on many sexual partners, and don't tend to use condoms.  It is hardly surprising that they spread HIV wherever they go.

In some regions of the world and sectors of society where HIV is prevalent, many people misunderstand the disease.  Some believe that anti-retrovirals can ‘cure’ AIDS, so they develop a false sense of security, and take dangerous risks with unsafe sex.   It is true that anti-retrovirals can delay the onset of symptoms, but they are not universally available or affordable, and they don't prevent infected people from passing the disease on to others.     In reality, the only long-term remedy for HIV infection is to avoid getting infected in the first place.  

In the United States, the Centers for Disease Control and Prevention (CDC) suggest that every one between 13 and 64 get tested for HIV at least once as part of their normal medical care.   People at particularly high risk of infection -- usually because they have unprotected sex with multiple partners, especially men who have sex with men -- should get tested once a year.  

Since antibodies to HIV don't develop in the body until at least 12 weeks after the virus has entered the body, it is possible to test negative immediately after getting infected, so the best course of action for people at high risk who test negative is to take a second test a few weeks after the first.  Several types of tests are available, including an oral "rapid" test, a traditional blood test, and a Home Access HIV-1 test.   The last test can be done at home, and the first two require a clinic.  In all cases a laboratory must analyze the tests and inform the patient of the results, but it is possible to stay anonymous by providing the lab only with a code number and typing in the code over the phone when calling for results.