HIV – everything you need to know about the disease: symptoms, signs, modes of transmission, treatment

Infectious disease specialist

Sinitsyn

Olga Valentinovna

34 years of experience

Highest qualification category of infectious disease doctor

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HIV (human immunodeficiency virus) is a virus that attacks the body's immune system. More precisely, it targets certain immune cells and kills them. The longer and more active this process lasts, the weaker the immune system becomes - over time, it is simply unable to cope even with infections that are relatively safe for an ordinary person.

HIV and AIDS - differences, duration of development, forecasts

AIDS is the final stage of HIV, which is characterized by severely reduced immunity. It is important not to confuse these two concepts. From the moment of HIV infection, the disease can develop to the AIDS stage without treatment within 9-11 years (on average). Once diagnosed with AIDS without treatment, life expectancy is short - on average up to 19 months.

If you start treatment on time, you can live a very long life at the HIV stage - the life expectancy of such patients thanks to modern treatment is 20-50 years. And although at the AIDS stage the situation is much more complicated, many patients, with proper treatment and a strong body, can live more than 10 years.

It is obvious that taking therapy is the most important factor for treating HIV and living a full, long life. Moreover, it is treatment that can significantly reduce the viral load and make the infected person harmless to the partner, as well as family members.

Diagnosis and treatment of the disease

The virus cannot be eliminated 100%. This is the main negative side. Initially, during the incubation period, the virus does not manifest itself in any way.

diagnosis of HIV infection

Symptoms of HIV infection in men initially appear in an acute form, but it is important not to miss the elimination of symptoms and diagnosis, because the virus quickly switches to the activation phase. There is no need to mix the concepts of HIV and AIDS. HIV is an infectious disease, and AIDS is a serious pathology. Therefore, it is so important to identify the development of the disease at the stage of its development. With early diagnosis and identification of the first symptoms of AIDS, life expectancy ranges from 20 to 50 years. However, if AIDS was diagnosed at a late stage of development and treatment was not prescribed, then it is worth talking about 6-9 months.

Routes of HIV transmission

Main routes of HIV infection:

unprotected sex with an infected person (the most common route of HIV transmission). You can become infected either after a single contact or after several;
using a needle to inject drugs after an infected person. Or other variants of situations in which the blood of a healthy person comes into contact with the blood of an infected person;
transmission from mother to fetus during childbirth or from mother to child during breastfeeding. An important note: if a woman is treated and is under the supervision of doctors, she has every chance of giving birth to a healthy baby;
transfusion of infected blood. In modern clinics and hospitals this is no longer possible, since all materials undergo very serious testing.

There are also so-called risk groups - these are people who are more susceptible to HIV infection than others:

people who are promiscuous;
homosexuals;
drug addicts who inject drugs;
people with a partner infected with the virus.

Such people should constantly get tested. In some cases, they are recommended to take preventive medications (only on the recommendation of a doctor).

When talking about how you can become infected with HIV, you should clarify in what cases this is impossible:

during everyday contacts;
when using infected utensils;
with an insect bite;
when kissing.

Contact with an HIV-infected person at the everyday level (in the family, at work, in other forms of communication) is absolutely safe and does not pose any threat to others.

Main stages of the disease

The stages of HIV are divided into the following:

incubation This is the stage at which infection and subsequent multiplication of the virus in the blood occurs. It lasts up to six weeks, sometimes less. Even if infected, at this stage a person will not see obvious signs, and a blood test will not show that there are antibodies in the blood;
primary. The first signs of infection may already appear here. The second stage lasts for 3 weeks - at this time antibodies appear, the virus is determined in the laboratory;
subclinical. The first sign of the disease appears - enlarged lymph nodes. The patient feels completely healthy and does not complain about his health;
the appearance of secondary diseases. The immune system begins to malfunction, causing a variety of diseases to appear: from frequent colds and candidiasis to pneumonia, tuberculosis;
terminal. The stage involves exhaustion (rather rapid and progressive), as well as the subsequent death of the patient.

The stages do not have one correct time frame - they may differ from person to person. For example, HIV-infected people often feel well for years or do not pay attention to small signs. The disease is detected only at the stage of severe deterioration in health or through random tests.

Harbingers of death

As a rule, at the terminal stage of the disease, the patient is in the hospital under the supervision of doctors. Due to external and physiological factors, from the moment of transition to the AIDS stage to death, it takes from several weeks to 3 years. Life expectancy is influenced by the quality of treatment and the patient’s condition, and the number of opportunistic infections. Increased symptoms of concomitant infections are considered harbingers of death.

The body is completely weakened, weight is greatly reduced, and organs are unable to perform their functions. Even enlarged lymph nodes lead to cracks and suppuration, as the skin loses its elasticity. When the lungs are damaged, sputum and blood are released with a cough, this is a sign of severe damage to the internal organs. There is practically no appetite. An attack on the central nervous system leads to mental disorders and atypical dementia. The patient may not be able to navigate dates, events and persons.

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Any opportunistic disease occurs in a more severe form. Kaposi's sarcoma covers large areas of the body, minor wounds lead to suppuration and erosion. As a rule, in recent weeks and months a person cannot take care of himself normally: bathe, eat, dress. Symptomatic treatment at this stage is aimed at maintaining an acceptable quality of life for the person. The infections themselves are not treatable or difficult to treat.

Symptoms of HIV

Once you know how HIV is transmitted, you need to understand the symptoms. The problem is that these symptoms appear at an early stage, then disappear and no longer bother the person for a long time - literally for years. They are also very similar to the manifestations of other diseases, which can be misleading.

So, at the first stage, when the virus manifests itself, a person may feel:

sore throat, fever;
soreness of the skin, joints, bones4
chills, fever.

At the same time, the cervical lymph nodes enlarge and various rashes may appear. All this is often mistaken for signs of ARVI or other similar diseases.

New HIV symptoms return after several years of a calm and healthy life. These include:

severe fatigue, fatigue;
enlargement of lymph nodes - not only in the cervical, but in several groups;
weight loss. Usually it looks causeless, the person does not understand what is going on;
fever, chills, sweating (mostly at night);
problems with the gastrointestinal tract - usually manifested by loose stools for no apparent reason.

At this stage, as a rule, the disease is detected - because the patient goes to the doctor, and the specialist prescribes an additional examination.

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Symptoms of concomitant diseases

AIDS occurs when the body is no longer able to control or defeat HIV infection. During this stage, patients lose weight, become easily infected, and develop tumors.

Of the accompanying signs, the following are relevant:

prolonged diarrhea;
enlarged lymph nodes;
increased sweating at night;
fever for several weeks or months.

This condition is not caused by the virus itself, but by opportunistic infections. Most often, patients experience inflammation of the lungs, gastrointestinal tract and central nervous system.

Lung infections

Approximately 65-80% of infected people are diagnosed with Pneumocystis pneumonia (PP); it threatens the lives of patients more than other infections. In developing countries, PP and tuberculosis remain the leading causes of death among HIV-positive people. The causative agent is a yeast-like fungus. It does not cause complications in a healthy person, but against the background of immunodeficiency it leads to a serious condition. Symptoms include a prolonged dry cough, shortness of breath, fever, and night sweats. As the disease progresses, the causative agent of PP can spread to other organs. In the lungs, due to the action of the fungus, the lumen of the alveoli decreases, gas exchange is disrupted, and oxygen deficiency occurs. If left untreated, PP becomes fatal.

The second problem for HIV-positive people is tuberculosis. Often people find out about their HIV status only after visiting a tuberculosis clinic.

In the early stages, patients have quite typical symptoms; TB is localized in the lungs and responds well to treatment. When the number of lymphocytes decreases to 200 or below, the infection takes on an atypical course. The pathogen affects the bone and brain, gastrointestinal tract, liver, and central nervous system. In treatment, antiretroviral therapy is often delayed until tuberculosis is eliminated. If the patient's condition does not allow stopping ART, two courses are combined. Up to the last stages, TB can be controlled and treated.

In addition to PP and TB, against the background of suppressed immunity, the lungs are affected by cryptococcosis, candidiasis, cytomegalovirus infection and others. They can occur in parallel with tuberculosis or pneumonia, which significantly complicates treatment. “Positive” patients are prescribed prophylaxis for life or a course against bacterial and fungal pathologies.

Gastrointestinal infections

The digestive organs, especially the intestines, can be damaged by the virus itself and by opportunistic diseases. Most often, the gastrointestinal tract suffers from candidiasis. Candida is a fungus specific to humans. It is also present in healthy people, but the normal protective function inhibits the growth and development of fungi. With AIDS, candida and other microorganisms grow out of control.

As a result of infection or an increase in the number of specific microorganisms, HIV-positive people develop esophagitis. This is an inflammation of the mucous membrane of the esophagus. Esophagitis is caused by candida, cytomegalovirus, herpes simplex virus and other microorganisms. Symptoms:

heartburn;
pain when swallowing;
nausea and vomiting;
prostration;
diarrhea.

With opportunistic diseases, not only internal organs are affected. AIDS is characterized by rashes and ulcers in the mouth, and a white coating. Among gastrointestinal pathologies, non-Hodgkin's lymphoma is relevant, which is accompanied by bleeding, pain in the epigastric region, and nausea.

Neurological and psychological complications

The immune system suffers the most from the immunodeficiency virus, followed by the central nervous system. A patient may have several severe pathologies combined at once, but the form of AIDS is determined by where the problems are most concentrated. In the neurological form, the central nervous system suffers.

Mental and neurological diseases develop when the virus penetrates the central nervous system or are a consequence of opportunistic diseases.

Any damage to the nervous system is dangerous, because they lead to loss of performance and loss of personality of the patient. HIV-associated diseases:

Cryptococcal meningitis is a fungal infection that affects the lining of the brain. In the early stages, headaches, nausea and vomiting, and disorientation are noted. With progress, seizures are observed, pain and fever intensify.
Progressive multifocal leukoencephalopathy is caused by a polyomavirus. Progresses quickly, leading to disruption of neural connections in the brain. Early symptoms are similar to meningitis: fever, migraines, nausea. Cognitive abilities are gradually erased, the patient’s personality changes.
AIDS dementia complex – appears when microglia and macrophages are infected with the HIV virus. Carrier cells produce a neurotoxin that disrupts brain function. The symptoms of the pathology are similar to dementia.

Damage to the central nervous system leads to patients gradually developing cognitive impairment. Patients' ability to read, understand the environment, and orientate is impaired. Motor function also suffers, up to paralysis.

Behavioral disorders lead to frequent mood swings, seizures, aggression or tearfulness. The psyche may suffer from the patient’s reaction to the fact of HIV infection. As a result, hypochondriacal and paranoid psychoses, depression, and hysteria develop. With the combination of several types of drugs and early treatment, neurological disorders are less common.

How is HIV diagnosed in Moscow?

There are two tests to diagnose the virus: preliminary ELISA and the most accurate immunoblot. The accuracy of ELISA is about 90%. It is recommended to carry out it 3-6 months after contact with the virus, then it gives maximum accuracy. The usual ELISA test is based on a blood test, but there are also rapid tests that help obtain information based on urine or saliva. Such texts are purchased exclusively at the pharmacy (in no case on the Internet!), since it is necessary to use officially approved products.

If the rapid test gives a positive result, you need to go to an infectious disease specialist yourself. In such a situation, as well as when ELISA in a blood test gives a positive result, the patient is prescribed an immunoblot. Its reliability is already 99.9%. Depending on the diagnosis, the diagnosis is made either on the basis of two repeated tests or a combination of both. The analysis is rechecked and only after this a diagnosis can be made. This is necessary in order to exclude false positive results that may occur during the diagnostic process.

Important: the test does not show how HIV is transmitted in a particular situation - that is, you can determine the route of infection only by analyzing your own actions.

How is diagnosis carried out?

How to detect HIV at home ? In general, diagnosis is carried out on the basis of blood tests - ELISA and immunoblotting. Through the first analysis, the quantitative ratio of the virus in the serum can be determined.

Immunoblotting has greater sensitivity and specificity up to 99.7%. The incubation period for AIDS lasts about three months. To diagnose AIDS, the transcript must demonstrate CD4 lymphocytes in the blood in an amount of no more than 200.

AIDS treatment

HIV treatment

Treatment boils down to prescribing antiretroviral therapy. The patient is given a medication regimen - and it must be followed as precisely as possible, without deviating from the program. Otherwise, the virus may develop resistance to treatment and cannot be further suppressed.

Indicators of quality treatment are a decrease in the viral load, as well as an increase in CD4+ cells in the blood, which indicates the activity of the immune system.

Medicines for treatment are issued in medical institutions, patients are registered and receive medications free of charge, in accordance with the established procedure. Information about the disease is confidential - it is not sent to work, place of study or other places. The patient has the right to keep it secret (if this is not provided for in separate work contracts).

If the rules for taking therapy are followed, the virus in the blood gradually decreases; over time, the patient becomes completely safe for his sexual partner and is not able to infect anyone.

Prevention of HIV infection

The first and most important rule is to be regularly tested for HIV, even if you have not had suspicious contacts. It is recommended to be examined once every six months - especially since there are convenient rapid tests for this.

You also need to be careful when choosing partners. You should not take the word of a person who says that he is definitely not sick - it is better to ask for the results of the study and see for yourself that you can trust him. But remember that within six months even contaminated blood may not give positive results.

HIV prevention consists of the following points:

protected sex with non-regular sexual partners, as well as regular ones, if there is no confidence that the partner is not sick or is faithful;
exclusion from life of drugs and promiscuity;
maintaining general hygiene. Avoid sharing razors, toothbrushes, nail clippers, and other items that may come into contact with small wounds.

The main prevention is to be aware of the infection and always remember the danger of infection.

Treatment technology

It is not possible to completely cure HIV. A cure for AIDS has not yet been found, but research in this area continues. The fundamental method of stopping the development of the first symptoms of HIV infection is through medications. They use drugs to treat AIDS, which can blunt the development and support our immunity. This includes drugs for opportunistic diseases and to prevent the development of other viruses and pathologies. Therapy is carried out throughout life.

LECTURE AIDS: symptoms, treatment and prevention