The Human Immunodeficiency Virus, first identified in 1981, is the cause of one of the deadliest and most persistent epidemics ever recorded in human history. HIV is a virus that affects those cells that enable the body to fight infections, rendering an individual more susceptible to other infections and diseases. Contact with certain bodily fluids of an HIV-positive individual, most commonly during unprotected intercourse (sex without the use of a condom), or sharing injection drug equipment, spreads the virus.
HIV can progress to Acquired Immunodeficiency Syndrome if left untreated. AIDS is the late stage of HIV infection that occurs when the body’s immune system is badly damaged because of the virus. This takes about 15 years to develop.
A person with HIV is considered to have progressed to AIDS when the number of their CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3). (In someone with a healthy immune system, CD4 counts are between 500 and 1,600 cells/mm3, or when they develop one or more opportunistic infections regardless of their CD4 count.
HIV has no cure. However, people with HIV can live long and healthy lives and prevent transmitting HIV to their sexual partners, by taking HIV medicine (called antiretroviral therapy or ART). HIV medicines can slow the progression of HIV to AIDS. Without HIV medicine, people with AIDS typically survive for only about three years. The presence of an opportunistic illness/infection further reduces life expectancy to about one year. Testing can enable the individual to know their status, so as to start HIV medicine or the ART soon.
As a result of the weakening effect of HIV on the immune system, cancers may develop more quickly and become harder to treat. Individuals with AIDS are substantially more prone to develop certain types of cancer than people without the disease. Healthcare practitioners consider HIV infection to have progressed to AIDS when persons with HIV develop specific malignancies or cancers. Kaposi sarcoma, non-Hodgkin lymphoma (a type of cancer where white blood cells called lymphocytes grow abnormally and can form growths (tumors) throughout the body), and cervical cancer are examples of these cancers. People living with HIV or AIDS are more prone to develop skin, anus, lung, and liver cancers, as well as Hodgkin lymphoma (a cancer of the lymphatic system, which is part of your immune system).
Kaposi sarcoma typically appears as painless purplish spots on the legs, feet or face. These lesions can also appear in the genital area (penis/vagina), mouth or lymph nodes. It is rarely seen in people who do not have HIV. The risk of Kaposi sarcoma is increased by several thousand times in those with HIV infection, compared with those who do not have HIV.
The key to preventing these AIDS-related malignancies is primarily preventing infection from HIV. This can be achieved by not sharing needles or syringes with other people, avoiding unprotected sex-using condoms, limiting the number of sexual partners you have, not coming into contact with other people’s blood, getting tested for HIV and other sexually transmitted diseases on a regular basis, having regular checkups which can allow your healthcare provider to find abnormal cells before they develop into cancer, and getting vaccinated against the HPV virus might also reduce the risk in people who are not already infected. In addition, there are effective methods to prevent getting HIV through sex or drug use, including the use of Pre-Exposure prophylaxis (PrEP) or Post-exposure prophylaxis (PEP).
For most people, HIV testing will be accurate four to six weeks after a possible infection. However, for some others, it may take longer — up to three months — for detectable antibodies to develop. This is called the “window period.” During the window period, HIV tests can come back negative even though the person has the virus. HIV is transmissible to people during the window period. A rule of thumb is, assume that everyone you come in contact with has this virus, until proved otherwise by testing. While the goal is to reduce the number of newly infected individuals, a diagnosis of HIV is not a death sentence. It is a challenging health situation that should be avoided when/if absolutely possible. However, a wider use of antiretroviral, or anti-HIV medicines have reduced the occurrence of certain AIDS-related cancers.
Ms Declan, a Certified Registered Nurse, is a public health literacy advocate based in Texas, United States
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