AIDS

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Human immunodeficiency virus, or HIV disease, is a spectrum of illnesses caused by the human immunodeficiency virus (HIV). The disease was first recognized in the very early 1980's. The virus HIV was first identified in 1984 by French and American scientists, but the human immunodeficiency virus did not get its name until 1986. HIV disease represents a potential threat to everyone - men, women, and children. The number of deaths, people with symptoms, and people infected, continues to climb at an alarming rate. From the beginning of the epidemic people of all sexes, ages, and backgrounds have been affected.

Very simply, HIV destroys the body's immune system over a period of time by killing the white blood cells (called T-Cells and B-Cells) that the body needs to respond to and destroy other infections. When germs, such as viruses, bacteria, parasites, and fungi, are detected, B-Cells and T-Cells are activated to defend the body. When HIV enters the body, it infects special T-Cells called CD4 cells. The virus grows and multiplies in these cells, weakening the immune system. As people with HIV progress in their disease, they have less and less ability to fend off these infections or cancers. Most people who die from this disease succumb to an "opportunistic infection" that occurs due to the weakened immune system. When a person with an HIV-weakened immune system has a CD4 count below 200, that person may be diagnosed by a doctor as having AIDS. "AIDS" stands for "Acquired Immune Deficiency Syndrome." The "syndrome" part means that AIDS is not a single disease but a collection of diseases. The Centers for Disease Control (CDC) publishes a list of 26 "AIDS-defining illnesses" in adults. Diagnosis of AIDS in children involves a list of slightly different ailments.

According to 1996 statistics from the Centers for Disease Control (CDC) there is one AIDS-related death every 11 minutes, one AIDS diagnosis every 9 minutes and someone is infected with HIV every 13 minutes in the United States. Around the world, one person is infected with HIV every eleven seconds. UNAIDS estimates about 21 million adults and more than 800,000 children are currently living with HIV and AIDS.

The disease is passed on through unprotected sex with an infected partner. Any potential blood contact with an infected person (shared drug needles, anal sex) increases the risk potential dramatically. There is another way that the virus can pass from one person to another: It can pass from an infected woman to her baby in the womb, during birth, or during breast-feeding.

In the early years of the disease, some people contracted HIV through blood transfusions. Blood transfusion are no longer a risk for contracting the disease in the United States. Since 1985, federally mandated screening of the blood supply has reduced the risk of transmission through this route. Routine screening of organ donors also began in 1985.

It is not easy to get HIV, the virus that causes AIDS. You can't get AIDS from shaking hands, hugging, or sharing dishes. Unfortunately, the number of reported AIDS cases continue to rise dramatically. Infection occurs when the virus is passed from an infected partner during sex or when needles are shared during drug use. The virus passes through a break in the skin or penetrates the moist mucosal membranes of the penis, vagina, cervix, anus, or oral cavities.

HIV is unique because it often presents with no symptoms for an extended period of time after infection. A person could be infected with HIV, not feel sick, and not be aware of the danger they present to themselves and others. This period of asymptomatic (no symptoms) infection can last years.

When HIV symptoms do present, they come in many forms. Some are related to HIV infection while others are due to infections attacking the body in its weakened state. Therefore, any combination of symptoms may appear and should be reason to seek qualified medical attention immediately. Some of the symptoms are: Lumps in the armpits, neck or groin; purple spots on the skin; purplish raised bumps on the skin; skin rashes, boils, or sores; growths beneath the skin; growths on the skin that line the mouth, nasal passages, anus, vagina, or inside the eyelids; a heavy white coating of the tongue (thrush); shingles; unexplained weight loss; fever or night sweats; ongoing dry cough or shortness of breath; persistent diarrhea; bleeding without cause from any body opening; being tired, dizzy, or faint frequently; difficulty swallowing; difficulty with urination or bowel movements; persistent pain; memory loss, blurred vision, and changes in hearing, smell, or taste.

In the later stages of disease, patients suffer a range of rare and unique infections. These include PCP (pneumocystis carinii pneumonia), Kaposi's sarcoma (a form of skin cancer), and cytomegalovirus (CMV). These infections are very debilitating, can recur, and often cause death.

You can find out if you have been infected with HIV by getting a blood test for the HIV antibody. If you have the HIV antibody in your blood, you are HIV-positive. Being HIV-positive does not mean that you have AIDS, but it does mean that you have become infected with HIV and that you can pass the infection to someone else. There's no way to tell from the positive result who gave you the virus, how long you've had it, or when it will begin to affect your health.

A qualified medical professional will take a blood sample and send it to a laboratory for one of two tests, the Western Blot test or the ELISA test. These tests are often done sequentially to verify the previous readings. In most cases the results are returned in about three days but it can take up to two weeks. The test can be done in a physician's office, a local clinic, or a specific testing center. These can be found in the local phone book.

There are two ways to be tested, anonymously or confidentially. Anonymous testing does not require a name. The patient is given a number for follow-up and test results. Confidential testing requires a name, but results and information are not to be given out without the patients consent. Some states, not all, offer both types of testing. Check with a local hotline or medical society to find out what is available in your area.

Earlier detection of HIV along with increasingly effective prophylaxis and treatment of opportunistic infections helps increase the life span of persons with HIV. There are a number of antiviral drugs available to slow the progression (increase of virus in the body) of the disease. The best known antiviral medications are "nucleoside analogue" drugs like AZT, ddI, ddC, d4T, 3TC and more recently, "protease inhibitors" like saquinavir, indinavir, and ritonavir. The most recent of all are drugs like nevirapine and delavirdine. These can be used alone or in combination. The challenge of using these drugs is knowing when and how much to use, and how to combine them. A healthcare provider can optimize a plan to meet each person's specific needs.

By 1987 the drug azidothymidine (AZT) was approved by the FDA as the first drug in the fight against AIDS. It is effective in slowing the reproduction of the HIV in humans, but it is highly toxic and cannot be taken by many patients. In 1989 researchers determined that lower doses of AZT would be effective and less harmful for patients. AZT remains the initial drug of choice for the treatment of adult persons with CD4 cell counts of 500 cells or less who have not yet received any prior anti-HIV therapy. AZT is also indicated for HIV-infected children over three months of age who are not yet displaying symptoms and have significant HIV-weakened immune systems. AZT has recently been approved for the use of preventing maternal fetal HIV transmission. Research published in the fall of 1994 by the National Institutes of Health revealed that when given to pregnant HIV-positive women, AZT has been successful in preventing the passage of the virus from the mother to the fetus in about two-thirds of the cases, resulting in the birth of healthy babies.

Dideoxyinosine (ddI) was approved in the United States in 1991 for the treatment of HIV infection. This drug is a useful replacement for AZT and is used in children and other patients for whom AZT is too toxic. In 1992 zalcitabine, or ddC, became the third drug approved to treat people infected with the AIDS virus. It was, however, approved for use only in combination with AZT to treat adults with advanced HIV infection.

There are also a growing number of therapies available to combat the other infections that attack the body.

The disease can progress faster and the patient is more likely to experience other infections sooner.

To find out more about the HIV disease, contact a qualified medical professional; a local AIDS Support Organization (ASO); or other qualified person. If in doubt about a partner, assume that protection is required. Condoms have demonstrated an ability to reduce the transmission of the HIV virus when used properly. For further information on risk factors, see section on Safe Sex.