HIV/AIDS. Symptoms. Short view on symptoms and complaints

Transcription

1 HIV/AIDS Symptoms Short view on symptoms and complaints The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages. HIV is an abbreviation of Human Immunodeficiency Virus. This is the virus which causes Acquired Immune Deficiency Syndrome (AIDS). AIDS is where the progression of HIV has reached the stage of being symptomatic. The HIV virus breaks down the immune system within the HIV+ individual. People living with HIV/AIDS (PLWHA) increasingly are unable to fight bacteria and viruses as easily as those who are HIV-, due to the deterioration of their immune system from HIV. Therefore they become ill more quickly than others. Often people are unaware that they have been infected with HIV directly after transmission. If a person is unaware that they have been infected, they risk infecting others with HIV, for example through unprotected sex. The first symptoms indicating sero-conversion from HIV- to HIV+ can be any of the following: - Lack of energy - A lot of weight loss without a very special reason (greater than 10 percent of body weight) - Nights sweats - Fever - Chronic diarrhea for more than one month - Chronic cough for more than one month - Painful sores or rashes - Sores on the lips that do not heal - Swollen glands in the neck, armpits and groin (very soon after the infection) - Thrush (a white rash) in the mouth or on the genitals - Repeated infections in the throat or ears - Recurring shingles After this phase, which is called the 'acute phase' when the symptoms subside, the infected person could live many years without experiencing symptoms associated with AIDS. They may not know that they are infected, nor will they appear sick. But they are able to spread the virus to others. A person s appearance cannot be used as an indicator of whether or not they are HIV+. A test is required to to be certain you have or haven t got HIV/AIDS. It can take years before the HIV becomes symptomatic and the HIV+ person has AIDS and becomes sick. This occurs when the amount of virus (known as the 'viral load') is increased to the point when it has attacked your immune system to the point that it is unable to fully function. At this point, a person may become unwell and experience various complaints. This may occur from anywhere between two and ten years. Eventually HIV infection progresses so that more obvious signs of sickness begin to appear. It can take anywhere from a few months of experiencing symptoms of AIDS before symptoms develop into the more serious, and life threatening infections and tumours which are characteristic infection experienced in the latter stages of AIDS. Symptoms of AIDS may include: - Infectious mononucleosis (also known as Pfeiffer's disease, colloquially as the kissing disease) a very

2 known complaint with this disease is a lack of energy - Fever - Rashes - Swollen lymph nodes - Malaise - Symptoms which may have been experienced at the time of sero-conversion (described above) Symptoms usually last for about three to fourte days, after which they usually disappear. However, lymph nodes may remain swollen. It can take years before further symptoms appear. Within a few months after infection with HIV, patients can repeatedly experience mild symptoms which are the latter stages of HIV and the early stages of AIDS, which fall short of the definition of late stages AIDS. Some can have mild symptoms from a HIV/AIDS infection for years. Late Stages of AIDS People in the latter stages of living with AIDS can develop any of these opportunistic infections or symptoms: - Chronic respiratory conditions such as atypical tuberculosis and severe recurrent pneumonia. - Weight loss (or further weight loss) - Extreme fatigue - Dark-blue or reddish brown marks on the skin (Kaposi s sarcoma) - Painful and itchy skin rashes - Prickly pain in the hands and feet - Thrush (a white rash) in the mouth or on the genitals - Mental disorders, such as dementia, resulting from infections in the brain - Candidiasis, commonly called yeast infection or thrush (this can be an infection of the mouth, vagina or the gullet because of Candida) can be the first infection who appears and who can be a symptom of an HIV-infection Comprehensive explanation of the symptoms By definition AIDS starts with a reduced number of a special cell in the blood (the CD4 + Mature Helper T cell) or the development of opportunistic infections (An opportunistic infection is an infection caused by pathogens/germs that usually do not cause disease in a healthy immune system). Tumours like Kaposi sarcoma and non-hodgkin lymphomas can also develop. The symptoms for AIDS are caused by the HIV infection itself and by the opportunistic infections and by the characteristic tumours. HIV can for example infect the brain, causing dementia, amnesia (loss of memory), problems with the concentration, and slowing of ability to retain information. Few AIDS patients die of the direct effects of the HIV infection. Most die of a combination ofl the effects caused by the different opportunistic infections and/or tumours. This occurs more often when the CD4 + Mature Helper T cell numbers in the blood are very low, when the AIDS patient can become sick or die from organism or pathogens/germs which are no threat to a healthy individual.

3 Pulmonary infections Pneumonia caused by Pneumocystis pneumonia (PCP) is a common recurrent and severe opportunistic infection experienced by AIDS patients. Tuberculosis is a disease which is prevalent in many areas of the world. TB combined with HIV is a deadly combination and is common in many developing countries. Gastrointestinal infections Esophagitis is inflammation of the oesophagus. The oesophagus is sometimes called the gullet. Increased bacterial infections and viruses can cause unexplained chronic diarrhea for PLWHA. These may include Microbacteria Mycobacterium avium comples which causes fevers, weight loss and diarrhea and is usually experienced by patients in latter stages of AIDS infection. Another example is Cryptosporidiosis which is a parasitic disease, also known as crypto. It can cause severe diarrhea, stomach-ache and losing weight. Neurological Toxoplasmosis is a disease usually infects the brain but it can also infect the eyes and lungs. Cryptococcal meningitis is an infection of the membrane covering the brain. The symptoms of this are fevers, headache, fatigue, nausea (trouble in the stomach, also called wamble) and vomiting. This may also develop into seizures and confusion. Progressive multifocal leukoencephalopathy (PML), also known as progressive multifocal leukoencephalitis is a viral infection of the brain. It can harm the function of the nerves. The first symptoms are usually loss of strength in the arms or legs and coordination and balance problems (loss of balance). This is a very severe and dangerous disease. AIDS dementia complex is a neurological disorder associated with HIV infections. Tumors and malignancies Different infections and types of cancers are characteristics of late stages in AIDS AIDS patients have increased incidence of some forms of cancer, especially with co-infection of some viruses as:epstein-barr virus (EBV), Kaposi s sarcoma-associated herpesvirus (KSHV) and human papilloma virus (HPV). Epstein-Barr virus may cause: infectious mononucleosis also known as Pfeiffer's disease, fever, swollen lymph nodes and sore throat. It can also cause lymphoma (Lymphoma is a type of cancer that originates in lymphocytes of the immune system). The Kaposi sarcoma is a form of cancer. It appears as painless red or purple raised spots on the skin. However, it may affect other organs, especially the mouth stomach, intestine and lungs. The human papilloma virus (HPV) can cause cervical cancer in women, particularly HIV+ women. Treatment HIV/AIDS has no preventative vaccine. It is a chronic disease, that is, there is currently no cure. There is a treatment which can be given after exposure (post exposure prophylaxis) which may prevent sero conversion (prevent a person becoming HIV+), however this needs to be taken as soon as possible after exposure, and usually within three days. However, once a person has seroconverted (become HIV+), there are treatments available. These do not cure HIV or AIDS, but they can stop people from becoming ill for many years. The treatment consists of anti-retroviral drugs. The most commonly prescribed drugs to treat HIV/AIDS are called HIV inhibitors. Several combinations (at least three different drugs) are recommend to be prescribed. A person living with HIV/AIDS has to take HIV drugs every day for the rest of their life, and they will need to regularly visit their doctor to monitor their treatment and regularly change their treatment to avoid drug resistance developing. Therefore, they need to find a doctor with whom they feel comfortable.

4 The aim of HIV inhibitors is to keep the amount of HIV in the body at a low level. This stops any weakening of the immune system and allows it to recover from any damage that HIV might have caused already. Because HIV/AIDS causes the immune system to weaken, people s immune systems are unable to fight infections/diseases such as pneumonia, skin infections and tumours, etc (even if the take antibiotics), nor can the body fight simple viral illnesses such as colds and influenza. A person who dies due to HIV/AIDS is often said to have died from an AIDS related illness, or AIDS related condition. This means that they have died from something such as pneumonia, which has not responded to antibiotic treatment due AIDS causing the body to be unable to fight this disease. The HIV inhibitors are divided into different classes, according to the way they work on the virus: nucleoside analog reverse transcript inhibitors, non-nucleoside analog reverse transcript inhibitors, proteaxe inhibitors and fusion inhibitors. Basically, HIV inhibitors work by block the virus from reaching the core of the cell (known as the T or CD4 cell), which prevents the cell becoming infected with the virus and thus inhibits the multiplying of HIV infected cells in the body. There are often unpleasant side effects from these drugs, such as tiredness, vomiting and diarrhoea. Some people find complementary therapies such as naturopathic remedies, acupuncture etc help with the side effects. Transmission Bodily fluids HIV is transmitted by certain bodily fluids of a person who is HIV-positive entering the bloodstream of another, HIV negative person. (A person who carries HIV is classified as 'HIV-positive'.) Bodily fluids that can contain and transmit HIV include: - Blood - Wound discharge or pus - Semen - Vaginal fluid - Breast milk Bodily fluids that can contain and transmit HIV which medical staff may contact, include: - Fluid surrounding the brain and spinal cord - Fluid surrounding bone joints - Fluid surrounding an unborn baby The most common ways of transmitting HIV and AIDS are: Sexual activity Sexual activity is the most common form of HIV transmission. HIV can be transmitted through any kind of sexual activity (vaginal, anal, and oral) and can occur when the bodily fluids which carry HIV of an HIVpositive sexual partner enter into the bloodstream of other partner, including through small, even unidentifiable, cuts or scratches. Sexually Transmitted Infections The risk of transmission is further increased if either partner has a Sexually Transmitted Infection (STI). An STI is a disease that is passed through sexual contact. A person with an STI is 10 times more likely to transmit or acquire HIV than a person without an STI because many STIs cause open sores or breaks in the skin, providing an avenue for HIV to enter the body, and the bodily fluids of individuals with STIs have an increased concentration of helper T cells, which serve as targets for HIV and may increase the risk of infection. Symptoms of STIs which increase the risk of HIV transmission may include: - Open sores or breaks in the skin around the genitals - White, yellow, or green vaginal discharge

5 - Burning sensation when passing urine - Itchiness in the genital area - Pain in the lower stomach or back - Pain in the testicles - Pain during sexual activity Blood transfusions An individual can become infected if she is given HIV-infected blood during a blood transfusion. Most countries now test all donated blood for HIV, lowering the risk. Needles, syringes, razor blades, and other instruments that pierce the skin (such as those used in piercings and tattooing) can transmit the virus if they were first used by an infected person. One can even contract HIV in a health care setting if syringes, needles, and equipment are not properly sterilized. All surgical instruments much be sterilised by correct use of an autoclave to prevent transmission of HIV. Mother-to-child transmission An HIV-infected woman can pass the virus to her baby through the placenta during pregnancy, and during childbirth through exposure to the mother s blood. Without treatment, approximately 15 to 30 percent of babies born to HIV-positive mothers are infected with the virus. HIV can also be transmitted to a breastfeeding baby. Breastfeeding by an HIV-positive mother increases the risk of transmission to her baby by 10 to 20 percent. Antiretroviral preventative treatment is an effective method of preventing mother-to-child transmission of HIV. When combined with the use of safer infant-feeding methods, it can halve the risk of infant infection. False transmitters HIV is not acquired through the following: - Living in the same place with people who have HIV/AIDS - Kissing (unless there are open sores or exposure to blood within the mouth) - Touch (hugging, hand-shaking, or sports contact) - Bites from mosquitoes or other insects - Shared food, utensils, cups, or dishes - Shared swimming pools or bathing facilities - Sneezes or coughs - Hospital visits - Sweat, saliva or tears - Urine or feces Prevention It s very important for people to know how to prevent AIDS, as this is the way to reduce the prevalence of AIDS. Prevention of sexual transmission Sexual transmission of HIV and AIDS can be prevented by encouraging people to adopt safer sexual behaviour, such as through media campaigns, peer education, small group counselling and social marketing. Peer education is (sex) education of peers ('friends'). Comprehensive sex education for young people is an essential part of HIV prevention. 'The ABC approach' is a slogan about avoiding AIDS by sexual transmission. A stands for Abstain (from sex) and is the safest way of avoiding sexual transmission of HIV. However, most people do not want to abstain from sex. B stands for Be faithful. Having one sexual partner is also a way of preventing the transmission of HIV, and once both parties have been tested and found to be HIV- (i.e. neither have HIV/AIDS), as long as the relationship remains

6 monogamous there is no change of HIV transmission. C stands for use a Condom. For those who have entered a new relationship where both parties have not yet been tested for HIV/AIDS, or for those who have multiple sexual partners, the safest way of avoiding transmission of HIV is through using a condom. If the condom breaks, there is a post exposure prophylactic treatment which is available through hospitals and medical centres, and is most effective the sooner after exposure as possible. Prevention of transmission through injected drug use Transmission of HIV and AIDS through blood can be prevented by drug treatment programmes. Those are effective ways to help people eliminate the risk by giving up injected drugs altogether. Injected drug users who are unwilling or unable to end their habit should be encouraged to minimise the risk of infection by not sharing or re-using any injecting equipment, including needles, syringes, spoons, filters, tourniquets, butterflies or swabs. Prevention of transmission through blood transfusions Transfusion of infected blood or blood products can be reduced by screening all blood supplies for the virus and by heat-treating blood products where possible. Prevention of mother to child transmission Mother-to-child transmission of HIV and AIDS can be prevented by preventing HIV infection in women and preventing unwanted pregnancies. Empowerment of women through support services, a supportive legal system and sexual and family planning education of women assist women to prevent exposure to HIV. Access to adequate antenatal care and other services to prevent mother-to-child transmission are important ways to prevent babies from getting infected. HIV can be passed from an HIV+ mother to her baby through breastfeeding (breast milk carries a small amount of HIV) and although the risk is small, HIV+ mothers may decide not to breastfeed their baby. Should the mother decide to breastfeed, transmission through blood (through cracked and bleeding nipples) may be prevented by the mother using nipple protectors. Prevention through HIV testing Many people don t want to know their status (i.e. whether they are HIV+). Many people who have been exposed to HIV avoid being tested as they fear of a positive result. They may also fear that once their status is known, they may experience discrimination, stigma and loss of employment. However, it s very important for people to know their status, to prevent further transmission of HIV/AIDS to others. Before a person is tested they should be provided with counselling. Following testing, they should again be provided with counselling. If they are HIV+, counselling may focus on dealing with shock and fear, as well as education on managing their care and treatment and strategies to prevent further transmission of HIV to others. If they are HIV- the counselling may focus on strategies to reduce their risk of exposure to HIV. To decrease the discrimination and stigma, good public education and marketing campaigns in addition to counselling programmes are needed. Prevention through economic development Economic development can improve the lives of poor people. Better circumstances can lead to improved access to HIV and AIDS education, prevention, testing, care and treatment. Economic help is more effective when it s combined with AIDS education. When women are empowered to earn an income, they don t just gain financial clout, but their husbands may also have opportunities to remain closer to home, so they don t have to seek work through migration, which may lead to each partner seeking other sexual relationships.

7 More information If you would like to read more about HIV/AIDS, you can take a look at these websites: - ipsnews.net/hivaids/section3_1.shtml - site.actingonaids.org - tolightonecandle.net/threeinone.htm