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Thursday, January 11, 2018

The HIV/AIDS epidemic: What you need to know

Written by: Doris Obinna

Every 1st of December has been marked by the global community as the world AIDS day. The event is usually a time to remember and honour those who lost their lives to AIDS, and also a renewal of commitment to assist those who are living with or at risk of Human Immunodeficiency Virus (HIV). Also, the event serves to celebrate caregivers, families, friends, and communities that support people living with HIV/AIDS.

HIV is a virus spread through certain body fluids that attack the body’s immune system, specifically the cluster of differentiation 4 (CD4 cells), often called T cells. Over time, HIV can destroy so many of these cells and make it impossible for the body to fight off infections and diseases.

When this happens, opportunistic infections or cancers take advantage of the weak immune system and wreak havoc on the body. The HIV/AIDS epidemic is a public health threat in countries around the world. The need for the critical role of transparency, accountability, and partnership among various countries of the world in achieving this goal is of great importance.

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), Nigeria has the second largest HIV epidemic in the world and has one of the highest infection rates in sub-Saharan Africa. Incidentally, many people living with HIV in Nigeria are unaware of their status due to the insufficient recommended number of HIV testing and counselling centres.

On the other hand, though an estimated 1.1 million people are living with HIV in the United States, with better treatments, these people are now living longer and with a better quality of life than ever before.
It is pertinent to note that HIV is not a death sentence. People living with HIV could still live long. However, it is important that they make choices that keep them healthy and protect others.

Reducing the risk to others
HIV is spread through certain body fluids from HIV-infected persons: blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk. HIV is most often transmitted by having unprotected anal or vaginal sex with someone who has HIV without using a condom or taking medicines to prevent or treat HIV.

In addition, a mother can pass HIV to her baby during pregnancy, during labour, through breastfeeding, or by pre-chewing her baby’s food.

The higher your viral load, the more likely you are to transmit HIV to others.

When your viral load is low (called Viral suppression, with less than 200 copies per millilitre of blood) or undetectable (about 40 copies per millilitre of blood), your chance of transmitting HIV is greatly reduced. However, this is true only if you can stay virally suppressed. One thing that can increase viral load is not taking HIV medicines the right way, every day.

HIV may not cause symptoms early. However, people who do have symptoms may mistake them for flu or mono.  Early symptoms of HIV are called acute retroviral syndrome, which may include: belly cramps, nausea, or vomiting. Other signs are diarrhoea, enlarged lymph nodes in the neck, armpits, and groin, fever, headache, muscle aches and joint pain, skin rash, sore throat and weight loss.

These first symptoms can range from mild to severe and usually disappear on their own after 2 to 3 weeks. But many people don’t have symptoms or they have such mild symptoms that they don’t notice them at this stage.

Untreated HIV infection progresses in stages. These stages are dependent on your symptoms and the amount of virus in the blood.

Stages of HIV
When people get HIV and don’t receive treatment, they will typically progress through the three stages of the disease. Medicine to treat HIV, known as antiretroviral therapy (ART), helps at all stages of the disease if taken the right away.
Treatment can slow or prevent progression from one stage to the next. It can also dramatically reduce the chance of transmitting HIV to someone else.

Stage 1: Acute HIV infection:
This occurs within 2 to 4 weeks after infection with HIV. At this stage, people may experience a flu-like illness, which may last for a few weeks. This is the body’s natural response to infection. When people have acute HIV infection, they have a large amount of virus in their blood and are very contagious.

But people with acute infection are often unaware that they are infected because they may not feel sick right away or at all. To know whether someone has an acute infection, either a fourth-generation antibody/antigen test or nucleic acid (NAT) test is necessary.
If you think you have been exposed to HIV through sex or drug use and you have flu-symptoms, seek medical care and ask for a test to diagnose acute infection.

Stage 2: Clinical latency (HIV inactivity or dormancy):
This period is sometimes called asymptomatic HIV infection or chronic HIV infection. During this phase, HIV is still active but reproduces at very low level. People may not have any symptoms or get sick during this time. For people who are not taking medicine to treat HIV, this period can last a decade or longer, but some may progress through this phase faster.

People, who are taking medicine to treat HIV (ART) the right way, maybe in this stage for several decades. It’s important to remember that people can still transmit HIV to others during this phase, although people who are on ART and stay virally suppressed (having a very low level of virus in their blood) are much less likely to transmit HIV than those who are not virally suppressed.

At the end of this phase, a person’s viral load starts to go up and CD4 cell count begins to go down. As this happens, the person may begin to have symptoms as the virus levels increase in the body, and the person moves into Stage 3.

Stage 3: Acquired Immunodeficiency Syndrome (AIDS):
AIDS is the most severe phase of HIV infection. People with AIDS have such badly damaged immune systems that they get an increasing number of severe illnesses, called opportunistic illnesses. 

Without treatment, people with AIDS typically survive about three years. Common symptoms of AIDS include chills, fever, sweats, swollen lymph gland, weakness and weight loss. People are diagnosed with AIDS when their CD4 cell count drops below 200 cells/mm or if they develop certain opportunistic illnesses. People with AIDS can have a high viral load and be very infectious.

How to know you have HIV
The only way to know for sure whether you have HIV is to get tested. Knowing your status is important because it helps you make healthy decisions to prevent getting or transmitting HIV. Some people may experience a flu-like illness within 2 to 4 weeks after infection (stages 1 HIV infection).

At advanced stages, there are other symptoms, which can last anywhere from a few days to several weeks. During this time, HIV infection may not show up on an HIV test, but people who have it are highly infectious and can spread the infection to others.
If you have these symptoms, however, this does not mean you have HIV. Each symptom can be caused by other illnesses. The only way to determine whether you are infected is to be tested for HIV infection.

All said and done, the world is not sleeping in relation to HIV/AIDS. Efforts are being made globally. And the result shows that AIDS is dreaded, but its impact is reducing as more people are aware of what to do. However, there are places it is spreading, with those infected not aware of their predicament and, therefore, go about infecting others.

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