A spectre has been transformed into one that can be easily controlled. Well treatable viral infection. What was unthinkable thirty years ago is now reality: a person with HIV can live a normal, long life. AIDS no longer has to break out. Why this is so and which path led to it, explain PD Dr. Christoph Spinner, Senior Physician in the Department of Infectious Diseases at the Klinikum rechts der Isar in Munich and Head of the Interdisciplinary HIV Center "IZAR", as well as Dr. Dieter Hoffmann, head of the virological diagnostics department.
In the 1990s, the topic of HIV and AIDS was always present in the media and in the minds of Germans. In sex education classes in schools, infection as a dangerous, sexually transmitted disease was talked about in a big way, widespread awareness campaigns ensured that everyone was aware of their risk of infection, and almost everyone in industrialized nations knew that condom use could protect them. Other viral diseases – such as Covid-19 this year – seem to have "outpaced" HIV and AIDS in the last two decades. Has an infection with the HI virus lost its terror?
PD Dr. Christoph Spinner and Dr. Dieter Hoffmann explain the effects of the HIV virus and the resulting disease AIDS on the human body, where the virus originates, how infected people are treated, and what goals the United Nations has set for itself in terms of combating HIV and AIDS.
The medical effects of the infection
"With an HIV infection one can lead a normal life in the today's time, because the infection is treatable" explains Dr. Spinner. Treatable should not be confused with curable. Nevertheless, with the appropriate medication, those affected can again have condomless sexual contact with healthy partners, for example, without endangering them. The risk of an infected mother infecting her child during pregnancy or birth has become easily controllable. As a rule, the children of affected mothers do not acquire the immunodeficiency disease.
If left untreated, HIV infection still regularly leads to death after a certain time, even in industrialized nations. After an infection with the HI virus, a series of secondary diseases follows – usually after a few years. The immune system is severely damaged – hence the name AIDS ("Acquired Immune Deficiency Syndrome"), Acquired immune deficiency syndrome). Other infectious diseases or fungal infections can no longer be kept in check by the weakened immune system. Kaposi's sarcoma, a rare skin cancer caused by a herpes virus, occurs mainly in people with a weakened immune system. This means that people with an untreated HIV infection, for example, are also particularly at risk. The aim of treatment after HIV infection is to bring the viral load in the body below the detection limit by means of suitable medication. Due to the extremely low viral load, infection of a healthy person is extremely unlikely, even during condomless sexual intercourse with an infected person. The same effect also occurs during childbirth. Due to the small amount of viruses in the mother's blood, the child is usually born healthy, even if it comes into contact with blood during birth.
Origin of the virus in Africa
Dr. Dieter Hoffmann reports that sequence analyses of the genetic structure of the virus have confirmed that the virus originated in Africa. Originally, the virus in different variants had crossed the species barrier at the beginning of the last century. This means that the virus has the "jump" through the contact of humans with monkey blood The virus enters the human body and uses it as a host. For example, humans have ingested the virus by eating monkey meat. The virus has also spread to industrialized nations through migration. However, it took several decades before people became aware of the disease Aids and research on it started intensively.
Focus on proper treatment
Prevention and treatment after the diagnosis of an infection with the HI virus are standardized in Germany today. In risk groups – such as men who have sex with men or workers in the sex industry – so-called pre-exposure prophylaxis is used. Here, the risk of HIV infection is reduced in HIV-negative persons by taking antiviral drugs. Since the 1. September 2019, drugs to prevent infection with HIV for people at increased risk of infection will be covered by statutory health insurance in Germany, according to a representative of the German Aids Federation.
In contrast, post-exposure prophylaxis is administered after a risk contact. If such contact has occurred, for example condomless sexual intercourse with an infected person or contact with viral material in the laboratory, drug post-exposure prophylaxis is initiated. In this case, taking medication as soon as possible after contact reduces the risk of infection.