HIV infection and AIDS: symptoms and therapyAn HIV infection is triggered by the human immunodeficiency virus. Symptoms may resemble a flu-like infection, making diagnosis of immunodeficiency more difficult. Not everyone who is infected with HIV automatically has AIDS, but HIV can progress to AIDS – sometimes only after several years.
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HIV-infected people are called HIV-positive. Affected persons often feel healthy. Do not notice any physical or psychological symptoms. This promotes the spread of HIV, because HIV-positive people are often unaware of their infection for a long time and thus continue to have unprotected sexual intercourse, for example.
What exactly is AIDS?
Aids stands for Acquired Immunodeficiency Syndrome, which translates as "acquired immunodeficiency syndrome is. The HI virus attacks the T-helper cells, which are responsible for the defense against pathogens and initially remains hidden in the cells for a long time. With time, however, more and more cells of the immune system are destroyed and the disease AIDS breaks out. the number of T-cells in the blood is then from 8.000-10.000 cells per milliliter of blood has dropped to about 200 per milliliter.
HIV infection: causes of immunodeficiency AIDS
The HI virus, which can cause HIV and thus subsequently the infectious disease Aids, is difficult to transmit. Only blood and sexual contacts allow infection to occur.
HIV is primarily transmitted by:
– unprotected sexual intercourse – infected blood products – swapped, contaminated drug paraphernalia
Unprotected sexual intercourse still poses the greatest risk of contracting HIV. The use of condoms is therefore the best protection. Transmission is possible through vaginal, anal and oral sexual intercourse. The virus is detectable in the semen and vaginal fluid of HIV-infected persons. It can be transmitted through the smallest injuries to the mucous membranes. Since the viral load in blood and other body fluids varies, the risk of infection through sexual contact also varies.
Children of HIV-positive women can become infected while breastfeeding, during pregnancy or during birth. Preventive measures can reduce the risk of infection from about 30 percent to less than five percent.
What does the virus do in the body?
The HI virus belongs to the group of retroviruses. The genetic material of these viruses consists of RNA (ribonucleic acid, responsible for the transport of genetic information). Only in the infected host cell is the RNA converted into DNA (deoxyribonucleic acid, carrier of genetic information) and integrated into the host genome – the genetic material of the human cell. Entry into the cells is only possible via certain specific receptor molecules on the surface of the cells. CD4 lymphocytes, which are part of the white blood cells, are the main target of the viruses. They are also called helper cells. Play a key role in the defense against pathogens.
Symptoms of HIV infection
A few days to six weeks after infection with HIV, the acute HIV phase (stage A) occurs in about 70 percent of cases, during which the viruses multiply rapidly in the body (high viral load), eliciting a response from the immune system. The symptomatic period after infection usually lasts one week, in exceptional cases two weeks.
Swollen lymph nodes to skin rash
If one or more of the following symptoms occur over a longer period of time, the affected person should definitely seek medical help in order to exclude a new infection with HIV or to initiate treatment. It is also important to specifically ask for an AIDS test in the doctor's office after a risk contact in order to exclude an infection.
Common signs of HIV after a few days to weeks:
Swelling of the lymph nodes, for example in the neck, throat and armpits
Night sweats (longer than one month)
Diarrhea (longer than one month)
Fever episodes with sometimes very high temperature (longer than one month)
Inflammation and pain in the throat
open sores in the mouth
Small-spotted, pronounced skin rash (HIV exanthema) with severe itching that lasts from one to a few days
The most frequent and clearest signs of a recently acquired HIV infection are fever (in about eight out of ten affected persons) and the characteristic skin rash, which is reported by about every second affected person in the acute phase. Around 45 percent of people with new infections have a combination of these two main symptoms.
Drugs prolong symptom-free phases
The acute HIV infection is followed by a disease-free interval, which usually lasts a few months, but can also last several years. During this phase, the immune system is able to keep the HIV pathogens in check. Today, treatment with antiretroviral drugs makes it possible to extend this phase.
Weakened immune system due to AIDS
If the immune system is weakened to such an extent that it can no longer defend itself against pathogens that do not pose a problem for healthy people, this is referred to as AIDS – after the often (years-long) symptom-free phase. The symptoms are also non-specific, so they also occur in other, usually more harmless, diseases such as the flu (influenza). At this stage, certain forms of pneumonia (pneumocystis pneumonia), tuberculosis or infections of the mouth and esophagus with the yeast Candida albicans are typical.
HIV also often causes certain cancers that are triggered by viral infection, such as Kaposi's sarcoma, cervical cancer, or lymphoma.
Diagnosis: How do I know if I have AIDS?? HIV infection can be relatively uncomplicated. Can be safely detected by a free blood test (HIV test). The most common test used is one that shows antibodies to the virus. However, antibodies against HIV can only be reliably detected four to twelve weeks after infection.
HIV-Test: Free of charge in health offices
If there is a suspicion of HIV, any doctor can order an HIV test. The costs are covered by the relevant health insurance company. In addition, many health offices offer the possibility of anonymous HIV tests free of charge and of receiving advice. The test results – negative as well as positive – may only be communicated personally. Those who are actually infected would test "positive" obtain.
Therapy: What treatment is available for HIV?
HIV cannot be cured. The extreme mutability of the HI virus makes the search for drugs very difficult. Nevertheless, the combination of several antiviral drugs can keep the virus concentration in the body so low for a long time that the full outbreak of the disease does not occur.
For HIV-infected people, this means consistently taking multiple medications every day for years. Although this HIV therapy is very expensive, it can be used by every HIV-infected person in Germany. In many other countries, patients do not have this chance.
Combination therapy for HIV
HIV therapy usually involves a combination of at least three different antiviral medications. This aggressive combination therapy is also called "highly active antiretroviral therapy" (HAART). Since the active ingredients come from three different drug classes with different modes of action, the risk of resistant strains of the virus developing is significantly reduced. Today's drugs have significantly fewer severe side effects and lead to complications and long-term damage much less frequently than in the 1990s.
Course and prognosis: Living with HIV
The AIDS pathogen is still not curable. But there are individual cases that give reason for hope: About 20 cases of a so-called functional cure are known, in which infected people are able to control the virus well after a therapy that has been discontinued after years, says Armin Schafberger, medical officer of the German Aids Federation. In other words, the viral load has fallen sharply in these patients.
How old can a patient with HIV become?
A range of modern drugs can now delay the onset of the disease and improve the quality of life of people with AIDS. With consistent therapy, HIV-infected persons can reach a normal age in countries such as Germany. "Those who start early and are well treated probably have a normal life expectancy", says Schafberger of the German Aids Federation. However, these are only extrapolations.
Will AIDS one day be completely defeated?
This is questionable. The available drugs can keep the multiplication of the virus in check, but they cannot remove it from the body. According to experts, a vaccine will not be available in the coming years because the HIV virus is too diverse and the AIDS virus mutates very quickly.
Preventing AIDS with simple measures
Protecting oneself from HIV infection is relatively simple. Wherever contact with bodily fluids of possibly infected persons cannot be avoided, caution is advised. For your own safety, be sure to avoid unprotected sex if you change partners frequently. The focus of all prevention measures is the education of the population – especially the risk groups: Drug addicts and homosexuals.
Many governments are now aware that prevention is an important sociopolitical task. In addition to governmental organizations, there are a large number of non-governmental organizations working in this area.
Facts and figures: How many people in Germany have AIDS?
Germany is one of the countries with the lowest prevalence of HIV and AIDS. In 2020, according to estimates by the Robert Koch Institute (RKI), there were around 2.000 new infections. At the end of 2020, a total of about 91.400 people with HIV in Germany. The RKI estimates that about 9.500 of them, however, do not know about their infection. In the same year, about 380 HIV-infected German citizens died.
Which countries are most affected by HIV?
Lack of education and cultural barriers facilitate the spread of AIDS. Worldwide, more than 38 million people were infected with HIV in 2020. Most of them live in sub-Saharan Africa. The further south you go, the more dramatic the HIV rate becomes, shows the world map of the United Nations AIDS Organization (Unaids). Consequently, most HIV-infected people are in South Africa, where the virus is a significant problem, especially in the slums. In the neighboring kingdom of Swaziland, about one in four people is HIV positive.
First cases occurred in the 1980s
The first cases of AIDS became known in the early 1980s: In 1983, virologist Luc Montagnier of the Institut Pasteur in Paris succeeded in isolating the HI virus for the first time. There has been much research and even more speculation about where the virus came from. It is considered certain that the HI virus is a descendant of the SI virus (Simian Immunodeficiency Virus), which affects great apes.
In the past 25 years, AIDS has become a pandemic with enormous sociopolitical consequences. Since the discovery of the HI virus, more than 36.3 million people have already died. Every year there are about three million new infections and more than two million people die from diseases caused by their immune system being weakened by HIV.