HIV infection is a condition caused by the human immunodeficiency virus (HIV).
The condition gradually destroys the immune system, which makes it harder for
the body to fight infections.
This article provides a general overview. For more detailed information, see:
AIDS
Acute HIV infection
Asymptomatic HIV infection
Early symptomatic HIV infection
Causes, incidence, and risk factors
The human immunodeficiency virus (HIV) can be spread by the following:
Through sexual contact -- including oral, vaginal, and anal sex
Through blood -- through blood transfusions, accidental needlesticks, or
needle sharing
From mother to child -- a pregnant woman can transmit the virus to her
fetus through their shared blood circulation, or a nursing mother can pass it
to her baby in her breast milk
People who become infected with HIV may have no symptoms for up to 10 years,
but they can still pass the infection to others. After being exposed to the
virus, it can take up to 3 months for the HIV ELISA blood test to change from
HIV negative to HIV positive.
HIV has spread throughout the U.S. The disease is more common in urban areas,
especially in inner cities.
See also: AIDS for a more complete description of how HIV is spread.
Symptoms
Symptoms related to HIV are usually due to a different infection in the body.
Some symptoms related to HIV infection include:
Diarrhea
Fatigue
Fever
Frequent vaginal yeast infections
Headache
Mouth sores, including yeast infection (thrush)
Muscle stiffness or aching
Rashes of different types, including seborrheic dermatitis
Sore throat
Swollen lymph glands
Note: Many people have no symptoms when they are diagnosed with HIV.
Signs and tests
The HIV ELISA and HIV Western blot tests detect antibodies to the HIV virus in
the blood. Both tests must be positive to confirm an HIV infection. Having
these antibodies means you are infected with HIV.
If the test is negative (no antibodies found) and you have risk factors
for HIV infection, you should be retested in 3 months.
If the HIV ELISA and HIV Western blot tests are positive, other blood
tests can be done to determine how much HIV is in your bloodstream.
A complete blood count (CBC) and white blood cell differential may also show
abnormalities.
A lower-than-normal CD4 cell count may be a sign that the virus is damaging
your immune system.
Treatment
Doctors often recommend drug therapy for patients who are committed to taking
all their medications and have a CD4 count below 500 cells/mm3 (indicating
their immune system is suppressed). Some people, including pregnant women and
people with kidney or neurological problems related to HIV, may need treatment
regardless of their CD4 count.
It is extremely important for people with HIV to take all doses of their
medications, otherwise the virus may become resistant to the drugs. Therapy
always involves a combination of antiviral drugs. Pregnant women with HIV
infection are treated to reduce the chance of transmitting HIV to their
babies.
People with HIV infection need to become educated about the disease and
treatment so that they can be active participants in making decisions with
their health care provider.
Support Groups
See: AIDS - support group
Expectations (prognosis)
HIV is a chronic medical condition that can be treated, but not yet cured.
There are effective ways to prevent complications and delay, but not always
prevent, progression to AIDS.
Almost all people infected with HIV will develop AIDS if not treated. However,
there is a small group of people who develop AIDS very slowly, or never at
all. These patients are called long-term nonprogressors.
Complications
Cancers
Chronic wasting (weight loss) from HIV infection
HIV dementia
HIV lipodystrophy
Opportunistic infections
Bacillary angiomatosis
Candidiasis
Cytomegalovirus infection
Cryptococcal infection
Cryptosporidium enterocolitis (or other protozoal infections)
Mycobacterium avium complex (MAC) infection
Pneumocystis jiroveci pneumonia (previously called Pneumocystis
carinii pneumonia or PCP)
Salmonella infection in the bloodstream
Toxoplasmosis
Tuberculosis (in the lungs or spread throughout the body)
Viral infection of the brain (progressive multifocal
leukoencephalopathy)
Calling your health care provider
Call your health care provider if you have had a possible or actual exposure
to AIDS or HIV infection.
Prevention
Avoid injecting illicit drugs. If you use injected drugs, avoid sharing
needles or syringes. Always use new needles. (Boiling or cleaning them with
alcohol does not guarantee that they're sterile and safe.)
Avoid oral, vaginal, or anal contact with semen from HIV-infected people.
Avoid unprotected anal intercourse, since it causes small tears in the rectal
tissues, through which HIV in an infected partner's semen may enter directly
into the other partner's blood.
If you have sex with people who use injected drugs, always use condoms.
If you have sex with many people or with people who have multiple
partners, always use condoms.
People with AIDS or who have had positive HIV antibody tests can pass the
disease on to others. They should not donate blood, plasma, body organs, or
sperm. They should not exchange genital fluids during sexual activity.
Safer sex behaviors may reduce the risk of getting the infection. There is
still a slight risk of getting the infection even if you practice "safe sex"
by using condoms. Abstinence is the only sure way to prevent sexual
transmission of the virus.
Use protection when having sexual contact with people you know or suspect
of being infected with HIV. Even better, use protection for ALL sexual
contact.
References
1.) Piot P. Human immunodeficiency virus infection and acquired
immunodeficiency syndrome: A global overview. In: Goldman L, Ausiello D, eds.
Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 407.
2.) Del Rio C, Curran JW. Epidemiology and prevention of acquired
immunodeficiency syndrome and human immunodeficiency virus infection. In:
Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious
Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap
118.
3.) Sterling TR, Chaisson RE. General clinical manifestations of human
immunodeficiency virus infection (including the acute retroviral syndrome and
oral, cutaenous, renal, ocular, metabolic, and cardiac diseases. In: Mandell
GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases.
7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 121.
The condition gradually destroys the immune system, which makes it harder for
the body to fight infections.
This article provides a general overview. For more detailed information, see:
AIDS
Acute HIV infection
Asymptomatic HIV infection
Early symptomatic HIV infection
Causes, incidence, and risk factors
The human immunodeficiency virus (HIV) can be spread by the following:
Through sexual contact -- including oral, vaginal, and anal sex
Through blood -- through blood transfusions, accidental needlesticks, or
needle sharing
From mother to child -- a pregnant woman can transmit the virus to her
fetus through their shared blood circulation, or a nursing mother can pass it
to her baby in her breast milk
People who become infected with HIV may have no symptoms for up to 10 years,
but they can still pass the infection to others. After being exposed to the
virus, it can take up to 3 months for the HIV ELISA blood test to change from
HIV negative to HIV positive.
HIV has spread throughout the U.S. The disease is more common in urban areas,
especially in inner cities.
See also: AIDS for a more complete description of how HIV is spread.
Symptoms
Symptoms related to HIV are usually due to a different infection in the body.
Some symptoms related to HIV infection include:
Diarrhea
Fatigue
Fever
Frequent vaginal yeast infections
Headache
Mouth sores, including yeast infection (thrush)
Muscle stiffness or aching
Rashes of different types, including seborrheic dermatitis
Sore throat
Swollen lymph glands
Note: Many people have no symptoms when they are diagnosed with HIV.
Signs and tests
The HIV ELISA and HIV Western blot tests detect antibodies to the HIV virus in
the blood. Both tests must be positive to confirm an HIV infection. Having
these antibodies means you are infected with HIV.
If the test is negative (no antibodies found) and you have risk factors
for HIV infection, you should be retested in 3 months.
If the HIV ELISA and HIV Western blot tests are positive, other blood
tests can be done to determine how much HIV is in your bloodstream.
A complete blood count (CBC) and white blood cell differential may also show
abnormalities.
A lower-than-normal CD4 cell count may be a sign that the virus is damaging
your immune system.
Treatment
Doctors often recommend drug therapy for patients who are committed to taking
all their medications and have a CD4 count below 500 cells/mm3 (indicating
their immune system is suppressed). Some people, including pregnant women and
people with kidney or neurological problems related to HIV, may need treatment
regardless of their CD4 count.
It is extremely important for people with HIV to take all doses of their
medications, otherwise the virus may become resistant to the drugs. Therapy
always involves a combination of antiviral drugs. Pregnant women with HIV
infection are treated to reduce the chance of transmitting HIV to their
babies.
People with HIV infection need to become educated about the disease and
treatment so that they can be active participants in making decisions with
their health care provider.
Support Groups
See: AIDS - support group
Expectations (prognosis)
HIV is a chronic medical condition that can be treated, but not yet cured.
There are effective ways to prevent complications and delay, but not always
prevent, progression to AIDS.
Almost all people infected with HIV will develop AIDS if not treated. However,
there is a small group of people who develop AIDS very slowly, or never at
all. These patients are called long-term nonprogressors.
Complications
Cancers
Chronic wasting (weight loss) from HIV infection
HIV dementia
HIV lipodystrophy
Opportunistic infections
Bacillary angiomatosis
Candidiasis
Cytomegalovirus infection
Cryptococcal infection
Cryptosporidium enterocolitis (or other protozoal infections)
Mycobacterium avium complex (MAC) infection
Pneumocystis jiroveci pneumonia (previously called Pneumocystis
carinii pneumonia or PCP)
Salmonella infection in the bloodstream
Toxoplasmosis
Tuberculosis (in the lungs or spread throughout the body)
Viral infection of the brain (progressive multifocal
leukoencephalopathy)
Calling your health care provider
Call your health care provider if you have had a possible or actual exposure
to AIDS or HIV infection.
Prevention
Avoid injecting illicit drugs. If you use injected drugs, avoid sharing
needles or syringes. Always use new needles. (Boiling or cleaning them with
alcohol does not guarantee that they're sterile and safe.)
Avoid oral, vaginal, or anal contact with semen from HIV-infected people.
Avoid unprotected anal intercourse, since it causes small tears in the rectal
tissues, through which HIV in an infected partner's semen may enter directly
into the other partner's blood.
If you have sex with people who use injected drugs, always use condoms.
If you have sex with many people or with people who have multiple
partners, always use condoms.
People with AIDS or who have had positive HIV antibody tests can pass the
disease on to others. They should not donate blood, plasma, body organs, or
sperm. They should not exchange genital fluids during sexual activity.
Safer sex behaviors may reduce the risk of getting the infection. There is
still a slight risk of getting the infection even if you practice "safe sex"
by using condoms. Abstinence is the only sure way to prevent sexual
transmission of the virus.
Use protection when having sexual contact with people you know or suspect
of being infected with HIV. Even better, use protection for ALL sexual
contact.
References
1.) Piot P. Human immunodeficiency virus infection and acquired
immunodeficiency syndrome: A global overview. In: Goldman L, Ausiello D, eds.
Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 407.
2.) Del Rio C, Curran JW. Epidemiology and prevention of acquired
immunodeficiency syndrome and human immunodeficiency virus infection. In:
Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious
Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap
118.
3.) Sterling TR, Chaisson RE. General clinical manifestations of human
immunodeficiency virus infection (including the acute retroviral syndrome and
oral, cutaenous, renal, ocular, metabolic, and cardiac diseases. In: Mandell
GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases.
7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 121.
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