• FAQs: What is HIV?

    What is HIV?

    AIDS RibbonHuman Immunodeficiency Virus, type 1 (HIV) is also known as the AIDS virus. HIV infection slowly destroys the patient's immune system by infecting and destroying CD4 lymphocytes (white blood cells also known as T cells, T helper cells, or CD4 cells). The immune system is responsible for fighting off infections due to viruses, bacteria, fungi and parasites. The immune system is very complex and protects individuals against illnesses such as pneumonia, blood stream infections and urinary tract infections. Once you are infected with HIV, you have a permanent, life-long infection. 

    What does a positive HIV test mean?

    A positive HIV test (a positive antibody test) means that your blood shows signs of fighting the virus that causes AIDS. A positive test does not mean that you have AIDS. It means you have HIV. HIV can lead to AIDS, but many people do not get AIDS for 10 or more years after they get infected. 

    How do you get HIV?

    HIV is passed from person to person through bodily fluids such as blood, semen (come), pre-seminal fluid (pre-come), vaginal fluid and breast milk. Saliva (spit) can sometimes pass the virus if there is blood or open sores in the mouth. People can get infected by sharing needles (works) or by having unprotected sex (sex without a condom) with a man or woman who has the virus.

    Pregnant women can pass the virus to their babies during pregnancy, delivery, or through breast-feeding. Before 1985, people also got HIV after getting a blood transfusion. Since then, all blood donations in the United States and most developed countries have been tested for HIV. The risk of infection is less than one in 400,000 units of blood transfused. 

    What happens in my body after HIV infection?

    Many people feel like they have the flu when they get infected. They might have fever or swollen glands, or feel tired and achy. Some people don't feel anything and don't know they've been infected. Symptoms typically go away in a week to a month and people feel fine- sometimes for up to 10 years. Even if you feel well, the HIV is still there.

    The HIV is infecting CD4 cells, making copies of itself, and then leaving to infect other CD4 cells. The more HIV (viral load) there is in the blood, the faster the damage occurs. Over time, the body can't keep making new CD4 cells, and the immune system gets weaker. Eventually, the immune system is so weak that you might be at risk for opportunistic infections, which cause sickness in people with a weakened immune system. Once a person's CD4 count is less than 200, or he/she has an opportunistic infection, he/she has AIDS.

    What do CD4 count and viral load mean?

    CD4 cells are part of the immune system. They help fight off infections. A normal CD4 count ranges from 400 to 1200, depending on the person.

    The viral load ("HIV PCR" "HIV load") measures the amount of HIV in your blood. The higher the viral load, the more HIV there is in your body, and the faster you are likely to get sick. Viral load can range from undetectable to 1 to 2 million. Undetectable does not mean that there is no HIV in your body, but rather that the amount is very small. People with undetectable viral loads still have HIV, and they can still pass the virus to other people.

    Are there special issues for women with HIV?

    • Women are more likely to get candida esophagitis than men.
    • Women are more likely to get chronic genital herpes than men.
    • Women are at risk for cervical cancer.
    • Women can transmit the virus to their unborn children.
    • Women are less likely to get Kaposi's sarcoma (a form of cancer) than men who have sex with men.

    Are there special issues for men with HIV?

    • Men who have sex with men are more likely to get Kaposi's Sarcoma.
    • Men can have low testosterone.

    What about treatment for HIV?

    Treatment for HIV infection is very different than treatment for other infections like pneumonia because HIV is a chronic infection. Treatment for HIV means taking medicines for the rest of your life, or until a cure is found.

    HIV treatment requires taking at least three different medications to decrease the amount of virus in your body. People sometimes call this combination therapy or a "triple drug cocktail". Treatment with three drugs is recommended because HIV can become resistant to any one medicine very quickly. If the HIV in your body is resistant to a medicine, then that medicine will not work against your virus anymore. Medicines available to treat HIV and their common side effects are described in the tables below.

    Doctors recommend treating the HIV virus if:

    • Your CD4 count is less than 350 or
    • Your viral load is greater than 55,000 or
    • You have symptoms from your HIV, no matter what your CD4 or viral load, or
    • You are ready to make a commitment to taking medicines.

    What is resistance?

    Resistance means that a medication or group of medications does not work against your virus. The fastest way to get a resistant virus is to take only some of your medication some of the time.

    What medicines are out there?

    There are four types of medicines: nucleoside analogs, non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs) and fusion inhibitors.

    Recommended Web sites:  

    • AIDSinfo: A U.S. Department of Health and Human Services (DHHS) project providing information on HIV/AIDS clinical trials and treatment. AIDSinfo is a central resource for current information on federally and privately funded clinical trials for AIDS patients and others infected with HIV. AIDS clinical trials evaluate experimental drugs and other therapies for adults and children at all stages of HIV infection -- from patients who are HIV positive with no symptoms to those with various symptoms of AIDS. As the main dissemination point for federally approved HIV treatment and prevention guidelines, AIDSinfo provides information about the current treatment regimens for HIV infection and AIDS-related illnesses, including the prevention of HIV transmission from occupational exposure and mother-to-child transmission during pregnancy.

    • CDC Division of HIV/AIDS Prevention's HIV/AIDS Fact Sheets: Comprehensive information on transmission, prevention, interaction with other diseases, and vaccine research.

    • AIDS Education Global Information System (AEGIS): Multiple links to sources of breaking HIV news, fact sheets, and online bulletin boards for exchange of information; at a layperson's level of understanding.

    • TheBody.com: Another comprehensive patient-oriented resource with information, ask the expert and bulletin boards discussing AIDS-related topics. http://www.thebody.com/index.shtml 
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