Sexually transmitted diseases - Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus (HIV) is a retrovirus that is the cause of the disease known as AIDS, or Acquired Immunodeficiency Syndrome, where the immune system begins to fail, leading to many life-threatening infections.
 
HIV primarily infects the vital components of the human immune system such as CD4+ T cells, macrophages and dendritic cells. CD4+ T cells are required for the proper functioning of the immune system, and when enough CD4+ T cells have been destroyed by HIV, the immune system functions poorly, which leads to AIDS. HIV also attacks the organs of the body such as the kidneys, heart and brain, leading to acute renal failure, cardiomyopathy, dementia and encephalopathy. Many of the problems faced by people infected with HIV result from failure of the immune system to protect from infections, cancers and other diseases.
 
HIV can be transmitted through direct contact of a mucous membrane with a bodily fluid containing HIV, such as blood, semen, vaginal fluid and breast milk. HIV transmissions can be in the form of penetrative (anal or vaginal) sex and oral sex, blood transfusion or contaminated needles, exchange between mother and infant during pregnancy, childbirth, or breastfeeding and other exposure to one of the above bodily fluids.

The first symptoms of a HIV infection can resemble symptoms of a common cold or flu viruses. Early infection symptoms can also be similar to the symptoms of other sexually transmitted diseases and other infections such as "mono" or hepatitis. Persons who do have symptoms generally experience fever, fatigue, and, often, rash. Other common symptoms can include sore throat, headache and swollen lymph nodes. These symptoms can occur within days or weeks of the infection of the virus during a period called primary or acute HIV infection.

Human immunodeficiency virus (HIV) Diagnosis
Because of the nonspecific symptoms associated with primary or acute HIV infection, signs or symptoms are not a reliable way to diagnose HIV infection. Testing for HIV antibodies is the best and only way to know whether you have been infected. However, the HIV antibody test only works after the infected person's immune system develops antibodies to HIV which during the "window period" or between the initial infection and the period in which antibodies are detectable standard HIV testing is ineffective.

There is no other way to know for sure if someone else has HIV. Many people infected with HIV look perfectly healthy. Other people who are sick with HIV may have symptoms that are identical to other common illnesses and diseases. You cannot tell by looking whether someone is HIV positive and the only way to know for sure is if someone tells you. It is important to consider how well you know someone and how much you trust them when talking about HIV.

Since HIV infection is a chronic infectious disease that can be treated, but can’t yet be cured, most of the means are only of preventing complications and delaying progression to AIDS. Currently, not everybody infected with HIV have progressed to AIDS, but it is commonly believed that the majority will eventually. Since people with HIV infection need to receive education about the disease and treatment they are required to be active partners in the decision making with their health care provider.

Several Anti-HIV (also called antiretroviral) medications are to be used to control the reproduction of the virus and to slow down the progression of HIV-related diseases. The Highly Active Antiretroviral Therapy (HAART) is the more recommended treatment for HIV infection since it combines three or more anti-HIV medications for a daily regimen, and is sometimes referred to as a “cocktail”. It has been very effective in dropping the number of HIV elements in the blood stream (this is measured by a blood test called the viral load). Further it improves T-cell counts.

These anti-HIV medications do not cure HIV infection and the risk of transmit HIV to others from individuals taking these medications are still very much possible.

The currently recommended treatments include at least a three drug effective regime to stimulate complete cease of viral replication and lessen the incidence of new mutations. The drug classes are NNRTI, NRTI, NtRTI, PI, FI. The drugs in these classes characterize individual pharmacodynamics and toxicities, requiring superior knowledge to appropriately choose and measure an effective combination.

Post-exposure prophylaxis (PEP) combined with a course of antiviral drugs is also thought to decrease the risk of seroconversion after high-risk contact (unprotected anal or vaginal sex) to HIV. For it to be effective, it must be started as soon as possible after contact and should be no later than 72 hours post-exposure. The treatment for HIV could last four weeks.  Whilst there is compelling data to recommend that PEP after HIV exposure is exceedingly effective, there have been cases where it also has failed.