Patients with HIV infection. Early signs of hiv that everyone should know. What is HIV infection
HIV infection at 3 stages of development is an intermediate stage between the time when the disease is still in principle curable and AIDS. The considered period of time is the most dangerous for the body.
On average, the duration of stage 3 does not exceed 6-7 years, but in some patients the disease can be asymptomatic for at least 20 years.
Subclinical stage 3 HIV in most is manifested as follows:
- Lymph nodes are enlarged;
- The immune system is weakened, the virus spreads throughout the body, provoking the development of dangerous diseases;
- Regular decrease in the number of CD4-lymphocytes.
Unfortunately, these characteristic features is not enough to refer the patient to the doctor. Most often, an increase in lymph nodes is attributed to other less dangerous diseases, the infection of which is weakened by HIV infection of the body, occurs approximately in this period.
Many specialists pay close attention to these symptoms only when three or more groups of enlarged lymph nodes located in different places are found in a patient. In this case, the patient is invited to undergo appropriate diagnostics, during which the latent stage of HIV is detected.
A patient who does not observe signs of HIV in himself often does not think about the danger that this infectious disease and he himself, as its carrier, pose to others. He leads a normal life, not knowing that he is a potential spreader of the disease. The duration of the latent stage depends on the strength of the immune system and the strength of the body.
Being interested in how long HIV patients live, one should pay special attention to the fact that the third stage of the disease is considered fatal, but it is still not possible to exclude a lethal outcome.
Death can occur due to pulmonary tuberculosis, the development of disseminated herpes zoster, and even pneumonia. In the third stage of HIV, a progressive decrease in body weight is often observed, on average, the patient loses up to 10% of his usual weight. Such a significant weight loss is most often due to prolonged diarrhea, the causes of which remain unexplained for more than 1 month.
Patients may experience discomfort in the oral cavity due to developed candidiasis. A direct consequence of infection is leukoplakia, peripheral neuropathy, a localized form of Kaposi's sarcoma, bacterial sinusitis, pyomyositis.
The disease may not progress for 12 or more years, which means that the person will be completely healthy outwardly. A strong body, supported by the necessary drug therapy, is able to fight infection for a long time. In medical practice, there are cases when a patient lives without knowing about his diagnosis until his death, which occurs due to natural causes and is in no way connected with this disease.
Latent stage of HIV in children
Infection of a child with HIV infection most often occurs in the womb, or in the process of transfusing the blood of a sick person to him. At the latent stage, the disease is relatively short-lived - several months and even weeks after infection. At the same time, the signs of HIV in a child are more pronounced - the entire skin, or its individual sections, mucous membranes is affected.
Maintaining the life and health of an HIV-infected child is extremely difficult. If the disease was not detected at the 1st, 2nd and 3rd stages, there is practically no chance of recovery. Having passed all three stages of infection, the body stops fighting, the child is diagnosed with AIDS.
Development phases
The third stage of the disease is also known as persistent generalized lymphadenopathy. For the most accurate determination of the main causes of the disease, its signs and consequences, the division of the considered period of time into separate phases is used:
- A person loses weight, but the weight lost by him is less than 10% of the total body weight. This phase is characterized by damage to the skin and mucous membranes by a pathogenic fungus, viruses and bacteria. As a result of the activity of pathogens, herpes zoster, pharyngitis, sinusitis develop;
- The patient loses weight rapidly. Body weight is reduced by more than 10% of the original weight. There is prolonged diarrhea. Loose stools disturb the infected for 1 month, while the reason for this behavior of the stomach remains unclear. If a person is weakened by other diseases, then the presence of HIV infection in the body can serve as an impetus for serious damage to internal organs, skin and mucous membranes. AT severe cases a malignant tumor is diagnosed - Kaposi's sarcoma;
- In patients, pneumonia begins, the Candida fungus affects the internal organs, and above all, the esophagus, intestines. An extrapulmonary form of tuberculosis may develop, the central nervous system is affected, viruses, fungi and bacteria provoke the appearance of pustules on the skin, ulcers and tumors. The result of this phase is the diagnosis of AIDS in a patient.
Unfortunately, the presented description of the development of the third stage of the disease is not always true. In most cases, the disease is asymptomatic, these signs are not taken seriously enough.
Naturally, the immune system is not capable of suppressing the virus, but it can contain its harmful effects for 10-15 years.
Diagnosis, treatment, prevention
Diagnosis is made by taking blood from a vein to detect antibodies to the virus. A positive test result is a reason for an immune system blot. The disease is incurable, but if it is detected in the latent stage, it is likely that the patient will be able to lead a full life and even live to old age.
Treatment of HIV infection at the latent stage is carried out in three directions:
- Etiotropic therapy. Drugs are used that act on the causative agent of the disease. For this purpose, the following are used: Acyclovir, Riboverin, Suramin, Azidomitin, Interferon;
- pathogenic therapy. A group of drugs that affect the immune system, stimulate its work and prevent the further development of the disease are used. In order to correct immunity, thymomimetics are used - Timalin, Thymosin, T-activin and Timostimulin;
- Getting rid of opportunistic conditions. The patient is prescribed a large number of antibiotics and immunoglobulins. So, pneumocystis pneumonia is treated with Biseptol and 1-difluoromethylornithine, Acyclovir, Zavirax and Virolex are used to treat herpes. Ulcers and erosions on the skin are treated with Amphoterricin B, Kaposi's sarcoma is treated with Vincristine, Epidodovillotoxin.
The drugs and medicines noted above can quite cope with some forms of manifestation of HIV at the latent stage, but they cannot completely cure the disease. As mentioned above, their use in the specified period of time allows you to slow down the development of the disease, but the infection will still remain in the body and continue its pathological effects on it.
Timely detection of an HIV-infected person allows not only to prevent the further spread of the disease, but also to increase his life expectancy.
There is no need to wait for the next medical examination or hospital admission to take an HIV test. You need to see a doctor if you have the following symptoms:
- Enlarged lymph nodes;
- Sudden weight loss;
- Constant feeling of fatigue, weakness.
In addition, there is loss of ability to work, insomnia, apathy, lack of appetite. The latent stage may be accompanied by fever and disorders digestive system especially diarrhea. The nature of these conditions cannot be identified for a long time, as a result, the prodromal period, when effective help can still be provided to the patient, ends, and HIV passes into the fourth (thermal) stage of development, or AIDS, as mentioned above.
If the disease is detected at the third stage preceding AIDS, one should not despair. According to scientists, patients who managed to reach this particular period in the development of the disease and not experience a clear feeling of discomfort may well continue to lead their usual way of life. They will not be able to recover from the virus, but it is quite realistic to prevent the disease from spreading throughout the body and leading to death.
With the help of the drugs described above, it is possible to stop the development of the disease for 5, 10, 20 or more years. If you follow the recommendations of a doctor with a diagnosis of HIV, you can live almost your whole life, of which there are a great many examples.
HIV is a virus that deprives the human body of protection by destroying the immune system. It became known about this disease in the 80s of the 20th century, when scientists found that in an adult infected with HIV, immunity became weak, like in a newborn.
The disease was called AIDS - immune deficiency syndrome. The human immunodeficiency virus was officially announced in 1983. Now the disease is so widespread that it has become an epidemic. It is estimated that 50 million people in the world are now carriers of the virus.
Story
In the summer of 1981, the US Centers for Disease Control published a report describing 5 cases of pneumocystis pneumonia and 26 cases of Kaposi's sarcoma in previously healthy homosexual men from Los Angeles and New York.
Over the next few months, cases were reported among injecting drug users, and shortly thereafter in people who had undergone blood transfusions.
- In 1982, the diagnosis of AIDS was formulated, but the causes of its occurrence were not established.
- In 1983, HIV was isolated for the first time from a cell culture of a sick person.
- In 1984, HIV was found to be the cause of AIDS.
- In 1985, a method for diagnosing HIV infection was developed using enzyme-linked immunosorbent assay (ELISA), which detects antibodies to HIV in the blood.
- In 1987, the first case of HIV infection was registered in Russia - it was a homosexual man who worked as an interpreter in African countries.
Where did HIV come from?
In search of an answer to this question, many different theories have been proposed. Nobody can answer it exactly.
However, it is known that during the first studies of the epidemiology of HIV infection, it was found that the maximum prevalence of HIV occurs in the region of Central Africa. In addition, the great apes (chimpanzees) living in this area have been isolated from the blood of a virus that can cause AIDS in humans, which may indicate the possibility of infection from these monkeys - possibly by biting or butchering carcasses.
There is an assumption that HIV existed for a long time among the tribal settlements of Central Africa, and only in the twentieth century, as a result of increased population migration, spread throughout the world.
HIV and AIDS - what's the difference?
Fundamental differences between AIDS and HIV infection:
HIV infection | a slowly manifesting viral infection that has a long-term course. All currently known methods of treating HIV infection do not lead to a complete cure. The disease affects the immune system that protects the human body from negative impacts external environment. The virus, having entered the body from a carrier of the disease, may not manifest itself in any way for a long time, but for several years it destroys the immune system. |
AIDS | a state of immunity in which the body is practically defenseless against the harmful effects of the environment, the development of oncological processes. Any infection, harmless to a healthy person, in an AIDS patient develops into a serious illness with complications and subsequent lethal outcome from complications, inflammation of the brain, malignant tumors. |
Statistics
Statistical data on the number of HIV-infected people:
- Worldwide, as of December 1, 2016, the number of infected people was 36.7 million;
- In Russia, as of December 2016, there were about 800,000 people, with 90,000 identified in 2015. In the same year, more than 25,000 people died of AIDS in Russia, and over 200,000 over the entire observation period since 1987.
For the CIS countries (data for 2015):
- Ukraine - about 410 thousand,
- Kazakhstan - about 20 thousand,
- Belarus - more than 30 thousand,
- Armenia - 4000,
- Tajikistan - 16400,
- Azerbaijan - 4171,
- Moldova - 17800,
- Georgia - 6600,
- Kyrgyzstan - about 10 thousand,
- Uzbekistan - about 33 thousand.
- Turkmenistan - official authorities claim that there are isolated cases of HIV infection in the country,
Since the statistics record only officially detected cases, the real picture is much worse. A huge number of people do not even suspect that they are HIV-infected, and continue to infect others.
Symptoms and stages
The manifestation of symptoms of HIV infection in a man or woman depends on the stage of development of HIV:
- incubation period;
- Primary manifestations are acute infection, asymptomatic and generalized lymphadenopathy;
- Secondary manifestations - lesions of internal organs of a persistent nature, lesions of the skin and mucous membranes, diseases of a generalized type;
- Terminal stage.
According to statistics, HIV infection is most often diagnosed at the stage of secondary manifestations and this is due to the fact that the symptoms of HIV become pronounced and begin to disturb the patient during this period of the course of the disease.
Incubation period
After a person has contracted HIV infection, no symptoms or even small hints of the development of any pathology are observed for a long time. Just this period is called the incubation period, it can last, in accordance with the classification of V.I. Pokrovsky, from 3 weeks to 3 months.
No examinations and laboratory tests of biomaterials (serological, immunological, hematological tests) will help to identify HIV infection, and the infected person himself does not look sick at all. But it is the incubation period, without any manifestations, that is of particular danger - a person serves as a source of infection.
Some time after infection, the patient enters an acute phase of the disease - the clinical picture during this period may become a reason for diagnosing HIV infection in question.
Stage of primary manifestations
Active reproduction of the virus continues, but the body is already beginning to respond to the introduction of HIV. This phase lasts about 3 months.
It can proceed in three ways:
- Asymptomatic - there are no signs of the disease, but antibodies to HIV are found in the blood.
- Acute HIV infection - this is where the first symptoms of HIV infection appear, accompanied by an unmotivated rise in body temperature to subfebrile numbers, increased fatigue, increased sweating, various rashes on the skin and mucous membranes, swollen lymph nodes (often posterior cervical, axillary, elbow), in some people may experience sore throat, diarrhea, enlarged spleen and liver. Blood test - reduced lymphocytes, leukocytes, thrombocytopenia. This period lasts on average from 2 weeks to 1.5 months, then goes into a latent stage.
- Acute HIV infection with secondary diseases - sometimes in the acute phase, the suppression of immunity is so strong that already at this stage HIV-associated infections (pneumonia, herpes, fungal infections, etc.) may appear.
Acute infection
The most common first manifestation of HIV infection is symptoms resembling infectious mononucleosis. In a person, for no apparent reason, the temperature rises to 38 ° C and above, inflammation of the tonsils (tonsillitis) appears, lymph nodes (usually cervical) become inflamed. The reason for the increase in temperature is often not possible to establish, it does not decrease after taking antipyretics and antibiotics. At the same time, there is a sharp weakness, weakness, profuse sweating, mainly at night. The patient is worried about headache, loss of appetite, sleep is disturbed.
- When examining a patient, one can determine an increase in the liver and spleen, which is accompanied by complaints of heaviness in the hypochondria, aching pains in the same place. A small maculopapular rash appears on the skin in the form of small pale pink spots, sometimes merging into larger formations. A prolonged bowel disorder appears in the form of frequent loose stools.
- In blood tests, with this variant of the onset of the disease, elevated level leukocytes, lymphocytes, atypical mononuclear cells are found. This variant of the first symptoms of HIV infection is observed in 30% of patients.
- In other cases, acute infection may present with serous meningitis or encephalitis. These conditions are characterized by intense headache, often nausea and vomiting, fever. Sometimes the first symptom of HIV infection is inflammation of the esophagus - esophagitis, accompanied by chest pain, swallowing disorders.
Other nonspecific symptoms of the disease are possible, as well as an oligosymptomatic course. The duration of this stage ranges from several days to 2 months, after which all signs of the disease disappear again. Antibodies to HIV at this stage may also not be detected.
Latent stage of HIV
It lasts up to 2-20 years or more. Immunodeficiency progresses slowly, the symptoms of HIV are expressed by lymphadenitis - an increase in lymph nodes. They are elastic and painless, mobile, the skin retains its normal color. When diagnosing latent HIV infection, the number of enlarged nodes is taken into account - at least two, and their localization - at least 2 groups that are not connected by a common lymph flow (the exception is the inguinal nodes).
Lymph moves in the same direction as venous blood, from the periphery to the heart. If 2 lymph nodes are enlarged in the head and neck, then this is not considered a sign of the latent stage of HIV. The combined increase in groups of nodes located in the upper and lower parts of the body, plus a progressive decrease in the number of T-lymphocytes (helpers) are in favor of HIV.
Stage of secondary diseases or AIDS
The number of lymphocytes decreases so much that such infections begin to cling to a person that would otherwise never have occurred. These diseases are called AIDS-associated infections:
- Kaposi's sarcoma;
- brain lymphoma;
- candidiasis of the esophagus, bronchi or lungs;
- cytomegalovirus infections;
- pneumocystis pneumonia;
- pulmonary and extrapulmonary tuberculosis, etc.
Actually this list is long. In 1987, a committee of WHO experts compiled a list of 23 diseases that are considered markers of AIDS, and the presence of the first 12 does not require immunological confirmation of the presence of the virus in the body.
Features of the first signs of HIV infection in women
Women are significantly more likely than men to have secondary manifestations such as herpes, cytomegalovirus infection and vaginal candidiasis, as well as candidal esophagitis.
In addition, at the stage of secondary manifestations, the first signs of the disease may be menstrual irregularities, inflammatory diseases of the pelvic organs, most often acute salpingitis. Diseases of the cervix, such as carcinoma or dysplasia, may be observed.
Can you get HIV through protected sex?
If a condom was used during sexual intercourse, it was used according to the instructions and remained intact, then the risk of becoming infected with HIV is minimized. If, after 3 or more months after a dubious contact, symptoms resembling an HIV infection appear, then you just need to contact a therapist. An increase in temperature, an increase in lymph nodes may indicate the development of SARS and other diseases. For your own peace of mind, you should take an HIV test.
What to do if you had unprotected intercourse?
There are a number of drugs that are used for post-exposure prophylaxis of HIV. Unfortunately, they are not available for free sale, so you will have to go to an appointment with a therapist and explain the situation. There is no guarantee that such measures will 100% prevent the development of HIV infection, but experts say that taking such drugs is quite advisable - the risk of developing the human immunodeficiency virus is reduced by 70-75%.
If there is no opportunity (or courage) to see a doctor with a similar problem, then there is only one thing left - to wait. It will be necessary to wait 3 months, then undergo an HIV test, and even if the result is negative, it is worth taking a control test after another 3 months.
Can you get infected through oral sex?
The risk of contracting HIV infection through oral sex is minimized. The fact is that the virus does not survive in environment, therefore, in order to infect them orally, two conditions must come together: there are wounds / abrasions on the partner's penis and wounds / abrasions in the partner's oral cavity. But even these circumstances do not in every case lead to infection with HIV infection.
For own peace of mind you need to pass a specific HIV test 3 months after a dangerous contact and undergo a “control” examination after another 3 months.
HIV infection develops in a person as a consequence of HIV infection. Symptoms of HIV and AIDS at different stages have certain symptoms, signs and manifestations. Early signs of HIV infection are nonspecific and resemble infectious mononucleosis. Then they pass, asymptomatic carriage begins.
The initial stage is observed 6 months after infection with HIV and lasts 0.5-1 month - HIV (AIDS) symptoms become apparent and indicate the possible presence of a retrovirus in the body. The lack of symptoms of HIV infection (AIDS) is due to the fact that the immune system actively fights the virus and contributes to its death.
The conclusion is that in the classical version of the development of HIV, the first symptoms of the disease are easily confused with the common cold. Read more about the first symptoms of HIV and AIDS below.
The first symptoms of HIV: how to determine the infection with the virus
The human immunodeficiency virus belongs to the group of retroviruses that provokes the development of HIV infection. This disease can proceed in several stages, each of which differs in the clinical picture, the intensity of manifestations.
HIV stages
Stages of development of HIV infection:
- incubation period;
- primary manifestations - acute infection, asymptomatic and generalized lymphadenopathy;
- secondary manifestations - lesions of internal organs of a persistent nature, lesions of the skin and mucous membranes, diseases of a generalized type;
- terminal stage.
According to statistics, HIV infection is most often diagnosed at the stage of secondary manifestations and this is due to the fact that the symptoms of HIV become pronounced and begin to disturb the patient during this period of the course of the disease.
At the first stage of the development of HIV infection, certain symptoms may also be present, but they, as a rule, proceed in a mild form, the clinical picture is blurred, and the patients themselves do not turn to doctors for such “little things”. But there is one more nuance - even if the patient seeks qualified medical help at the first stage of the course of HIV infection, specialists may not diagnose the pathology. Moreover - at this stage of the development of the disease in question, the symptoms will be the same in men and women - this is often confusing for physicians. And only at the secondary stage is it quite realistic to hear the diagnosis of HIV infection, and the symptoms will be individual for male and female.
How long does it take for HIV to show up?
The first signs of HIV infection go unnoticed, but they are there. And appear on average in the period from 3 weeks to 3 months after infection. A longer period is also possible.
Signs of secondary manifestations of the disease in question can also appear only many years after infection with HIV infection, but manifestations can also occur as early as 4-6 months from the moment of infection.
Incubation period
After a person has contracted HIV infection, no symptoms or even small hints of the development of any pathology are observed for a long time. Just this period is called the incubation period, it can last, in accordance with the classification of V.I. Pokrovsky, from 3 weeks to 3 months.
No examinations and laboratory tests of biomaterials (serological, immunological, hematological tests) will help to identify HIV infection, and the infected person himself does not look sick at all. But it is the incubation period, without any manifestations, that is of particular danger - a person serves as a source of infection.
Some time after infection, the patient enters an acute phase of the disease - the clinical picture during this period may be the reason for the diagnosis of HIV infection "in question".
Acute infection
The first manifestations of HIV infection in the acute phase of the course strongly resemble the symptoms of mononucleosis. They appear on average in the period from 3 weeks to 3 months from the moment of infection. These include:
- inflammation of the palatine tonsils - patients complain of frequently recurring tonsillitis;
- inflammation of the lymph nodes - more often this process affects the cervical lymph nodes, but the examination does not reveal any obvious pathology;
- an increase in body temperature to subfebrile indicators - the cause of such hyperthermia cannot be established, but the indicators do not normalize even after use medicines with antipyretic effect;
- profuse sweating, general weakness and insomnia at night - these symptoms are often "written off" to chronic fatigue;
- headaches, loss of appetite, apathy towards the environment.
When examining a patient, a doctor can determine a slight increase in the size of the spleen and liver - the patient, by the way, may also complain of recurrent pain in the right hypochondrium. The patient's skin may be covered with a small rash - pale pink spots that do not have clear boundaries. Often there are complaints from infected people about a long-term violation of the stool - they are tormented by diarrhea, which is not removed even by specific medications and a change in diet.
Please note: with such a course of the acute phase of HIV infection, lymphocytes / leukocytes in an increased number and atypical mononuclear cells will be detected in the blood.
The above signs of the acute phase of the disease in question can be observed in 30% of patients. Another 30-40% of patients live an acute phase in the development of serous meningitis or encephalitis - the symptoms will be radically different from those already described: nausea, vomiting, fever to critical levels, severe headache.
Often the first symptom of HIV infection is esophagitis - an inflammatory process in the esophagus, which is characterized by swallowing disorders and chest pain.
In whatever form the acute phase of HIV infection proceeds, after 30-60 days all the symptoms disappear - often the patient thinks that he has completely recovered, especially if this period of the pathology was almost asymptomatic or their intensity was low (and this can also be ).
Asymptomatic stage
During the course of this stage of the disease in question, there are no symptoms - the patient feels great, does not consider it necessary to appear in medical institution for a preventive examination. But it is at the stage of an asymptomatic course that antibodies to HIV can be detected in the blood! This makes it possible to diagnose pathology at one of the early stages of development and begin adequate, effective treatment.
The asymptomatic stage of HIV infection can last several years, but only if the patient's immune system has not undergone significant damage. The statistics are rather contradictory - only in 30% of patients within 5 years after the asymptomatic course of HIV infection, symptoms of the following stages begin to appear, but in some infected asymptomatic stages of the course proceed rapidly, lasting no more than 30 days.
Generalized lymphadenopathy
This stage is characterized by an increase in almost all groups of lymph nodes, this process does not affect only the inguinal lymph nodes. It is noteworthy that it is generalized lymphadenopathy that can become the main symptom of HIV infection, if all previous stages of development of the disease in question proceeded without any manifestations.
Lymph nodes increase by 1-5 cm, remain mobile and painless, and the surface of the skin above them has absolutely no signs of a pathological process. But with such a pronounced symptom as an increase in groups of lymph nodes, the standard causes of this phenomenon are excluded. And here, too, there is a danger - some doctors classify lymphadenopathy as difficult to explain.
The stage of generalized lymphadenopathy lasts 3 months, about 2 months after the onset of the stage, the patient begins to lose weight.
Secondary manifestations
It often happens that it is the secondary manifestations of HIV infection that serve as the basis for a qualitative diagnosis. Secondary manifestations include:
Pneumocystis pneumonia
The patient notes a sudden increase in body temperature, he develops a dry, obsessive cough, which eventually turns into a wet one. The patient develops intense dyspnea with minimal exertion, and general state the patient is rapidly deteriorating. Therapy carried out with the use of antibacterial drugs (antibiotics) does not give a positive effect.
Generalized infection
These include herpes, tuberculosis, cytomegalovirus infection, candidiasis. Most often, these infections affect women and, against the background of the human immunodeficiency virus, they are extremely difficult.
Kaposi's sarcoma
This is a neoplasm / tumor that develops from the lymphatic vessels. It is more often diagnosed in men, has the appearance of multiple tumors of a characteristic cherry color, located on the head, trunk and in the oral cavity.
Damage to the central nervous system
At first, this is manifested only by minor problems with memory, a decrease in concentration. But in the course of the development of pathology, the patient develops dementia.
Features of the first signs of HIV infection in women
If infection with the human immunodeficiency virus has occurred in a woman, then secondary symptoms will most likely manifest themselves in the form of development, progression of generalized infections - herpes, candidiasis, cytomegalovirus infection, tuberculosis.
Often, secondary manifestations of HIV infection begin with a banal menstrual cycle disorder, inflammatory processes in the pelvic organs, for example, salpingitis, can develop. Often diagnosed and cancer of the cervix - carcinoma or dysplasia.
Features of HIV infection in children
Children who were infected with the human immunodeficiency virus during pregnancy (intrauterine from the mother) have some features in the course of the disease. First, the disease begins its development at 4-6 months of age. Secondly, the earliest and main symptom of HIV infection during intrauterine infection is considered to be a disorder of the central nervous system- the baby lags behind his peers in physical and mental development. Thirdly, children with human immunodeficiency virus are prone to progression of digestive system disorders and the appearance of purulent diseases.
The human immunodeficiency virus is still an unexplored disease - too many questions arise in both diagnosis and treatment. But doctors say that only the patients themselves can detect HIV infection at an early stage - it is they who should carefully monitor their health and periodically undergo preventive examinations. Even if the symptoms of HIV infection are hidden, the disease develops - only a timely test analysis will help save the patient's life for several years.
Answers to popular questions about HIV
Due to the large number of requests from our readers, we decided to group the most common questions and answers to them in one section.
When do the first symptoms of HIV infection appear? »
Signs of HIV infection appear approximately 3 weeks to 3 months after the hazardous exposure. An increase in temperature, sore throat and swollen lymph nodes in the first days after infection may indicate any pathology, except for the human immunodeficiency virus. During this period (doctors call it the incubation period), not only are there no symptoms of HIV, but deep laboratory blood tests will not give a positive result.
Can HIV be asymptomatic? »
Yes, unfortunately, this is rare, but it happens (in about 30% of cases): a person does not notice any characteristic symptoms during the acute phase, and then the disease passes into a latent phase (this is, in fact, an asymptomatic course for about 8-10 years ).
Will the result of an analysis taken immediately after a possible infection be reliable? »
Most modern screening tests are based on enzyme immunoassay (ELISA) - this is the "gold standard" of diagnosis, while an accurate result can be expected no earlier than 3 to 6 months after infection. Therefore, the analysis must be taken twice: 3 months after a possible infection and then another 3 months later.
If the body temperature has risen and the lymph nodes have increased, is this HIV? »
It is impossible to answer this question categorically. First, you need to take into account the period that has passed since a potentially dangerous contact - if less than 3 weeks have passed, then these symptoms may also indicate a common cold.
Secondly, if more than 3 weeks have already passed after a possible infection, then you should not make yourself nervous - just wait and undergo a specific examination 3 months after the dangerous contact.
Thirdly, fever and swollen lymph nodes are not "classic" signs of HIV infection! Often, the first manifestations of the disease are expressed by pain in the chest and a burning sensation in the esophagus, a violation of the stool (a person is worried about frequent diarrhea), a pale pink rash on the skin.
Can you get infected through oral sex? »
The risk of contracting HIV infection through oral sex is minimized. The fact is that the virus does not survive in the environment, therefore, for it to be transmitted orally, two conditions must come together: there are wounds / abrasions on the partner's penis and wounds / abrasions in the partner's oral cavity. But even these circumstances do not in every case lead to infection with HIV infection. For your own peace of mind, you need to pass a specific HIV test 3 months after a dangerous contact and undergo a “control” examination after another 3 months.
What to do if you had unprotected intercourse? »
There are a number of drugs that are used for post-exposure prophylaxis of HIV. Unfortunately, they are not available for free sale, so you will have to go to an appointment with a therapist and explain the situation. There is no guarantee that such measures will 100% prevent the development of HIV infection, but experts say that taking such drugs is quite advisable - the risk of developing the human immunodeficiency virus is reduced by 70-75%.
If there is no opportunity (or courage) to see a doctor with a similar problem, then there is only one thing left - to wait. It will be necessary to wait 3 months, then undergo an HIV test, and even if the result is negative, it is worth taking a control test after another 3 months.
Is it possible to get infected with HIV through everyday life? »
No! The human immunodeficiency virus does not survive in the environment, therefore, with people who are HIV-positive, you can without hesitation use common dishes, bed linen, visit the pool and bathhouse.
If I slept (sleeped) with an HIV-infected person, will I definitely get infected? »
There are risks of infection, but they are quite small. So, with a single vaginal intercourse without a condom, the risk is 0.01 - 0.15%. With oral sex, the risks are from 0.005 to 0.01%, with anal sex - from 0.065 to 0.5%. Such statistics are provided in the clinical protocols for the WHO European Region of HIV/AIDS Treatment and Care.
In medicine, cases are described when married couples, where one of the spouses was HIV-infected, lived sexually without using condoms for several years, and the second spouse remained healthy.
Is it possible to get HIV in the process of mutual masturbation? »
The risks are almost zero (if there are no open wounds on the hands and genitals of the partners).
Is it possible to become infected through contact with dried blood or semen? »
When biological fluids dry out, the immunodeficiency virus contained in them dies.
Can you get HIV through protected sex? »
If a condom was used during sexual intercourse, it was used according to the instructions and remained intact, then the risk of becoming infected with HIV is minimized. If, after 3 or more months after a dubious contact, symptoms resembling an HIV infection appear, then you just need to contact a therapist. An increase in temperature, an increase in lymph nodes may indicate the development of SARS and other diseases. For your own peace of mind, you should take an HIV test.
If the HIV test result is negative, am I not sick? »
To answer this question, you need to know at what time and how many times a similar analysis was given:
- a negative result in the first 3 months after a dangerous contact cannot be accurate, doctors talk about a false negative result;
- negative response of the HIV test after 3 months from the moment of dangerous contact - most likely the subject is not infected, but one more test must be done 3 months after the first one for control;
- negative response of the HIV test 6 months or more after the dangerous contact - the subject is not infected.
Can I get infected if I step on a needle in the street and get hurt? »
The risks in this case are extremely small - the virus quickly dies in the environment, therefore, even if the blood of an infected person remains on the needle, it is almost impossible to become infected with HIV by injuring yourself with such a needle. Dried biological fluid (blood) cannot contain the virus. However, after 3 months, and then again - after another 3 months - it is still worth taking an HIV test.
Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category.
Materials used: http://okeydoc.ru/pervye-simptomy-vich/ Save in social networks:
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HIV infection. Syn.:
AIDS (acquired immunodeficiency syndrome).
SPIN (acquired immune deficiency syndrome).
HIV infection - anthroponotic retroviral infection, characterized by epidemic spread.
Widespread in Russia and CIS countries classification proposed by academician V.I. Pokrovsky 1989.
Stage I - Stage of incubation.
Stage II - Stage of primary manifestations:
BUT- acute febrile phase;
B- asymptomatic phase;
AT- persistent generalized lymphadenopathy.
Stage III - Stage of secondary diseases:
BUT- loss of body weight less than 10%, superficial fungal, bacterial, viral lesions of the skin and mucous membranes, herpes zoster, repeated pharyngitis, sinusitis;
B- progressive weight loss of more than 10%, unexplained diarrhea or fever for more than 1 month, repeated or persistent bacterial, fungal, protozoal lesions of internal organs (without dissemination) or deep lesions of the skin and mucous membranes, recurrent or disseminated herpes zoster, localized Kaposi's sarcoma;
Stage IV - Terminal stage.
Clinical picture (Symptoms) of HIV infection (AIDS)
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Stage I - Stage of incubation.
In stage I (incubation), the diagnosis can only be speculative, as it is based solely on epidemiological data (sexual contact with an HIV-infected partner, blood transfusion from an HIV-seropositive donor, use of non-sterile syringes for group drug administration, etc.).
The incubation period for HIV infection lasts from 2–3 weeks to several months or even years. There are no clinical manifestations of the disease, antibodies to HIV are not detected. But already during this period, it is possible to detect the virus by the NDP method.
Stage II - Stage of primary manifestations.
Phase IIA- acute febrile. She is the initial (acute) HIV infection. In some of the infected, 2-5 months after the virus enters the body, an acute illness may develop, which often occurs with an increase in body temperature, severe intoxication, tonsillitis, and a mononucleosis-like syndrome. In addition to fever, in this phase of the disease, a crust- or rubella-like rash on the skin, myalgia, arthralgia, ulcers in the throat, and less often in the oral cavity, are common. Sometimes the disease proceeds as an acute respiratory infection (cough bothers). Some patients develop polyadenopathy with an increase in 2-3 groups of lymph nodes. An increase in superficial lymph nodes often begins with the occipital and posterior cervical, then the submandibular, axillary and inguinal ones increase. On palpation, the lymph nodes are elastic, painless, mobile, not soldered to each other and the surrounding tissue, with a diameter of 1 to 5 cm (usually 2-3 cm). Sometimes these phenomena are accompanied by unmotivated fatigue, weakness. In addition, transient disorders of the central nervous system are recorded - from headaches to encephalitis. In the blood of patients during this period, lymphopenia is detected, but the number of CD4 + – more than 500 lymphocytes in 1 µl. By the end of the 2nd week, specific antibodies to HIV antigens can be detected in the blood serum. The duration of this febrile state is from several days to 1-2 months, after which the lymphadenopathy may disappear, and the disease passes into an asymptomatic phase (IIB).
Phase IIB. The duration of phase IIB is from 1–2 months to several years, but on average about 6 months. clinical signs disease is not noted, although the virus remains in the body and replicates. At the same time, the immune status remains within the normal range, the number of lymphocytes, including CD4 + , normal. The results of studies in ELISA and immunoblotting are positive.
Phase IIB- persistent generalized lymphadenopathy. The only clinical manifestation of the disease at this stage can only be an increase in lymph nodes, which persists for months and even years. Almost all peripheral lymph nodes are enlarged, but the most characteristic increase in the posterior cervical, supraclavicular, axillary and ulnar lymph nodes. An increase in submandibular lymph nodes in the absence of pathology of the oral cavity should be considered especially characteristic and alarming for the doctor. Often the mesenteric lymph nodes are enlarged. They are painful on palpation, which sometimes simulates a picture of an "acute" abdomen. But lymph nodes up to 5 cm in diameter may remain painless and tend to coalesce. In 20% of patients, an increase in the liver and spleen is detected. In this phase, the disease must be differentiated from acute toxoplasmosis, infectious mononucleosis, syphilis, rheumatoid arthritis, systemic lupus erythematosus, lymphogranulomatosis, sarcoidosis. The total number of lymphocytes decreases, but it is more than 50% of the regional and age norm, the number of CD4 + – more than 500 lymphocytes in 1 µl. Labor and sexual activity of patients is saved.
Stage III - Stage of secondary diseases
Stage III (secondary diseases) is characterized by the development of bacterial, viral and protozoal diseases and/or neoplastic process, more often lymphoma or Kaposi's sarcoma.
Phase IIIA is transitional from persistent generalized lymphadenopathy to an AIDS-associated complex. During this period, immunosuppression is pronounced and persistent: the content of gamma globulins in the blood serum increases (up to 20–27%), the level of immunoglobulins increases, mainly due to the IgG class, and the phagocytic activity of leukocytes and RBTL for mitogens decreases. CD4 number + -lymphocytes falls below 500 and during this and the next phase up to 200 cells in 1 µl. Clinically, signs of viral intoxication are detected, fever with an increase in body temperature up to 38 ° C is permanent or intermittent, accompanied by night sweats, weakness, fatigue, diarrhea. There is a loss of body weight up to 10%. In this phase, there are no severe superinfections or invasions yet, Kaposi's sarcoma or other malignant tumors do not develop. But nevertheless, against the background of immunodeficiency, superinfection with the herpes simplex virus occurs, toxoplasmosis, candidal esophagitis are possible. On the skin, the process in the form of candidiasis, warts, leukoplakia is possible. Phase IIIA is essentially an uncomplicated generalized infection or a malignant tumor form, so some clinicians believe that under the influence of adequate therapy it can end in recovery and it is advisable to isolate it into an independent form. Some clinicians refer to this phase as the AIDS prodrome.
In phase IIIB HIV infection, symptoms of a pronounced impairment of cellular immunity appear: lack of HRT response to 3 out of 4 skin tests(intradermal administration of tuberculin, candidin, trichophytin, etc.). The clinical picture is characterized by fever lasting more than 1 month, persistent unexplained diarrhea, night sweats, accompanied by intoxication, weight loss by more than 10%. Persistent lymphadenopathy becomes generalized. A decrease in the CD4 / CD8 ratio is detected in the laboratory, leukopenia, thrombocytopenia, anemia increase, the level of circulating immune complexes in the blood increases; there is a further decrease in RBTL indicators, suppression of HRT. In this phase, the presence of 2 characteristic clinical manifestations and 2 laboratory parameters, especially taking into account epidemiology, allows diagnosing HIV infection with a high degree of certainty.
Phase IIIB presents the big picture of AIDS. Due to the deep damage to the immune system (the number of CD4-lymphocytes is less than 200 per 1 ml), superinfections become generalized, neoplasms develop or superimpose on the infectious process in the form of disseminated sarcoma and malignant lymphoma. The most common infectious agents are pneumocystis, Candida fungi, and herpetic group viruses (herpes simplex virus, herpes zoster, cytomegalovirus, Epstein-Barr virus). The causative agents of the infectious process can be mycobacteria, legionella, candida, salmonella, mycoplasmas, as well as (in the southern region) toxoplasma, cryptosporidium, strongyloidia, histoplasma, cryptococci, etc.
Stage IV - Terminal Stage
Stage IV (terminal) proceeds with the maximum deployment of the clinical picture: cachexia sets in, fever persists, intoxication is pronounced, the patient spends all the time in bed; dementia develops, viremia increases, the content of lymphocytes reaches critical values. The disease progresses and the patient dies.
The experience accumulated by clinicians allowed the employee of V.I. Pokrovsky O.G. Yurin (1999) to supplement the classification proposed by him in 1989 and make some changes. Thus, stage 2A (acute infection) has become separate in the classification, since it is pathogenetically different from stages 2B and 2C and requires different approaches to the tactics of treating a patient who needs antiretroviral therapy at this stage. Stages 2B and 2C do not differ in prognostic value and tactics of patient management, so the author combines them into one stage - latent infection.
In the new version of the classification, stages 4A, 4B, 4C correspond to stages 3A, 3B, 3C of the 1989 classification.
Clinical forms of HIV infection
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Depending on the predominant localization of the infectious process, a number of clinical forms are distinguished:
a) With predominant lung involvement(up to 60% of cases);
b) With damage to the gastrointestinal tract;
in) With cerebral lesions and/or neuropsychiatric manifestations;
G) With damage to the skin and mucous membranes;
e) Generalized and/or septic forms;
e) Undifferentiated forms, mainly with asthenovegetative syndrome, prolonged fever and weight loss. The disease is characterized by the development of purulent complications, asthenia - the patient is forced to stay in bed for more than half the time. In the course of the disease, etiological factors may change.
Pulmonary AIDS
The pulmonary form of AIDS, according to autopsy data, is detected in 2/3 of cases. This variant of the disease is characterized by hypoxemia, chest pain, and diffuse pulmonary infiltrates on chest radiographs. In these cases, most often clinical picture determines pneumocystis pneumonia, less often the process in the lungs is caused by aspergillus, legionella and cytomegaloviruses.
Gastrointestinal (dyspeptic) form of AIDS
The gastrointestinal (dyspeptic) form ranks second in terms of the frequency of clinical manifestations of AIDS. Patients present with severe diarrhea, malabsorption, and steatorrhea. Histological changes in biopsy specimens of the jejunum and rectum are characterized by villous atrophy, crypt hyperplasia with focal cell regeneration at the base of the crypts. Most often, the defeat of the gastrointestinal tract is a consequence of candidiasis of the esophagus and stomach, cryptosporidiosis.
Neurological form (neuroAIDS)
The neurological form (neuroAIDS) occurs in 1/3 of AIDS patients. Damage to the nervous system is the direct cause of death in every fourth AIDS patient.
NeuroAIDS proceeds in the form of 4 main variants:
- abscess of toxoplasma etiology, progressive multifocal leukoencephalopathy, cryptococcal meningitis, subacute cytomegalovirus encephalitis;
- tumors (primary or secondary B-cell lymphoma of the brain);
- vascular lesions of the central nervous system and other systems (non-bacterial thrombotic endocarditis and cerebral hemorrhage);
- focal brain lesions with self-limiting meningitis.
Infection is possible through unprotected sex, the birth and feeding of a child by an HIV-infected mother, and especially when using medical instruments containing infected blood particles.
The pathogenesis is due to the destruction and death of immunocompetent cells due to the development of the immunodeficiency virus in them. Over time, the virus infects more and more lymphocytes, their number is rapidly decreasing, and the person is unprotected against any opportunistic (conditionally pathogenic) microflora.
A previously unknown HIV infection has spread around the world at great speed and has caused pandemics in many countries. This epidemic has already claimed millions human lives, although the first case of a previously unfamiliar disease was registered in the middle of the last century, and the pathogen was isolated only in the 80s of the last century.
It is believed that the human immunodeficiency virus has turned into a mutating and “jumping” the species barrier, an infectious agent that previously affected only monkeys.
One of the features of the development of HIV is the slow rate of spread of the infectious process inside the human body, which is due to the high frequency of genetic changes in the pathogen itself. To date, 4 types of the virus are known, some of which are highly pathogenic, while others do not play a special role in the development of the disease. The most aggressive is HIV-1.
From the moment the infection enters the body until the appearance of tangible signs of acquired immunodeficiency syndrome, an average of about 10 years passes if treatment is not carried out, that is, without active influence on the pathogen. This does not mean that in 10 years a person will die, just that his immune system becomes defenseless, so it is advisable to avoid all kinds of infections that cause severe complications of the respiratory and cardiovascular systems. In addition, pathogenic microbes that previously existed under the control of the immune system are out of control and contribute to the poisoning and intoxication of the body.
Today developed quite effective drugs involved in the treatment of HIV infection, capable of restraining the development of pathology and maintaining the immune system in working condition for years and decades.
Secondary (opportunistic) diseases develop, which are the causes of death.
seronegative window
HIV infection is characterized by a long latent period and the absence of severe symptoms of the disease. At this time, pathogens can only be detected by chance - in laboratory tests for other ailments, when antibodies to the human immunity virus appear in the blood.
Moreover, due to the belated recognition of the infectious agent, the defense system does not detect infection immediately, but only after a few weeks. This is the so-called seronegative window period. If you take an HIV test at this time, the answer will be negative. But in fact, the virus is already multiplying and a person is quite capable of infecting another person with it.
Epidemiology of HIV infections
Source of infection: HIV-infected person in all stages of the disease.
There may be infection in everyday life:
- when using one razor, toothbrush, washcloth;
- with pedicure, manicure, shaving, deep sexual kisses with bites;
- when carrying out piercing, tattoos, circumcision, acupuncture.
Risk groups: drug addicts, homosexuals, medical workers, infected sexual partners, patients with viral hepatitis B, C, D, hemophilia.
How is HIV spread?
The spread and wide spread of HIV infection is mainly due to the increase in the number of people who use drugs. Neither the infection of babies by a sick mother, nor accidental infection during medical manipulations, nor any other causes can be compared with the non-sterile syringes of drug addicts. In second place (40%) - infection during unprotected intercourse.
To date, hundreds of thousands of people with HIV infection have been registered in Russia (according to various sources, from 200 to 800 thousand). The statistics are so blurry because the infection is very hidden and the picture is constantly changing.
A dangerous virus is found in almost all body fluids, but in different quantities. Through saliva, sweat, tears, HIV is not transmitted. Enough to infect the amount is only in the blood and semen. Domestic transmission of HIV infection practically does not occur, since the pathogen is not stable in the external environment, it dies when heated and dried. But the ingress of infected blood into the bloodstream of a healthy person in 95% of cases is fraught with the development of the disease.
Sexual contacts do not always lead to infection. The greatest danger is unprotected (without the use of a condom) anal sex, since there is a higher risk of damage to the mucous membranes.
HIV is not transmitted through swimming pools, food, mosquito bites, dishes, clothes, handshakes, sneezes and coughs. A negligible percentage of the likely infection falls on kisses, since theoretically there is the possibility of bleeding and open wounds on the mucous membranes of the kissers.
Symptoms and manifestations of HIV infection
The insidious immunodeficiency virus is a very silent and secretive enemy. Having taken root in the body, it practically does not show itself for a long time. In response to an unfamiliar infection, a slightly elevated temperature, an incomprehensible allergy in the form of mild urticaria, a slight inflammation of the lymph nodes that usually goes unnoticed, or a flu-like condition may appear in a week or a month. But even these mild symptoms disappear after 10-20 days.
True, then, with a gradual increase in HIV infection, the lymph nodes, in which it concentrates the largest number immune cells become dense and enlarged, but painless, and the process of destruction of the body's defense system purposefully continues - a year, two, three or ten ... Until the presence of oppressed and weak cellular immunity becomes a clear and obvious factor.
How does this manifest itself?
First of all, opportunistic infections raise their heads: herpetic eruptions constantly occur, the fungal flora in the mouth causes stomatitis, candidiasis aggravates in the genital area, and previously dormant inflammatory processes in various organs often recur ...
In the future, third-party, accidentally encountered infections begin to stick: SARS, tuberculosis, salmonellosis, etc.
The asymptomatic onset of the disease accounts for about half of the cases.
The second half of those infected with HIV may feel signs of developing an acute fever.
Against the background of subfebrile temperature, the throat and head begin to hurt, pain in the muscles and eyes also appears, appetite decreases, nausea and diarrhea develop, rashes of unknown origin appear on the skin.
These signs of an acute illness last a couple of weeks, and then the disease becomes asymptomatic, without any clinical manifestations.
In rare cases, HIV infection can start violently, giving a sharp and lightning-fast deterioration in the general condition.
Suspicion of HIV infection
If a person has:
- a feverish state of unknown origin persists for a week;
- in the absence of inflammatory processes, axillary, inguinal, cervical and other lymph nodes increase and lymphadenopathy does not go away within a few weeks;
- there is prolonged diarrhea (diarrhea);
- thrush develops in the mouth (candidiasis);
- extensive herpetic eruptions appear on the body;
- body weight inexplicably decreases, that is, a reason to suspect the introduction of the human immunodeficiency virus into the body.
The picture of the disease drawn by the virus
The human immunodeficiency virus is dangerous because it chooses macrophages and monocytes for residence and reproduction.
Macrophages are a type of white blood cells involved in the elimination of various eaters of pathogenic flora that have entered the human body. These are very important cells - they are the "eaters" of the infection. Macrophages are produced by the bone marrow, but not indefinitely: the reserve supply can be depleted, and the macrophages themselves are mortal.
Monocytes are a group of cells of the immune system from the category of leukocytes and their main task is to cleanse tissues of pathogens. And now a cunning immunodeficiency virus makes its way inside these defenders. It is not difficult for him to do this: he is ten times smaller than such large cells. The cells of the immune system become a reservoir for the virus. Instead of destroying the infection, they promote its reproduction.
This happens because the innate immune system does not know how to timely and effectively identify this new virus for it, so a quick specific response of lymphocytes does not occur. Without a drug system to contain it, HIV infection quite effectively destroys lymphocytes, and their lack ultimately becomes the destruction of all immunity.
Diagnosis of HIV infections
Diagnosis based on:
- passport data (belonging to risk groups, profession);
- anamnesis of the disease - the sequence of the development of the disease;
- complaints - unmotivated fever, cough, diarrhea, weight loss, damage to the mucous membranes, skin;
- epidemiological history - the presence of parenteral interventions, the use of psychotropic drugs;
- clinical examination - examination of the skin, mucous membranes, anus, genital organs, the condition of nails, hair (fungal infection, hair loss). Lymph nodes of all groups are larger than 1 cm, painless, decrease in the 5th stage. Shortness of breath at rest, respiratory failure. Pain behind the sternum, stool - 15-20 times, the liver, spleen are enlarged. Candidiasis of the genital tract, warts;
- analysis of laboratory tests - detection of antibodies to the virus. It takes 25 days to 3 months to produce antibodies. Blood for ELISA (enzyme-linked immunosorbent assay), if 2 positive results, then the blood is examined in the reaction of immune blotting. With doubtful results and for the examination of pregnant women and children, the PCR method is used;
- immunological studies: determination of CD4 and CD8, an increase in immunoglobulins of all classes develops;
- OAK - leukopenia, lymphocytosis, monocytosis, with secondary lesions leukocytosis, increased ESR;
- x-ray examination, ultrasound, EEG, endoscopy, CT, nuclear magnetic resonance imaging.
Differential diagnosis is carried out with bronchial or pulmonary candidiasis, intestinal cryptosporidiosis, disseminated histoplasmosis, cryptococcal meningoencephalitis, brain toxoplasmosis, cytomegalovirus chorioretinitis, malignant lymphomas, infectious mononucleosis, adenovirus infection, leukemia, rubella, yersiniosis.
Blood test for HIV infection
Early diagnosis of HIV is extremely important, as it allows you to start treatment on time, improve the effectiveness of therapy, and thus prolong the life of patients to the nature of the appointed time.
A blood test for HIV infection is recommended when planning pregnancy, preoperative preparation, sudden weight loss of an unknown cause, casual sexual contact without barrier contraception, and in some other cases. This analysis is free and is carried out regardless of the person's place of residence.
If a person is suspected of being infected with the immunodeficiency virus, a special enzyme immunoassay (ELISA) is performed, showing the presence of antibodies to HIV infection. PCR analysis will show the presence of the virus 2-3 weeks after infection.
If the virus is detected, the result is called positive, if there is no virus - negative. In some isolated cases, the result is said to be questionable. Upon receipt of positive results, doctors usually double-check the data additional test(immunoblotting) to be 100% reliable.
Today, there are already test systems capable of detecting both antibodies and antigens of HIV infection, which significantly reduces the period of the latent "window" and allows diagnosing the disease in the acute period.
No special preparation is required before donating blood for HIV infection. Usually, doctors only recommend doing this in the morning on an empty stomach, since for reliability it is required that at least 8 hours elapse between eating and taking blood.
Blood is taken from a vein, and the results will be known in 5-10 days.
Who is at higher risk of contracting HIV?
At risk:
- drug addicts sharing non-sterilized syringes;
- homosexuals having unprotected sex;
- people who have anal sex without using a condom;
- people with other sexually transmitted diseases;
- children of infected mothers.
What and how is HIV treated?
To date, there are no drugs that can eliminate the immunodeficiency virus from the human body.
All scientific developments have reached only the level that made it possible to create drugs that can slow down the development of infection, stop the progression of the disease and thus prevent the transition of the disease to the stage of AIDS.
This is a huge achievement, as it allows HIV-infected people to live normal life. If the selected drugs are effective enough for a given person, if he takes them regularly and according to the prescribed scheme, if he does not lead an anti-social lifestyle, then, according to doctors, damage to health is actually caused only by natural causes of aging.
Unfortunately, theoretical calculations are not always confirmed by practice, since the virus mutates, and a new treatment regimen has to be selected. It takes some time, and during this period, HIV continues to do its dirty work to destroy immunity. After a year or two, and the new scheme becomes ineffective, and start all over again. When selecting all drugs, doctors have to take into account the possible individual intolerance of the patient, side effects of drugs, concomitant diseases.
It makes no sense to list all the names of medicines here - there are dozens of them, and only a few are suitable for a specific person. It depends on the degree of infection, the severity of the course and duration of the disease, and many other factors.
In our country, after studying the activity and stage of infection, determining the viral load (the number of viruses in a unit of blood), the following are used for treatment:
- retrovir (zidovudine) together with other drugs. Monotherapy with retrovir is prescribed only for pregnant women in order to minimize the risk to the fetus. Side effects drug - violation of hematopoiesis, headache, liver enlargement, muscular dystrophy;
- videks (didanosine) - after treatment with retrovir in combination with other drugs. Side effects - pancreatitis, peripheral neuritis, diarrhea;
- chivid - with intolerance or ineffectiveness of the previous treatment. Side effects - neuritis, stomatitis;
- nevirapine, delavirdine - with the progression of the disease. Side effects - papular rash;
- saquinavir - in the later stages of the disease. Side effects - headache, diarrhea, increased blood sugar;
- ritonavir, indinavir, nelfinavir and other antiretrovirals.
The treatment also uses symptomatic agents that eliminate the manifestations of opportunistic infections: antimicrobial, antiviral, antifungal, and antitumor drugs.
The main thing that infectious disease specialists do not get tired of reminding us is that it is necessary to lead the right lifestyle in order to strain as little as possible and strengthen the immune system as much as possible, to which HIV infection has already caused irreparable damage. Healthy sleep, alternation of stress and rest, rejection of bad habits, physical education, proper nutrition, avoidance stressful situations, refusal to stay in the sun for a long time, etc. - an indispensable condition for effective inhibition of HIV infection.
And besides, constant (2-4 times a year) monitoring of the health status of a specialist.
Antiretroviral Therapy for HIV Infection
Medical science tirelessly studies the effectiveness of new drugs that are being improved year by year. Despite promising results, it is not possible to throw a hat on HIV infection, although doctors hoped to defeat it back in the last century. The fact is that viruses are able to persist in immune cells in a latent state for a long time. Without taking antiretrovirals, the infection can flare up again at any time. In other words, the sick person is forced to take the appropriate medicines constantly.
In this case, the treatment reduces the viral load (that is, the number of pathogens in the blood) to a level where transmission of the virus to partners does not occur. In addition, with active antiviral treatment, pathogens do not mutate. However, in some cases, the virus still acquires resistance (resistance) to the drug.
Why is this happening? Partly due to the indiscipline of patients, because in the treatment regimen it may be necessary to follow absolutely exactly. If you make the intervals between taking the medicine too large, or take them not on an empty stomach, but with food, the concentration of the active substance in the blood decreases and the most persistent of the viruses get the opportunity to mutate (modify). So there are strains of HIV that are not amenable to any treatment.
If today it is not possible to completely rid the body of the virus with medication, then scientists are also working on a parallel task - to develop drugs that will be effective for a long time.
Now an HIV-infected person is forced to take pills according to a strictly defined and rigid scheme several times a day and in fairly large quantities. How much more convenient it would be to have a means of prolonged action, so that you can limit yourself to taking the medicine once a day or even a week. This would be a huge breakthrough, and achieving such a result is quite realistic.
Long-term funds are being developed.
Opportunistic infections accompany HIV infection
Opportunistic doctors call such infections, the causative agents of which almost constantly live in the human body. They are opportunistic pathogens. This means that strong immunity keeps the process of their reproduction under control and does not allow the number of microbes to cross the line beyond which the disease occurs.
When immunity is weakened, that is, when the number of cells that destroy an opportunistic infection decreases, this system stops working. Therefore, HIV-positive people are powerless to overcome the simplest diseases, which in ordinary people often go away on their own even without treatment.
Hence the conclusion: it is necessary to carry out preventive measures and timely eliminate the factors that provoke the exacerbation and reproduction of pathogenic microflora.
Thus, the prevention of tuberculosis is mandatory for all HIV-infected people with an annual study (Mantoux test). In case of a negative reaction to the introduction of tuberculin, anti-tuberculosis drugs are prescribed for a year. Prevention of pneumonia is carried out with biseptol and other means, since this disease, when immunity is weakened, often takes a very severe course, gives generalized forms (with the spread of infection from the primary focus throughout the body), fraught with the occurrence of sepsis.
Intestinal infections can last for a very long time, threatening a person with dehydration and numerous complications. Candida fungus, which constantly lives on the mucous membranes of many healthy people, in HIV-infected people causes severe candidiasis not only in the oropharynx, but also in the genitals. In later stages, candidiasis can affect the bronchi and lungs, as well as the digestive tract.
Another type of fungal infection - cryptococci - with the progression of HIV infection causes meningitis - inflammation of the meninges. There is also pulmonary cryptococcosis, which causes hemoptysis.
Herpes infection is extremely painful when the immune system is weakened. Rashes are not only on the lips, but also on the mucous membranes of the genital organs, as well as around the anus. They do not heal for a long time and constantly recur, causing deep skin lesions.
Almost all HIV-infected people at a late stage of the disease have hepatitis B, to which the hepatitis D virus also joins. B-hepatitis does not cause serious complications, but D can cause irreparable harm to the body.
Cryptococcal meningitis
In HIV-infected people, without treatment of the underlying infection, the development of inflammation in the tissues of the brain and meninges may begin. Most often in such cases, cryptococcal meningitis occurs. Cryptococci cause this complication in every tenth AIDS patient.
Cryptococci are not microbes, as you might think, but fungi, the spores of which enter the respiratory tract of a person with an air current, and then enter the central nervous system through the circulatory system. In addition to the brain, cryptococci can cause pathogenic processes in the skin, lungs, liver, and other organs and systems. Foci of inflammation occur only when there are clear signs of immunodeficiency.
Often cryptococcal meningitis makes itself felt with acute fever and headache, much less often symptoms of trouble are observed in the gastrointestinal tract. If an inflammatory focus occurs in the parenchyma (the main functioning tissue) of the brain, the patient may begin to have seizures.
Diagnosis of cryptococcal lesions of the brain is quite difficult. To detect the pathogen in order to determine the causes of the disease, it is sometimes necessary to do a biopsy of inflammatory foci in the brain.
Treat such meningitis with antifungal agents. However, if mental disorders develop against the background of meningitis, the disease becomes protracted, since the infection does not respond well to systemic antimycotic therapy. What is the HIV-dementia complex?
Dementia is a neurological disorder, degradation of the intellectual sphere of the personality, progressive dementia of a person.
How are HIV and dementia related, why are they able to combine into a complex?
Dementia is characterized by many indicators: a person's ability to perceive the outside world weakens, the ability to process incoming information is lost, and the adequacy of response to surrounding circumstances is impaired.
But what about the decrease in immunity? The connection is direct. The fact is that HIV-infected cells secrete a toxin that destroys neurons. They cause irreparable damage to the latter. There is metabolic encephalopathy - a degenerative disease of the brain. A very formidable complication of a viral infection that affects a quarter of people with acquired immunodeficiency syndrome.
Without appropriate treatment with antiretroviral drugs, dementia progresses to such an extent that the person not only begins to experience difficulties in communication, but can also completely lose touch with the outside world. Gradually, but steadily, behavioral changes such as apathy, memory loss, deterioration in concentration, impaired coordination of movements, etc. develop. Mental abnormalities significantly complicate everyday life. Over time, the patient loses most of the skills, often losing the ability to serve himself.
HIV dementia is treated with a combination of antiretroviral drugs, along with antidepressants and antipsychotics.
HIV infection and childbearing
HIV-infected women can give birth to both sick and healthy children. It depends on the viral load, that is, on how much of the pathogen is in the mother's blood. Virus-infected pregnant women are more difficult to tolerate this difficult period in the life of a woman, moreover, they risk losing a child, unable to bear it.
Every fourth woman infected with HIV, even after preventive preparation for childbirth and treatment during pregnancy, is at risk of giving birth to a baby with immunodeficiency. In this case, in 5-10 cases, infection occurs in utero, in 15% of cases - during childbirth. In the future, infection of the child through breastfeeding is possible.
All pregnant women with the immunodeficiency virus have a delivery through surgery (through C-section), and feed the newborn with artificial mixtures. These interventions significantly reduce the risk of infant HIV infection.
When a baby is born to a mother infected with the HIV immunodeficiency virus, it is impossible to immediately say whether he is healthy or also infected. The fact is that the mother passes her own antibodies to HIV with her blood to the newborn. In order to accurately determine whose antibodies it is, mother or child, a sufficiently long time is needed: maternal antibodies disappear from the baby's blood about a year and a half after birth.
Therefore, all children born to HIV-positive women are under the close supervision of pediatricians. When the baby is 15 months old, he is given a detailed blood test. If there are no antibodies to the infection, then the child is healthy.
Immunodeficiency contributes to the appearance of tumors
The immune system largely controls the process of occurrence and development of tumors, both benign and malignant neoplasms (sarcoma, lymphoma, etc.).
When the immune system is weakened, vascular tumors (Kaposi's sarcoma) often appear, which look like purple nodules that rise above the surface of the skin. They appear first on open areas of the body exposed to sunlight, but in the future are able to metastasize to the lungs and digestive tract.
Lymphomas are tumors of the lymph nodes, but can appear in different parts of the spinal cord and brain. The development of lymphomas is accompanied by acute fever, weight loss and epileptic seizures.
Neoplasms in patients at a late stage of development of HIV infection, during the development of immunodeficiency syndrome, are very difficult to treat, therefore they grow rapidly and metastasize rapidly.
How to live an HIV-infected person?
When a person learns of a positive HIV test result, they panic. This is without a doubt a powerful blow to the psyche. And although the doctor will tell you what to eat effective medicines, subject to the rules of admission of which it is quite possible to live the most ordinary life, this information does not relieve depression. It will take a long time until a person understands that life goes on even if there is a destructive virus in the body.
Strict rules of conduct have been developed for all HIV-infected people. First of all, this concerns the strict implementation of the recommendations given by the doctor on medicinal effects.
- You will have to follow a diet to support the work of the liver, which bears an additional load. Water must be thoroughly disinfected. Fruits and vegetables, if they are to be consumed raw, must not only be washed, but also peeled. The greens are washed with boiled water.
- Of course, you must immediately abandon bad habits.
- From now on, all sexual intercourse should take place exclusively with the use of a reliable condom.
- The most careful way to avoid viral diseases, even influenza and common SARS. It is not always possible for people with immunodeficiency to receive preventive vaccinations, in particular, it is forbidden to use live vaccines.
- Communication with animals should be carefully considered: a pet can bring an infection from a walk. In any case, after touching a pet, you should always wash your hands. Think about how to reduce the likelihood of stressful situations.
- Moderate physical exercise positively affect the immune status.
- And of course: regular visits to the doctor from now on become both a necessity and a norm.
Pneumocystis pneumonia is an HIV-associated disease.
Pneumocystis pneumonia is a dangerous disease that occurs in people with acquired immunodeficiency syndrome. This is one of the opportunistic infections, the development of which is characterized by a pathological weakening of the body's defenses. Doctors call such illnesses AIDS indicators.
The most dangerous thing about this type of pneumonia is that it can lead to a generalized infectious process and capture all systems with inflammatory processes.
The causative agent of pneumocystosis in the lungs, unlike pneumonia caused by bacteria, is a microorganism that occupies an intermediate position between fungi and microbes. Researchers call pneumocystis microorganisms of uncertain systematic position.
Pneumocysts with air flow enter the human body, where they live in the status of conditionally pathogenic microflora. The source of the pathogen is a sick person who releases an infectious agent when coughing and sneezing.
In healthy people, their development and overproduction are inhibited by immune cells. But when the immune response is suppressed, pathogens are sharply activated, their number during the incubation period turns from thousands into hundreds of millions and billions, which causes the disease.
The severity of the disease is explained by the fact that even after correct, active and long-term treatment, complete recovery of lung tissue does not occur, since pneumocysts clear the field for colonization by antibiotic-resistant strains of other microorganisms. It has been proven that cysts contribute to an increase in the contamination of the respiratory tract with pathological microflora with an expanded species composition.
In severe forms of immunodeficiency, pneumocystis colonize the bone marrow, heart muscle, kidneys, joints, and many other organs.
More than 90% of cases of pneumocystis pneumonia occur in people in whose blood the number of T-lymphocytes is reduced to a level of 200 per 1 μl. In AIDS patients, the disease at the first stage does not cause any noticeable symptoms, but over time, a long-term increase in temperature appears: 40 degrees and above for several months. A person is tormented by cough and shortness of breath, the symptoms of respiratory failure gradually progress.
Pneumocystis pneumonia is treated with strong antibiotics. newest generation, but in a third of patients it still gives relapses.
HIV-infected women can pass pneumocystosis to the fetus.
To prevent the occurrence of pneumocystis pneumonia in people with immunodeficiency, a drug course is carried out to suppress conditionally pathogenic microflora. However, such measures are effective only while taking the drugs, so AIDS patients carry out such chemoprophylaxis throughout their lives.
AIDS is an advanced stage of HIV infection
When the number of lymphocytes in the blood decreases to a critical level, an advanced stage of HIV infection occurs - acquired immunodeficiency syndrome (AIDS). At this stage, a person can die from any infection caused by opportunistic pathogens.
There are two stages of AIDS, which are characterized by weight loss. If a! a person loses weight by 10% against the initial weight, this is the first stage, if more - the second.
At the first stage, a person constantly has skin and mucous membrane lesions with a fungal infection, shingles, pharyngitis, otitis media, sinusitis replace each other or develop all together, the gums bleed, the body is covered with a hemorrhagic rash.
In the second stage, many more serious ones join the existing symptoms. infectious diseases. These are tuberculosis, toxoplasmosis, pneumonia and others. In addition, there are neurological disorders.
If pneumonia is very severe...
In severe cases of acute pneumonia, adequate treatment of the patient can be carried out only in a hospital. Here, if necessary, he will be detoxified, for example, with gemodez or rheopolyglucin, and drugs will be prescribed to help normalize the condition.
With concomitant diseases and corresponding symptoms, cardiac, diuretic, painkillers, tranquilizers may be needed. It is easier to carry out oxygen therapy in a hospital.
If a patient develops complications, they are transferred to the intensive care unit.
In some cases, the inflammatory process in the lungs can be joined by cardiovascular insufficiency, disorders of the blood coagulation system, renal and hepatic insufficiency, acute respiratory failure, which require enhanced medical care using special equipment.
Due to the fact that in patients with acute pneumonia vitamin deficiency occurs, which is aggravated by antibiotic therapy, patients need vitamins C, A, P and group B. Most often in these cases they are injected, and not orally.
With the normalization of body temperature and the disappearance of symptoms of intoxication, the patient with pneumonia is changed in the antibiotic therapy regimen, and in the regimen recovery period introduce physical therapy and physiotherapy. Diathermy (heating with high frequency currents), inductothermy (exposure to a high frequency magnetic field), microwave therapy (microwave treatment) and UHF therapy (Ultra high frequency currents are used) are used.
Chest massage is almost always prescribed. In order to prevent pneumosclerosis, electrophoresis with drugs is performed.
Short question - short answer
Why is it necessary to take such a huge amount of pills?
Monotherapy for HIV infection quickly ceases to bring results, since the virus mutates and does not respond to ongoing treatment. Only a combined treatment regimen that simultaneously includes 3 antiretroviral drugs is sufficiently effective. It reduces the progression of HIV infection by 80%.
The doctor thinks that I need to take medication to maintain hepatocytes. Is this additional load good for the body?
People diagnosed with HIV infection should take special care of their liver health. And the point is not only that it is in this organ that important substances are synthesized that help strengthen the immune system, but also because it decomposes and removes drugs that patients are forced to take for life. Unfortunately, these drugs have strong side effects, toxic effect on hepatocytes and contribute to their destruction. Liver health is usually supported not by drugs, but by BDD, herbal complexes.
How much does the number of leukocytes in the blood decrease with the progression of immunodeficiency?
In healthy people, there are 600 to 1500 special immune cells (T-lymphocytes) in every cubic microliter of blood. Without treatment at different stages of HIV infection, their number gradually decreases. When this figure drops to 200 T-lymphocytes per 1 cubic microliter of blood, doctors diagnose acquired immunodeficiency syndrome. People with severe immunodeficiency are at high risk of developing serious diseases against which the usual treatment regimens are powerless.
The doctor says that I have lowered immunity. It that - a HIV?
Probably not. Many conditions can significantly reduce the level of immunity in adults. Among the causes are exhaustion and radiation exposure, toxic poisoning and metabolic disorders, and many chronic diseases. But only viral infection with the causative agent of human immunodeficiency is a diagnosis of HIV and, without treatment, leads to AIDS.
Why does the doctor change my immunodeficiency medications so often?
HIV infection is treated with three types of drugs that affect the replication of the virus in different ways, in particular, they block the enzymes necessary for the reproduction of the pathogen. However, viruses quickly get used to a particular drug. Literally after six months of treatment with one drug, they create new strains, which is why the remedy ceases to be effective and needs to be replaced.
In the blood, antibodies to the HIV virus were found. What does this mean and could it be a bug?
The detection of antibodies to the immunodeficiency virus in human blood indicates that the immune system is familiar with these pathogens, it has been introduced into the body. The infection may not make itself felt by obvious signs, it may doze off in immune cells. False-positive test results can occur in a person with an oncological or autoimmune disease.
How can you suspect HIV infection in yourself?
There are no strictly specific symptoms for HIV, so even official diagnosis cannot be based on external signs, not to mention self-diagnosis. Data on the presence of the HIV virus are based solely on laboratory tests and modern methods research. You should not look for non-existent symptoms on your own, you just need to donate blood for HIV. Timely detection of the virus is a guarantee that, with proper treatment, the infection will not develop into AIDS.
Hepatitis due to HIV infection
Against the background of a decrease in immunity, chronic hepatitis often occurs. Inflammatory process in the liver is characterized by extensive damage to hepatocytes.
Most often, the disease is caused by viruses of type D, C, and also herpes. Contribute to the development of this type of disease and some drugs used to treat immunodeficiency.
The essence of the pathological process is reduced to a violation of the body's immunoregulation, which is often manifested by the presence of pronounced systemic (extrahepatic) lesions.
The disease takes a protracted course, and the inflammation does not stop even several months after the start of treatment.
Immunodeficiency causes the era of candidiasis to flourish
Candidiasis is caused by fungi of the genus Candida. These are unicellular yeast-like plants that live in the soil, on vegetables and fruits, can settle on human skin, in the epithelial cells of the mucous membranes of the oral cavity and genitals.
This circumstance explains both frequent relapses, and the multiplicity of pathogenic foci, and chronic course candidiasis.
If, with candidiasis, the oral mucosa becomes bright red, it is covered with whitish films, the doctor diagnoses candidal stomatitis. When a tongue is affected by a fungus, it is candidal glossitis, and well-known seizures are candidiasis of the corners of the mouth. Female thrush, in which curdled white discharge is found on the genital mucosa, is also a manifestation of a decrease in immunity.
Rashes, which are localized on the whole body and limbs, have various forms, more often it is lichen, eczema, erythema, seborrhea, urticaria, etc. vascular system. Chronic stress, mental strain, beriberi, uncontrolled antibiotic treatment, etc. contribute to the appearance of such undesirable consequences.
A typical symptom of this disease is itching and burning sensation, which are sometimes felt even in 8 places where the skin has no external damage.
Treatment of extensive processes on the skin is carried out with antifungal agents (diflucan, nizoral, etc.), with a local focus, external agents are sometimes sufficient - lubrication with alcohol solutions with further application of antifungal ointment (nystatin, levorin, travogen, pimafucin, mycosolone, travocort etc.). But when the process is chronicized, external means alone cannot be dispensed with; complex antimycotic therapy is necessary. Chronic candidiasis is treated with antibiotics and antimycotics, combining these drugs with immunostimulating therapy.
Systemic remedies for candidiasis are prescribed strictly according to indications, because their use is associated with the risk of side effects. They are quite toxic to the body, and their intake is carried out for a long time, for many months. Therefore, the doctor before prescribing a medicine weighs the benefits and harms in order to minimize the risk.
Especially when prescribing mycotics, concomitant diseases of the liver and kidneys, previously detected drug allergies, should alert.
Systemic antimycotic therapy is not prescribed for pregnant and lactating mothers.
Chronic candidiasis of smooth skin and mucous membranes is caused not only by reduced immunity, but also by an allergic predisposition to candida.
Shingles - a consequence of a decrease in immunity
Shingles is caused by a type of herpes virus (the varicella-zoster virus), the same type that is manifested by the well-known fever on the lips. But if on the lips the bubbles, and then the crusts occupy only a few square millimeters, then on the smooth skin of the body, herpes causes much more extensive lesions and much more severe pain. This is a very common phenomenon that develops as a complication in the development of immunodeficiency.
Reactivation of the herpes virus is characterized by the appearance of ribbon red vesicles and spots on the skin, localized along the location of the nerve trunks, more often intercostal on one side of the body, but any part of the body can be affected. The fact is that this viral pathology is associated with the autonomic nervous system - the pathogen is localized in the nerve nodes. The bubbles soon burst, and crusts appear in this place.
Mostly adults are ill in case of a decrease in their body's defenses. At the same time, the rashes stay on the skin for a long time, are widespread and bright, go deep into the epidermis, severely affect the subcutaneous layer, which indicates the beginning of a difficult process. This pathology is resolved with the formation of scars and is characterized by frequent relapses.
Pain in shingles can be both weak and strong. Sometimes a real burning sensation occurs even before the appearance of rashes, it is especially tormenting at night or under the influence of any irritants - cold, light, touch, etc. Among other characteristic symptoms is a headache, which worsens when the position of the head changes. Also, the disease is often accompanied by nausea, vomiting, loss of appetite, general weakness, which indicates a general intoxication of the body.
Due to the fact that nerve cells suffer from this type of disease, the skin loses sensitivity along the course of the lesion. With severe herpetic toxicosis, hospitalization of the patient is most often required, where individual antiviral therapy is selected, since against the background of a sharp decrease in immunity, not all antiherpes drugs can be used. Herpes associated with HIV infection gives long-term pain, which is difficult and briefly relieved by painkillers.
In complex therapy, drugs are used to normalize the activity of the nervous system, in particular sedatives. With cerebral disorders, medications are prescribed that correct the work of the central nervous system. A good effect also gives the use of ultraviolet radiation, the use of high-frequency currents, barotherapy and other methods of physiotherapy.
Hygiene plays a special role in the treatment process: the skin must be dry and clean. To sweat less, do not wear synthetic underwear, tight clothing. It is undesirable to use ointments and creams containing antibiotics, as they can cause irritation.