What is HIV/AIDS?
Acquired Immunodeficiency Syndrome (AIDS) is a condition that destroys the body’s immune defense system. It is caused by infection with the human immunodeficiency virus (HIV). After HIV invades the body it lives in the white blood cells, which are the cells that protect the body from disease.
What is the difference between HIV and AIDS?
HIV is a virus that attacks the immune system, which protects the body from germs and illness. Once a person contracts HIV, the immune system is weakened. When someone with HIV gets certain types of infections or when his or her CD4 cells are below 200, they are diagnosed with AIDS (Acquired Immunodeficiency Syndrome). For some, it takes a long time for AIDS to develop, for others it develops quickly.
How does someone contract HIV?
People become infected with HIV through specific bodily fluids: blood and semen. These fluids can be passed between two people in a variety of ways, including having sex and/or sharing needles. People do not get HIV by hugging, shaking hands or eating with someone who has HIV. In addition, an HIV positive woman may pass the virus to her unborn child.
What medical treatments are there for HIV disease?
There is no cure for AIDS, however, with new medications and protease inhibitors available, people diagnosed as being HIV+ are living longer. In the early years of the epidemic many died within two years.
Why is it important to test for HIV?
If you test negative, take precautions to keep yourself healthy. If you test positive, immediately seek the treatment and support you will need. Also, tell anyone who was exposed to your blood, semen or vaginal fluid, including sexual partners or needle sharing partners. If you do not feel you can tell them, have your physician, case manager, or trusted friend/family member inform these partners.
What will happen when someone is first diagnosed with HIV?
A doctor will do a complete physical examination, ask several questions and collect some blood for tests. These first meetings with the doctor are very important because they establish open communication. Many questions seem very personal but are extremely important to treatment.
What is a CD4 or T-cell count, and why is it important?
Our immune system contains different types of cells that work together to fight infections. CD4 cells are one type of immune cells. CD4 cells are often called T-cells. CD4 cells, a.k.a. T-cells, are the “captains” of the immune system team; they help the other cells do their jobs. After HIV enters the body, it begins turning CD4 cells into small “factories” that make more HIV. Each CD4 cell makes thousands of new copies of the virus. This process eventually exhausts the CD4 cell. At first, the body is able to make more CD4 cells to replace those lost due to HIV. Over time, fewer CD4 cells are produced, and the body is less able to fight germs and infection. A CD4 count is a test that tells you how many CD4 cells are in the blood. A higher count means a stronger immune system. Usually doctors measure CD4 counts when a patient is first diagnosed and then every three to six months. Most people have about 700 to 1,000 CD4 cells, but a count of at least 500 is considered “normal.” If CD4 cells drop below 200, a person is diagnosed with AIDS and begins prophylaxis treatment to prevent certain kinds of infections.
What is viral load, and why is it important?
Viral load is a measure of HIV in the blood. It is also called HIV RNA. The amount of HIV, or viral load, is important. People with higher viral loads tend to progress to AIDS sooner than those with lower viral loads. Viral loads are measured with a blood test. A patient will have their first viral load test when diagnosed with HIV, followed by a test every three months, when medicines are changed or HIV/AIDS symptoms occur. A viral load measure helps the doctor determine if the patient’s medicines are working. A patient’s treatment goal is to suppress the viral load to an undetectable level and keep it there.
If a patient’s viral load is undetectable, is the practice of safe sex necessary?
YES! There is no cure for HIV/AIDS. If unsafe sex is practiced, others can be infected, and you can be re-infected with a different and perhaps harder to treat type of HIV
How can HIV medicines help? HIV medicines, also referred to as combination therapy, ARV (antiretroviral) medicine or HAART (highly active antiretroviral therapy), interferes with new copies of HIV as it reproduces. In stopping the reproduction, CD4 cell counts are maintained at a higher level and viral load counts are kept down. This can prevent other infections common with AIDS and can help the patient live longer.
When should a patient start treatment for HIV?
Experts agree that people who have infections or symptoms should start treatment, but many people with HIV infection do not have symptoms. For these people, it can be difficult to know the correct time to begin treatment. Some experts think a patient should begin treating with a strong combination early in the infection; other experts think it may be okay for patients who are not experiencing symptoms to wait until they manifest before starting treatment. Any patient should know that once HIV treatments begin, it is very important to take them as prescribed by the doctor. If HIV medicines are not taken properly, resistance can develop.
Why must a patient take several HIV medicines at one time?
When the decision to treat HIV has been made, many experts strongly recommend taking a combination of HIV medicines. At least three medicines are needed to decrease the viral load to undetectable levels and keep it there. HIV multiplies very quickly, making one to ten billion new copies of the virus in a day. The new HIV copies are different from the original but usually similar enough for the medicines to work. Every once in a while, the copies are different enough to make the medicine less and less effective. This is called resistance. With combination therapy, the chances of developing resistance are smaller.
Does it matter if a patient misses a dose of medicine?
Yes. When a patient has less medicine in the blood supply, HIV can multiply. This increases the chance that the combination therapy will not work as well, and the patient may develop resistance. Therefore, it is very important for a patient to take the medicine as directed. When a patient begins HIV treatment, it is critical to have an open discussion with the doctor to ensure a combination that works best for the individual.
What should a patient do if a dose is missed?
If a patient misses a dose of medicines, the missed pills should be taken as soon as possible. If a patient does not realize that a dose has been missed until the next dose is due, twice the normal dosage Should Not be taken. Instead, the patient should “get back on schedule” with the next dose.
What does it mean for a patient’s treatment to fail? It means the patient’s combination of medicines is not working well enough to fight HIV. There are many causes for treatments to fail. Perhaps, the combination does not include the correct medicines, or the virus may have changed due to resistance, so the medicines are no longer effective. It is not unusual to change combination therapy over time.
When will the combination of medicines change?
There are several reasons a doctor may decide a change is necessary. For example, if a patient is experiencing difficult side effects, changing one or more medicines may make the combination easier to take. Most importantly, a patient must always talk with the doctor prior to changing any part of the HIV therapy.
What should a patient do if she is pregnant or thinks she may be pregnant?
The patient should talk to a doctor immediately. There are medicines that can reduce the risk of passing HIV infection to the unborn child. Unfortunately, most HIV medicines have not been studied to determine if they are safe for unborn babies. It is most important for the patient to discuss the risks and benefits of taking HIV medicines during pregnancy.