AIDS Symptoms, Diagnosis and Treatment
What is AIDS :
AIDS (acquired immunodeficiency syndrome) is the final stage of the infection by the human immunodeficiency virus (HIV). HIV infection is usually three stages: primary infection or acute infection, asymptomatic stage and advanced disease or AIDS.
HIV is a virus of the family of retroviruses, and there are two types described the HIV-I (most frequent) and HIV-II (originally described only in Africa).Acute infection usually does not kill the infected, but the virus remains in the body and becomes a chronic infection that can go unnoticed for many years, until the individual’s immune system is altered and complications appear.
How does it occur ?
The first step is contagion. The infection is transmitted among humans, in different ways:
- As a sexually transmitted disease through sex. It is the main route of transmission and can present in both heterosexual and homosexual relationships.
- Transmission by blood and derivatives:
- Blood transfusions and contaminated tissue transplants: When the disease appeared in the 80s and was not known until the virus could be detected in blood, was the most important route of infection (particularly in patients with hemophilia). With the current legislation and precautions, and not a common route of infection in developed countries.
- Addicted to intravenous drugs: was the main cause of infection during the 80′s in our country.
- Prick casual with contaminated material: extremely rare but not impossible. It can occur in health care workers.
- Maternal-fetal and infant: HIV can be transmitted from an infected woman to her fetus during pregnancy, at birth and during lactation. This mode of transmission is, along with the sexual, especially important in developing countries.
Once the virus has infected a person be spreading throughout the body. The virus has special appetite for cells expressing the CD4 molecule on their surface, especially CD4 + T lymphocytes of the immune system.
The feature that sets the advanced infection by HIV is the intense immunodeficiency caused when the number of CD4 + T cells drops below certain limits. In this situation appear opportunistic infections and some tumor types that define AIDS.
Symptoms of AIDS
HIV primary infection is usually asymptomatic (no symptoms) but can also lead to a fever, malaise, fatigue, lymphadenopathy and mild hepatitis.
In the asymptomatic phase of infection, the infected person has no symptoms but the infection is present and the virus is depleting the immune system. This phase can last from months to several years.
In the advanced stage of the disease or AIDS: the person has the symptoms of opportunistic infections or other diseases directly caused by the virus that define it. The symptoms of these infections are dependent on location and the microorganism that cause and are highly variable.
Different opportunistic infections that define AIDS are, among others:
- Or disseminated pulmonary tuberculosis
- Mucosal candidiasis (oral, esophageal, genital) or disseminated.
- Meningitis by parasites (Cryptococcus)
- Diarrheal gut infection by Cryptosporidium
- Eye infections like Cytomegalovirus keratitis.
- Brain infections such as cerebral toxoplasmosis.
- There are some types of tumors that are characteristic of AIDS such as Kaposi sarcoma or cerebral lymphoma.
Diagnosis of AIDS
The diagnosis of HIV infection is by analysis of blood. In analyzes of blood serology looks, i.e. the presence of antibodies against HIV. When positive means the person is infected with human immunodeficiency virus.Always be confirmed by a second test.
If it is suspected that the infection is recent and serology is negative, can be determined in the blood virus antigen (p24), which will be positive in most cases. This time period with a negative serology but positive HIV antigen, called window period, indicating recent infection (first 3 weeks).
Once diagnosed HIV infection, it is always advisable to know the immune status of the patient through a blood test and viral load, or amount of virus in the blood.
The diagnosis of AIDS is made when you have a confirmed positive serology and from opportunistic infections or AIDS defining tumors.
Treatment of AIDS
The treatment of AIDS and HIV infection is very complex as the disease itself includes a wide range of situations.
To summarize it is noted that one side is the treatment of human immunodeficiency virus, and secondly treating the complications of the disease gives ie intercurrent opportunistic infections and tumors.
Opportunistic infections are treated with specific drugs for each. The tumors are treated with appropriate cancer treatments.
The treatment is performed virus called antiretroviral drugs. Different retroviral groups, depending on the performance level of virus: reverse transcriptase inhibitors, protease inhibitors, inhibitors of the entry and integrase inhibitors.
In recent years, the treatment of HIV infection focuses on maintaining the most inactive virus possible, and this is measured by viral load and levels of CD4 + T cells in blood. This has been achieved thanks to the combination therapy or high-intensity antiretroviral therapy (HAART or highly active antiretroviral therapy). With these treatments HIV infection has become a chronic infection in developed countries. Treatment must be individualized and prescribed by doctors specializing in HIV. When the patient starts taking antiretroviral drugs, will have to follow your doctor’s instructions about any changes in treatment because these drugs can have significant toxicity and human immunodeficiency virus may develop resistance.
The two options for the initial treatment used today are two different treatment regimens with three drugs.
AIDS Precautions
For now there is no vaccine against HIV marketed, but is under active investigation.
The condom has been shown to significantly reduce the risk of infection during sex with intercourse, both heterosexual and homosexual, though not 100% especially if not used properly, or breaks.
The kisses are considered safe, although there is a “theoretical” possibility of transmission through saliva (the concentration of virus in the saliva of infected people is very low and also saliva has enzymes that inactivate some viruses).
In drug addicts injecting must avoid sharing syringes and other utensils.
The maternal-fetal transmission of HIV can be controlled with the administration of antiretroviral drugs during pregnancy, at birth and during lactation. In developed countries, thanks to birth control and these treatments, maternal-fetal transmission is relatively rare. In developing countries, it has been shown that administration of doses of antiretrovirals at the time of delivery and then also decrease the incidence of infection in infants, so it is vital that the management of pregnancy and childbirth assisted in these countries, to control HIV infection overall.
Worth
The research in the treatment of HIV is very active internationally, and usually involved both governments and universities and, of course, the pharmaceutical industry. Numerous clinical trials for new drugs or new combinations of drugs under study.
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