What is HIV/AIDS?
HIV, or human immunodeficiency virus, is a virus that specifically targets and infects the cells of the human immune system, impairing their function and leading to a progressive depletion of the immune system, resulting in immunodeficiency. This condition makes individuals more likely to develop a variety of opportunistic infections and cancers, which are typically rare in those with a healthy immune system.
AIDS, or acquired immunodeficiency syndrome, represents the most advanced stage of HIV infection. It encompasses a collection of symptoms and infections that arise due to a significant deficiency in the immune system. The level of immunodeficiency or the emergence of specific infections serves as indicators that HIV has progressed to AIDS. Most individuals living with untreated HIV will develop signs of AIDS within approximately 8 to 10 years.
According to the World Health Organization (WHO), it is estimated that by the end of 2023, around 9.9 million people globally will be living with HIV, with 65% residing in the WHO African Region. In 2023 alone, WHO recorded 1.3 million new cases, while approximately 630,000 individuals lost their lives due to HIV-related causes.
In Nigeria, the first case of AIDS was reported in 1986, and currently, the prevalence of HIV among individuals aged 15 to 64 stands at 1.4%. As at January 2024, Nigeria had 5,087 newly diagnosed HIV-positive cases amongst 15 years+ individuals (National HIV Surveillance Report,2024)
Staging of HIV
***Please note that the staging is different for adults and children
HIV and AIDS are clinically categorized into four stages for adults and adolescents aged 15 and above:
In adults, are three stages of the disease, categorized by the signs and symptoms experienced and the degree of immune system depletion:
1) Acute infection: This stage is seen 2-4 weeks after initial exposure to HIV. Flu-like symptoms like headache, fever, sore throat may be seen. Also, one can transmit the virus to others at this stage.
2) Chronic infection: Here the virus replicates at a slower pace and gradually damages the immune system. It is usually asymptomatic and may continue for several years.
3) Acquired ImmunoDeficiency Syndrome (AIDS): This is the most advanced stage where opportunistic infections and even cancer can arise because the immune system is severely damaged. Infections here include tuberculosis, pneumonia etc.
In children however, there are four stages of the disease:
Stage 1: Asymptomatic Phase
In this stage, individuals infected with HIV typically do not show any symptoms of the virus. However, some may experience persistent swelling of lymph nodes throughout the body.
This stage is crucial as individuals can transmit the virus to others without showing any symptoms.
Stage 2: Symptomatic Phase
In Stage 2, individuals begin to exhibit unexplained weight loss of less than 10% of total body weight, recurrent respiratory infections and a variety of dermatological issues and fungal nail infections.
Stage 3: Advanced HIV Disease
As the disease progresses to Stage 3, more severe clinical manifestations become apparent. These may include significant weight loss of greater than 10% of total body weight, uncommon, persistent or recurrent bacterial, viral, fungal or parasitic infections, some rare cancers like lymphomas, gastrointestinal issues, developmental delays and neurological symptoms such as seizures.
Stage 4: Acquired Immune Deficiency Syndrome
This stage is characterized by the manifestation of a number of illnesses called AIDS-defining illnesses, which are specific conditions, listed by the Centers for Disease Control and Prevention (CDC), that are associated with a high risk of mortality in people living with HIV/AIDS. These illnesses indicate that the HIV infection has progressed to AIDS, which is the most advanced stage of HIV infection.
These include, but are not limited to pneumonia, tuberculosis, candidiasis (thrush), toxoplasmosis etc.
To find a list of all the conditions present in stage 3, and the AIDS-defining illnesses, go to cdc.gov
This list may not be exhaustive as the CDC may update the definition of AIDS-defining illnesses as medical knowledge evolves.
Transmission
HIV can be found in body fluids, such as blood, semen, vaginal fluids, and breast milk, and can be transmitted through:
Penetrative unprotected sexual intercourse
Mother to infant transmission
Blood transfusion
Needle stick injuries and sharing of sharp objects (for injecting drug users- IDU)
Medical procedures that involve non-sterile cutting or piercing
Intravenous drug users
Childbirth and breastfeeding
It is noted that people cannot become infected with HIV through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food, or water.
Prevention
HIV can be prevented by:
Consistent and correct use of male or female condoms
Pre-exposure prophylaxis taken by people who are not infected with HIV
Having a voluntary medical male circumcision
Harm reduction services for people who inject and use drugs
Being tested for HIV and sexually transmitted infections regularly
HIV Testing
An HIV test reveals whether a person has been infected with HIV. These tests usually detect the antibodies produced by the immune system in response to HIV, known as the HIV antibody test. It typically takes about a month for these antibodies to develop in most individuals, and they can be found in blood or saliva.
Although HIV antibody tests are very sensitive, there is a window period of about two months, depending on the specific test being used. The window period is the time between infection with HIV and the appearance of detectable antibodies to the virus. The most sensitive anti-HIV tests have window periods of about three weeks, while less-sensitive tests may have longer periods. Therefore, the more sensitive tests are recommended.
During the window period, individuals infected with HIV may have no detectable antibodies in their blood, even though they could have high levels of HIV in their body fluids. Consequently, HIV can be transmitted to another person during this window period, even if an HIV test shows a negative result.
For these reasons, regular HIV testing is encouraged. The earlier you discover your HIV status, the better it is for you and those around you, as you can promptly begin the necessary treatment and protect others from getting infected.
Where can you get tested?
HIV testing can be done in the offices of private doctors, hospitals, local clinics, and specific HIV testing sites. You can also take an HIV test in privacy using an HIV self-test kit.
A positive HIV test result is not a death sentence. Thanks to new treatments, people living with HIV can now lead long, healthy lives. However, it is very important to seek counseling from a trained professional or doctor experienced in the treatment of HIV.
Treatment
HIV has no cure; however, there is effective treatment that, if taken promptly, properly, and regularly, can improve the length and quality of life for individuals. This treatment is generally referred to as Antiretroviral Therapy (ART), and these drugs act through different mechanisms to effectively block the reproduction or replication of HIV in the body.
The importance of multi-drug or combination therapy must be emphasized, as these are used to counteract the rapid mutation rate of HIV. This approach increases antiviral activity, reduces drug dosage and the associated risk of toxicity, and minimizes the development of drug resistance. Therefore, single agents are seldom used to treat HIV infection. The term Highly Active Antiretroviral Therapy (HAART) is often used to describe this combination therapy.
Conclusion
Information is power and so the purpose of the information above, is to empower you to take responsibility for your safety. Getting tested is the very next recommended action if you got to this point in this article; it is the only way to know if you have HIV. Remember that people can live long, healthy lives if appropriate steps are taken. Today is a great day to take the first step!