How HIV turns into AIDS. Will HIV definitely turn into AIDS?

HIV infection and AIDS.

Instructions

Individually selected antiviral therapy, which suppresses the activity of the infection, helps to significantly slow down the development of HIV. With proper treatment, the patient remains highly likely to live for decades. Refusal to take specialized medications significantly shortens the patient’s life and subsequently becomes the cause of the development of AIDS.

The acute infectious stage of the disease usually begins within 1-4 weeks after the virus enters the body. Infection is characterized by symptoms that are similar to those of the flu. Patients usually experience fever, fatigue, muscle and joint pain, and headaches. The intensity of the manifestations depends on the individual characteristics of the organism and depends on the state of the person’s immunity. During this period, the virus actively reproduces. The existing symptoms usually disappear after 2-4 weeks and the disease moves to the next stage of development.

The stage of clinical latency (asymptomatic HIV infection) is characterized by the absence of symptoms. At the same time, the virus continues to multiply, but does so with a lesser degree of intensity. This stage is the longest and can last several decades in patients who take antiviral drugs. Without appropriate treatment, the stage lasts on average about 10 years. It is worth noting that even in the absence of any manifestations, HIV can be transmitted from person to person.

AIDS is the third and irreversible stage of the disease with a fatal outcome. By the time this stage begins, the immune system becomes almost completely destroyed due to the activity of the virus. The body becomes vulnerable to various ailments called opportunistic infections. It is they who subsequently become lethal for the patient. During the period of AIDS, the risk of cancer increases significantly. Common diseases include tuberculosis, meningitis, pneumonia, herpes zoster, toxoplasmosis and cytomegalovirus. The life expectancy of a patient at this stage is 3 years, but the likelihood of living this amount of time drops significantly when infected with an opportunistic infection, which shortens this period to 1 year, several months or even weeks.

HIV and AIDS - what is it?

HIV infection is an incurable infectious disease caused by the human immunodeficiency virus (HIV).

AIDS (acquired immunodeficiency syndrome) is the last stage of HIV infection, which develops on average 10-12 years after infection and is accompanied by destruction of the immune system.

What happens when you become infected with HIV?

Immediately after contracting HIV, most people do not feel anything unusual. However, the virus hidden in the body begins to multiply and slowly, imperceptibly destroy the human immune system.

Are there any symptoms of HIV infection?

The virus can remain in the body for several years before symptoms appear. A third of those infected may develop a condition similar to an acute respiratory infection or flu within a few weeks; doctors call it “acute HIV infection.” As a rule, no one associates this with HIV infection. In this case, the person’s temperature rises, he feels weakness, headache, and sore throat. Sometimes there is diarrhea (diarrhea) or a rash. This condition usually lasts a couple of weeks, after which it goes away. The most unpleasant thing is that during this initial period, even testing for HIV can give an incorrect result, because the body has not yet developed antibodies to the virus.

A person can look and feel completely healthy for a long time and still transmit the virus to others. This is the danger of HIV infection.

Symptoms of HIV infection always appear in an infected person at the AIDS stage. Against the background of immunodeficiency, a person develops secondary diseases such as tuberculosis, pneumonia, tumors and other diseases.

How does HIV turn into AIDS?

HIV attacks various cells of the body, primarily cells of the immune system (CD4 lymphocytes), causing their death. Over time, lymphocytes lose their ability to produce antibodies and fight infections. Human immunity declines. Gradually, HIV infection enters its final stage, and the person is diagnosed with AIDS.

A weakened body becomes susceptible to diseases that the immune system of a healthy person can usually cope with. When the body's resistance is completely lost, the disease becomes so severe that the person dies.

How is HIV transmitted?

• Through blood - most often through drug use, but can also be transmitted through the use of unsterile medical instruments, transfusion of blood components, tattooing, piercing with a contaminated instrument, and the use of someone else's razor and manicure equipment.
• When having sex without a condom. Even a single contact can lead to infection.
• From mother to child - during pregnancy, childbirth and breastfeeding.

1. How is it not transmitted?

   • With generally accepted forms of greetings (handshakes, friendly kisses, hugs).
   • When using shared personal items, household items, toys, bedding, toilet, bathtub, shower, swimming pool, cutlery and dishes, drinking fountains, sports equipment (saliva, sweat, tears, urine are not dangerous for infection if they do not contain visible blood).
   • For insect bites.
   • By airborne droplets (coughing and sneezing).
   • HIV is not transmitted through saliva through kissing either!

   

   Can an HIV test give an incorrect result?

   Unfortunately yes. In the first 3 months after HIV infection, HIV testing may give incorrect results. For some people with special immune system conditions, this period can even increase to 6 months. This happens because the body has not yet developed antibodies to the virus, which the test detects. Doctors call this period the “seronegative window.” Therefore, you should not run for examination the next morning after a dangerous contact, it will still not show the correct result - you will have to wait at least 1-3 months. It’s better to save nerve cells and not take risks!

   How many people have become infected with HIV in the world?

   According to UN estimates, the number of people living with HIV infection by the end of 2014 was 36.9 million. During the existence of HIV infection (since 1981), about 34 million people have died from the disease in the world - that is, almost half of the 70 million who became infected with HIV. This characterizes the disease as the most destructive epidemic in human history and explains the scale of measures taken.

   There were 5,600 new HIV infections every day in 2014, and during the year, 2 million people became infected with HIV and 1.2 million people died from AIDS-related illnesses.

   Currently, the majority of patients in the world still do not receive treatment, and about half do not even know about their diagnosis because they have not been tested for HIV.

   How many sick people are there in Russia?

   In Russia, the HIV epidemic began much later than in America and Europe, and continues to grow. In 2015, 824,706 people in Russia were living with HIV infection.

   Over the entire period of the epidemic in the country (from 1987 to 2015), 237,790 people infected with HIV died. Of course, we were not able to identify all patients, since not everyone is tested for HIV, and in reality there are even more of them.

   In recent years in Russia, the number of new cases of HIV infection has increased by 10-12% per year, and mortality due to the disease has also increased. In 2015, 100,220 Russians were first identified - every 5 minutes in the country, 1 person became infected with HIV.

   Who is most at risk of contracting HIV in Russia?

   Of course, people who are most at risk of contracting HIV are those who engage in HIV-risk behaviors: drug users, women who provide sexual services for compensation, and men who have sex with men. In all of these groups in Russia, more than 5% are already infected with HIV, and among drug users - 20%. It’s better not to have any dangerous contacts with them at all.

   If we talk about the population as a whole, in the country the most infected people are among men aged 30-39 years, among them 2.3% lived with an established diagnosis of HIV infection. Young women are now at great risk of becoming infected from these men. Quite often in recent years, women become infected from their only sexual partners - their husbands.

   The most unfavorable situation regarding HIV infection in the country has developed in the Urals and Siberia: in the Irkutsk, Sverdlovsk, Kemerovo, Samara, Orenburg, Leningrad, Tyumen regions and the Khanty-Mansi Autonomous Okrug.

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The human immunodeficiency virus has several stages from the moment of infection to the death of a person. Such stages have changed several times, but today it is customary to use a classification of the stages of HIV infections, divided into: We recommend that you familiarize yourself with HOW MUCH ARE THEY LIVING WITH HIV?

Stage 1 of HIV: Incubation stage. This is the period when a sick person, or rather an infected person, does not know or suspect that he is sick with HIV infection, and even the test does not give a positive result.

Stage 2 HIV: Stage of primary manifestations of HIV. This stage is divided into several phases, which are designated by letters. A – phase of acute fever, B – phase in which there are no symptoms, C – persistent generalized lymphadenopathy

Stage 4 of HIV: Thermal stage: This is exactly the stage when HIV infection goes into the AIDS stage, that is, this is the most extreme stage at which a person’s life expectancy can range from several months to three years.

MORE DETAILS ABOUT HOW HIV DISEASE PROMOTES

From the moment of infection to the moment when the analysis can show a positive result, with good immunity the time passes from 2 weeks to 1 year, and with bad immunity from two weeks to 6 months. This period is called the "Window Period" or "Incubation Period".

ACUTE PHASE: During this period, many people infected with HIV notice clinical manifestations, such as respiratory diseases, enlarged lymph nodes, stomatitis, urticaria, diarrhea, headache, etc. For more information, see here: SYMPTOMS OF HIV INFECTION. It is in this phase that the virus reaches huge quantities in the human body, and it is in this stage that the risk of infecting a partner is greatest, just as it is greatest in the AIDS stage.

LATENT PERIOD: After the end of the acute phase of HIV, a period begins when the amount of the HIV virus in the human body drops and equilibrium occurs when the immune system begins to contain the spread of the virus, but not completely. This stage of HIV can last 8-10 years or more with the use of antiviral therapy.

Pre-AIDS: This is the stage when the destruction of the human immune system by the virus and its active reproduction begins to intensify. At this stage, the immune system is so depressed that long-term and untreatable diseases appear, such as stomatitis, leukoplakia of the tongue, candidiasis of the mouth and genital organs, etc. The duration of the HIV PreAIDS stage is approximately 1-2 years.

AIDS: This is the final stage of HIV infection, in which the immune system is suppressed to such an extent that the human body completely loses the ability to fight various diseases. The duration of the stage is a maximum of three years; in the absence of treatment, the average life expectancy in this stage of HIV is less than one year. During this stage, oncological diseases, tuberculosis, salmonellosis, encephalitis, meningitis, herpes, influenza, etc. appear. We recommend that you read: WHAT IS THE DIFFERENCE between HIV and AIDS?

What are AIDS and HIV?

AIDS – Acquired Immunodeficiency Syndrome. A syndrome is a collection of certain signs of a disease - symptoms. AIDS develops in people infected with HIV and is the final stage of the disease.

HIV – Human Immunodeficiency Virus. It affects various cells of the human body, but primarily the cells of the immune system - T-lymphocytes (CD-4). People infected with HIV are called "HIV-infected".

An HIV-infected person and an AIDS patient are not the same thing. Many people confuse these two concepts. From the moment of HIV infection to the development of AIDS, it can take from 5 to 15 years, i.e. the time varies in each individual case. While HIV infection has not progressed to the AIDS stage, an infected person may feel well, look healthy and not even suspect that he is infected and at the same time can transmit this virus to others.

How does HIV progress to the AIDS stage?

HIV destroys cells of the immune system - T-lymphocytes. This process occurs constantly, but ultimately leads to immunodeficiency, when the immune system cannot effectively fight any disease, and the person develops serious health problems. Pneumonia, cancer, various forms of fever, and other serious illnesses may develop. These diseases are called opportunistic. Then there comes a moment when the body’s resistance is completely lost, and the disease worsens so much that the person dies. AIDS develops faster in those whose health is initially poor. Smoking, alcohol abuse, drug use, poor nutrition and stress also have a negative impact.

How many types of HIV viruses are there?

There are 2 types of viruses: HIV-1 and HIV-2.

HIV-2 is less common than HIV-1 and is primarily found in West Africa. AIDS may develop more slowly with HIV-2 infection. There are cases where people were infected with both viruses at the same time - HIV-1 and HIV-2.

Where did HIV come from?

There is a lot of information, sometimes the most ridiculous, about the origin of HIV - from tales that this virus was bred in special CIA laboratories to mysterious stories that it was brought from African countries. Scientists have not yet come to a common opinion. It is possible that HIV has existed for centuries in a fairly harmless form and has only recently evolved into a more aggressive state. Most researchers agree that human immunodeficiency viruses - HIV 1, HIV 2 - are fundamentally similar to simian immunodeficiency viruses - SIV.

A common hypothesis is that humans were initially infected through direct contact with monkeys, and then the virus developed in the human body, acquiring new properties. There are objections to this theory, but it is supported by the fact that people have been hunting monkeys for many years, and it is easy to assume infection from punctures or scratches.

The first case of HIV infection dates back to the early 1980s, although antibodies to HIV were found in rare blood samples preserved from 1959. There is reason to believe that HIV has been around for a long time, but it was not always so dangerous.

What are the symptoms of a person with AIDS and a person infected with HIV?

Can a person be HIV positive?

and not know about it?

The initial period after HIV infection is often accompanied by mild, cold-like symptoms. This is followed by a latent, or hidden, period when the virus practically does not manifest itself in any way. This period can last for years. All this time, the HIV-infected person feels well and does not even know that he is infected. But as the virus multiplies, the immune system becomes weaker. As a result, the body is affected by various diseases.

The symptoms that often appear during HIV infection - fever, fever, fungal skin diseases, profuse night sweats - do not mean that a person has AIDS. Such symptoms can appear in an uninfected person, but in an HIV-positive person they are more intense and do not go away for a long time.

The diagnosis of AIDS is made when the body with a weakened immune system is affected by certain special diseases, for example, a specific skin cancer - Kaposi's sarcoma or Pneumocystis pneumonia, which is not dangerous for people with healthy immune function.

The main cause of morbidity and mortality in people with HIV is not the virus itself, but other infections to which the body becomes susceptible as a result of HIV.

The course of disease development in people with HIV infection takes a variety of forms and depends on many factors, including psychological mood and past health status.

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AIDS symptoms

AIDS is a disease that threatens the existence of humanity. The final fatal stage of an infectious disease resulting from infection with the human immunodeficiency virus (HIV). The virus, which enters the blood, semen and other body fluids, spreads and destroys a special type of white blood cell, CD4 lymphocytes, which are a major component of the human immune system. The virus is transmitted mainly through sexual contact (homosexual or heterosexual), through the needle of drug addicts, and also from an infected woman to her child.

After first entering the body, the virus spreads over several weeks, sometimes causing fever, fatigue, sore throat, skin rash and other symptoms similar to those caused by mononucleosis. These symptoms only last one or two weeks. After this, the patient may not experience symptoms for 5-10 years or more, although the virus continually spreads and the person remains infected. As the number of CD4 lymphocytes destroyed by the virus increases, symptoms such as swollen glands, night sweats, diarrhea and weight loss may appear.

AIDS develops when the immune system is very damaged (when there are fewer than 200 CD4 cells per microliter) and/or when there are opportunistic diseases that do not develop in a body with a healthy immune system, or unusual types of cancer (Kaposi's angiomatosis or lymphoma) . Without treatment, death from an opportunistic disease occurs quickly. Although AIDS has no cure, powerful new drugs against HIV have significantly reduced the death rate among those affected. These medications reduce the number of viruses in the blood and often increase the CD4 count. Today, AIDS is widespread throughout the world; more than 30 million people are infected with it. New information about AIDS here.

History of discovery

The first reports of a new deadly disease appeared in the United States in mid-1981. Five cases of unusual pneumonia caused by Pneumocystis have been identified among young gay men in New York and Los Angeles. In addition, this same group of people often had Kaposi's sarcoma, a malignant tumor that was usually rare in young people. The number of patients began to increase sharply. The disease was named. At first there are no symptoms. Swelling of the lymph nodes. Constant fatigue and general poor health. Recurrent and prolonged fever, chills and night sweats. Susceptibility to fungal infections (candidiasis), frequent occurrence of herpes, fungal infections in the mouth (candidal stomatitis), etc. Loss of appetite and unintentional weight loss. Cough and breathing problems. Changes in bowel habits, such as frequent diarrhea or constipation. The appearance of a skin rash or discoloration of the skin, especially the appearance of reddish spots (Kaposi's angiomatosis). Memory loss, confusion, changes in character.

AIDS is caused by the human immunodeficiency virus (HIV), which is found in any body fluid (blood, semen, female genital secretions, saliva and breast milk) of an infected person. The virus gradually destroys a person's immunity, leaving him vulnerable to many potentially fatal diseases or cancer.

HIV is transmitted through the exchange of fluids between organisms through sexual contact with an infected partner or through the ingestion of contaminated blood. This occurs among intravenous drug users who share a needle, or among hemophiliacs who undergo multiple blood transfusions (recent improvements in blood testing have reduced the risk of contracting HIV from blood transfusions). An infected woman can pass the virus to her baby before birth or through breastfeeding. HIV is a very unstable virus and cannot survive outside the body for long. It is impossible to become infected with it through short contacts, such as hugging, lightly kissing, or drinking from a glass of an infected person.

Distribution methods

Penetrating into the human body, the immunodeficiency virus affects the immune system, damaging mainly T-lymphocytes - helpers (translated from English as “helper”), which help B-lymphocytes produce antibodies against various microbes.

Having penetrated T-lymphocytes and other cells of the immune system, HIV multiplies slowly at first, but after some time its quantity becomes so huge that the number of T-helper cells can decrease by 10 times due to the destructive influence of the virus. This is the latent, or hidden, period of AIDS, which varies in duration for different people (from several months to 10 years or more). The reason for such different durations of the latent period has not yet been fully elucidated. Obviously, this is influenced by the virulence (aggressiveness) of the virus, the state of the host body, primarily its immune system, and the presence of concomitant diseases (for example, with simultaneous infection with viruses from the herpes group, the reproduction of HIV in the body is accelerated).

Now - about the ways of HIV infection.

1. Sexual tract. Can be ordinary (heterosexual) or homosexual. In the latter case, the virus enters the body through the single-layer epithelium of the rectum, which is much more dangerous than when passing through the multilayer epithelium of the vagina. In addition, during homosexual contacts it is quite

often occurs, tearing of the rectum. Therefore, the likelihood of infection during normal sexual contact with HIV-infected people is several times lower than during homosexual contact.

Currently, sexual transmission in the world accounts for over 80% of the total number of infections, with 70% as a result of ordinary heterosexual contacts. The risk of infection especially increases with repeated contact with different partners and group sex. The phenomenon of prostitution also significantly increases the risk. There are known cases where people infected with AIDS deliberately, as a sign of revenge, infected one partner after another, for which they were brought to criminal liability.

The likelihood of a woman becoming infected from an infected man is higher than with the opposite option. During homosexual contacts, the passive partner suffers more.

In African countries, they are most often infected through ordinary heterosexual contact. The homosexual path was common in the USA and European countries.

Infection is facilitated by: the presence of inflammatory foci, ulcerations on the genitals, other sexually transmitted diseases, sexual intercourse during menstruation, etc. The likelihood of infection is sharply reduced by the use of condoms during sexual intercourse.

2. Parenteral infection. By such infection we mean cases when viruses enter directly into the blood: blood transfusion, injections (usually intravenous), etc. The probability of intravenous parenteral infection from an HIV-infected person is close to 100%. Teenagers often become victims of AIDS.

3. There are known cases of infection of many hundreds of patients with hemophilia due to the administration of medicinal drugs prepared from the blood of people who were not well examined for HIV and turned out to be carriers of HIV infection. Many people remember the trial in France in connection with the massive infection of hemophilia patients there. One can imagine the horror of parents whose child is already very seriously ill, and in a medical institution receives another dangerous disease instead of help.

4. There is a certain risk of HIV infection during dental procedures due to insufficiently sterile medical instruments.

5. Cases of infection of health workers due to careless manipulations have been described (infected blood coming into contact with unprotected skin surfaces, mucous membranes, accidental injections, etc.).

6. Vertical transmission mechanism. Infection occurs from an HIV-infected mother through the placenta or during childbirth. The probability of transmission increases with subsequent pregnancies (from 20 - 30% in the first pregnancy, to 50 - 60% in subsequent ones).

The possibility of infection of a newborn from an infected mother during breastfeeding cannot be ruled out, which in these cases is best not to practice at all. V.V. Pokrovsky described a case of infection of a mother in Elista from an HIV-infected infant while breastfeeding (the mother had cracked nipples, and the child had ulcerative changes in the oral cavity).

Risk groups for AIDS:

Prostitutes; ? drug addicts; ? homosexuals (and bisexuals) prone to group sex; ? patients who require frequent blood transfusions and blood products; ? patients with venereal diseases.

From the listed risk groups, HIV can be introduced into medical institutions, families, etc.

The stability of HIV in the external environment is not too high: at 25 °C, the infectivity of the virus remains up to 15 days, at 37 °C - 11 days, at room temperature, HIV remains infectious in a dried state for 4 - 7 days. At sub-zero temperatures, it can persist in the external environment for several months.

Disinfectants are very effective against HIV (1 - 3% chloramine solution, 0.5% sodium hypochloride solution, 4 - 6% hydrogen peroxide solution, 70% alcohol solution, etc.). Boiling kills HIV within minutes.

Currently, it has not been proven that HIV is not transmitted through insect bites. It is impossible to become infected with HIV through ordinary household contacts, since the virus is not excreted in feces, urine, sweat, tears, or through breathing or coughing. Due to the low concentration of the virus in saliva, HIV infection through kissing is very unlikely. You cannot become infected with AIDS by sharing a meal, talking, shaking hands, traveling on public transport, etc. Meanwhile, because of their ignorance, people often avoid and avoid those infected with the AIDS virus. Although we should treat them not with contempt, but with compassion. As the Bible says, “Judge not, and you will not be judged.”

Diagnostics

To make a diagnosis as early as possible, you must first collect information regarding possible infection: whether there was sexual contact with an unknown person, whether the patient is a drug addict, whether he received a blood transfusion, whether he underwent surgery, etc.

Let us turn to the classification of AIDS proposed by the Russian scientist, Professor V.I. Pokrovsky. According to it, the disease has 4 stages in its course:

Stage I - incubation. It begins from the moment of infection and continues until the first clinical signs appear or (in their absence) until specific antibodies appear in the blood. This stage can last from two weeks to 3 years.

Stage II - primary manifestations. In 10 - 50% of cases, antibodies against the AIDS virus can be detected in the blood without any clinical manifestations of the disease. But in 50 - 90% of cases, the first clinical signs appear simultaneously: this is either an acute infection or generalized lymphadenopathy (widespread enlargement of lymph nodes). Acute infection is usually characterized by the so-called mononucleosis-like syndrome (or less commonly, influenza-like syndrome): fever, weakness, headache, sore throat, especially when swallowing. Often a pinpoint or spotty rash appears on the body. The submandibular, cervical, and sometimes axillary and inguinal lymph nodes are enlarged. Some patients experience enlargement of the liver and spleen. Herpetic or fungal rashes (in the form of thrush) in the oral cavity are characteristic. There may be pain in muscles and joints.

In many patients, blood tests already show a slight decrease in helper T-lymphocytes. This stage of the disease rarely lasts more than 2 weeks. Then all symptoms usually subside without any treatment. However, upon a detailed examination, one can notice a widespread enlargement of the lymph nodes; many patients also experience increased fatigue, poor sleep, night sweats, pustular lesions of the skin and fungal nails, and aphthous stomatitis.

Stage III - secondary diseases. It is characterized by a loss of body weight of less than 10%, viral, bacterial, fungal infections of the skin and mucous membranes, herpes zoster (itchy, painful rashes along the nerves on the skin of the lateral surfaces of the chest), frequent sinusitis, pharyngitis.

Subsequently, the patient continues to lose weight, he experiences fever (more than one month), prolonged diarrhea, changes in the oral mucosa, repeated manifestations of herpes zoster, localized Galoshi sarcoma, and signs of pulmonary tuberculosis.

AIDS-associated (provoked by AIDS) lesions, as well as cachexia (severe weight loss), etc.

In the event of an unfavorable course of the disease and its progression or ineffectiveness of the treatment, IV stage of the disease- terminal, ending in the death of the patient. With modern comprehensive therapy, the course of HIV infection is more favorable and may not progress to subsequent stages.

Laboratory confirmation is required to accurately diagnose AIDS. However, even without laboratory data, there are signs of the disease that are highly likely to suspect HIV infection.

The so-called “big signs”:

1) loss of more than 10% of body weight; 2) prolonged diarrhea (more than one month); 3) long-term (more than one month) temperature.

1) generalized lymphadenopathy; 2) herpes zoster; 3) candidiasis (fungal infection of the mouth and pharynx); 4) long-term disseminated herpetic infection; 5) persistent cough (more than one month); 6) generalized pruritic dermatitis.

The diagnosis of HIV infection is most likely if at least two major signs and one minor are present.

Between the second and third stages of AIDS, in the case of a favorable course, there may be a period of long (up to 10 years or more) latency, when patients maintain satisfactory health and performance. In some patients, such a long latent period can begin immediately after infection and proceed without the presence of acute phenomena. There have already been cases where latency lasts more than 20 years, and scientists hope that perhaps some HIV-infected people will not show severe signs of the disease at all.

Unfortunately, on the part of the immune system, special studies reveal the process of the destructive effect of the virus on lymphoid cells - mainly the number of T-helper lymphocytes decreases (from 600 to 200 -100 - 50 in 1 μl of blood).

It is usually believed that if the number of T-lymphocytes passes the lower limit - 200 cells in 1 μl, the disease takes a particularly severe course due to AIDS-associated diseases. The causative agents of these diseases do not pose a danger to healthy people in most cases. Moreover, some of them are organisms that live freely in water, soil, etc. A healthy immune system reliably resists them, and for AIDS patients in whom it is destroyed, these organisms turn from neutral agents into their worst enemies. The US Center for Infectious Disease Control has proposed that all patients whose CD4 lymphocyte count does not reach 200 cells/μL be considered as having AIDS. All other cases are classified as AIDS-associated diseases.

Among the AIDS-associated diseases are those caused by fungi (candidiasis, cryptococcosis, aspergillosis, histoplasmosis), protozoa and worms: toxoplasmosis, pneumocystosis, cryptosporidiosis, blastocystosis, strongyloidiasis, etc. Among viral diseases, the most common are cytomegalovirus infections, herpes zoster, etc.

Under the influence of HIV infection, the incidence of tuberculosis is increasing, which often has an unfavorable course in patients with AIDS. Infection with helminths increases, leading to contamination of all organs and, as a rule, putting on masks of cancer.

In people suffering from immune deficiency, the virus causes multiple pathologies. They experience severe damage to the gastrointestinal tract (up to complete exhaustion), the central nervous system, respiratory tract, and eye membranes. Only rapid antiviral therapy (acyclovir, ganciclovir, etc.) can slow down this process.

In newborns born from HIV-infected mothers, it is impossible to differentiate HIV antibodies detected in the blood (at least until 1.5 years of age) with antibodies that passively penetrated the placenta from the mother’s blood, since during this time they remain in her body. Therefore, examinations of newborns should be carried out repeatedly, and the dynamics of the antibody titer can be used to judge their origin. But it is better to determine the virus itself using PCR (polymerase chain reaction - see the section “New technologies for laboratory gene diagnostics” in the third part of the book). Detection of early clinical signs helps diagnose AIDS in newborns. In them, unlike adults, they appear quite early and progress quickly. When carrying out drug prophylaxis in infected pregnant women, the risk of infection of newborns is significantly reduced.

Although HIV cannot be completely eradicated, a combination of medications (protease inhibitor, nucleosides and non-nucleosides) prevents the virus from multiplying and allows the immune system to function more normally. Anyone taking these medications should be monitored regularly by a doctor.

You should start taking medications when your immune system is compromised and/or the virus level in the blood is high. Early treatment can prevent immune system damage for many years. Even patients in the late stages of AIDS can experience significant improvements in their immunity, accompanied by a decrease in the number of diseases.

Antibiotics may be prescribed to prevent the development of certain infectious diseases.

Pregnant women should use a range of medications that reduce the risk of transmitting HIV to their baby by 70 to 80 percent.

Vaccines and antibiotics can be used to prevent the development of opportunistic diseases such as pneumococcal pneumonia and Pneumocystis carinii pneumonia, which are potentially life-threatening diseases that affect people with AIDS.

A diagnosis of HIV infection often leads to emotional devastation. Psychological counseling, support groups and help from friends and family are invaluable support.

Contact your doctor if you think you may be at risk of contracting HIV infection or if you experience any symptoms of HIV infection or AIDS.

Get tested if you have the slightest reason to suspect that you have been infected with HIV. Many clinics provide confidential and anonymous tests.

All pregnant women should consider getting tested for HIV infection.

Treatment of HIV infection includes the use of drugs directed against the AIDS virus itself, as well as those that counteract the causative agents of AIDS-associated infections. As for the first group of drugs, there are still a lot of problems. The first antiviral drug AZT (azidothymidine), or zidovidine, which began to be used soon after the first AIDS patients were identified, had only a temporary effect, softened the clinical picture, but could not radically affect the reproduction of viruses in the body.

Subsequently, a number of similar drugs with a similar mechanism of action were created. Currently these include: zidovudine (its domestic analogue is thymoside), didanosine, zalcitabine, stavudine, lamivudine. All of them block an enzyme important for the virus - the so-called transcriptase. In addition, drugs are used that block viral proteases (that is, enzymes that break down proteins). Among them: saquinavir, ritonavir, indinavir (Crixevan), nelfinavir (Viracept). Unfortunately, all these drugs quite often have side effects, which is their significant drawback, given the need for their long-term use.

In 1996, American scientist David Ho was declared “Person of the Year” for his proposed triple therapy for HIV infection. Combination treatment consists of two reverse transcriptase blocking drugs (AZT and lamivudine) and one antiprotease drug (Crixevan).

Such therapy should be used for a long time before the onset of AIDS symptoms. It allows you to prolong the life of patients, sharply reducing the number of viruses in the body, but still not completely destroying them. In addition, not everyone can afford such expensive treatment, especially since treatment must take place for many years.

In addition to medications that block HIV, doctors recommend taking medications against the most likely HIV-associated diseases, even at the slightest suspicion of their occurrence, and even for purely preventive purposes. This is especially important for the prevention of Pneumocystis pneumonia, cytomegalovirus infection and toxoplasmosis (up to 50-90% of the population is usually infected with it, and while in healthy adults toxoplasmosis is most often asymptomatic, in AIDS it takes an extremely severe, septic course).

In the future - the development of more effective and less expensive drugs for the treatment of AIDS. Every year information appears in the press about the allegedly successful use of some unusual folk remedies, herbal preparations, etc. for this purpose, but all these reports have not yet been confirmed by serious research.

Prevention

Nowadays, AIDS prevention is an important government task in any country. In each country and even specific region, it is necessary to take into account the prevailing routes of infection. For African countries where infection predominates through ordinary heterosexual contacts, preventive measures should be aimed at protecting them as much as possible. However, this is not so easy to do: multiple sexual contacts with a negative attitude towards the use of condoms have become part of the mentality here. Even the threat of economic collapse and population extinction cannot yet stop the destructive process. In addition, prostitution here has become the main way for many women to earn a living. Promoting the universal and mandatory use of condoms has yielded some positive results: for example, in Nigeria, the frequency of condom use has increased 5-fold in recent years, which helps reduce the spread of AIDS.

Measures are being taken to “block” other routes of HIV infection (fighting drug addiction, disinfecting medical instruments, screening donors, etc.). A large number of infected women lead to infection of newborns during pregnancy and childbirth - prophylactic medication is recommended for HIV-infected pregnant women to reduce the risk.

In the USA, European and other countries where homosexuality is widespread, propaganda is being conducted aimed at eliminating group forms of sex, as well as the mandatory use of condoms. Of course, one of the main tasks is the fight against drug addiction and prostitution. The problem of thorough screening of donors for HIV also remains relevant.

For Russia, preventing the spread of HIV by drug addicts is of paramount importance. In our country, more than 3 million people regularly use drugs and psychotropic substances. Drug addicts become infected not only by sharing syringes, but even by sharing utensils from which everyone takes the drug mixture.

Currently, Russia has adopted a new program to combat AIDS, aimed at “reducing harm from drug use.” It is already being implemented in many regions of Russia with the assistance of international organizations (UNAIDS joint program). The program provides for educating drug addicts about the ways of HIV transmission, free replacement of used syringes with sterile ones, and free distribution of condoms. And, as they say, by and large, its goal is to persuade drug addicts everywhere to undergo treatment for drug addiction and, in the end, to give up drugs.

As for creating an effective vaccine, this is a matter for the future. And perhaps not the closest one. Although work in this regard is underway: the vaccines created by scientists are currently being tested in Thailand and some other countries.

Our planet has established World Day of Remembrance for those who died from AIDS. On this day, the living remember people, usually young, often very talented and famous. Let us also remember the names of some of them: Rudolf Nureyev, ballet soloist (France, born in the USSR); Freddie Mercury, rock singer (USA); Miles Davis, jazz trumpeter (USA); Anthony Perkens, film actor (UK); Herve Guibert, writer (France); Cluse Welle, anti-AIDS activist (France); Arne Huzdal, activist for the rights of people living with HIV (Norway).

Modern medicine has made a huge step by extending the time from infection with the immunodeficiency virus to the development of AIDS, making it possible to live with a slow-onset infection for more than 25 years, which very few patients with cancer or diabetes can count on. But the two words “HIV” and “AIDS” have not become less frightening; the disease is shrouded in myths and fantasies. People know little about the disease, hence the incorrect reaction to the carrier of the virus, who is perceived as almost a fiend, while he is an ordinary person who is unlucky.

So what is HIV? This is a chronic, slow-onset infection, the final stage of which is the development of a fatal immune deficiency, when the patient easily develops severe diseases leading to death. The stage of a catastrophic decline in immunity with opportunistic diseases is acquired immunodeficiency syndrome or AIDS, and everything that precedes it is HIV infection.

The source of trouble is a virus

The immunodeficiency virus was discovered in 1982, by which time there were already thousands of AIDS patients. Three years later, its sibling was discovered, differing only in the structure of the surface shell; the clinical picture of the disease they cause is not at all different, therefore both viruses are named type1 and type2. Lentiviruses, a group of which includes HIV, live in animal bodies for millions of years, suggesting that the very first HIV came to humans from a monkey about a hundred years ago, and this happened somewhere in West Africa.

No one knows who actually was the first or even the thousandth infected, because the infection was discovered when it had already formed an epidemic, when the patients were already in the last stage of the disease, to which years and years had passed. This is the first infection that was so belatedly revealed to humanity. The reason for this is the peculiarity of the course, when there are no symptoms of the disease for many years. As if trying to make up for lost time, scientists have developed HIV into the most studied viruses, writing hundreds of thousands of articles about it.

How does the immunodeficiency virus work?

The virus consists of a piece of genetic code in two strands of RNA - a tiny fragment of DNA, enclosed together with the enzyme transcriptase in a two-layer capsule. The enzyme is necessary for the assembly of complete viral DNA inside the host cell. The virus comes into the cell with a tool and a piece of genetic code; it assembles a complete organism from available cellular materials. On top of the capsule there is a supercapsid, it is this that recognizes in the blood the cell that will become the place of residence for the virus.

The virus meticulously selects only special blood cells that have CD4 antigens on their surface. The antigens favored by the virus are inherent in T-lymphocytes, monocytes, from which macrophages are formed inside tissues, and cells of auxiliary tissue surrounding neurons and helping the transmission of nerve impulses to neuroglia. All these cells, except neuroglia, are responsible for immunity. Therefore, the more viruses, the worse the human immune defense, and a moment comes when, under the influence of the uncontrolled aggression of the virus, the human immune system is almost completely depleted.

Having entered the cell, the virus makes a superstructure on two tiny RNAs, gradually turning them into large DNA. The virus integrates the DNA collected from pieces into the DNA of a human cell, and they live monolithically until the death of the cell. A virus does not always destroy a cell, it can hide in a cell and can sit like that for years, and the immune system is blind to it, because it is not just inside its own cell, it is almost its own - the DNA of the virus and the person are welded into one genetic figure.

Hiding intracellularly in this way, the virus avoids death from drugs, because as soon as it destroys the host cell, it will have to go out into the blood and look for a new place of residence. While searching for cellular living space, the medicine will slam him down. Such viral hide-and-seek forces the patient to take medications for the rest of his life. Unfortunately, the virus manages to come up with a defense so as not to sense the drug, but there are several therapeutic alternatives to overcome drug resistance, and the simplest is changing the drug to another.

How HIV gets inside a person

The human immunodeficiency virus circulates in all tissues, secretions and secretions of the host. Therefore, infection is possible through blood transfusion of a patient, tissue transplantation, from a pregnant woman to the fetus through a single blood supply system, or through close contact of blood, saliva, sperm of an infected person with damaged skin or mucous membrane of a healthy person. Risk groups include anyone who comes into contact with the secretions and blood of an HIV-infected person.

The virus invades alone or in a cell of a sick person captured by it. As expected, the invading enemy is captured by the immune defender - the monocyte and drags it into the tissue, where the monocyte is reformatted into a macrophage in order to be digested into its constituent atoms at rest. And that’s all the virus needs, it devours the cell from the inside, divides and is thrown out with newborn comrades from the dead nurse in order to infiltrate a new and fresh one. It wanders like this until it multiplies to a certain level in order to show itself in the form of a disease.

Initial stages of HIV

The period from the introduction of the first virus to the appearance of the first symptoms of infection is called the latent period or incubation stage. The average duration of the period is about two to four weeks, but can be longer. As a rule, in nine out of ten infected people the virus manifests itself after 3 weeks, but in only one infected person the interval before symptoms appear can be more than three or even six months. During this period, there is no indication of the presence of an enemy agent in the blood - antibodies to HIV are not detected, therefore the time is called seronegative, that is, literally “absence of signs in the blood.”

The clinical manifestations of the primary infection are very insignificant, something similar to a mild flu or as if an atypical infectious mononucleosis had arrived: fever, an incomprehensible rash, enlarged lymph nodes. All this lasts about a week, and is called “early HIV infection.” Who pays attention to illness if a normal adult suffers from a respiratory viral infection six times a year, for at least five days. This is some kind of infection, like a virus, but it’s not like ARVI, but it goes away quickly and why bother if you’ve already recovered.

The appearance of short-term clinical signs of the disease indicates that the process has begun. At this time, the virus multiplies, and there are already traces of its presence in the blood, which is called seropositivity; the immune system is still reacting to it. Clinical signs go away, but the life of the virus continues, and until six months to a year the immune system reacts to it with increased activity - this is an acute variant without clinical signs. If you donate blood, there will be no doubt about the presence of infection.

Longest stage of HIV

The next subclinical or latent stage lasts for years. If a person has taken a blood test for HIV and is taken under observation, the level of the virus in the blood is regularly determined. There is sometimes more virus in the blood, sometimes it becomes less under the influence of treatment. There are no or almost no symptoms, for example, somewhere a lymph node has become enlarged, sometimes there is a headache, some kind of vague malaise, but by and large - everything is fine. During this period, damage to the immune defense slowly progresses. During this period, it is necessary to control the replication of the virus, because treatment started at the wrong time reduces life expectancy.

The patient is observed on schedule at the AIDS center, where PCR is performed - a polymerase chain reaction that clearly senses and even allows one to count the number of copies of the RNA of the virus floating in the host’s blood. Treatment is prescribed when a certain viral load barrier is overcome. The number of the army of immune cells is regularly calculated: CD4 T-lymphocytes, also called T-helpers, T-suppressors or CD8 T-lymphocytes, and their ratio is calculated. You must have at least 1400 T-helpers; if their number drops below 500 cells, then you need to sound the alarm - against the background of immunosuppression, AIDS is approaching, not immediately, of course, but in five patients out of a hundred in the next two years it can happen.

The effect of treatment is monitored by PCR and the increase in the level of T-lymphocytes, if the number of virus RNA has decreased threefold - good, the best result is RNA in the blood is not detected. If after a month of treatment the T-helper cells have grown, the treatment is not useless. The effect is usually initiated after 12 weeks of therapy. Sometimes the virus is not detected at all in the blood, but this does not mean that the patient has been cured. This can continue for almost three decades, but gradually the immunodeficiency worsens and the number of CD4 lymphocytes decreases.

Secondary diseases - the road to AIDS

The patient enters the next stage with clinical manifestations with fever, night sweats, enlarged lymph nodes and even diarrhea, he is tormented by headaches and progressive weakness. The virus multiplies, destroying CD4 lymphocytes, which are not replaced by new defenders - over the years of illness, the bone marrow has been depleted, it does not give birth to new cells. With a decrease in the population of immune cells, the likelihood of opportunistic infections increases: Pneumocystis pneumonia, cytomegalovirus infection, candidiasis and toxoplasmosis, tuberculosis.

Opportunistic infections are caused by microorganisms familiar to a healthy person, but against the background of a significant decline in immunity, these “good friends” become the worst enemies of a defenseless organism. Treatment with antivirals and highly active antibiotics helps if the level of T-lymphocytes can be raised. Americans consider a decrease in T-lymphocytes below 200 cells to be AIDS in the presence of at least one opportunistic infection or Kaposi's sarcoma. The level of CD4 lymphocytes can be either 100 or below 50 cells; if treatment improves the immune status and cures the infection, then the progression of the disease stops and life goes on.

The inability to increase the number of lymphocytes indicates immune dysfunction and the progression of AIDS; life continues for several more months, but it is a very difficult life.