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Exploring The Facets of HIV/AIDS

By Sanjana PB

Abstract

​HIV/AIDS has always been one of the most dangerous and globally widespread diseases. The Human Immunodeficiency Virus (HIV) is the retrovirus that causes the disease, Acquired Immunodeficiency Syndrome (AIDS). AIDS is a condition in humans in which progressive failure of the immune system allows life-threatening infections and cancers to thrive. HIV infects vital cells in the human immune system such as helper CD4 T cells and macrophages (A et al., 2016). Patients are prone to conditions and infections caused by opportunistic bacteria, viruses, fungi, and parasites that are normally controlled by the elements of the immune system that HIV damages and weakens. 

Global Prevalence

​The scale of the AIDS epidemic caused by HIV has exceeded all expected estimations in the past few decades and has had a significant staggering impact, not only on the patients, their families, and their health, but also on society as a whole and on human development in general, by negatively affecting social capital, population structure, and economic growth. A study in 2001 claimed that globally, an estimated 36 million people were living with HIV, and some 20 million people had already died of the virus, with the worst of the epidemic centered on sub-Saharan Africa (Piot et al., 2001).

Causes and Transmission

​Understanding the transmission pattern of AIDS helps us in identifying the potential causal factors of the disease. Principally, HIV has been proven to be transmitted via sexual contact, blood products/contaminated needles, or by passage from mother to child. 

​Therefore, we can list out the causes of AIDS as follows –  

  • Sharing intravenous drug needles or vaccination syringes.
  • An HIV-positive mother can transmit the infection to babies during pregnancy, birth, and breastfeeding. 
  • Transfusion of body fluids (blood, semen, vaginal secretions, breast milk).
  • Having sexual contact (including but not limited to oral, vaginal, and anal intercourse) with someone who is HIV positive.

​Additionally, having other STDs such as syphilis, herpes, and gonorrhea seems to increase the risk of being infected by HIV during unprotected sexual contact with an infected partner (A et al., 2016). 

​Some infamous misconceptions are that HIV is transmitted via acts of casual contact (touching, hugging, or even kissing), fecal-oral route, aerosols, or insects, and these are simply untrue.

Symptoms and Diagnosis 

​Part of what makes AIDS one of the most notorious illnesses is the fact that it is asymptomatic in most patients. This increases the difficulty involved in the diagnosis of the disease, leading to a further increase in complications that could have been avoided through early diagnosis. 

​The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Recent evidence shows that between 70% to 90% of people who become infected with HIV experience flu-like symptoms within a few weeks after infection (A et al., 2016). 

​Other significant symptoms include – 

  • Frequent fevers and sweats. 
  • Short-term memory loss. 
  • Sustained skin rashes or flaky skin.
  • Swollen lymph nodes.
  • Seizures and lack of coordination. 
  • Difficult/Painful swallowing. 
  • Prolonged nausea, cramps, diarrhea, vomiting.  
  • Confusion and forgetfulness.
  • Drastic/Unexplained weight loss.

​HIV can cause various complications such as – 

  • Frequent yeast infections (oral/vaginal).
  • Severe herpes infections that cause mouth/ genital/ anal sores. 
  • Pelvic Inflammatory Diseases (PIDs) especially in women.
  • The nervous system (nerves, spinal cord, brain) can be attacked leading to various neurological problems. 

​HIV is most commonly diagnosed by testing blood and saliva for antibodies prepared by the body against the virus. This can be done after 12 weeks of infection since it takes time for the body to develop antibodies. However, a newer type of test checks for HIV antigens instead, and can be used for screening immediately after infection. Further tests for CD4 count and viral load can help in tailoring the appropriate treatment for the patient. 

Prevention and Treatment

​Prevention is always better than treatment, as the treatments we have currently do not guarantee a cure. Preventive measures also help protect one’s quality of life much better than treatment options.

​Some preventive measures that can be taken against AIDS – 

  • Promote sex education in schools and eliminate the social stigma attached to talking about essential aspects of coitus.
  • Practice safe and healthy sexual practices which include using protection (condoms) during intercourse, limiting the number of sexual partners, and avoiding sexual interaction with unknown partners.
  • Make sure to use fresh and unused blades, syringes, etc to avoid contact with an infected person’s blood. 
  • Pre-exposure prophylaxis (PrEP) is a prevention option for people who have frequent exposure to HIV (eg. having an infected partner) and are at high risk, to reduce their chances of getting the infection. PrEP medications can be taken in the form of pills (daily) or injections (monthly). This should be done under the supervision of your healthcare provider. 
  • Post-exposure prophylaxis (PEP) medications can be taken 72 hours after a possible exposure to HIV to prevent the infection. PEP should be used only in emergency situations and is not meant for regular use by people who may be exposed to HIV frequently (The Basics of HIV Prevention | NIH, n.d.). 
  • To prevent perinatal transmission of HIV (from parent to child via pregnancy, childbirth, or breastfeeding), HIV medications can be administered both to the parent and the newborn. 
  • Get tested for HIV if there is the slightest doubt or if any doubtful symptoms are experienced, since early diagnosis can help in the treatment process. 

​AIDS is a seriously deadly disease mainly because it is not completely curable, but some treatment options are available to help people live longer lives. Some of them include - 

  • Antiretroviral Therapy (ART) - Antiretroviral drugs are used to treat HIV, and they help prolong and improve the quality of life of patients (A et al., 2016). 
  • Highly Active Antiretroviral Therapy (HAART) – This is a more advanced way of treating HIV, and is done by administering a combination of three antiretroviral drugs to reduce the viral load to undetectable levels. 
  • CRISPR-Cas Cure (gene therapy) – HIV can establish a long-lived viral reservoir, which can be targeted and edited through gene therapy. With modern advancements in genetics, the CRISPR (Clustered Regularly Interspaced Palindromic Repeat) - Cas system proves to be a promising tool in the treatment of HIV. The CRISPR-Cas approach targets the host and viral genes to activate anti-viral host factors and inhibit viral replication simultaneously (Hussein et al., 2023).

Breaking Societal Stigma

​Stigma is not new to public health, nor is it unique to HIV/AIDS. History provides an unfortunate abundance of examples of “prejudice, discounting, discrediting, and discrimination” directed toward persons who are ill or perceived to be ill (Valdiserri, 2002). 

​Stigma towards HIV/AIDS particularly stems from the fact that this disease deals with tabooed and sensitive topics such as coitus and drug usage. The knowledge gaps and misconceptions surrounding the disease, especially regarding its transmission, add to the societal stigma against this illness. Societally induced shame and stigma, without a doubt, act as a huge barrier to HIV care and prevention programs, by deterring people from getting diagnosed and getting the proper treatment accordingly. As a society, it is our responsibility to work towards minimizing the stigma attached to this disease. 

Conclusion

​Human Immunodeficiency Virus (HIV) Infections and HIV-induced Acquired Immunodeficiency Syndrome (AIDS) continue to represent a global health burden (Hussein et al., 2023). Responding to AIDS on a scale commensurate with that of the epidemic is a global imperative. Nothing less than a sustained social mobilization is necessary to combat one of the most serious crises facing human development (Piot et al., 2001). 


Works Cited

A, K., S, C., Rb, S., H, V., Ss, S., & A, G. (2016). A REVIEW ON: HIV AIDS. Indian Journal of Pharmaceutical and Biological Research, 4(03), 69–73. https://doi.org/10.30750/ijpbr.4.3.9

Hussein, M., Molina, M. A., Berkhout, B., & Herrera-Carrillo, E. (2023). A CRISPR-Cas Cure for HIV/AIDS. International Journal of Molecular Sciences, 24(2), 1563. https://doi.org/10.3390/ijms24021563

Piot, P., Bartos, M., Ghys, P. D., Walker, N., & Schwartländer, B. (2001). The global impact of HIV/AIDS. Nature, 410(6831), 968–973. https://doi.org/10.1038/35073639

The Basics of HIV Prevention | NIH. (n.d.). https://hivinfo.nih.gov/understanding-hiv/fact-sheets/basics-hiv-prevention

Valdiserri, R. O. (2002). HIV/AIDS Stigma: An Impediment to Public Health. American Journal of Public Health, 92(3), 341–342. https://doi.org/10.2105/ajph.92.3.341