The mere mention of HIV or AIDS is enough to evoke terror in any audience. It is difficult to believe that just 32 years ago, no one knew this illness existed. Now, AIDS is a global catastrophe that virtually everybody is aware of.
According to the World Health Organisation (WHO), there were 35.3 million people worldwide living with HIV in 2012 of which 2.1 million were adolescents (10 – 19 years).
AIDS is short for Acquired Immune Deficiency Syndrome. It is a group of conditions that result from infection with a virus called the Human Immunodeficiency virus (HIV). A virus is an extremely small disease-causing particle. There are very many different viruses causing different illnesses ranging from the mild common cold to several deadly diseases.
HIV is transmitted from person to person by several means. The most common means of transmission is through sexual intercourse. The virus also spreads through transfusion with infected blood and blood products. Sharing of sharp objects, use of contaminated needles and syringes, accidental needle-stick injuries may also allow the virus to infect new persons.
HIV cannot cross intact skin so touching or hugging persons with HIV is usually absolutely safe. Mosquitoes and other insects have not been shown to spread HIV.
HIV is a tricky virus. It invades the very cells that protect the body against disease, essentially crippling the body’s defences. This leaves the gates wide open for many unusual germs that normally would not be able to cause disease (opportunistic infections). The body also becomes prone to certain cancers.
The virus also changes its structure frequently, staying several steps ahead of the body’s attempts to clear it.
Some virus particles hide in areas of the body outside the reach of the immune system, providing a reservoir for future re-infection. These features have made it difficult to cure HIV infection.
Following HIV infection, there are no immediate signs of illness. In the early stages, there is a flu-like illness lasting for a short period. This may be mistaken for an attack of malaria. However, the virus continues to silently destroy the body’s immune system until features of illness begin to appear. Initially, the person may develop rashes on the skin and in the mouth. Some develop swellings of their lymph glands. Recurrent fever, weight loss, chronic cough, recurrent diarrhea are other features that may occur. Eventually, the infection leads to AIDS. This is the final stage where severe infections and/or cancers occur that lead to death if not treated.
There are several ways of diagnosing HIV infection. The most common is called ELISA (Enzyme linked immunosorbent assay). It detects the proteins (antibodies) that the body produces to fight HIV. However, it may take up to 6 months for the body to start producing these antibodies.
Thus, an ELISA test with a negative result needs to be repeated after 6 months.
It is also not reliable in newborn children of HIV-infected mothers; the antibodies from the mother can enter the child producing a positive result even when the child is not infected. Testing in Nigeria is voluntary following a pretest counselling. In the US, routine screening is done for all adults with the clients being allowed to opt-out if they desire to.
Someone once said that if it weren’t for the seriousness of HIV, the drugs used (called antiretrovirals) would probably never have been approved for use in humans.
This is because of their serious side-effects. Patients on these drugs are placed on a combination of at least three different drugs. This is done to suppress the virus from multiplying and to prevent it from developing resistance to the drugs. Patients are also advised to take their drugs religiously for the same reasons. In the US, all adults with HIV infection receive these drugs but in Nigeria, drug therapy is given to selected patients who meet certain criteria.
Other aspects of HIV care include a proper diet, exercise and support from family and society.
People living with HIV/AIDS often suffer from stigma and discrimination due to ignorance and fear.
Prevention of HIV infection is paramount.
For sexual transmission, abstinence from sex, faithfulness to a single partner and consistent use of condoms are advocated. (the ABC strategy: A-Abstinence, B-Be faithful, C-Condoms).
Screening of blood and blood products for HIV before transfusion is also done.
Sharing of sharp objects, re-use of syringes is discouraged.
Prevention of mother to child transmission is done by giving the mother anti-retroviral drugs during pregnancy, use of Caesarean sections for delivery and avoidance of breastfeeding.
Post-exposure prevention is done for health workers with accidental exposure and for cases of non-consensual sexual exposure (rape).
AIDS is real. AIDS is with us. AIDS is best prevented. Hate the virus and not the victim. Let’s spread knowledge and not the virus.