Hiv: Human retrovirus, cause of AIDS

This is a kind of retrovirus. It infects the human immune system, which is the system in the body which fights off infections.

Human immunodeficiency viruses
Scanning electron micrograph of HIV-1 (in green) budding from cultured lymphocyte. Multiple round bumps on cell surface represent sites of assembly and budding of virions.
Scientific classification
(unranked):	Virus
Realm:	Riboviria
Kingdom:	Pararnavirae
Phylum:	Artverviricota
Class:	Revtraviricetes
Order:	Ortervirales
Family:	Retroviridae
Subfamily:	Orthoretrovirinae
Genus:	Lentivirus
Groups included
Human immunodeficiency virus 1 Human immunodeficiency virus 2
Other lentiviruses
Bovine immunodeficiency virus Caprine arthritis encephalitis virus Equine infectious anemia virus Feline immunodeficiency virus Jembrana disease virus Puma lentivirus Simian immunodeficiency virus Visna-maedi virus

HIV may cause AIDS. This kills the white blood cells which a healthy body uses to fight diseases.

A person can get infected with HIV if any body liquid with the virus gets into their body. The body liquids that carry HIV are blood, semen, liquid from the vagina, and breast milk.

The virus may get into the body through injured skin. More usually it gets in through the mouth, eyes, nose, vagina, anus, or penis.

However, when people get HIV by having sex, the virus may enter the body through the vagina or anus.

There are some common ways to get HIV:

• A person with HIV can give a sexual partner the virus if they have unprotected sex. That means having sexual intercourse without a condom.
• A person can get HIV if he or she uses the same needle as a person with HIV to inject drugs or get a tattoo.
• A person may get HIV if he or she is stuck by a needle that was used on a patient with HIV.
• Babies can get the virus from their mothers when they are born or when they are breastfeeding. A baby may be protected from getting HIV this way if their mother takes certain medications while she is pregnant.
• Blood transfusions using infected blood products was a common cause of HIV. The blood had been taken from people with HIV infections. Now, in the developed world screening of blood products for HIV has mostly stopped this happening. However, people may still get HIV from blood transfusions in less-developed countries if the blood is not screened.

A person cannot get infected with HIV from non-sexual touching, like a hug or handshake, or touching someone else's saliva. A person cannot get HIV from an insect bite, a cough, or a sneeze. People also cannot get HIV from touching light switches, using toilets, or drinking from the same glass as a person with HIV.

Data

^a Other studies found insufficient evidence that male circumcision protects against HIV infection among men who have sex with men
^b Oral trauma, sores, inflammation, concomitant sexually transmitted infections, ejaculation in the mouth, and systemic immune suppression may increase HIV transmission rate.
^† "best-guess estimate"
^‡ Pooled transmission probability estimate.
Bracketed values represent 95% confidence interval.

Drug treatment

HIV causes a person to become more prone to illness, so infected people need treatment options. However, there is no cure for HIV. To help ease negative symptoms, drugs called anti-retroviral therapy (ART) are available. This treatment is also called high active anti-retroviral therapy (HAART). HAART treatment begins with one non-nucleoside reverse transcriptase inhibitor (NNRTI) and two nucleoside analogue reverse transcriptase inhibitors (NRTIs). The NRTI drug could be named zidovudine (AZT), tenofovir (TDF), andlamivudine (3TC), or emtricitabine (FTC).

These drugs slow the progression of the HIV virus in the body. Usually, these treatments consist of a combination of three or more drugs, and each drug performs a different job in fighting the virus. In general, HAART prevents the HIV from multiplying and destroying CD4 cells. CD4 cells are necessary to help protect the body from infections and cancer. Since the HIV virus destroys CD4 cells, it causes people with HIV to be more prone to illness.

It is recommended to start HAART if a person has HIV and has a CD4 cell count of less than or equal to 350 cells/mm3. This number can be determined by a doctor. A person’s age, sex, and other infections determine which treatment he or she should take. These medication regimens can help HIV-infected people live longer, healthier lives, and can also help prevent the HIV from advancing to AIDS.

 

General treatment

There has been controversy surrounding when the correct time to start therapy should be after a person discovers that he or she has HIV. Recently, the answer has been that earlier treatment is recommended. This is because, first, effective therapy can prevent non-AIDS-related deaths. Second, therapy can prevent harm to a person’s immune system. Third, therapy can help prevent transmission of HIV to others, and can therefore reduce HIV prevalence overall. Although there are some negative side effects of antiretroviral medications, the benefits of therapy usually outweigh the negative effects.

Effects of therapy

Patients on HAART have reported significant improvements in physical health, emotional health, mental health, and daily function compared to HIV-positive patients not yet on treatment. Most research has occurred in developing countries, and little research has been done on the impacts of ART on household wellbeing.

Although HAART can be an effective means to treating HIV, there can be many negative side effects. Negative side effects can vary by drug, by ethnicity, and by drug interactions in the body. The following list contains the most common and serious negative side effects associated with HAART medications to treat HIV.

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

• Lactic acidosis, hepatic steatosis, and body fat redistribution (lipodystrophy)
• Fever, headache, rash, nausea, vomiting, diarrhea, fatigue

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

• Rash, Stevens-Johnson syndrome, and toxic epidermal necrolysis
• Fatigue, mood changes, liver function, insomnia
• May have significant interactions with other drugs; dosage adjustments would be required

Protease Inhibitors (PIs)

• Metabolic abnormalities including dyslipidemia, hyperglycemia, insulin resistance, and lipodystrophy
• May increase risk of bleeding in hemophiliacs
• Rash, diarrhea, vomiting, taste perversion, fatigue
• May have significant interactions with other drugs; dosage adjustment would be required

Fusion Inhibitors

• Injection site reactions, neutropenia, increased frequency of pneumonia

Chemokine Coreceptor Antagonists

• Diarrhea, nausea, fatigue, dizziness, headache, liver function, joint pain

Integrase Inhibitors

• Nausea, diarrhea, headache, rash

Pharmacokinetic Enhancers

• Increased serum creatinine, proteinuria, nausea, diarrhea

Alternative therapy

Many people living with HIV have tried using alternative treatment methods, known as complementary and alternative medicine (CAM). Some types of CAM include stress management, natural health products, massage/therapeutic touch, acupuncture, and homeopathy. Stress management can increase quality of life for a person with HIV. Even with little evidence of its effectiveness, many people chose to try CAM because of the many negative side effects associated with HAART and the few negative side effects associated with CAM. Some HIV-infected people also try herbal medicines to treat HIV, but there has been no evidence showing any positive outcomes with the use of herbal remedies.

Another type of alternative therapy for treating HIV is micronutrient supplementation. Micronutrients are vitamins and minerals, so these supplements would be in the form of a general daily multivitamin. These supplements have been proven to help treat HIV because HIV can cause micronutrient deficiencies, so the supplements can help replenish these needed vitamins and minerals. Although the supplements may not help ease all negative symptoms, they offer some benefits and are safe for HIV-infected patients. Supplements are also safe for HIV-infected pregnant women and their children. Specifically, vitamin A and zinc have shown positive health effects. There are no major negative side effects of vitamin and mineral supplements.

Alternative therapies can help to reduce symptoms of diseases like HIV, but do not cure the disease, or stop the disease from spreading to other people.

"PREP" or "PrEP" is pre-exposure prophylaxis. This means a person takes a drug before having risky sex. The drug 'Truvada' is a combination of two different anti-viral treatments: tenofovir and emtricitabine. Truvada is very expensive, and was not available on the UK's National Health Service before 2016. A study, published in The Lancet in 2023 found that PrEP reduced the chances of getting HIV by almost 87% and recommended that it should be more easily available.

References

• AIDS-HIV Resources and guidelines for prevention Archived 2010-01-28 at the Wayback Machine
• University of California, Santa Barbara's SexInfo^{[permanent dead link]} This article provides basic information about HIV/AIDS in a way that is easy to understand. This site also has an article that provides A Personal Guide for Preventing AIDS Transmission^{[permanent dead link]}.
• AIDS Education Global Information System (AEGiS)