Diagnosis, Treatment and Prevention of HIV/AIDS

Diagnosis of HIV/AIDS
A 2011 report issued by the CDC (Centers for Disease Control and Prevention), USA, found that about 1 in every 5 HIV-positive Americans is unaware of their HIV-status, and only 49% of those who are aware receive ongoing medical care and treatment.

HIV blood test

Diagnosis is made through a blood test that screens specifically for the virus.

If the HIV virus has been found, the test result is "positive". The blood is re-tested several times before a positive result is given to the patient.

For those whose tests came back positive, they will be asked to undergo some other tests to see how the infection has progressed, and also to decide when to start treatment.
If a person has been exposed to the virus, it is crucial that they get tested as soon as possible. The earlier HIV is detected, the more likely the treatment will be successful. Also, precautions can be taken to prevent the virus from spreading to other people.

After infection with HIV, it can take up from three weeks to three months for the virus to show up in testing. Re- testing may be necessary.

If a patient's most at risk moment of becoming HIV infected was within the last three months, he/she can have the test immediately. However, a good doctor will urge that another test be carried out within a few weeks.

Treatments for HIV/AIDS
Earlier HIV antiretroviral treatment is crucial - it improves quality of life, extends life expectancy and reduces the risk of transmission, according to the World Health Organization's guidelines issued in June 2013.

When an HIV-positive adult's CD4 cell count is 500 cells/mm3 or lower they should start treatment immediately.

According to Margaret Chan, WHO Director-General "These guidelines represent another leap ahead in a trend of ever-higher goals and ever-greater achievements. With nearly 10 million people now on antiretroviral therapy, we see that such prospects - unthinkable just a few years ago - can now fuel the momentum needed to push the HIV epidemic into irreversible decline."

Currently, there is no vaccine or cure for HIV/AIDS. But treatments have evolved which are much more efficacious - they can improve patients' general health and quality of life considerably.

Emergency HIV pills. If an individual believes they have been exposed to the virus within the last 72 hours (three days), anti-HIV medication, called PEP (post-exposure prophylaxis) may stop infection. The treatment should be taken as soon as possible after contact with the virus.

PEP is a very demanding treatment lasting four weeks. It is also associated with unpleasant side effects (diarrhea, malaise, nausea, weakness and fatigue).

After a positive HIV diagnosis, regular blood tests are necessary to monitor the progress of the virus before starting treatment. The therapy is designed to reduce the level of HIV in the blood.

Antiretroviral drugs. HIV is treated with antiretrovirals (ARVs). The treatment fights the HIV infection and slows down the spread of the virus in the body. Generally, patients take a combination of medications called HAART (highly active antiretroviral therapy).

The combination of drugs is adapted to each individual. HIV treatment is usually permanent and lifelong. HIV treatment is based on routine dosage. Pills must be taken on a regular schedule, every time. Common side effects include nausea, fatigue, diarrhea, skin rashes, moodiness, alterations to the adipose (fat) tissue, birth defects.

Antifungal cream Ciclopirox eradicates HIV - researchers at the Rutgers New Jersey Medical School reported in the journal PLoS ONE that Ciclopirox, a widely used antifungal cream, as well as Deferiprone, a medication used to remove excess iron from the body, eradicate HIV in cultured cells. They added that when treatment stops, the virus does not return.

Complementary or alternative medicine. Although widely used, alternative/complementary medications, such has herbal ones, have not been proven to be effective or ineffective. According to some limited studies, mineral or vitamin supplements may provide some benefits. Patients are urged to discuss these options with their doctors.

HIV Prevention
Unprotected sex. Having sex without a condom can put a person at risk of being infected with HIV and other sexually transmitted infections (STIs). HIV can be spread by having unprotected sex (vaginal, oral and anal sex). It can also be caught from sharing sex toys with someone infected with HIV.

Even hours after sex, a vaginal gel could protect women against HIV - A research team, led by investigators from the Centers for Disease Control and Prevention, has developed a new vaginal gel that they say could protect women from HIV. The researchers state that they need to improve the gel's effectiveness before it can be entered into human clinical trials and point out that although the gel protected the majority of monkeys against HIV, it may not necessarily have the same effect in humans.

Drug abuse and needle sharing. Intravenous drug use is an important factor in HIV transmission in developed countries. Sharing needles can expose users to HIV and other viruses, such as hepatitis C.

Strategies such as needle-exchange programs are used to reduce the infections caused by drug abuse.

Body fluid exposure. Exposure to HIV can be controlled by employing precautions to reduce the risk of exposure to contaminated blood. At all times, health care workers should use barriers (gloves, masks, protective eyewear, shields, and gowns). Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection.

Pregnancy. Anti-HIV medicines can harm the unborn child. But an effective treatment plan can prevent HIV transmission from mother to baby. Precautions have to be taken to protect the baby´s health. Delivery through caesarean section may be necessary. Breastfeeding may have to give way to bottle-feeding if the mother is infected.

A study by scientists from Columbia University, New York, found that breastfeeding for 6+ months with antiretroviral therapy could help reduce mother-to-child HIV transmission as well as improve chances of infant's survival.

Education. Health education is an important factor in reducing risky behavior.

Managing HIV
Adherence. HIV treatment is effective if the patient is committed and constant in taking the medication on time. Missing even a few doses will jeopardize the treatment. A daily methodical routine has to be programmed to fit the treatment plan around the patient's lifestyle and schedule. "Adherence" is sometimes known as "compliance".

General Health. It is crucial for patients to take medication correctly and take steps to avoid illness. Patients should seek to improve their general health and reduce the risk of falling ill by practicing regular exercise, healthy eating, and not smoking.

Additional precautions. HIV-infected people should be extra cautious to prevent exposure to infection. They should be careful around animals, avoid coming into contact with cat litter, animal feces. Meticulous and regular washing of hands is recommended.

Long-term condition. HIV is a lasting condition, and therefore patients have to be in regular contact with their healthcare team. Treatment plan is reviewed regularly.

Psychological Common misconceptions about AIDS/ HIV are diminishing. However, the stigma of the condition persists in many parts of the world. People infected with the virus may feel excluded, rejected, discriminated and isolated.

Being diagnosed with HIV can be very distressing, and feelings of anxiety or depression are common. If a patient feel anxious or have symptoms of depression, seek medical help immediately.

Written by Christian Nordqvist.


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