Introduction: What is HIV and AIDs?

Human immune-deficiency virus (HIV) is a virus that attacks the human immune system. In the
process of reproducing itself, it destroys the body’s natural ability to fight off disease and other
infections. HIV causes people to be more vulnerable to disease. HIV leads to Acquired Immune
Deficiency Syndrome (AIDs). Due to weakened immune system, people infected with AIDs die from
peripheral illness such as malaria, tuberculosis, or various STDs which would otherwise be treatable
in no-HIV positive people.

Causes of AIDs
AIDS is a sexually transmitted disease caused by HIV at its
advanced stage of infection. At this point much of the body’s
immune system is damaged, making the HIV infected person more
vulnerable to infectious diseases.

Transmission
HIV is transmitted in blood, semen, vaginal fluids, and breast milk. The most common ways HIV is
spread are by:

 Having vaginal or anal intercourse

without a condom with someone who has
HIV/AIDS
 Sharing needles or syringes with someone
who has HIV/AIDS
 Being deeply punctured with a needle or
surgical instrument contaminated with HIV
 Getting HIV-infected blood, semen, or
vaginal secretions into open wounds or sores

A pregnant woman who is HIV positive can also infect her baby with the virus.
 In a pregnant woman who has HIV, the virus is transmitted to the baby during exchange of
substances between maternal blood and fetus.
 HIV is also transmitted to the baby form the mother during breastfeeding.

HIV is not transmitted by simple casual contact such as kissing, sharing drinking glasses, or hugging.

Symptoms of HIV and AIDS

Some people develop HIV symptoms shortly after being infected. But it usually takes more than 10
years. There are several stages of HIV disease. The first HIV symptoms may include swollen glands
in the throat, armpit, or groin. Other early HIV symptoms include slight fever, headaches, fatigue,
and muscle aches. These symptoms may last for only a few weeks. Then there are usually no HIV
symptoms for many years. That is why it can be hard to know if a person has HIV, and so to
determine if a person has HIV medical tests are important.
AIDS symptoms appear much later than HIV symptoms. In addition to a badly damaged immune
system, a person with AIDS may also have:

 thrush — a thick, whitish coating of the tongue or mouth that is caused by a yeast infection
and sometimes accompanied by a sore throat
 chronic pelvic inflammatory disease 
 severe and frequent infections
 periods of extreme and unexplained tiredness that may be combined with headaches,
lightheadedness, and/or dizziness
 bruising more easily than normal
 long periods of frequent diarrhea
 frequent fevers and night sweats
 swelling or hardening of glands located in
the throat, armpit, or groin
 periods of persistent, deep, dry coughing
 increasing shortness of breath
 the appearance of discolored or purplish
growths on the skin or inside the mouth
 unexplained bleeding from growths on the
skin, from the mouth, nose, anus, vagina, or from
any opening in the body
 frequent or unusual skin rashes
 severe numbness or pain in the hands or
feet, the loss of muscle control and reflex,
paralysis, or loss of muscular strength
 Confusion, personality change, or decreased mental abilities.

How HIV affects the body

HIV infects the cells of the immune system. In particular,

HIV attacks and destroys the T helper lymphocytes, or T-
cells, which are crucial to the immune system and immune
response. (These cells are also called CD4-positive
lymphocytes because HIV uses the protein CD4, present on
the surface of the cell, to attach itself and pry its way into the
cell.) Each day, our body produces millions of CD4+ T-cells
to help maintain our immunity and fight off invading viruses
and germs. Once HIV is in a person’s body, the virus is able
to copy itself over and over, increasing its ability to kill CD4+ T-cells. Soon, infected cells
outnumber healthy T-cells.

The lower a person’s CD4+ T-cell count goes, the more susceptible the person is to viruses and
infections that an otherwise healthy body could fight. In the initial stages of the infection, the
decline in T-cell count is gradual. The first few months and years after a person is infected, T-cell
counts may remain very near normal or only slightly decreased. It’s when T-cell numbers begin to
decrease at a greater rate that patients with HIV begin noticing additional, worsening symptoms of
the infection.

The Four Stages of HIV

An HIV infection is typically divided into four stages: acute primary infection, clinical latent
infection, symptomatic HIV infection, and progression from HIV to AIDS.

Acute Primary Infection

Within the first few weeks of contracting HIV, 70 percent of people will experience flu-like
symptoms: fever, headache, upset stomach, and muscle soreness are among the most common
initial signs of an HIV infection. A positive diagnosis is possible at this stage, but many will not
associate their symptoms with an HIV infection, unaware they have contracted the virus.
During the acute primary infection, HIV-infected cells are circulating throughout the blood system.
Our body responds by producing HIV antibodies and cytotoxic lymphocytes (killer T-cells that seek
out and destroy invading viruses or bacteria). Two to four weeks after infection, the immune system
mounts an attack against the HIV with these antibodies and killer T-cells. HIV levels in the blood
will be greatly reduced, and CD4+ T-cell counts rebound slightly.

Clinical Latent Infection

The second stage of an HIV infection has an average duration of 10 years. During this phase, people
infected with HIV live almost normal, asymptomatic lives because the infection has likely not
caused any additional symptoms or complications. The circulating level of HIV in the blood will
become very low and possibly almost undetectable. However, people with HIV remain infectious
and can pass HIV to another individual during this phase.
Despite being present in very small amounts in blood, HIV is very active in the person’s body’s
lymph system. Doctors may suggest the person to start a drug treatment as soon as he/she is
diagnosed. The person may experience side effects as a result of this medication during this phase
of treatment. If the infected person chooses not to take medication, his/her doctor may want to
monitor him/her regularly during the latency period to monitor the virus’s progress.

Symptomatic HIV Infection

Over time, HIV destroys the infected person’s immune system. Once a person’s viral load (a
measurement of how many cells in your blood are infected with HIV) begins rising to higher and
higher levels, this is an indication that the immune system is deteriorating; the disease is reaching a
more advanced stage. If they are not already, many patients will begin treatment with antiretroviral
medications at this point.
If the anti-HIV drug treatment does not work, or if a person chooses not to begin treatment, the
immune system will begin to deteriorate more quickly. Initially, HIV-infected individuals will
experience mild symptoms—fever, headache, and fatigue—but as the disease progresses, the
immune system will weaken, and the symptoms will become worse. Symptoms of later-stage HIV
infection include rapid weight loss, memory loss, recurring fever, and diarrhea that lasts more than
a week. During this time, opportunistic infections become increasingly likely. These infections
would not be a problem in a person with a normal immune system, but for people with a
compromised immune system, they can become very troublesome. The infections are treated, but
the progress of the disease cannot be stopped.

Progression from HIV to AIDS

In the final stage of HIV, the immune system is severely compromised. Infections become
increasingly worse. CD4+ T-cell counts fall dramatically, and viral load increases significantly.
When a person’s CD4+ T-cell count falls below 200 cells per cubic millimeter of blood and he/she
is diagnosed with a stage-4 HIV-related condition (such as tuberculosis, cancer, and pneumonia),
the HIV has progressed to AIDS. Once HIV progresses to AIDS, a person is more likely to die.
Some patients will live only a few months after reaching the fourth stage of HIV, although
treatment allows a person to live many more years.

Process of infection and suitable treatment

The HIV virus attaches itself to a healthy CD4+ T-cell and enters its RNA into the cell, where it is
converted to DNA to be incorporated in the cell’s DNA. The cell then creates more RNA of the
virus. At one point the cell bursts, releasing the RNA to infect other cells and spread the virus,
eventually destroying the immune system of the body in the process.
Currently there is no cure for AIDS, but treatment is available which can increase the life
expectancy of an infected person. The treatment involves use of a combination of drugs.
The following are the processes of HIV infection, the types of drugs for treatment and the process
by which they work.

Entry Inhibitors

Entry inhibitors work by preventing HIV from entering healthy CD4 cells (T-cells) in the body.
They work by attaching themselves to proteins on the surface of CD4 cells or proteins on the
surface of HIV. In order for HIV to bind to CD4 cells, the proteins on HIV's outer coat must bind to
the proteins on the surface of CD4 cells. Entry inhibitors prevent this from happening. Some entry
inhibitors target the gp120 or gp41 proteins on HIV's surface. Some entry inhibitors target the CD4
protein or the CCR5 or CXCR4 receptors on a CD4 cell's surface. If entry inhibitors are successful
in blocking these proteins, HIV is unable to bind to the surface of CD4 cells and gain entry into the
cells.

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)

When HIV infects a CD4 cell in a person's body, it copies its own genetic code into the cell's DNA.
In this way, the cell is then "programmed" to create new copies of HIV. HIV's genetic material is in
the form of RNA. In order for it to infect CD4 cells, it must first convert its RNA into DNA. HIV's
reverse transcriptase enzyme is needed to perform this process.
NNRTIs, also known as "non-nucleosides" or "non-nukes" for short, attach themselves to reverse
transcriptase and prevent the enzyme from converting RNA to DNA. In turn, HIV's genetic material
cannot be incorporated into the healthy genetic material of the cell, and prevents the cell from
producing new virus.

Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)

NRTIs, sometimes called "nucleoside analogues" or "nukes," contain faulty versions of the building
blocks (nucleotides) used by reverse transcriptase to convert RNA to DNA. When reverse
transcriptase uses these faulty building blocks, the new DNA cannot be built correctly. In turn,
HIV's genetic material cannot be incorporated into the healthy genetic material of the cell and
prevents the cell from producing new virus.

Integrase Inhibitors

In order for HIV to successfully take over a CD4 cell's machinery so that it can produce new
viruses, HIV's RNA is converted into DNA by the reverse transcriptase enzyme
(nucleotide/nucleoside reverse transcriptase inhibitors can block this process). After the "reverse
transcription" of RNA into DNA is complete, HIV's DNA must then be incorporated into the CD4
cell's DNA. This is known as integration. As their name implies, integrase inhibitors work by
blocking this process.

Protease Inhibitors (PIs)

When HIV infects a CD4 cell in a person's body, it copies its own genetic code into the cell's DNA.
The CD4 cell is then "programmed" to make new HIV genetic material and HIV proteins. The
proteins must be cut up by the HIV protease—a protein-cutting enzyme—to make functional new
HIV particles. PIs block the protease enzyme and prevent the cell from producing new viruses.

Prevention of AIDS

Treatment of AIDS greatly increases the lifespan of the infected

person, but it cannot entirely cure the disease. There is, therefore,
always a chance that the virus can spread from the infected
person. Although complete cure is not possible, protective
measures can be taken to prevent spreading of the virus.

Spreading of HIV can be prevented by the following ways:

 Avoid promiscuous sex
 Use protection/ barriers while having sex
 Do not share needles for taking drugs, vaccines or
hormones
 Sterilize needles and other surgical instruments before use
to destroy any virus present
 Educate people on HIV, AIDS, how it spreads and how to prevent spreading.

These processes are quite effective in preventing the spread of HIV, thus decreasing the chances
and number of people being infected by the virus and being safe from AIDS as a result.