HIV may be considered a taboo topic in Singapore, but let’s not shun away from talking about it. Below, everything you need to know about HIV.
HIV, or Human Immunodeficiency Virus, is a virus that makes your immune system weaker. It achieves this by destroying important body cells that are known to protect your body against disease-causing pathogens, making you susceptible to diseases and infections.
It is important to note that HIV is not the same as AIDS or Acquired Immune Deficiency Syndrome. AIDS is a general term used to describe a condition, whereas an HIV infected individual has a highly compromised immune system, making him/her highly susceptible to a number of life-threatening infections and illnesses. HIV remains a global health pandemic that is currently affecting millions of people across the globe, particularly in Africa.
Unfortunately, there is no cure for HIV. However, there are a number of highly effective medications available for HIV patients to help regulate the severity of the virus, allowing such people to still live a long, fulfilling, and quality healthy life. Along with the early diagnosis, good management of HIV is critical in preventing its progression to AIDs.
Let’s find out more about this virus.
Where did HIV originate from?
Scientists discovered a type of chimpanzee in parts of central Africa as the source of HIV infection among humans. According to these researchers, it is strongly believed that the chimpanzee version of the HIV known as simian immunodeficiency virus, also known as SIV, was most probably transmitted to humans. When inside humans, this SIV must have mutated into HIV. It is also believed that humans first came into contact with the virus through humans who hunted these chimpanzees and eventually came into contact with the animals' infected blood. Researchers have also revealed that this deadly virus might have jumped from apes to humans in the late 1800s.
Over the years, this virus gradually spread across Africa and later into other parts of the globe. It is also apparent that the virus has lived in the United States since at least the mid to late 1970s.
How does HIV infect the body?
After invading your bloodstream, HIV usually attaches itself to immune system cells referred to as CD4 lymphocyte cells. These are vital cells that offer protection against various pathogens such as bacteria, viruses, and germs. Once attached to the CD4 lymphocytes, it will enter your body cells, constantly replicating and making a copy of itself. As this happens, the viral copies will eventually kill the CD4 lymphocytes. This scenario will continue until the CD4 cells die and their number will ultimately decline dramatically, leaving the affected person with a severely compromised immune system.
What are the virus stages of HIV?
When you get infected with HIV and don't receive effective treatment, you will pass through three distinct stages including:
Stage one: Acute HIV Infection
During the first 2-4 weeks after contracting HIV, patients may experience flu-like symptoms, which usually lasts for a few weeks. This is usually the body's natural response to a foreign pathogen or simply infection. Here’s the kick — when you are suffering from acute HIV infection, there is a large amount of the virus in your system and you are extremely contagious. However, a significant number of people with acute infection always don't know that they are infected. This is because they don't get sick right away. To ascertain that you have an acute infection, you need to undergo either an antibody or antigen test or a NAT test. If you think that you may have been exposed to HIV through either unprotected intercourse or drug use and are currently experiencing flu-like symptoms, seek immediate medical attention, and ask for a test to help diagnose acute HIV infection.
Stage two: Clinical latency (HIV inactivity or dormancy)
This particular stage is usually described as chronic HIV infection or asymptomatic HIV infection. During this stage, HIV is still active in your system. However, it reproduces at a relatively slower rate. You may never display any symptoms or fall sick during this phase. Those who are not on medication to treat HIV can potentially remain in this stage for decades, but others may progress through this same stage at a somewhat faster rate. On the other hand, those who are taking medication to treat HIV according to their doctor's prescription can potentially stay in the dormancy stage for decades.
Regardless, it is important to note that you can still transmit the virus to others even during this stage. However, patients who take their medication according to their doctor's prescription have absolutely no risk of transmitting the virus to their HIV-negative sexual partners. At the end of this stage, the victim's viral load will begin to increase and the CD4 cell count will equally start to decline. When this occurs, the affected individual will start to experience symptoms and as the levels of the virus continue to increase on the body, he/she will progress to the final stage.
Stage three: Acquired Immunodeficiency Syndrome (AIDS)
It is worth mentioning that this is the most severe HIV infection stage. People suffering from AIDS have extremely damaged immune systems, and this means that they always suffer from numerous severe illnesses, usually referred to as opportunistic diseases. Without effective treatment, those with AIDs usually succumb to their condition within three years. AIDS patients are usually very infectious because they have a very high viral load.
How will I know that I have HIV?
As previously explained, the surest way to know your HIV status is to get tested. Being aware of your HIV status is imperative because it allows you to make healthy and safe choices to prevent either contracting or transmitting the virus.
Individuals who are infected with HIV usually display some common symptoms such as:
- The appearance of a rash in the body.
- Swollen glands.
- Joint and muscle ache.
- Sore throat.
However, please know that just having any of these symptoms doesn't necessarily imply that you are HIV positive. These symptoms may also occur as a result of other illnesses.
With time, the above symptoms will eventually diminish, and you may never experience any other symptom for years. HIV will silently cause damage to your immune system until you reach the later stages. And when your immune system has been severely compromised, you may develop more serious symptoms such as:
- Night sweats.
- Unexplained weight loss.
- Skin rash.
- Serious life-threatening illnesses.
- Recurrent infections.
- Unending diarrhea.
If you experience any of these symptoms, especially after a potential exposure to HIV, you should discuss with your doctor further.
How is HIV transmitted from one person to another?
A significant number of HIV cases are transmitted through unprotected sexual intercourse. An asymptomatic HIV patient can still spread the virus. However, an HIV positive individual who is on treatment can substantially minimize his/her transmission risk. In general, HIV can be spread through:
- Sexual intercourse: Most people acquire the virus through having unprotected sexual encounters with an HIV positive partner.
- Sharing of needles among drug abusers.
- Mother-to-baby transmission during either breastfeeding or delivery.
- Sharing of sex toys with an individual who is HIV positive.
- Needlestick injury among healthcare workers.
- Blood transfusion.
There are groups of people who are at a relatively higher risk of acquiring HIV, including:
- People who regularly use chemical drugs to enhance sexual pleasure.
- Those who inject drugs and share needles.
- Those having an underlying sexually transmitted infection.
- People who engage in unprotected sex with multiple sexual partners.
It is worth mentioning that HIV is known to thrive in blood as well as other types of fluids. In order to acquire HIV, any of these infected fluids need to get into your bloodstream. Body fluids that are known to contain HIV include vaginal fluid, semen, blood, menstrual blood, breast milk, and perhaps mucous membrane or the anal lining.
On the other hand, common body fluids such as urine, sweat, and saliva don't contain sufficient virus that can be transmitted from one person to another. In summary, HIV cannot be transmitted through the following activities.
- Towel sharing.
- Mouth to mouth resuscitation.
- Being spit or sneezed on.
- Contact with healthy intact skin of an infected individual.
- Sharing of cutleries.
- Being bitten by animals, ticks, insects, or mosquitoes.
What is the link between HIV and other sexually transmitted infections?
It has been proven that having an STI enhances your risk of contracting and transmitting HIV. HIV negative individuals with another STI are three times more likely to become infected with HIV if they have unprotected intercourse with an HIV positive partner. If the STI triggers skin irritation, sores, or skin breakages, this will give the virus an easy entry into the body when sexual contact is initiated.
Even if you have an STI that doesn't cause wounds or breaks, you are still at risk of getting an HIV infection. This is because STIs can potentially result in body inflammation, leading to an increase in the number of immune cells being used as HIV target cells.
What's more, if you have HIV and equally suffer from another STI, you are three times more likely to transmit the virus through sexual contact. This is because there are higher concentrations of HIV in your genital fluid as well as semen compared to an HIV positive person who doesn't have an STI.
Is HIV curable?
Currently, as it stands, there is no cure for HIV. Thankfully, with proper medical intervention, HIV is very much manageable. Drugs used to treat or manage HIV are referred to as antiretroviral therapy or simply ART. If HIV victims take ART as prescribed, the amount of HIV in their blood may become undetectable. When this happens, these people can potentially live longer and stay healthy. What's more, there will be no risk of them transmitting the virus to their HIV-negative partners through intercourse.
In the mid-1990s, before ART was developed, HIV patients used to progress to AIDs after a few years. However, today, an individual diagnosed with this virus and effectively treated before the disease advances to other stages can live almost as long as someone who is HIV negative.
So keep faith, and stay safe!
- Fanales-Belasio, E., Raimondo, M., Suligoi, B., & Buttò, S. (2010). HIV virology and pathogenetic mechanisms of infection: a brief overview. Annali dell'Istituto superiore di sanita, 46(1), 5–14. https://doi.org/10.4415/ANN_10_01_02
- Katzenstein T. L. (2003). Molecular biological assessment methods and understanding the course of the HIV infection. APMIS. Supplementum, (114), 1–37.
This article was written and medically reviewed by Dr Ben, M.D on 10/06/2021