Tell me about... HIV and immunity

HIV is a sexually transmitted disease caused by the Human Immunodeficiency Virus (HIV). The HIV virus causes Acquired Immune Deficiency Syndrome (AIDS).

HIV positive infection means that you are infected by the HIV virus, but this hasn't progressed to AIDS yet.

Nowadays, with modern medication, it may take years and years before the HIV virus weakens the immune system enough to cause AIDS.

HIV can also be spread through contact with infected blood (through blood transfusions) or from mother to child during pregnancy or breastfeeding.

How does the virus weaken the immune system?

HIV infects certain cells in the immune system, such as the CD4+ T cell (a type of helper T-cell lymphocyte or white blood cell) and macrophages (another type of cell that engulfs and destroys targeted cells).

Once these immune cells are infected by HIV, they are destroyed. So the number of T cells in the body decreases. Once this decline reaches a certain low point, cell-mediated immunity in the body is lost. The body then becomes more prone to certain infections.

HIV is a sexually transmitted disease, right? Is it transmitted through sexual intercourse or are there other ways of getting it? What about kissing, for example?

No. You can't get HIV through ordinary contact like holding hands, touching, kissing, hugging or dancing with someone who has HIV or AIDS.

You can't get HIV through mosquito bites, sharing a cup or utensils with a person infected with HIV or sharing room space either.

However, you can get it through unprotected vaginal, anal or oral sex with an infected person. The HIV virus enters the body through tears that can sometimes develop in the vagina, rectum or mouth during sexual activity.

How will I know if I have HIV infection? Is it only through a blood test?

A lot of people think HIV infection is "silent". But actually, there are symptoms.

This can be divided into:

Primary infection (acute HIV): Most people who are infected by HIV develop a flu-like illness within one or two months after the virus enters the body. This illness may last for a few weeks.

This flu-like illness unfortunately is indistinguishable from other viral infections. You may get the usual fever, headache, muscle aches, joint pains, sore throat, rash and even some swollen neck lymph nodes.

Although these symptoms are very mild, the amount of HIV virus present in the blood at this time is very high. You are very infectious at this time.

Chronic HIV: Chronic HIV is a clinical latent infection. Here, there are no specific signs and symptoms, though some people can have swollen lymph nodes.

If you don't receive treatment at this point, this part of the infection can last for 10 years. But if you do take medication, this part can last for decades.

Early symptomatic HIV infection: Here, the HIV virus keeps on multiplying and destroying T-cells. The fever and flu-like symptoms may come back, along with the swollen lymph nodes, diarrhoea and oral yeast infection.

Progression to AIDS: This happens in 10 years from when you first got the HIV infection if you don't get treatment. The immune system is now severely damaged, and you are prone to all sorts of opportunistic infections that usually don't happen in normal healthy people.

You may get night sweats, fever that keeps on recurring, chronic diarrhoea, unusual white spots on the tongue, persistent fatigue, weight lost, skin rashes or bumps, and pneumonia.

What treatments are there available for HIV infection these days? Is there a cure today?

There is still no cure, but a lot of anti-retroviral drugs can be used to control and slow down the spread and multiplication of the virus.

These include taking a combination of drugs from several different classes, such as the protease inhibitors and the non-nucleoside reverse transcriptase inhibitors.

Everyone with HIV infection should start these drugs immediately, regardless of their viral load.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.