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Chronic Human Immunodeficiency Virus(HIV) Infection, Human Immunodeficiency Virus
Student Health Information Page compiled by: Emmanuel Njoku MD

What is HIV?

Human immunodeficiency virus(HIV) is a chronic infectious disease. It is the Virus that causes acquired immunodeficiency syndrome (AIDS), a condition characterized by defective immune system and inability of the body to protect itself against common infections. It was first reported in the United States in the early 80’s in San Francisco , in a group of gay men identified with peculiar type of cancer called ‘Kaposi Sarcoma’. Since then, it has reached pandemic levels with over 42 million people worldwide living with HIV/AIDS and an estimated 36 million people with AIDS have died worldwide since the pandemic began. Sub-Saharan Africa bears the biggest burden of HIV/AIDS, with nearly 1 in 20 adults living with HIV1

Mode of Transmission/Risk Factors: HIV can be acquired through Sexual relationship (heterosexual or homosexual), blood transfusion, from mother to child, intravenous drug use or sharing needles, oral sex and rarely, occupational exposure(Percutaneous or mucous membrane exposure to body fluids).

Epidemiology/distribution: In the United States, CDC estimates that 1,144,500 persons aged 13 years and older are living with HIV infection, including 180,900 (15.8%) who are unaware of their infection1. Over the past decade, the number of people living with HIV(prevalence) has increased, while the annual number of new HIV infections(incidence) has remained relatively stable. It is estimated that about 50,000 new HIV infections occur per year2. Within the overall estimates, however, some groups are affected more than others. Men who have sex with men(MSM) continue to bear the greatest burden of HIV infection, and among races/ethnicities, African Americans continue to be disproportionately affected.

By Race/Ethnicity: Blacks/African Americans continue to experience the most severe burden of HIV, compared with other races and ethnicities. Blacks represent approximately 12% of the U.S. population, but account for an estimated 44% of new HIV infections in 2010. They also accounted for 44% of people living with HIV infection in 2009 [1,2]. Since the epidemic began, more than 260,800 blacks with an AIDS diagnosis have died, including an estimated 7,678 in 20103 .

Hispanics/Latinos are also disproportionately affected by HIV. They represented 16% of the population but accounted for 21% of new HIV infections in 20104. They accounted for 19% of people living with HIV infection in 2009 [1]. In 2010, the rate of new HIV infections for Latino males was 2.9 times that for white males, and the rate of new infections for Latino females was 4.2 times that for white females [2]. HIV statistics

What are the symptoms of HIV infection?

There are no clear cut symptoms of HIV infection, symptoms experience by patients vary, depending on the individual and what stage of disease they are in.

Early HIV Infection: Symptoms
Sometimes within 2-4 weeks after HIV infection, many, but not all, people experience flu-like symptoms. This is called “acute retroviral syndrome” (ARS) or “primary HIV infection,” and it’s the body’s natural response to the HIV infection. Symptoms may include:

  • Fever (this is the most common symptom), Swollen glands, Sore throat, Rash, Fatigue Muscle and joint aches and headaches.
These symptoms can last anywhere from a few days to several weeks. However, you should not assume you have HIV if you have any of these symptoms. Each of these symptoms can be caused by other illnesses. Many people who are infected with HIV do not have any symptoms at all, sometimes for up to 10 years or more. You cannot rely on symptoms to know whether you have HIV. The only way to know for sure if you are infected with HIV is to get tested. During the late stage of HIV infection, people infected with HIV may have the following symptoms:
  • Rapid weight loss, recurring fever or profuse night sweats and extreme and unexplained tiredness.
  • Prolonged swelling of the lymph glands in the armpits, groin, or neck
  • Diarrhea that lasts for more than a week, Sores of the mouth, anus, or genitals
  • Recurrent pneumonia ,memory loss, depression, and other neurologic disorders.
Each of these symptoms can be related to other illnesses, the only way to know for sure if you are infected with HIV is to get tested.

Diagnosis of HIV Infection

Blood tests are the most common way to diagnose HIV. These tests look for specific materials produced by the body against the virus called “antibodies”, in an attempt to fight the virus. Saliva can also be used in rapid screening. The Initial screening test is called an ELISA, which stands for enzyme-linked immunosorbent assay. If an ELISA test is positive, the Western blot test is usually administered to confirm the diagnosis. There are home test kits available with instruction.

Treatment

In the early 1980s when the HIV/AIDS epidemic began, people with AIDS were not likely to live longer than a few years. Today, there are 31 drugs approved by the Food and Drug Administration to treat HIV infection. These treatments do not cure people of HIV or AIDS. Rather, they suppress the virus, to undetectable levels, but they do not completely eliminate HIV from the body. By suppressing the amount of virus in the body, people infected with HIV can now lead longer and healthier lives. However, they can still transmit the virus and must continuously take HIV drugs in order to maintain their health quality.

Public Health Concerns and Prevention

  • Early diagnosis is essential both to link patients to effective care and to prevent the spread of infection. The CDC estimates that more than half of new HIV infections are spread by HIV-positive people who are unaware they are infected.
  • Voluntary HIV screening and linkage to care especially in high prevalence communities should become a normal part of medical practice, similar to screening for other treatable conditions, such as high cholesterol levels, hypertension, diabetes, and breast cancer.
  • Discrimination and stigma associated with HIV infection prevents people from coming forth to be tested and seeking help when diagnosed.
  • Mental health issues, mostly depression , associates with HIV infection. Many patients have committed suicide following diagnosis. Support groups and appropriate linkage into care has been helpful.
  • HIV medications are very expensive and unaffordable for most infected people.
HIV Prevention
  • Avoid high risk sexual behavior ( multiple partners, trading sex for money or drugs).
  • Avoid sharing needles or intravenous drug use.
  • Protected sex( male and female condoms).
  • Treatment is a form of prevention because it reduces risk of transmission to other people.
  • Please Get Tested to Know Your HIV Status.

Resources and Support

Test Positive Aware Network (TPAN)
They offer HIV/AIDS prevention counseling, on site rapid HIV testing and counseling, mental health services. Also offer safe and legal needle exchange and distribution of sterile injection equipment.
5050 N Broadway St. #300, Chicago, IL 60640 . (773) 989-9400. Web: www.prosnetworkchicago.org/tpan-test-positive-aware-network

The AIDS Drug Assistance Program (ADAP)
Provides HIV medications to low-income people with HIV or AIDS. The Illinois Continuation of Health Insurance Coverage (CHIC) Program helps HIV positive persons in Illinois to maintain a continuity of health insurance or receive medical benefits under a health insurance program.
Illinois ADAP Office
525 West Jefferson Street, First Floor
Springfield, IL 62761
Fax: 217-785-8013
Office: 217-782-4977
Web: www.idph.state.il.us/health/aids/adap.htm

AIDS Foundation of Chicago
Promoting strategies to improve the availability of safe and affordable housing for low-income people with HIV/ADS, free testing, legal services and a perinatal HIV hotline: 1-800-439-4079
200 West Jackson Boulevard, Suite 2100
Chicago, IL 60606
Phone: (312) 922-2322
Fax: (312) 922-2916
Web: www.aidschicago.org

Division of STI/HIV/AIDS
Housing Opportunities for Persons with AIDS (HOPWA) Program sponsored by The Chicago Department of Public Health.
Web: https://www.onecpd.info/hopwa/
Most states in the country have their own HIV/AIDS sponsored program in addition to Ryan white federal government funding.

References

1. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. dependent areas—2011. HIV Surveillance Supplemental Report 2013;18(No. 5). Published October 2013.

2. CDC. Estimated HIV incidence in the United States, 2007–2010. HIV Surveillance Supplemental Report 2012;17(No. 4). Published December 2012.

3. CDC. HIV Surveillance Report, 2011; vol. 23. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Published February 2013.

4. CDC. Estimated lifetime risk for diagnosis of HIV infection among Hispanics/Latinos— 37 states and Puerto Rico, 2007. MMWR 2010:59 (40);1297-1301.

5. Advancing HIV prevention: the four strategies. Atlanta: Centers for Disease Control and Prevention. July 23, 2003. (Accessed October 27, 2005.

6. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr 2005;39:446-453