What is HIV/AIDS?
HIV (Human
Immunodeficiency Virus) is the virus that causes AIDS (Acquired
Immune Deficiency Syndrome). The virus is passed from an infected
person to another person through blood-to-blood contact, sexual
contact, or from mother to infant during pregnancy, birth process
or breast feeding.
HIV attacks
certain types of white blood cells, primarily T4 cells (commonly
known as T-cells) and macrophages, which are crucial to the normal
functioning of the immune system. The disruption of these cells
causes the breakdown in the immune system that characterizes AIDS.
AIDS
is an illness that damages a person's ability to fight off disease,
leaving the body open to attack from unusual types of cancer and
from infections that the body's immune system could ordinarily fight
off. These types of infections are known as "opportunistic"
infections because they take advantage of a weakened immune system
to cause illness. AIDS is not a single disease, but rather a collection
of symptoms caused by opportunistic infections and/or cancers. Pneumocystis
carinii pneumonia and Kaposi's sarcoma, once a rare type of cancer,
have been the most common causes of death in people with AIDS in
the US
Where did HIV come from?
Unfortunately,
we don't know. Scientists have different theories about the origin
of HIV, but none have been proven. The earliest known case of HIV
was from a blood sample collected in 1959 from a man in Kinshasa,
Democratic Republic of Congo and the source of his infection is
not known. Genetic analysis of this blood sample suggests that HIV
may have stemmed from a single virus in the late 1940s or early
1950s.
We do
know that the virus has existed in the US since at least the mid
to late 1970s. From 1979 to 1981 rare types of pneumonia, cancer,
and other illnesses were being reported by doctors in Los Angeles
and New York among a number of gay male patients. These were conditions
not usually found in people with healthy immune systems.
In 1982
public health officials began to use the term "acquired immunodeficiency
syndrome," or AIDS, to describe the occurrences of opportunistic
infections, Kaposi's sarcoma, and Pneumocystis carinii pneumonia
in previously healthy men. Formal tracking of AIDS cases began that
year in the US Scientists isolated the HIV virus as the cause of
AIDS in 1983.
Is it common?
Through
December 2000, a total of 774,467 cases of AIDS had been reported
in the US to the Centers for Disease Control (CDC). Because many
people contract the virus and don't know they are infected, the
CDC estimates that between 800,000 and 900,000 or 1 out of every
300 people are living with HIV or AIDS in the US
How is it transmitted?
This virus
is passed from an infected person to another person through blood-to-blood
contact, sexual contact, or mother-to-infant contact. These body
fluids have been proven to spread HIV:
Blood
Semen
Vaginal
fluid
Breast
milk
Other
body fluids containing blood
HIV enters
the body through cuts in the skin, open sores, tiny tears in the
mucous membranes of the mouth, rectum, or vagina, and directly into
the blood by a needle. It is generally accepted that the virus is
transmitted through direct exposure to contaminated bodily fluids
that have not been exposed to the air. HIV is commonly spread by:
Having
unprotected sexual intercourse with someone who has the virus
Getting
HIV-infected blood, semen, or vaginal secretions into open wounds
or sores
Sharing
needles or syringes with someone who has the virus
Being
deeply punctured with a needle or surgical instrument contaminated
with the virus
Passing
from a woman to her infant during pregnancy, birth, or breast
feeding
Receiving
transfusions of blood products donated by someone who has the
virus (although the risk of transmitting HIV by a screened blood
transfusion is practically nonexistent. Since 1985, the US blood
supply has been screened for HIV and is believed to be very safe.)
HIV cannot
go through unbroken skin. In comparison to the flu and common cold
viruses, HIV is actually quite fragile and will die rather quickly
if exposed to air. HIV is not transmitted through:
What are the symptoms?
It is
possible to be infected with HIV and to transmit the virus without
showing symptoms of illness. Many people do not develop any symptoms
when they first become infected with HIV. Some people, however,
have a flu-like illness within a month or two after exposure to
the virus. They may have symptoms including:
Fever
Headaches
Lack
of energy
Enlarged
lymph nodes easily felt in the neck and groin
These
symptoms usually disappear within a week to a month and are often
mistaken for the flu. The only way to determine for sure whether
you are infected is to be tested for HIV infection. The following
symptoms may develop after years of being infected with HIV and
may signal that the infection has progressed to AIDS:
Rapid
weight loss
Deep,
dry coughing
Recurring
fever or profuse night sweats
Profound
and unexplained fatigue
Swollen
lymph glands in the armpits, groin, or neck
Diarrhea
that lasts for more than a week
Bruising
more easily than normal
White
spots or unusual blemishes on the tongue, in the mouth, or in
the throat
Recurring
yeast infections
Pneumonia
Red,
brown, pink, or purplish blotches on or under the skin or inside
the mouth, nose, or eyelids
Numbness
or pain in the hands or feet
Loss
of muscle control and reflex, paralysis, or loss of muscular strength
Memory
loss, depression, and other neurological disorders.
Because
these symptoms can take years to manifest, their absence is not
an indicator of HIV status. Only a medical provider can diagnose
AIDS based on specific criteria established by the CDC.
How soon after exposure to HIV will symptoms
appear?
More persistent
or severe symptoms may not surface for 10 years or more after HIV
first enters the body in adults, and within 2 years in children
born with HIV. This period of "asymptomatic" infection
is variable, however, and can depend on many factors, including
a person's health status and their health-related behaviors. Some
people may begin to have symptoms in as soon as a few months, whereas
others may be symptom-free for more than 10 years. During the asymptomatic
period, however, HIV is actively infecting and killing cells of
the immune system. HIV's effect is seen most obviously by measuring
the levels of T cells in the blood -- the immune system's key infection
fighters. The virus initially disables or destroys these cells without
causing symptoms.
How is it diagnosed? HIV
The tests commonly used to detect HIV infection look for the presence of antibodies that fight HIV. The length of time between infection and when there are enough antibodies to be detected by the HIV test is often called the "window period." According to the CDC, while almost all people infected with HIV (99%) develop detectable antibodies against the virus within 3 months of infection, it is still possible that the window period is longer, However, CDC studies indicate that it is highly unlikely that HIV infection would go unrecognized for over 6 months in persons who are infected. If an HIV test is negative 3 months after a high risk experience, an individual should consult their medical provider to determine if the test should be repeated.
Health Services is now offering the Rapid Oral HIV test for Brown students. This sensitive screening test, called Oraquick, detects HIV antibodies through an oral swab sample; therefore, no blood needs to be drawn. Students can expect their results within 40 minutes. You can make an appointment at Health Services by calling 401.863-3953. You can learn more about HIV testing, and rapid testing in particular, by viewing this 10 minute video developed by the Brown University AIDS Program.
There are other testing sites in Providence and RI that can be accessed by clicking here for locations and phone numbers. Note that the types of tests offered at these sites can differ. Depending on the type, tests may require an oral swab or a blood sample, and results may be available quickly (in under an hour) or may not be available for a period of days. Be sure to ask the clinic which testing options they offer.
AIDS
An HIV-infected
person receives a diagnosis of AIDS after developing one of the
CDC-defined AIDS indicator illnesses and having a t-cell count below 200. However, studies have revealed
that most people infected with HIV carry the virus for years before
enough damage is done to the immune system for noticeable AIDS symptoms
to develop. So an HIV infected person who has not had any serious
illnesses can receive an AIDS diagnosis on the basis of certain
blood tests (T cell counts). The loss of T cells in people with
HIV is a very strong predictor of the development of AIDS.
What is the difference between confidential
and anonymous testing?
Confidential
testing for STIs, including HIV, means that the test results will
be part of your medical record. This information cannot be accessed
by anyone other than you and your medical providers unless you give
written permission to release your information. Anonymous testing
means that you never provide your name. You are given a number or
a code and no one besides you and your testing counselor will ever
know your results.
How is an HIV infection treated?
Today
there are medical treatments that can slow down the rate at which
HIV weakens the immune system. Sixteen drugs have been approved
for treating HIV infection. They are called anti-retroviral drugs
because they attack HIV, which is a retrovirus. Once inside the
cell, HIV uses specific enzymes to survive. Anti-retroviral drugs
work by interfering with the virus' ability to use these enzymes.
They fall into two categories:
Reverse
transcriptase inhibitors interfere with an enzyme called reverse
transcriptase (RT) that HIV needs to make copies of itself.
Protease
inhibitors interfere with the protease enzyme that HIV uses to
produce infectious viral particles.
In addition
to the anti-retroviral drugs, there are other treatments that can
prevent or cure some of the illnesses associated with AIDS. As with
other diseases, early detection offers more options for treatment
and preventative care. Unfortunately, the drugs currently available
cannot cure an HIV infection. HIV can become resistant to any one
drug and even a combination of drugs cannot suppress the virus indefinitely.
However, scientists continue to develop new drugs and treatments
that are helping many people infected with HIV live longer and healthier
lives.
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
