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Summary

HIV stands for the human immunodeficiency virus, which causes the disease AIDS i.e. acquired immunodeficiency syndrome. The virus is usually transmitted sexually through the exchange of bodily fluids, via blood through infected needles or from an infected pregnant mother to her child. The virus hampers the immune system, disabling the very defence system of the body and making the person prone to other infections and diseases. There are two types of the virus, HIV-1 and HIV-2. The disease progresses from an acute to chronic phase and finally leads to AIDS where the life expectancy is reduced. Symptoms vary from a flu-like state in stage 1 to diminished symptoms in stage 2 and more serious problems like cancer and organ failure in stage 3. Those who abuse drugs, have unprotected sex and are not circumcised, are at a greater risk of acquiring HIV.

Blood tests and some home tests help diagnose the condition, but they must be followed by the Western Blot test to confirm the result. HIV/AIDS has no cure, but can be managed to a large extent with antiretroviral therapy (ART). Most medicines for HIV are inhibitors, which prevent the formation of certain proteins that help the virus to multiply, while others prevent the virus from entering specific immune cells called the CD4 cells through which the virus can affect the very bedrock of the body’s immunity. Some modifications to the diet and support from the family in availing treatment and coping with mental and physical stress help manage the condition well. There may be several complications including the side effects of the treatment, allied diseases, which thrive due to a weakened immune system and cancer, which may affect people who are in stage 3. If treated in time, people with HIV can live an active life with the infection for up to 50 years, while those with AIDS have an expected lifespan of up to 10 years.

  1. What is HIV/AIDS (Acquired Immunodeficiency Syndrome)
  2. Types of HIV/AIDS
  3. Stages of HIV/AIDS
  4. HIV/AIDS symptoms
  5. HIV/AIDS causes & risk factors
  6. Prevention of HIV/AIDS
  7. Diagnosis of HIV/AIDS
  8. HIV/AIDS treatment
  9. HIV/AIDS prognosis and complications
  10. Medicines for HIV - AIDS
  11. Doctors for HIV - AIDS

What is HIV/AIDS (Acquired Immunodeficiency Syndrome)

AIDS is among the most serious and widely researched and discussed diseases. Although it only came to be understood recently, it has affected a significant percentage of the population and proves to be a potential global health hazard unless addressed appropriately.

AIDS is the disease caused by the HIV or human immunodeficiency virus. Once the body is affected by this virus, the immune system is compromised, as is the ability of the body to fight diseases. Thus, the person doesn’t live with the symptoms of the infection, but with the symptoms of the other infections and diseases that attack the body due to a weak immune system. HIV infection is most commonly spread sexually. It can be life-threatening and chronic since it has no permanent cure.

AIDS is the most advanced stage of HIV infection. It stands for acquired immunodeficiency syndrome. When untreated, HIV infection gradually progresses to AIDS, which is fatal.

Types of HIV/AIDS

HIV can be found as two strains or types – HIV-1 and HIV-2. There are many subtypes within these two categories.

HIV-1 

This is the more common type of HIV. This strain has four sub-types:

  • Group M 
    The major or most popular of this type, this kind of HIV is found in nearly 90 per cent of the infections. This group has nine sub-groups. They range from A to K, the most common form found all over the world is the form C.
  • Group N 
    This is a very rare strain, which has not been found outside Africa. Very little information and research are available on this type.
  • Group O 
    Also called the outlier group, this type has many variants within it, but is also extremely rare and less known.
  • Group P 
    The newest of the HIV strains found, this group differs from all the other kinds. Very little information has been discovered about this group.

HIV-2 

This type is rarely found outside Africa. It is not transmitted as easily from one person to another and does not progress to AIDS as quickly as HIV-1.

HIV tends to change and mutate within the body. An infection which began as one strain may change into another over time, making the treatment a challenge. In rare cases, more than one strain may be present, causing a condition known as a superinfection.

Stages of HIV/AIDS

HIV infection is progressive and goes through three typical stages:

Acute HIV infection

This stage usually develops between two to four weeks after the virus infects a person. In this earliest stage, the virus is usually most active and spreads very rapidly through the whole body, and levels of HIV in the blood are highest. This is, therefore, the period when the risk of spreading the HIV virus is greatest. In this stage, the CD4 cells, which play a major role in the body’s defence mechanism, are attacked. Flu-like symptoms, such as a mild fever, body ache, or a rash might develop.

Chronic HIV infection

This is the second stage and is also called asymptomatic HIV infection. The virus now continues to replicate in the body, but not as aggressively. While people in this stage may not exhibit symptoms as those in stage 1, they still can spread the disease to others. If left untreated at this stage, the disease is most likely to advance to AIDS, however, this typically takes 10 years or longer.

AIDS

This is the final or terminal stage of HIV infection. In this stage, the CD4 cell count falls drastically and is 200 cells/mm3 or lower. Due to a heavily compromised immune system, people in this stage are most prone to developing infection-related cancer and other opportunistic infections. People with AIDS live for about three years if they do not receive appropriate and timely treatment.

HIV/AIDS symptoms

Symptoms of HIV infection differ depending on the stage of the disease. They may present as follows:

Acute HIV infection

Within the first four weeks of being infected, those in the acute stage are likely to experience:

Symptoms in this stage are likely to subside in some time.

Chronic HIV infection

In this stage, it is common to see that the symptoms of the acute stage start to disappear, although the individual is still a carrier of the infection. Through this stage and especially at the end, the virus affects CD4 cells and eventually, the virus becomes more potent and the CD4 count drops. As the person approaches the third and final stage, symptoms start to develop.

AIDS

The body is at its weakest in this stage. Several infections called opportunistic infections start to manifest. These infections are called so because they develop as a result of a weakened immune system of the infected person and many of them usually do not cause symptoms in healthy individuals without HIV. Some of these infections are:

  • Pneumonia that is accompanied by a dry cough.
  • Cerebral infection, with stroke-like symptoms, called toxoplasmosis.
  • Yeast infections in the throat and mouth (oral thrush).
  • Fungal infections, especially by Cryptococcus, leading to meningitis.
  • Viral infections that result in progressive multifocal leukoencephalopathy (progressive damage of the white matter of the brain at multiple locations) which eventually leads to death.
  • Cancer of the mouth, skin, throat or nose and other body organs which are the characteristic features of a condition called Kaposi’s sarcoma.
  • Lymphoma or cancer of the lymph nodes.

HIV/AIDS causes & risk factors

Causes

There are several myths surrounding the cause and spread of HIV. Although it is a communicable disease, there are certain ways in which it can be spread. It does not spread through air and water, or through touching, kissing or shaking hands.

HIV spreads through contact with infected blood, semen, rectal and vaginal fluids or breast milk of an infected person. Here are some causes:

  • Having oral, vaginal or anal sex with an infected person. When blood, semen or other secretions enter the body, they can spread the disease. The virus enters the bloodstream through ulcers, sores or wounds in the mouth, or ruptures and tears in the vagina or rectum.
  • Getting a blood transfusion done where the blood came from an infected person. However, since most hospitals screen all blood before transfusing, the risk of contracting HIV through infected blood transfusion is low.
  • From a pregnant mother to her child, through the placenta while in the womb, during childbirth and through breastfeeding.
  • Using an infected needle. This is most commonly seen in people who are drug addicts.
  • A needle injury to a healthcare professional attending to an HIV patient.

Risk factors

Individuals who are at higher risk include those:

  • Who have unprotected sex or sex with multiple partners.
  • With sores on their genitals, which then act as entry points for the virus.
  • Who inject drugs intravenously, since the exchange of needles and syringes is common.
  • Healthcare workers who attend to patients with HIV infection and might come in contact with needles or blood from the patient.
  • Who are uncircumcised are usually at higher risk through heterosexual transmission.

Prevention of HIV/AIDS

The easiest path to avoid AIDS is protection against HIV infection. Prevention against HIV infection involves the following:

  • Avoid unprotected sex and sex with multiple partners.
  • Use a new condom each time you have intercourse.
  • Stop using drugs as you have a very high chance of getting HIV by sharing needles. Seek help from family and friends or a rehab centre to get rid of the habit. 
  • Do not share razors or other instruments where blood exchange via cuts is possible.
  • Male circumcision can help reduce the risk of infection.
  • Seek immediate medical assistance if you are pregnant and have HIV. This will help in preventing the transmission of infection to the baby.
  • Couples should get a medical checkup done before tying a knot. It may help in early diagnosis of diseases and taking necessary measures while family planning.
  • Always tell your partners if you have the infection.
  • Always make sure that the injection or syringe used to administer medicines is new and is opened by the healthcare professional in front of you.

Diagnosis of HIV/AIDS

The diagnosis of HIV is mainly through blood tests. Tests are run in two phases. If the initial round of screening tests is positive, a second test is done to confirm the diagnosis. The main tests include an HIV antibody test, testing for a viral protein known as p24 antigen and an RNA test. The confirmation test is called the Western Blot. Since the virus takes a couple of weeks to develop and spread, some initial tests may not be positive. In case any test results are unclear, they should be repeated after a couple of months. This is called the window period.

In addition to these tests, swabs from the mouth, vagina or urine samples may also be collected for testing. Any tests conducted must be confirmed using the Western Blot test. There may also be additional tests run to check for any complications like TB, kidney or liver damage or UTI.

HIV/AIDS treatment

Since both HIV infection and AIDS have no cure, the focus of treatment revolves around containing the virus and trying to prevent the condition from worsening. The term for this form of therapy is antiretroviral therapy (ART), which essentially involves a combination of various drugs to curb the virus and its action. Medications to aid this process are:

  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are drugs that help cut off certain proteins, which are required by HIV to multiply.
  • Protease inhibitors are another set of drugs, which inhibit a protein called protease which also helps HIV in multiplying.
  • Fusion inhibitors are drugs that prevent HIV from entering CD4 cells and thereby keep CD4 count intact.
  • Integrase inhibitors prevent the genetic material of HIV from fusing with the DNA of CD4 cells by inhibiting an essential protein called integrase.

Lifestyle management

Those undergoing treatment for HIV infection/AIDS may need a lot of help from friends and family. Since treatment is prolonged and also rather draining, people may need help with:

  • Travelling to and from healthcare facilities.
  • Financial assistance.
  • Employment support.
  • Legal aid.
  • Self and child care.
  • Emotional support and acceptance from friends, family and society.

Changes made to the lifestyle include quitting habits like drug and alcohol abuse and making healthier eating choices. Food choices include:

  • Eating more fruits, vegetables and grains.
  • Avoiding eggs and raw meat, or foods that may increase the chance of acquiring any food-borne infection. Opt for cooked foods as far as possible.
  • Taking timely treatment.
  • Taking an alternative treatment to boost immunity.
  • Immediately seeking medical assistance at the hint of a possible infection, as infections tend to flare up and become severe rapidly in people with HIV infection.

HIV/AIDS prognosis and complications

Prognosis

People with AIDS have an expected lifespan of up to 10 years. However, those who receive timely, appropriate medical help can live for up to 50 more years, as long as the conditions are optimally managed and health is maintained. 

Complications

A range of complications may arise from both the disease as well as the treatment prescribed for HIV/AIDS. These are:

  • A host of side effects of medicines can be experienced. These include nausea, fatigue, diarrhoea, loss of bone density, heart disease, high cholesterol and blood sugar and loss of muscle tissue.
  • Complications arising from the condition itself are many, considering the weakened immune system. TB, hepatitis, sexually transmitted diseases, liver and kidney damage and UTI are some complications associated with the disease.
  • Increased risk of cancer in people who are either in or approaching stage 3 of the disease.
  • Risk of organ failure, which may affect people at any stage. 
Dr. Jogya Bori

Dr. Jogya Bori

संक्रामक रोग

Dr. Lalit Shishara

Dr. Lalit Shishara

संक्रामक रोग

Dr. Amisha Mirchandani

Dr. Amisha Mirchandani

संक्रामक रोग

Medicines for HIV - AIDS

Medicines listed below are available for HIV - AIDS. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.

Medicine NamePack SizePrice (Rs.)
AbamuneAbamune 300 Mg Tablet1378.0
A BecA Bec 300 Mg Tablet1532.0
AbhopeAbhope 300 Mg Tablet2796.0
Primol DPrimol D Tablet36.0
VirolVirol 300 Mg Tablet7215.0
EfamatEfamat 600 Mg Tablet1939.0
EfavirEfavir 100 Mg Capsule852.0
EfcureEfcure 200 Mg Tablet729.0
EffahopeEffahope 600 Mg Tablet1922.0
EffervenEfferven 600 Mg Tablet2356.0
EstivaEstiva 600 Mg Capsule2070.0
EvirenzEvirenz 200 Mg Tablet288.0
ViranzViranz 600 Mg Capsule1922.0
RicovirRicovir 300 Mg Tablet1550.0
TeravirTeravir 300 Mg Tablet1714.0
HepdozeHepdoze 300 Mg Tablet1285.0
ReviroReviro 300 Mg Tablet1725.0
RivofonetRivofonet Tablet1300.0
TavinTavin 300 Mg Tablet1100.0
TenfoclearTenfoclear 300 Mg Tablet1379.0
TenocruzTenocruz 300 Mg Tablet520.0
TenofTenof 300 Mg Tablet440.0
TenohepTenohep 300 Mg Tablet466.0
TentideTentide 300 Mg Tablet1500.0
TenvirTenvir 300 Mg Tablet1379.0
Valten 300 Mg TabletValten 300 Mg Tablet1428.0
VireadViread 300 Mg Tablet2380.0
ForstavirForstavir 200 Mg/300 Mg/600 Mg Tablet2380.0
TeevirTeevir 200 Mg/300 Mg/600 Mg Tablet4000.0
Forstavir EmForstavir Em Tablet1272.0
TofodayTofoday 200 Mg/300 Mg/600 Mg Tablet4330.0
TrustivaTrustiva 200 Mg/300 Mg/600 Mg Tablet3800.0
ViradayViraday 200 Mg/300 Mg/600 Mg Tablet3900.0
VirotrenzVirotrenz 200 Mg/300 Mg/600 Mg Tablet3714.0
VonavirVonavir 200 Mg/300 Mg/600 Mg Tablet3900.0
HeptavirHeptavir 10 Mg Syrup80.0
LamimatLamimat Tablet571.42
LamivirLamivir 150 Mg Tablet101.06
EpivirEpivir Solution1350.0
HepitecHepitec 100 Mg Tablet565.0
LamihopeLamihope 150 Mg Tablet538.06
LavirLavir 150 Mg Tablet564.0
RetrolamRetrolam 150 Mg Injection11.52
NevimatNevimat 200 Mg Tablet857.13
Nevirex(Cit)Nevirex 200 Mg Tablet142.5
NevihopeNevihope 200 Mg Tablet829.73
NevimuneNevimune 200 Mg Tablet857.07
NevipanNevipan 200 Mg Tablet850.0
NevirNevir 200 Mg Tablet820.76
NeviretroNeviretro 200 Mg Tablet137.6
NevivirNevivir 200 Mg Tablet471.22
ZidineZidine 300 Mg Tablet932.71
ZidohopeZidohope 100 Mg Tablet596.72
ZidovexZidovex 300 Mg Capsule259.56
Zidovex L Plus EZidovex L Plus E 300 Mg Tablet104.0
ZidovirZidovir 300 Mg Tablet168.72
ZilionZilion 300 Mg Tablet215.0
EmpetusEmpetus 100 Mg Tablet978.0
RitovirRitovir 100 Mg Capsule865.37
RitomaxRitomax 100 Mg Capsule2648.25
RitomuneRitomune 100 Mg Capsule1800.0
ViritonViriton 100 Mg Tablet1890.0
AtavirAtavir 300 Mg Capsule2300.0
AtazorAtazor 200 Mg Capsule3004.76
ViratazVirataz 300 Mg Capsule2100.0
DaruvirDaruvir 300 Mg Tablet4571.51
ViremVirem 300 Mg Tablet10549.8
DinosinDinosin 100 Mg Tablet929.75
Dinex EcDinex Ec 400 Mg Tablet1131.13
MaximuneMaximune 500 Mg Tablet3086.53
SaquinSaquin 500 Mg Tablet500.0
StahopeStahope 40 Mg Tablet229.98
StavirStavir 30 Mg Capsule35.31
IsentressIsentress 400 Mg Tablet10023.3
ZepdonZepdon 400 Mg Tablet9400.0
IndivanIndivan 400 Mg Capsule561.75
IndivirIndivir 400 Mg Capsule523.39
NelfinNelfin 625 Mg Tablet1528.85
NelvirNelvir 250 Mg Capsule2400.0
AllteraAlltera 50 Mg/200 Mg Tablet5850.0
Emletra JuniorEmletra Junior 25 Mg/100 Mg Tablet1474.28
Hivus LrHivus Lr 200 Mg/50 Mg Tablet2062.5
AluviaAluvia 200 Mg/50 Mg Tablet5634.98
EmletraEmletra 200 Mg/50 Mg Tablet3000.0
LopimuneLopimune 50 Mg/200 Mg Capsule2761.91
RitocomRitocom 50 Mg/200 Mg Tablet1500.0
Ritomax LRitomax L 33.3 Mg/133.3 Mg Capsule4590.0
Ritomax L ForteRitomax L Forte 50 Mg/200 Mg Tablet1557.68
V LetraV Letra 33.3 Mg/133.3 Mg Capsule2900.0
Anzavir RAnzavir R 300 Mg/100 Mg Tablet3200.0
Atazor RAtazor R 300 Mg/100 Mg Kit576.92
Virataz RVirataz R 300 Mg/100 Mg Tablet3000.0
AtaclipAtaclip 300 Mg/100 Mg Tablet3789.16
RitovazRitovaz 300 Mg/100 Mg Tabcap2857.5
SynthivanSynthivan Tablet2885.4
DinmekDinmek 300 Mg/300 Mg Tablet2250.0
Ricovir LRicovir L 300 Mg/300 Mg Tablet1600.0
Tavin LTavin L Tablet1200.0
TenolamTenolam Tablet1430.0
Tenvir LTenvir L Tablet1550.0
VirofovirVirofovir 300 Mg/300 Mg Tablet833.33
VonadayVonaday 300 Mg/300 Mg Tablet3245.0
LamistarLamistar 150 Mg/30 Mg Tablet101.18
LamostadLamostad 150 Mg/30 Mg Tablet105.57
VirolisVirolis 150 Mg/30 Mg Tablet626.75
NevilastNevilast 150 Mg/30 Mg/200 Mg Tablet192.0
Stavex LnStavex Ln 150 Mg/30 Mg/200 Mg Tablet644.0
Emduo NEmduo N 150 Mg/30 Mg/200 Mg Kit38.45
Emtri JuniorEmtri Junior 40 Mg/10 Mg/70 Mg Tablet77.67
EmtriEmtri 150 Mg/30 Mg/200 Mg Tablet551.38
Lamostad NLamostad N 150 Mg/30 Mg/200 Mg Tablet207.68
Nevilast Baby TabletNevilast Baby 150 Mg/30 Mg/200 Mg Tablet210.0
Nevilast JuniorNevilast Junior 150 Mg/30 Mg/200 Mg Tablet365.4
TriomuneTriomune 150 Mg/30 Mg/200 Mg Tablet584.61
VirolansVirolans 100 Mg/30 Mg/200 Mg Tablet Dt1236.48
Ricovir EmRicovir Em 200 Mg/300 Mg Tablet1952.37
Tavin EmTavin Em Tablet2000.0
Tenof EmTenof Em Tablet1540.0
Tentide EmTentide Em Tablet2000.0
Tenvir EmTenvir Em Tablet2200.0
TofocomTofocom 200 Mg/300 Mg Tablet1971.42
TruvadaTruvada 200 Mg/300 Mg Tablet2510.0
TeluraTelura Tablet3300.0
EffodayEffoday 300 Mg/300 Mg/600 Mg Tablet3300.0
Tenolam ETenolam E Tablet3000.0
TriodayTrioday 300 Mg/300 Mg/600 Mg Tablet3200.0
ZidolamZidolam 150 Mg/300 Mg Tablet210.0
CombivirCombivir 150 Mg/300 Mg Tablet911.12
CytocomCytocom 150 Mg/300 Mg Tablet190.38
Duovir EpDuovir Ep 150 Mg/300 Mg Tablet1324.55
DuovirDuovir 150 Mg/300 Mg Tablet1324.55
LazidLazid Tablet1284.15
VirocombVirocomb 150 Mg/300 Mg Tablet1251.58
Zidolam NZidolam N 150 Mg/300 Mg/200 Mg Tablet210.0
Zidolam N NZidolam N N 150 Mg/300 Mg/200 Mg Tablet654.2
Zidovex LnZidovex Ln 150 Mg/300 Mg/200 Mg Tablet675.0
Cytocom NCytocom N 150 Mg/300 Mg/200 Mg Tablet229.32
Duovir NDuovir N Tablet644.11
Virocomb NVirocomb N 150 Mg/300 Mg/200 Mg Tablet1214.43
Abamune LAbamune L 600 Mg/300 Mg Tablet2950.0
A Bec LA Bec L 600 Mg/300 Mg Tablet2950.0

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