Human immunodeficiency virus , also known as HIV is a blood borne illness that has caused worldwide health concerns. HIV enters the body through blood and body fluids such as semen and in rare cases saliva. HIV refers to the state of being infected with the retrovirus, meaning they test positive for HIV. Once the HIV virus has infected a person and the disease is active, this is known as AIDS (Acquired Immune deficiency syndrome). HIV/AIDS is an incurable disease, but there are medications available to improve the quality of life. Since the appearance of the first case in 1981, a rapid and silent spread of the HIV infection has continued. With the increasing availability of medicines to fight against HIV infection, the life expectancy has raised to the great extent. However, the war against HIV still continues and we are far away from the finish line. Prevalence of HIV Due to the long window period from the time of exposure to HIV virus versus the time that the patient will test positive for HIV, the actual incidence and prevalence cannot be calculated. However, it is estimated that more than 37 million people globally are infected with HIV. This number includes 3 million children.

Pathology of HIV The HIV virus is highly intelligent and adaptable, which makes it harder to treat. There are many efforts being taken by people all around the world to understand the actual pathology, disease progress, and probable cure for the HIV infection and AIDS. HIV virus typically cannot survive outside of the body for long periods of time, it is however speculated to be able to can live in body fluids or blood droplets for several weeks in favorable conditions. The HIV virus requires human blood cells to replicate. Once inside the human body, HIV virus invades in the immune cells and blood cells, like CD4+ T cells and macrophages. The virus attaches to the CD4 and CCR5 (co-receptors) and fuses with the cell surface. The virus releases viral RNS and proteins into the cell and viral RNA reverse transcribes onto the cells DNA. The DNA is then transported into the cell’s nucleus and becomes part of the cell’s genome. The CD4 lymph is most targeted by HIV, which is why the infection typically starts in the lymph nodes where most of the immune cells are present. The HIV infection leads to scarring and shrinkage of these nodes. The infected immune cells are destroyed by our body, which ultimately leads to a decrease in a total number of immune cells.

Symptoms of HIV After initial exposure, when the HIV load peaks at 3-9 weeks,  flu-like symptoms may be experienced, however, throughout the infection and during later stages the following symptoms can be experienced:    Weight loss    Fatigue    Swollen and painful lymph nodes    Respiratory infections are not resolving after treatment    Skin infections are not resolving after treatment    Diarrhea    Relapse of previous infections (tuberculosis, herpes , and other conditions)    Opportunistic infections Often the HIV/AIDS disease is diagnosed at a later stage when the virus has spread extensively. However, due to increased campaigns for routine HIV screening, the infection is often diagnosed earlier. The sooner medication is started the better the outcome. Stages of HIV In primary infection, the patient suffers from the flu-like symptoms like fever, chills, cough, sore throat, fatigue, body ache, etc. for the short duration. These symptoms usually occur within 1 – 2 months of the infection. Many recipients of the HIV virus do not suffer from any of these symptoms which make the primary infection more difficult to detect. The second stage starts once the primary infection has spread into body’s immune system. This stage normally starts after 12 weeks of exposure.

Many risk factors affect the spread of HIV infection , it is important to be aware in order to stop the spread.    Heterosexual men and women, especially when they don’t practice safe sex.    Homosexual and bisexual men with the multiple partners increase chances of getting the HIV infection.    Women who have sex with multiple partners especially without using any protective device like condoms.    Drug addiction, especially those who use injectable drugs.    Health care providers and hospital staff, laboratory technician, blood bank staff, etc. who has chances of getting an accidental prick or cut by needles and other instruments which are contaminated with HIV-infected blood or body fluids.   An infant born to the HIV-infected mother. The chances of transmitting infection increases if a mother is not receiving any therapy. Patients with kidney disease, blood cancers and other patients who require multiple blood transfusion are also exposed to higher risk of HIV infection.

There are multiple diagnostic tests available to detect HIV/AIDS. The traditional test was not sensitive enough to detect the infection at the early stage, but newer variants are able to. Older testing took up to 3-6 months after exposure to test positive, newer methods can detect the virus in 3 weeks to 3 months. Understanding HIV testing Apart from government health centres, there are lots of organisations working to control the spread of HIV and have free test centres available. These centres are sensitive to your privacy and all testing will be done with the concept of confidentiality. The HIV counselor will guide you through the HIV testing process and explain the possible implications of the test results. The test results cannot be declared to anyone unless you authorise them to release the results. There are HIV test kits available for self-testing at home, however, it is advised that the interpretation of the result should be done by an expert only. Other situations when the HIV testing should be done are as follows:    Before donating a blood    Sperm donation for artificial insemination    Before donating any organs for transplantation    Adoption of a child It is very important to understand that HIV test may be negative during initial weeks of the infection.