The history of the spread of AIDS on a pandemic (or ‘global epidemic’) scale is usually traced back to 1981, when a new disease was recognised in patients in the United States: in reality, the infection had existed for many years, but had always been mistaken for something else. This article explains the differences between HIV and AIDS. The causes, symptoms and current treatment options, even though there is no vaccine or definitive cure.
HIV and AIDS are not the same thing. What are the differences?
HIV (human immunodeficiency virus) is a virus that attacks and destroys, in particular, a type of white blood cell, the CD4 lymphocytes, which are responsible for the body’s immune response. The immune system is weakened to the point of nullifying the response against other viruses, bacteria, protozoa, fungi and tumours. The HIV infection does not have its own specific manifestation, but reveals itself through the effects it has on the immune system. The presence of HIV antibodies in the blood is referred to as HIV seropositivity. Even with an HIV infection, it is possible to live for years without any symptoms and only become aware of the infection when an opportunistic disease occurs. An HIV test is therefore the only way to detect the infection.
AIDS (acquired immune deficiency syndrome) is an advanced clinical stage of HIV infection. It is a syndrome that can occur in people with HIV even several years after acquiring the infection, when the CD4 cells of the immune system drop dramatically and the body loses its ability to fight even the most trivial infections (opportunistic infections/diseases). Advances in scientific research and the use of antiretroviral therapy have made it possible for people with HIV to have a good quality of life, thanks in part to the lower impact on the body and fewer side effects. Scientific evidence suggests that the life prospects for those who now find out they have HIV and immediately enter treatment are similar to those who don’t have HIV. Therapy that has persistently maintained the viral load (i.e. the amount of virus present in the blood/secretions) at unmeasurable levels for at least 6 months also nullifies the possibility of transmitting the virus to others. In this case we speak of U=U Undetectable = Untrasmittable.
How does HIV infection occur?
HIV is transmitted through direct contact with body fluids containing the virus or cells infected with the virus (such as blood, semen or vaginal secretions). HIV destroys certain types of white blood cells, weakening the body’s defences against infection and cancer.
What are the causes of AIDS?
HIV is transmitted at any stage of the disease through unprotected sexual intercourse, contact with blood, vertical transmission between mother and child during pregnancy, birth and breastfeeding.
What are the symptoms of AIDS?
The manifestation of the virus is generally characterised by two distinct phases. In the first phase, several weeks after infection, patients may complain of symptoms of a flu-like syndrome characterised by fever, swollen lymph glands, joint and muscle pain, skin manifestations, night sweats. The progression of the infection can vary from person to person. In some cases it can remain without symptoms (clinical latency) for many years. When not controlled early with antiretroviral therapy, the infection progresses to AIDS; at this stage infections caused by ‘opportunistic’ pathogens already present in the body can occur, leading to illnesses whose progression can be potentially fatal.
How to prevent AIDS?
The only prevention from infection is to avoid behaviour that may expose you to the risk of infection. A condom must be worn during sexual intercourse.
The diagnosis of HIV infection can be made following a blood test (ELISA test) that detects the presence of virus-specific antibodies. A positive ELISA test must always be confirmed by an additional test (Western Blot test). In the first few months after a possible exposure, the virus may still be undetectable in the test; this is the so-called ‘window period’, during which one is already infected and contagious, but seroconversion has not yet occurred. There are now early tests available to determine positivity for HIV infection (p24 antigen test, combined tests). The test is easy to perform, consists of a blood sample, and by law is carried out completely anonymously.
There is currently no cure for the eradication of HIV infection. The treatment of HIV infection consists of controlling the virus through a combination of drugs that blocks the replication of the virus, reducing viral load and consequently destroying the immune system. Due to the strong tendency of HIV to mutate, it is necessary not only to find new drugs, but also to administer several antiretroviral drugs simultaneously (combination therapy). This is intended to minimise or delay the emergence of viral strains that are resistant to antiretroviral drugs. New classes of drugs aimed at stimulating and supporting the immune system, rather than having a direct antiviral action, are currently being tested. In addition to drugs, studies have been under way for several years to develop a vaccine that can prevent infection among HIV-negative people, or improve the course of the disease in those already infected.
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