Persistent HIV symptoms at all stages. How does HIV manifest in men?

HIV is an abbreviation for Human Immunodeficiency Virus, which attacks the human immune system, causing HIV infection.

The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome).

HIV infection and AIDS: what is the fundamental difference between these two conditions?

HIV infection
An incurable infectious disease. It belongs to a group of slow viral infections with a long-term course that affects the immune system.

That is, a virus, having entered the body of a healthy person from a sick person, may not manifest itself in any way for many years.

However, HIV gradually destroys the cells of the immune system, which is designed to protect the human body from all kinds of infections and negative influences.
Therefore, over time, immunity "loses its ground."

AIDS
A condition in which the human immune system is practically unable to fight infections, resist the development of cancer cells and various harmful environmental factors. At this stage, any infection, even the most harmless one, can lead to the development of a serious illness, and subsequently to the death of the patient from complications, encephalitis or a tumor.

Disease facts

Perhaps now there is not a single adult who has never heard of HIV infection. It is not without reason that it is called the "plague of the 20th century." And in the XI century, it is moving forward with "leaps and bounds", daily claiming about 5,000 human lives around the world. Though, as a disease of HIV has a not so long history.

It is believed that HIV infection began its "triumphal march" across the planet back in the 70s of the last century, when the first mass cases of infection were described in terms of symptoms similar to AIDS.

However, they started talking about HIV officially only in the early 80s of the last century:

• In 1981, two articles were published that described the development of unusual Pneumocystis pneumonia (caused by a yeast-like fungus) and Kaposi's sarcoma (a malignant tumor of the skin) in homosexual men.
• In July 1982, the term AIDS was coined to denote a new disease.
• The human immunodeficiency virus was discovered in 1983 in two independent laboratories simultaneously:
  • In France at the Institute. Louis Pasteur under the direction of Luc Montagnier
  • In the USA at the National Cancer Institute under the direction of Robert Gallo
• In 1985, a method was developed that determined the presence of antibodies to HIV in the blood of patients - enzyme-linked immunosorbent assay.
• In 1987, the first case of HIV infection was diagnosed in the USSR. The patient is a homosexual man who worked as a translator in African countries.
• In 1988, the World Health Organization declared International AIDS Day - December 1.

A bit of history

Where did HIV come from? There is no definite answer to this question. However, there are several hypotheses.

The most common theory is that humans were infected by a monkey. It is based on the fact that great apes (chimpanzees) living in Central Africa (Congo) have isolated a virus from their blood that can cause the development of AIDS in humans. Probably, a person was infected by accidental injury while cutting a monkey carcass or a monkey bite a person.

However, monkey HIV is a weak virus and the human body copes with it within one week. But for the virus to harm the immune system, it must be transmitted from one person to another within a short time. Then the virus mutates (changes), acquiring properties characteristic of human HIV.

There is also an assumption that HIV has existed for a long time among the tribes of Central Africa. However, it was only with the onset of increased migration in the 20th century that the virus spread throughout the world.

Statistics

Every year, a huge number of people around the world are infected with HIV.

Number of HIV-infected

• Worldwide as of 01.01.2013 amounted to 35.3 million people
• In Russia at the end of 2013 - about 780,000 people, and 51,190 thousand were identified in the period from 01/01/13 to 08/31/13
• By CIS countries(data at the end of 2013):
  • Ukraine - about 350,000
  • Kazakhstan - about 16,000
  • Belarus - 15,711
  • Moldova - 7 800
  • Georgia - 4,094
  • Armenia - 3,500
  • Tajikistan - 4,700
  • Azerbaijan - 4,171
  • Kyrgyzstan - about 5,000
  • Turkmenistan - Officials say there is no HIV infection in the country
  • Uzbekistan - about 7 800

The given data do not fully characterize the actual statistics, since not everyone is tested for HIV. In fact, the numbers are much higher, which, undoubtedly, should alert the governments of all countries and the WHO.

Mortality

Since the beginning of the epidemic, about 36 million people have died from AIDS. Moreover, the mortality rate of patients decreases from year to year - thanks to the successful highly active antiretroviral therapy (HAART or ART).

Celebrities who have passed away from AIDS

• Jia Carangi is an American supermodel. She died in 1986. She suffered from a severe form of drug addiction.
• Freddie Mercury- the lead singer of the legendary rock group Queen. He died in 1991.
• Michael Wastfall- famous tennis player. He died at the age of 26.
• Rudolf Nureyev- the legend of world ballet. He died in 1993.
• Ryne White- the first and most famous child with HIV infection. He suffered from hemophilia and contracted HIV through a blood transfusion at the age of 13. The boy, together with his mother, fought for the rights of HIV-infected people all his life. Ryan White died of AIDS in 1990 at the age of 18, but he did not lose: he proved to the whole world that HIV-infected people do not pose a threat when taking basic precautions, having the right to an ordinary life.

The list is far from complete. The story continues ...

AIDS virus

Perhaps there is no other virus that is so thoroughly studied and at the same time remains a big mystery for scientists, claiming thousands of lives every year, including children. This is due to the fact that the human immunodeficiency virus is changing very quickly: 1000 mutations per gene. Therefore, an effective drug against it has not yet been found and a vaccine has not been developed. Whereas, for example, the flu virus mutates 30 (!) Less often.

In addition, there are several varieties of the virus itself.

HIV: structure

There are two main types of HIV:

• HIV-1 or HIV-1(opened in 1983) - the main causative agent of infection. It is quite aggressive, causing the typical manifestations of the disease. Most often found in Western Europe and Asia, South and North America, Central Africa.

• HIV-2 or HIV-2(opened in 1986) - a less aggressive analogue of HIV-1, so the disease is milder. Not so widespread: found in West Africa, Germany, France, Portugal.

There is HIV-3 and HIV-4, but they are rare.

Structure

Hiv- a spherical (spherical) particle with a size of 100 to 120 nanometers. The envelope of the virus is dense, formed by a double lipid (fat-like substance) layer with "spikes", and under it is a protein layer (p-24-Capsid).

Below the capsule are:

• two strands of viral RNA (ribonucleic acid) - a carrier of genetic information
• viral enzymes: protease, intergrase and transcriptase
• p7 protein

HIV belongs to the family of slow (lentiviruses) retroviruses. It has no cellular structure, does not synthesize protein on its own, but reproduces only in the cells of the human body.

The most important feature of retroviruses is the presence of a special enzyme: reverse transcriptase. Thanks to this enzyme, the virus converts its RNA into DNA (a molecule that provides storage and transmission of genetic information to future generations), which is then inserted into the host's cells.

HIV: properties

HIV in the external environment is unstable:

• quickly dies under the influence of 5% hydrogen peroxide solution, ether, chloramine solution, 70 0 С alcohol, acetone
• outside the body in the open air dies within a few minutes
• at +56 0 С - 30 minutes
• when boiling - instantly

However, the virus retains its viability for 4-6 days in a dried state at a temperature of + 22 0 C, in a solution of heroin for up to 21 days, a needle cavity for several days. HIV is resistant to freezing, it is not affected by ionizing and ultraviolet radiation.

HIV: features of the life cycle

HIV has a special affinity (prefers) to some cells of the immune system - T-helper lymphocytes, monocytes, macrophages, as well as cells of the nervous system, in the membrane of which there are special receptors - CD4 cells. However, there is speculation that HIV infects other cells as well.

What are the cells of the immune system responsible for?

T-lymphocytes-helpers activate the work of almost all cells of the immune system, and also produce special substances that fight against foreign agents: viruses, microbes, fungi, allergens. That is, in fact, they control the work of almost the entire immune system.

Monocytes and macrophages - cells that absorb foreign particles, viruses and microbes, digesting them.

The life cycle of HIV includes several phases

Let us consider them using the example of a helper T-lymphocyte:

• Once in the body, the virus binds to special receptors on the surface of the T-lymphocyte - CD4 cells. Then it enters the host cell and sheds its outer shell.

• Using reverse transcriptase a DNA copy (one strand) is synthesized on viral RNA (matrix). Then the copy is completed into double-stranded DNA.
• Double-stranded DNA moves to the nucleus of the T-lymphocyte, where it is incorporated into the DNA of the host cell. At this stage, the acting enzyme is integrase.
• The DNA copy is stored in the host cell from several months to several years, so to speak, "sleeps". At this stage, the presence of the virus in the human body can be detected using tests with specific antibodies.
• Any secondary infection provokes the transfer of information from the DNA copy to the matrix (viral) RNA, which leads to further multiplication of the virus.
• Further, the ribosomes of the host cell (particles that produce protein) on viral RNA synthesize viral proteins.
• Then from viral RNA and newly synthesized viral proteins assembling new parts of viruses that leave the cage, destroying it.
• New viruses attach to receptors on the surface of other T-lymphocytes - and the cycle begins again.

Thus, if no treatment is given, HIV reproduces itself quite quickly: from 10 to 100 billion new viruses a day.

General scheme of HIV division along with a photograph taken under an electron microscope.

HIV infection

Gone are the days when it was believed that HIV infection is a disease that affects only drug addicts, sex workers and homosexuals.

Anyone can get infected, regardless of social status, financial wealth, gender, age and sexual orientation. The source of infection is an HIV-infected person at any stage of the infectious process.

It's just that HIV doesn't fly through the air. It is found in biological fluids of the body: blood, semen, vaginal secretions, breast milk, cerebrospinal fluid. For infection, it is necessary that an infectious dose - about 10,000 viral particles - enter the bloodstream.

Routes of HIV transmission

1. Heterosexual contact- unprotected vaginal sex.

The most common route of HIV transmission in the world is about 70-80% of cases of infection, in Russia - 40.3%.

The risk of infection after one sexual contact with ejaculation is from 0.1 to 0.32% for the passive partner ("receiving" side), and 0.01-0.1% for the active ("entering" side).

However, infection can occur after one sexual contact if there is any other sexually transmitted disease (STD): syphilis, gonorrhea, trichomoniasis and others. Since the number of T-helper lymphocytes and other cells of the immune system increases in the inflammatory focus. And then HIV "enters the human body on a white horse."

In addition, with all STDs, the mucous membrane is prone to injury, therefore, its integrity is often violated: cracks, ulcers, and erosion appear. As a result, infection occurs much faster.

The likelihood of infection increases with prolonged sexual intercourse: if the husband is sick, then within three years in 45-50% of cases the wife becomes infected, if the wife is sick - in 35-45% of the husband. The risk of infection in a woman is higher, since a large amount of infected sperm enters the vagina, it is in contact with the mucous membrane longer, and the contact area is larger.

1. Intravenous drug use

In the world, 5-10% of patients become infected in this way, in Russia - 57.9%.

Since intravenous drug addicts often use shared non-sterile medical syringes or common utensils for solution preparation. The probability of infection is 30-35%.

In addition, drug addicts often engage in promiscuous sex, which several times increases the likelihood of infection, both themselves and others.

1. Unprotected anal sex regardless of sexual orientation

The likelihood of infecting a passive partner after one sexual contact with felation ranges from 0.8 to 3.2%, an active partner - 0.06%. The risk of infection is higher because the rectal mucosa is vulnerable and well supplied with blood.

1. Unprotected oral sex

The probability of infection is lower: a passive partner after one contact with ejaculation is not more than 0.03-0.04%, an active partner is practically zero.

However, the risk of infection increases if there are seizures in the corners of the mouth, and wounds and ulcers in the cavity.

1. Children born to HIV-infected mothers

They are infected in 25-35% of cases through a defective placenta, at the time of childbirth, during breastfeeding.

It is possible for a healthy mother to become infected while breastfeeding a sick child, if a woman has cracks in her nipples, and the baby's gums are bleeding.

1. Accidental injuries with medical instruments, subcutaneous and intramuscular injections

Infection occurs in 0.2-1% of cases if there was contact with the biological fluid of an HIV-infected.

1. Blood transfusion and organ transplants

Infection - in 100% of cases, if the donor was HIV-positive.

On a note

The likelihood of infection depends on the initial state of the human immune system: the weaker it is, the faster the infection occurs, and the disease is more severe. In addition, it matters what the viral load of an HIV-infected person is, if it is high, then the risk of infection increases several times.

Diagnosis of HIV infection

Quite difficult, since its symptoms appear long after infection and are similar to other diseases. So the main method of early diagnosis is testing for HIV infection.

Methods for diagnosing HIV infection

Developed for a long time and are constantly being improved, reducing the risk of both false negative and false positive results to a minimum. Most often blood is used for diagnosis. However, there are test systems for determining HIV in saliva (scraping from the oral mucosa) and in urine, but they have not yet found widespread use.

There are three main stages of diagnosis HIV infections in adults:

1. Preliminary- screening (sorting), which serves to select suspected infected persons
2. Reference

1. Confirming- expert

The need for several stages is due to the fact that the more complex the method, the more expensive and more laborious it is.

Some concepts in the context of HIV diagnosis:

• Antigen- the virus itself or its particles (proteins, fats, enzymes, capsule particles, and so on).
• Antibody- cells produced by the immune system in response to HIV entering the body.
• Seroconversion- the immune response. Once in the body, HIV multiplies intensively. In response, the immune system begins to produce antibodies, the concentration of which increases over the next several weeks. And only when their number reaches a certain level (seroconversion), they are detected by special test systems. Further, the level of the virus drops, and the immune system calms down.
• "Window period"- the interval from the moment of infection to the appearance of seroconversion (on average from 6-12 weeks). This is the most dangerous period, since the risk of HIV transmission is high, and the test system gives a false negative result.

Screening stage

Definition common antibodies to HIV-1 and HIV-2 using enzyme-linked immunosorbent assay - ELISA . It is informative usually 3-6 months after infection. However, sometimes he detects antibodies a little earlier: three to five weeks after a dangerous contact.

It is preferable to use test systems of the fourth generation. They have one feature - in addition to antibodies, they also determine the HIV antigen - p-24-Capsid, which makes it possible to detect the virus even before the development of a sufficient level of antibodies, reducing the "window period".

However, in most countries, outdated third or even second generation test systems (only detect antibodies) are still used, since they are cheaper.

However, they are more often give false positive results: if there is an infectious disease during pregnancy, autoimmune processes (rheumatism, systemic lupus erythematosus, psoriasis), the presence of the Epstein-Bar virus in the body and in some other diseases.

If the ELISA result is positive, then the diagnosis of HIV infection is not made, but proceeds to the next stage of diagnosis.

Reference stage

It is carried out with more sensitive test systems 2-3 times. In case of two positive results, proceed to the third stage.

Expert stage - immunoblotting

A method in which antibodies to specific HIV proteins are determined.

Consists of several stages:

• HIV is destroyed by electrophoresis into antigens.
• by blotting (in a special chamber) they are transferred to special strips, on which the proteins characteristic of HIV have already been applied.
• the patient's blood is applied to the strips, if there are antibodies to antigens in it, a reaction occurs that is visible on the test strips.

However, the result can be false-negative, since there are sometimes not enough antibodies in the blood - in the "window period" or in the terminal stages of AIDS.

Therefore, there are two options for the expert stage laboratory diagnosis of HIV infection:

First option	Second option

There is another sensitive diagnostic method HIV infection - polymerase chain reaction (PCR) - determination of the DNA and RNA of the virus. However, it has a significant drawback - a high percentage of false positives. Therefore, it is used in combination with other methods.

Diagnosis in children born to HIV-infected mothers

It has its own characteristics, since maternal antibodies to HIV may be present in the child's blood, which cross the placenta. They are available from the moment of birth, remaining up to 15-18 months of life. However, the absence of antibodies is not an indication that the child is not infected.

Diagnostic tactics

• up to 1 month - PCR, since the virus does not multiply intensively during this period
• over a month - determination of p24-Capsid antigen
• laboratory diagnostic examination and observation from the moment of birth to 36 months

Symptoms and signs of HIV in men and women

Diagnosis is difficult because the clinical manifestations are similar to those of other infections and diseases. In addition, HIV infection progresses differently from person to person.

Stages of HIV infection

According to the Russian clinical classification of HIV infection (V.I. Pokrovsky)

HIV infection symptoms

• The first stage is incubation

  The virus is actively multiplying. Duration - from the moment of infection to 3-6 weeks (sometimes up to one year). With weakened immunity - up to two weeks.

  Symptoms
  None. You can suspect if there was a dangerous situation: unprotected casual sexual contact, blood transfusion, and so on. Test systems do not detect antibodies in the blood.

• Second stage - primary manifestations

  The body's immune response to the introduction, reproduction and massive spread of HIV. The first symptoms appear within the first three months after infection and may outpace seroconversion. Duration - usually 2-3 weeks (rarely several months).

  Flow options

• 2A - Asymptomatic There are no manifestations of the disease. Only antibody production is present.

• 2B - Acute infection without secondary diseases It is observed in 15-30% of patients. It proceeds as an acute viral infection or infectious mononucleosis.

Most common symptoms

• Increased body temperature 38.8C and above is the response to the introduction of the virus. The body begins to produce an active biological substance - interleukin, which "gives a signal" to the hypothalamus (located in the brain) that there is a "stranger" in the body. Therefore, energy production increases and heat output decreases.
• Swollen lymph nodes- the reaction of the immune system. In the lymph nodes, the production of antibodies by lymphocytes against HIV increases, which leads to working hypertophia (enlargement) of the lymph nodes.
• Skin rashes in the form of red spots and seals, small hemorrhages up to 10 mm in diameter, prone to merging with each other. The rash is located symmetrically mainly on the skin on the trunk, but sometimes on the face and neck. It is a consequence of direct damage by the virus to T-lymphocytes and macrophages in the skin, which leads to a violation of local immunity. Therefore, in the future there is an increased susceptibility to various pathogens.
• Diarrhea(frequent loose stools) develops due to the direct effect of HIV on the intestinal mucosa, which causes changes in the local immune system, and also interferes with absorption.
• Sore throat(tonsillitis, pharyngitis) and the oral cavity is associated with the fact that HIV affects the mucous membranes of the mouth and nose, as well as lymphoid tissue (tonsils). As a result, swelling of the mucous membrane appears, tonsils enlarge, which causes a sore throat, painful swallowing and other symptoms characteristic of a viral infection.
• Enlargement of the liver and spleen associated with the response of the immune system to the introduction of HIV into the body.
• Sometimes autoimmune diseases develop(psoriasis, seborrheic dermatitis and others). The reason and mechanism of formation are still unclear. However, most often these diseases occur at a later stage.
• 2B - Acute infection with secondary diseases

  It is observed in 50-90% of patients. It proceeds against the background of a temporary decrease in CD4-lymphocytes, therefore the immune system is weakened and cannot fully resist "outsiders".

  There are secondary diseases caused by microbes, fungi, viruses: candidiasis, herpes, respiratory tract infections, stomatitis, dermatitis, tonsillitis and others. They usually respond well to treatment. Further, the state of the immune system is stabilized, and the disease moves on to the next stage.

• Stage three - long-term, widespread enlargement of the lymph nodes

  Duration - from 2 to 15-20 years, since the immune system inhibits the multiplication of the virus. During this period, the level of CD4-lymphocytes gradually decreases: approximately at a rate of 0.05-0.07x109 / l per year.

  There is only an increase in at least two groups of lymph nodes (LN), not connected with each other for three months, with the exception of the inguinal. LU size in adults is more than 1 cm, in children - more than 0.5 cm. They are painless and elastic. LNs gradually decrease in size, remaining in this state for a long time. But sometimes they can increase again and then decrease - and so on for several years.

• Stage four - secondary diseases (pre-AIDS)

  It develops when the immune system is depleted: the level of CD4 lymphocytes, macrophages, and other cells of the immune system drops significantly.

  Therefore, HIV, practically not meeting a response from the immune system, begins to multiply intensively. It affects more and more healthy cells, leading to the development of tumors and serious infectious diseases - opurtonic infections (under normal conditions, the body easily copes with them). Some of them are found only in HIV-infected people, and some in ordinary people, only in HIV-positive people they are much more severe.

  The disease can be suspected if there are at least 2-3 diseases or conditions listed at each stage.

  Has three stages

  1. 4A. Develops 6-10 years after infection when the level of CD4 lymphocytes is 350-500 CD4 / mm3 (in healthy people it ranges from 600-1900 CD4 / mm3).
     • Loss of body weight up to 10% of the original weight in less than 6 months. The reason is that the proteins of the virus are introduced into the cells of the body, suppressing the synthesis of proteins in them. Therefore, the patient literally "dries out before our eyes," and the absorption of nutrients in the intestine is also impaired.
     • Repeated damage to the skin and mucous membranes by bacteria (abscesses, boils), fungi (candidiasis, lichen), viruses (herpes zoster)
     • Pharyngitis and sinusitis (more than three times a year).

Diseases are treatable, but require longer medication.

1. 4B. Occurs 7-10 years after infection when the level of CD4 lymphocytes is 350-200 CD4 / mm3.

   It is characterized by diseases and conditions:

   • Weight loss of more than 10% in 6 months. There is a weakness.
   • An increase in body temperature to 38.0-38.5 0 С for more than 1 month.
   • Chronic diarrhea (diarrhea) for more than 1 month develops as a result of both a direct virus infection of the intestinal mucosa and the addition of a secondary infection, usually mixed.
   • Leukoplakia is an overgrowth of the papillary layer of the tongue: white filamentous formations appear on its lateral surface, sometimes on the mucous membrane of the cheeks. Its occurrence is a bad sign for the prognosis of the disease.
   • Deep lesions of the skin and mucous membranes (candidiasis, blister lichen simplex, molluscum contagiosum, rubrophytosis, versicolor versicolor and others) with a protracted course.
   • Repeated and persistent bacterial (tonsillitis, pneumonia), viral (cytomegalovirus, Epstein-Bar virus, herpes simplex virus) infections.
   • Recurrent or widespread shingles caused by the varicella-zoster virus.
   • Localized (uncommon) Kaposi's sarcoma is a malignant skin tumor that develops from the vessels of the lymphatic and circulatory system.
   • Pulmonary tuberculosis.

Without HAART, diseases are long-term and recurrent (symptoms come back again).

1. 4B. Develops 10-12 years after infection if the level of CD4 lymphocytes is less than 200 CD4 / mm3. Life-threatening diseases occur.

   It is characterized by diseases and conditions:

   • Extreme emaciation, lack of appetite and severe weakness. Patients have to spend more than a month in bed.
   • Pneumocystis pneumonia (caused by a yeast-like fungus) is a marker of HIV infection.
   • Often recurrent herpes, manifested by non-healing erosions and ulcers on the mucous membranes.
   • Protozoal diseases: cryptosporidiosis and isosporosis (affecting the intestines), toxoplasmosis (focal and diffuse brain lesions, pneumonia) are markers of HIV infection.
   • Candidiasis of the skin and internal organs: esophagus, respiratory tract and so on
   • Extrapulmonary tuberculosis: bones, meninges, intestines and other organs.
   • Common Kaposi's sarcoma.
   • Mycobacteriosis affecting the skin, lungs, gastrointestinal tract, central nervous system and other internal organs. Mycobacteria are present in water, soil, dust. They cause illness only in HIV-infected people.
   • Cryptococcal meningitis is caused by a fungus that is present in the soil. It usually does not occur in a healthy body.
   • Diseases of the central nervous system: dementia, movement disorders, forgetfulness, decreased ability to concentrate, slowed thinking, gait disturbance, personality changes, awkwardness in the hands. It develops both due to the direct effect of HIV on nerve cells for a long time, and as a result of complications that have developed after the transferred diseases.
   • Malignant tumors of any location.
   • Kidney and heart damage due to HIV infection.

All infections are hard and difficult to treat. However, the fourth stage is reversible spontaneously or as a result of HAART.

• Fifth stage - terminal

  It develops when the number of CD4 cells is below 50-100 CD4 / mm3. At this stage, all existing diseases progress, the treatment of secondary infections is ineffective. The patient's life depends on the HAART, but, unfortunately, it, as well as the treatment of secondary diseases, is ineffective. Therefore, patients usually die within a few months.

  There is a WHO classification of HIV infection, but it is less structured, therefore, mainly specialists prefer to work according to Pokrovsky's classification.

Important!

The given data on the stages and their manifestations of HIV infection are of an average nature. Not all patients pass sequentially through the stages, sometimes "jumping" over them or staying at a certain stage for a long time.

Therefore, the course of the disease can be quite long (up to 20 years) or short-lived (cases of a fulminant course are known, when patients died within 7-9 months from the moment of infection). This is associated with the characteristics of the patient's immune system (for example, some have few CD4 lymphocytes or initially reduced immunity), as well as the type of HIV.

HIV infection in men

Symptoms fit into the usual clinic, without specific manifestations.

HIV infection in women

As a rule, they have menstrual irregularities (irregular periods with the presence of intermenstrual bleeding), and the menstruation itself is painful.

Women have a slightly higher risk of developing malignant tumors on the cervix.

In addition, their inflammatory processes of the female genital organs occur more often (more than three times a year) than in healthy women, proceeding more severely.

HIV infection in children

The course does not differ from that in adults, but there is a difference - they are somewhat behind in physical and mental development from their peers.

Treatment of HIV infection

Unfortunately, there is no drug yet that would completely cure this disease. However, there are drugs that significantly reduce the multiplication of the virus, prolonging the life of patients.

Moreover, these drugs are so effective that with proper treatment, CD4 cells grow, and even the most sensitive methods are hardly detectable in the body.

To achieve this u the patient must have self-discipline:

• taking the medicine at the same time
• adherence to dosage and diet
• continuity of treatment

Therefore, recently, patients with HIV infection more and more often die from diseases common to all people: heart disease, diabetes mellitus, and so on.

The main directions of treatment

• Prevent and delay the development of life-threatening conditions
• Ensure a longer preservation of the quality of life of infected patients
• With the help of HAART and the prevention of secondary diseases, achieve remission (no clinical symptoms)
• Emotional and practical support for patients
• Provision of free drugs

Principles of prescribing HAART

First stage

No treatment is prescribed. However, if there was contact with an HIV-infected, then chemoprophylaxis is recommended in the first three days after it.

Second stage

2A. No treatment unless CD4 count is less than 200 CD4 / mm3

2B. Treatment is prescribed, but if the CD4 count is more than 350 CD4 / mm3, then refrain from it.

2B. Treatment is prescribed if the patient has manifestations characteristic of stage 4, but with the exception of cases when the level of CD4 lymphocytes is more than 350 CD4 / mm3.

Third stage

HAART is prescribed if the CD4-lymphocyte count is less than 200 CD4 / mm3, and the HIV RNA level is more than 100,000 copies, or the patient actively wants to start therapy.

Fourth stage

Treatment is prescribed if the CD4 cell count is less than 350 CD4 / mm3 or the HIV RNA count is more than 100,000 copies.

Fifth stage

Treatment is always prescribed.

On a note

Children are prescribed HAART regardless of the stage of the disease.

These are the existing standards for the treatment of HIV infection today. But recent studies have shown that earlier initiation of HAART produces better results. Therefore, most likely, these recommendations will be revised soon.

Drugs Used to Treat HIV

• Nucleoside viral reverse transcriptase inhibitors (Didanosine, Lamivudine, Zidovudine, Abakovir, Stavudine, Zalcitabine)
• Non-nucleoside reverse transcriptase inhibitors (Nevirapine, Efavirenz, Delavirdine)
• Virus protease (enzyme) inhibitors (Saquinavir, Indinavir, Nelfinavir, ritonavir, Nelfinavir)

When prescribing treatment, as a rule, several drugs are combined.

However, a new drug will soon enter the market - Quad, which promises to radically change the lives of people living with HIV. Since it works faster, it has fewer side effects. In addition, it solves the problem of HIV drug resistance. And patients no longer have to swallow handfuls of pills. Because the new drug combines the effects of several drugs for the treatment of HIV infection, and is taken once a day.

Prevention of HIV infection

"Any disease is easier to prevent than to cure later."

Perhaps there is no person who does not agree with this statement. It also applies to HIV / AIDS. Therefore, in most countries, various programs are being implemented to reduce the rate of spread of this infection.

However, we'll talk about what everyone can do. After all, not so much effort is needed to protect yourself and your loved ones from this plague.

Prevention of HIV / AIDS among people at higher risk

Heterosexual and homosexual contact

• The surest way is to have one sexual partner whose HIV status is known.

• Have casual sex (vaginal, anal) only with a condom. The most reliable are latex with standard lubrication.

However, even in this case, there is no 100% guarantee, since the size of HIV is smaller than the pores of latex, which can pass it. In addition, with intense friction, the pores of the latex expand, making it easier for the virus to pass through.

But the likelihood of infection is still reduced to almost zero if you use the condom correctly: you need to put it on before intercourse, make sure that there is no air between the latex and the penis (there is a risk of rupture), always use a condom in accordance with the size.

Almost all condoms made from other materials do not protect against HIV at all.

Intravenous drug use

Drug addiction and HIV often go “hand in hand”, so the most reliable way is to stop taking intravenous drugs.

However, if this path is nevertheless chosen, precautions must be taken:

• Individual and single use of sterile medical syringes
• Preparation of a solution for injection in a sterile individual container

HIV positive pregnant woman It is best to determine your HIV status before pregnancy. If it is positive, the woman is examined, all the risks associated with pregnancy are explained (the likelihood of infection of the fetus, worsening of the course of the disease in the mother, etc.). In the event that an HIV-infected woman still decides to become a mother, conception should be as safe as possible in order to reduce the risk of infection of the fetus:

• using a self-insemination kit (HIV-negative parterre)

• semen cleaning followed by insemination (both partners are HIV positive)

• in vitro fertilization

It is necessary to exclude factors that increase the permeability of the placenta for HIV: smoking, alcohol and drug use. It is important to treat STDs, chronic diseases (diabetes mellitus, pyelonephritis, etc.), since they also increase the permeability of the placenta.

Taking medications:

• HAART (if necessary) with a therapeutic or prophylactic purpose, depending on the duration of pregnancy
• multivitamins
• iron preparations and others

In addition, a woman should protect herself as much as possible from possible other infectious diseases.

It is important to pass all the necessary tests on time: determine the viral load, the level of CD4 cells, smears, and so on.

Medical staff

Risk of infection if the activity is associated with penetration through natural barriers (skin, mucous membranes) and manipulations during which they come into contact with biological fluids.

Prevention of infection

• use of protective equipment: goggles, gloves, mask and protective clothing

• promptly dump the used needle into a special non-puncture-resistant container

• contact with HIV-infected biological fluid - chemoprophylaxis - taking complex HAART according to the scheme

• contact with a suspected infected body fluid:
  • damage to the skin (puncture or cut) - the blood does not need to be stopped for a few seconds, then treat the injury site with 700C alcohol

• contact with biological fluid on intact parts of the body - rinse with running water and soap, then wipe with 700C alcohol

• eye contact - rinse with running water

• in the mouth - rinse 700C with alcohol

• on clothes - take it off and soak it in one of the disinfectants (chloramine and others), and wipe the skin under it with 70% alcohol

• on shoes - wiping twice with a rag soaked in one of the disinfectants

• on walls, floors, tiles - pour disinfectant solution for 30 minutes, then wipe

How is HIV transmitted?

A healthy person becomes infected from an HIV-infected person at any stage of the disease when an infectious dose enters the bloodstream.

Virus transmission methods

• Unprotected sexual intercourse with an HIV-infected person (heterosexual and homosexual contacts). Most often - in persons leading a promiscuous sex life. The risk increases with anal sex, regardless of sexual orientation.

• When using intravenous drugs: using a non-sterile syringe or utensils for solution preparation together with an HIV-infected person.

• From an HIV-infected woman to a baby during pregnancy, childbirth and breastfeeding.

• When health workers come into contact with contaminated biological fluid: contact with mucous membranes, injections or cuts.

• Blood transfusion or organ transplant from HIV-infected. Of course, the donor organ or blood is tested before medical procedures. However, if it falls within the "window period", the test gives a false negative result.

Where can you donate blood for HIV?

Thanks to special programs, as well as the laws adopted to protect HIV-infected people, information is not disclosed or transferred to third parties. Therefore, you should not be afraid of disclosure of status or discrimination in case of a positive result.

There are two ways to donate blood for HIV infection:

• Anonymous A person does not give his name, but he is assigned a number by which you can find out the result (for many, this is more comfortable).

• Confidential The laboratory staff becomes aware of the person's name and surname, but they keep medical confidentiality.

Testing can be done:

• at any regional AIDS center

• in the city, regional or district polyclinic in the offices of anonymous and voluntary testing, where blood is taken to detect HIV infection.

In almost all of these institutions, a person who has decided to find out his HIV status will be consulted both before and after testing, providing psychological assistance.

In addition, you can take an analysis at a private medical center, which is equipped with special equipment, but, most likely, for a fee.

Depending on the laboratory's capabilities, the result can be obtained on the same day, after 2-3 days or after 2 weeks. Given that testing is stressful for many people, it is best to clarify the timing in advance.

What to eat if your HIV test is positive?

Usually when you get a positive HIV test result doctor anonymously invites the patient to her place and explains:

• the course of the disease itself

• what research still needs to be done

• how to live with this diagnosis

• what treatment to take if necessary, and so on

However, if for some reason this did not happen, you need to see an infectious disease doctor to the regional AIDS center or to a medical and preventive institution at the place of residence.

Necessarily defined:

• CD4 cell count

• the presence of viral hepatitis (B, C, D)

• in some cases, p-24-Capsid antigen

All other studies are carried out according to indications: detection of STDs, determination of the general immune status, markers of malignant tumors, computed tomography, and so on.

How can you not get infected with HIV?

• when coughing or sneezing
• with insect or animal bites
• through shared tableware and cutlery
• during medical examinations
• when swimming in a pool or pond
• in the sauna, steam room
• through a handshake, hug and kiss
• when using a shared toilet
• in public places

In fact, people with HIV infection are less contagious than those with viral hepatitis.

Who are HIV dissidents?

People who deny the existence of HIV infection.

Their beliefs are based on the fact that:

• HIV has not been identified unequivocally and indisputably

Like, no one saw him through a microscope, and also that he was not artificially cultivated outside the human body. All that has been isolated so far is a set of proteins, and there is no evidence that they belong to only one virus.

In fact, there are plenty of photos taken under an electron microscope.

• Patients die faster from treatment with antiviral drugs than from illness

  This is partly true, since the very first drugs did cause a large number of side effects. However, modern medicines are much more effective and safer. In addition, science is not standing still, inventing more effective and safer means.

• Considered a worldwide conspiracy of pharmaceutical companies

  If this were the case, then pharmaceutical companies would disseminate information not about the disease itself and its treatment, but about some kind of miraculous vaccine, which, by the way, does not exist to this day.

• AIDS is said to be a disease of the immune system, not caused by a virus

  They say that it is a consequence of immunodeficiency that has developed as a result of stress, after strong radiation, exposure to poison or strong drugs, and some other reasons.

  This can be contrasted with the fact that as soon as an HIV-infected patient starts taking HAART, his condition improves significantly.

  All these statements mislead patients, so they refuse treatment. Whereas HAART started on time slows down the course of the disease, prolonging life and allowing HIV-infected people to be full-fledged members of society: to work, give birth to healthy children, live in a normal rhythm, and so on. Therefore, it is so important to detect HIV on time, and, if necessary, start HAART.

The body's immune defense is a reliable barrier that protects it from disease-causing organisms.

However, there is a virus that can breach this system or destroy it completely.

One of these is the Human Immunodeficiency Virus (HIV). In order to start therapy on time, it is important to know what are the signs of HIV in women in the early stages. Timely antiretroviral therapy hundreds of times reduces the risk of developing an extreme stage of infection - AIDS and prolongs the patient's life up to 70 - 80 years.

HIV disease occurs as a result of human infection with an immunodeficiency virus or, in other words, a retrovirus. The virus destroys immune cells, causing the body to lose its ability to defend itself against pathogenic microorganisms. HIV is classified by type (HPV-1 and HPV-2), groups, and subtypes.

For a long time, the disease lacks unambiguous distinctive features that would directly indicate HIV infection. This can lead to the fact that the patient learns about the infection too late, when the immune defense is damaged so much that it is no longer possible to restore it.

It does not survive in the external environment, therefore HIV cannot be transmitted through the air, through touch, household items, etc. The only way of transmission is the exchange of human body fluids. Infection occurs through blood, semen, breast milk, pre-seminal fluid, and vaginal secretions.

Ways of infection can be:

• injection syringes;
• tools used to get tattoos or piercings;
• any kind of unprotected sex;
• breast-feeding;
• getting infected fluid on open wounds;
• blood transfusion.

The virus cannot penetrate the skin, since they do not have cells into which it can invade. Insect bites, saliva or tears are also not ways of infection. Anyone is afraid of a terrible virus. The fair sex is especially concerned, as they are more emotional than men.

Therefore, many of them are interested in the question of how to recognize the signs of HIV in women in the early stages. And this is correct, because timely therapy helps to preserve immune cells by blocking the multiplication of the virus.

It is extremely difficult to identify HIV disease in the early stages. This is due to the fact that viruses destroy immune cells, the death of which does not cause the usual symptoms: pain, swelling or fever. However, there are distinctive signs that a woman should be tested for HIV after noticing.

1. Symptoms that are typical for a cold: cough, sore throat and other manifestations may indicate an activation of the retrovirus.
2. Severe fatigue, which does not go away even after a good rest, can accompany many illnesses. However, it is worth noting this symptom and, if possible, undergo an examination to exclude HIV disease.
3. Frequent dyspeptic symptoms can be a sign of HIV in women in the early stages. Attention should be paid to daily stool disturbance, nausea or vomiting.
4. As a result of the destructive activity of the retrovirus, an increase in lymph nodes is observed. The cervical lymph nodes change especially strongly, and in the groin and armpits this symptom is less pronounced.
5. If sores on the genitals or in the mouth are added to the listed symptoms, then you should be on your guard more seriously.

HIV can manifest itself more vividly with an increase in body temperature, cramping pains, increased sweating, lack of appetite, etc. All of these symptoms are similar to other viral infections caused by rotovirus, influenza virus or enterovirus. If such signs appear unexpectedly and also disappear, then it is better not to neglect the blood test for HIV.

The hallmarks of HIV seen early in women

The main symptoms of the presence of a retrovirus in the body are characteristic of any person, regardless of gender.

However, there are signs that can only be found in women, in particular:

• sudden weight loss (in the later stages - anorexia);
• the appearance of sores and warts on the genitals;
• heavy sweating;
• pathological changes in the cervix;
• painful periods;
• frequent genitourinary infections.

A combination of several signs, such as swollen lymph nodes, lower abdominal pain during menstruation, heavy vaginal discharge, frequent diarrhea, and lack of energy, is a good reason to be tested for HIV.

Symptoms of HIV in women in the early stages of the disease

The symptomatology of the disease directly depends on the state of the human immune system at the time of infection.

The virus can be in a latent state for several years, but more often it becomes active after one or two months. The symptoms of HIV in women depend on the stage of the disease.

The early stages are divided into two periods, at which time the infection can still be treated, and the symptoms are mild.

At the third stage of the development of the disease, the symptoms appear more intensively. The late stage is characterized by a complete destruction of the immune defense and the addition of many secondary infections.

Stages of development of the immunodeficiency virus:

1. The period of incubation maturation of the virus. The duration of this stage of the disease varies from one month to one year. At this time, the virus actively spreads throughout the body, but does not show activity against immune cells.
2. Primary stage. The beginning of this period is preceded by the appearance of antibodies to HIV. This stage takes seven to ten years. The virus attacks immune cells, which is manifested by an increase in lymph nodes, an increase in infectious diseases, a disorder in the gastrointestinal tract and other symptoms.
3. Progressive stage. During this period, the immune system is already in a depletion phase. The number of associated bacterial and viral infections is increasing. Oncological diseases can be detected at a progressive stage.
4. Immunodeficiency Syndrome. The period is characterized by extensive damage to all organs. The symptoms of AIDS can be seen even from the photo, since all the skin is covered with spots and rashes, and the mucous membranes are covered with white bloom. No cure has yet been found for AIDS. Due to the fact that the immune system is completely destroyed, a person quickly dies.

Symptoms of HIV in women in the early stages during the development of the virus may not manifest themselves in any way. If the immune system is weakened, then symptoms similar to those of a cold occur.

An infected person may suffer from diarrhea, sore throat accompanied by swelling of the glands, chills. Various rashes are possible on the skin. Such phenomena are of a short-term nature, and the patient often confuses them with the common cold. In the early stages of the second period, the symptoms of HIV in women may also be unclear.

The disease can be accompanied by the following phenomena:

• a periodic rise in temperature in the absence of other signs of disease;
• severe weakness, apathy, or depression;
• frequent colds;
• violation of coordination of movement;
• an increase in lymph nodes;
• frequent exacerbations of herpes;
• decrease in body weight;
• increased sweating;
• systematic stool disorder;
• muscle and joint pain;
• persistent dry cough.

The symptoms of HIV in women in the early stage of the second stage of the disease often involve the reproductive system. If at this time a woman contracted genital infections, then they are poorly cured. The same applies to inflammatory diseases of the genitourinary system. In women, HIV can provoke hormonal disruptions.

The menstrual cycle becomes unstable, accompanied by pain, and heavy bleeding is possible. After ten years of the activity of the virus, the immune system weakens so much that different infections can be present in a woman's body at the same time: fungal, bacterial, viral and others.

Diseases are practically not cured, which characterizes the onset of the development of AIDS. Early diagnosis of HIV disease is very important. This determines the state of the human immune system, since after the administration of drugs, viruses will cease to actively multiply and destroy immune cells. In Russia, HIV infection is diagnosed using ELISA tests or IB (immune blotting).

Additionally, other methods can be used - express tests and PCR. In the early stages, it is difficult to diagnose an infection. If a doctor suspects that a woman's body may contain retroviruses, then even with a negative test result, he can register her. A woman needs to visit a doctor and re-donate blood for analysis.

Mandatory analyzes:

• ELISA test systems. The first diagnosis is performed by a screening test (ELISA). For this purpose, blood is taken from the patient from a vein (5 ml). Blood sampling is carried out in the morning on an empty stomach. This analysis detects antibodies to the virus, but does not determine the presence of the viral agent itself. Since the incubation period of viruses is different (from 2 to 6 weeks), soon after infection, the test may not reveal anything. Therefore, it is recommended to take it no earlier than 3 weeks after the alleged infection.
• Immune blotting. This test is performed only after a positive screening test result. For it, blood is also taken from a vein, then serum with antibodies to HIV is separated from the material obtained and the liquid is applied to a special strip. If antibodies bind to antigens that were previously placed on the strip, then the virus is clearly present in the body. The IB result is 100% correct.

Treatment of HIV disease

An HIV patient is prescribed antiretroviral therapy. Modern drugs stop the processes of suppression of the immune system by blocking the introduction of virions into cells, preventing them from multiplying.

Your doctor may prescribe one of the drugs: Zidovudine, Didanosine, or Nevirapine. There are other analogues of antiretroviral drugs. Treatment should be supervised by a physician, as viral agents are adaptable to different chemicals and may require a change in treatment regimen. In addition, such drugs have serious side effects, so you cannot purchase drugs for HIV infection on your own. After prescribing medication, the person must take the pill for the rest of his life.

In Russia, there is a program to provide those in need with such medicines, but they are not always enough. Therefore, you need to be prepared for the fact that medicines will need to be bought. In addition to the main therapy, a woman should strengthen the immune system by all available means. Eat right, treat diseases on time, take vitamins and lead an active lifestyle.

Symptoms of AIDS in women in the early stages and how it differs from HIV

The progressive stage of HIV infection turns into AIDS. Some people confuse the two. HIV is a virus that kills cells of the immune system and causes AIDS, acquired immunodeficiency syndrome. Such a diagnosis is made when a person develops opportunistic diseases, that is, those that the immune system of a healthy person can easily cope with on its own.

AIDS stands for the following:

• syndrome - a series of symptoms that characterize any pathological condition;
• acquired - indicates that the person was infected with an infection from the outside;
• immune - has to do with human immunity;
• deficiency - means a shortage, lack of immune cells.

The symptoms of AIDS in women in the early stages are already acute, since most of the immune cells have died, and the rest cannot cope with numerous infections. Women often suffer from colds, inflammatory, infectious and fungal diseases.

They develop diseases that were not present during the period of normal functioning of the body's defense system. Since the transition of HIV infection to the stage of acquired immunodeficiency syndrome, a woman's life expectancy is a maximum of four years.

The symptoms of AIDS in women in the early stages are multiple, in particular, she suffers:

• fungal diseases of the mucous membranes (candidiasis);
• chronic fatigue syndrome and lingering depression;
• persistent diarrhea;
• mental disorders;
• weight loss, anorexia;
• papillomas and warts on the genitals;
• extensive damage to the mucous membranes of the herpes virus;
• infectious and inflammatory diseases that develop in different organs;
• oncological diseases.

There are a number of diseases that most commonly accompany AIDS. These are candidiasis, seborrheic dermatitis, Kaposi's sarcoma and shingles.

• Candidiasis. Fungi affect any mucous membranes. With AIDS, traces of candida activity are especially noticeable in the mouth and on the lips of a woman.
• Seborrheic dermatitis. It affects all the skin of a woman. The skin is blotchy and flaky.
• Kaposi's sarcoma. More than other skin diseases characterize AIDS. With this disease, pink spots appear on the skin, which eventually change color to brown and purple.
• Shingles. The disease can be inherited or occur with a significant decrease in immunity, that is, with AIDS. With this disease, skin rashes cause pain.

The doctor on how the first symptoms appear (video)

Many people ask the question: What is AIDS? This is the final stage of the disease caused by the human immunodeficiency virus - HIV (see photo below). Thus, from what has been said, we can conclude about the difference between these two concepts.

HIV and AIDS: what's the difference

So how is HIV different from AIDS? The difference is that the first abbreviation denotes the name of the virus - the cause of the disease, and the second - the disease itself, which manifests itself in the form of acquired immunodeficiency syndrome. Do not confuse these two concepts, as they are not identical!

What is HIV infection

HIV infection is a disease of which it is caused. This virus contains two identical RNA molecules, each of which contains complete genetic information. An important feature of the causative agent of AIDS is pronounced lymphotropism, especially to T-lymphocytes "helpers". A definite relationship was revealed between the virus and the histocompatibility antigens of the HLA system.

The stages of the HIV replication cycle are shown in the figure below.

Specific interaction of the virus on the surface of the cell membrane (1) with subsequent penetration into the cell (2); synthesis of a DNA copy of the RNA genome of the virus using reverse transcriptase (3); the transfer of virus-specific DNA from the cytoplasm of an infected cell to its nucleus (4) and the insertion of virus-specific DNA into the genome of the host cell (5); assembly and budding of newly formed particles (6).

Under the influence of the products of expression of viral genes, the host cell undergoes degeneration or neoplastic transformation. The listed cytopathic effects are an important feature of HIV infection and are not typical for most retroviruses. The cytopathic effect of an infectious agent is associated with the presence of a virus-specific transactivating factor.

How HIV is transmitted from person to person

The human immunodeficiency virus is isolated in almost all body fluids: from saliva to cerebrospinal fluid. It is found directly in the tissues of the brain, lymph nodes, bone marrow cells and skin. But, despite the vastness of localizations, HIV can be transmitted from person to person only through blood and semen. Therefore, the question “is HIV transmitted through saliva” widespread among the population can only be answered in the negative.

Infection in the overwhelming majority of cases occurs through sexual contact during homo- and heterosexual contacts. Transmission of the virus is possible through transfusion of whole blood, red blood cells and plasma. Most cases of AIDS in children are associated with congenital from a sick mother to a child, as well as with transplacental infection. A number of cases of the disease are due to the transmission of the human immunodeficiency virus by intramuscular, intravenous and subcutaneous injections, medical scarification or tattoos.

Risk groups for HIV infection

• Homosexuals
• Bisexual
• People who use drugs
• Patients with hemophilia
• Prostitutes
• Children from mothers with AIDS
• Patients with venereal diseases

The key mechanism of various disorders of the system of cellular and humoral immune status in HIV is that the AIDS virus primarily affects T-helpers as a result of its cytopathic action of the etiological factor.

The main manifestations of impaired functioning of the immune system in AIDS are presented below.

Immune system disorders in human immunodeficiency virus

1. Decrease in the total number of circulating lymphocytes
2. A decrease in the number of T-helpers and a change in the content of T-suppressors, leading to a decrease in the ratio of T-helpers / T-suppressors in AIDS - less than 1; normal - about 2
3. Decrease in delayed-type hypersensitivity reaction Decrease in lymphokine production
4. Increased levels of serum immunoglobulins and circulating immune complexes
5. Functional disorders of monocytes / macrophages: decreased chemotaxis, spontaneous increase in the production of such as interleukin-1 and prostaglandin E 2
6. High serum titer of altered acid-labile alpha-interferon

The incubation period of HIV before the appearance of the first symptoms and the development of manifest forms of AIDS can be quite long and depends on the routes and nature of infection, the size of the infectious dose of the pathogen, as well as other factors that contribute to the reproduction of the virus in the body.

On average, the incubation period is 12-15 months, with fluctuations from 2 weeks to 2-4 years or more.

A shorter incubation period is observed with homosexual and parenteral routes of infection and in children born to sick parents.

Antibodies to HIV can be detected as early as 2-8 weeks after infection, but the seronegative period sometimes lasts up to 6 weeks or more.

Depending on the characteristics of the symptoms, the course of the infectious process in AIDS can be:

• asymptomatic
• clinically pronounced
• rapidly progressing.

The first symptoms of HIV

The first symptoms of AIDS are as follows:

• Fever up to 1 month or more
• Generalized lymphadenopathy
• Decrease in body weight (by 10% or more)
• Long-term (at least 2 months)
• Anemia
• Opportunistic infections:
  • :
    • generalized candidiasis,
    • herpes infection,
    • Kaposi's sarcoma,
  • cytomegalovirus and bacterial infections,
  • tuberculosis
• HIV-associated lesions of the central nervous system:
  • dementia,
  • myelopathy,
  • peripheral neuropathy,
  • aseptic meningitis
• Pneumocystis pneumonia
• Laboratory indicators:
  • lymph and leukopenia,
  • thrombocytopenia,
  • erythropenia,
  • signs of deficiency of humoral and cellular immunity

Diagnosis of HIV infection

For the serological diagnosis of HIV infection, the methods of enzyme-linked immunosorbent assay are primarily used. Two modifications of this method have been developed in Russia. A common disadvantage of enzyme-linked immunosorbent assays for AIDS research is the rather high frequency of false positive reactions. They are due to the very nature of this particular disease, in which the disintegration of cells affected by the virus is accompanied by the release of various cellular antigens into the blood, to which antibodies are produced. A positive AIDS immunoassay is the primary screening method and should be confirmed by immune blotting.

Immunoblot for HIV

The meaning of the immunoblot is as follows:

The purified virus is destroyed with a detergent, its proteins are separated by gel electrophoresis, and then transferred to strips of nitrocellulose. The reaction is set by immersing a strip with a virus protein in the test serum diluted in a buffer solution, adding a conjugate of antibodies to human immunoglobulins, washing, setting and accounting for the enzymatic reaction.

The immune blot reaction in AIDS is quite specific, since after separation of proteins by electrophoresis, each of them occupies a strictly defined place depending on its molecular weight.

The Institute of Immunology of the Academy of Medical Sciences of the Russian Federation has developed a highly sensitive and safe test system "Peptoscrin", based on the use of synthetic antigens to antibodies against the virus.

When using any diagnostic AIDS tests, in order to increase the reliability of positive test results for the presence of antibodies to HIV, it is advisable to carry out the reactions again with the same reagents or additionally carry out a parallel reaction under identical conditions.

During the initial examination of risk groups, as well as in the absence of data in dynamics, the test results obtained cannot yet reliably indicate the absence or presence of AIDS. Primary positive results require increased attention when conducting a repeated in-depth study of a patient or a donor suspected of a disease, including epidemiological, immunological and clinical methods.

Screening the population and donors for the diagnosis of HIV infection is the most important, but not the only, but rather the first link in the overall system for tracking the spread of the disease and identifying persons - sources of infection.

HIV treatment

Groups of drugs for antiretroviral therapy for AIDS (clickable photo)

Treatment of HIV patients should be carried out in a hospital with subsequent dispensary observation and periodic hospitalization. An AIDS patient should be informed about the diagnosis and warned about criminal liability for infecting others.

Infected, but not sick, are subject to periodic (at least 1 time per quarter) re-examination to identify the dynamics of the infectious process and the possible detection of symptoms of AIDS in an active form or, conversely, recovery.

Individuals with antibodies to the human immunodeficiency virus, who have not detected the expression of the virus, should be re-examined at least once every 6-10 months. They should be warned that they cannot donate blood.

A list of drugs for antiretroviral therapy for human immunodeficiency virus is shown in the photo above.

The combination of medications and the frequency, as well as the duration of their administration should be determined exclusively by the doctor!

Is HIV cured or not?

This question worries many, especially those infected with AIDS. Unfortunately, despite the achievements of scientists in the development of drugs for antiretroviral therapy for human immunodeficiency virus, there is still no drug that can cure HIV. AIDS can only be introduced into the stage of remission, but the body cannot be rid of it.

AIDS is a dangerous disease, the development of which is provoked by HIV (human immunodeficiency virus). Until now, scientists have not yet managed to create a pharmaceutical agent that could defeat this "killer". It is for this reason that the main method of fighting HIV is its effective prevention. Scientists first started talking about AIDS in the 1980s. But in fact, HIV began to infect people in West Africa back in the thirties. Now this disease has become a modern "plague", as more and more people are infected with it. The consequences of AIDS are often dire (fatal).

- this is a whole group of different retroviruses, which are also called lenviruses or "slow". This name is due to their characteristic feature - from the moment they enter the body, until signs of pathology appear, it takes a very long time. This process may drag on for more than one year. After HIV is transmitted to a person, it enters the bloodstream and attaches to those blood cells that are directly responsible for the body's reactivity, that is, for the full functioning of the immune system. Inside such cells, HIV actively multiplies, and before an immune response occurs, infectious agents will spread throughout the human body. The first "target" is the lymph nodes, since they contain a large number of lymphocytes.

During the course of the disease, the body does not respond to the presence of HIV in it. This is due to the fact that the affected immune cells cannot function normally. It is also worth noting the fact that HIV can change its structure over time, so the immune system simply cannot identify the virus and destroy it.

It should be noted right away that the two terms "AIDS" and "HIV" differ from each other. These are not synonyms as most people think. AIDS is a term for an immune deficiency that can develop as a result of prolonged exposure to radiation, chronic ailments, and the use of potent pharmaceuticals. But recently, this term has been used only to refer to the last stage of HIV.

Etiology

The source of HIV can be a virus carrier who does not show symptoms of an illness, or a sick person.

• sexual transmission. HIV can be transmitted to a healthy person through sexual contact. The greatest danger is anal and vaginal sex;
• perinatal route. In this case, the child becomes infected from a sick mother. A newborn can become infected already during the passage of a woman through the birth canal;
• blood transfusion transmission. Infection occurs during transfusion of blood, plasma, leukocyte and platelet mass;
• Milky Way. A baby can become infected with HIV while consuming milk from an infected mother;
• injection route of transmission. It is more typical for people who use narcotic drugs, and at the same time use the same syringe several times. But infection in this way is not excluded in medical institutions where workers do not comply with the norms for the use of instruments and syringes;
• transplant transmission route. Infection is carried out during organ or bone marrow transplantation from a sick person;
• household transmission path. In this case, HIV can enter the body through microtraumas on the skin and mucous membranes (if a person comes into contact with the biological fluids of an AIDS patient).

You cannot get AIDS:

• through a kiss;
• when coughing or sneezing;
• eating food with an infected person;
• through a handshake;
• in saunas and baths.

Symptoms

It should be noted that HIV proceeds in three stages:

• acute febrile;
• asymptomatic;
• AIDS or advanced stage.

Acute febrile

This stage appears 1-2 months after infection. It does not manifest itself in all patients, but only in 50–70%. In the rest, the incubation period is replaced by an asymptomatic phase.

Symptoms:

• sore throat;
• slight hyperthermia;
• diarrhea;
• nausea and vomiting;
• joint pain;
• the appearance of various elements of the rash on the skin is possible.

Asymptomatic

It runs over a long period of time. In half of patients, it lasts up to 10 years. The rate of progression of this stage is significantly influenced by the rate of virus reproduction in cells. Symptoms of the disease in the asymptomatic phase are not noted, but in rare cases, an increase in some groups of lymph nodes is possible.

AIDS or advanced stage

This stage is characterized by the activation of opportunistic microorganisms that live in the body of every person. The symptoms of AIDS in women and men are the same. The entire pathological process can be divided into two stages.

The first signs of AIDS (stage 1):

• decrease in body weight by 10%;
• appears often;
• hairy mouth is a characteristic symptom of AIDS in men and women. White plaque accumulates on the lateral surfaces of the tongue;
• decrease in blood concentration. This causes the appearance of a hemorrhagic rash on the limbs;
• the patient often has, and so on;
• an increase in several groups of lymph nodes;
• increased sweating at night;
• decreased visual function.

At the second stage of the disease, there is a decrease in body weight by more than 10%. The following infections join the above pathological processes:

• hyperthermia;
• diarrhea;
• Kaposi's sarcoma.

Diagnostics

If a person shows the first signs of AIDS, he should immediately contact a medical institution for diagnosis, confirmation or refutation of the diagnosis. Only a competent doctor can confirm the presence of such a dangerous ailment after examination and receiving test results. You can detect the presence of HIV by taking a blood test.

One of the most dangerous consequences of unprotected sex can be HIV infection (Human Immunodeficiency Virus). The initial phase of the development of the disease has no symptoms, so a person may not even realize for a long time that he is a carrier of a dangerous virus, continuing to infect others. During the first months after infection, even complex examination methods are not able to detect its presence in the body. When do the first signs of HIV appear in men?

It is customary to refer to the main ways of contracting HIV infection:

• Unprotected sexual contact with a carrier of the infection.
• Transfusion of contaminated donor blood.
• Use of non-sterile medical instruments, including needles.
• Contact with an open wound with infected blood or other body fluids of the patient.
• The virus is passed from an infected mother to her newborn baby.

Evgeny Olegovich Komarovsky, Candidate of Medical Sciences, tells about the ways of transmission of the virus:

Since the virus can be transmitted through the biological fluids of the human body, there is the likelihood of contracting HIV through oral sex. Especially if the ejaculation occurred directly into the mouth, where there are wounds.

Due to the fact that HIV is transmitted at the time of contact of the mucous membranes, on which microtrauma may appear, it is possible to become infected with it even if ejaculation (ejaculation) has not occurred.

At the same time, a man cannot become infected with HIV:

1. When shaking hands.
2. After being bitten by a mosquito.
3. Contact with animals.

1. Through food, water and household items.
2. Airborne droplets (when coughing, sneezing).
3. Through a half-smoked cigarette.

The peculiarity of infection in men

The first symptoms of HIV in men may appear within a few weeks after infection, or they may not show themselves for many years. It depends on the individual characteristics of the male body.

After HIV enters a man's body, it begins to destroy T-lymphocytes - cells that the immune system produces to defend against foreign microorganisms. At the same time, in some men, the virus, after entering the cell, can be in an inactive state for up to 10 years, not giving itself away.

The scheme of the virus

Due to the fact that a man's immune system is affected by a virus, it turns out to be unable to resist even the simplest infections. In the case when a man is diagnosed with HIV, he is prescribed a course of immunomodulators that will help improve the general condition and eliminate its main manifestations. Additionally, the patient is prescribed drugs that help to normalize metabolism and stabilize the nervous system.

Timing of manifestation of HIV

If a man closely monitors the state of his body, then after a few weeks he may notice the first signs of the disease, which include general malaise. However, many do not attach much importance to this symptom, suggesting that it is a common cold. One month after infection, fever may join the weakness. As a rule, it does not exceed 38 degrees. After 2 months, HIV becomes asymptomatic. This is connected with the fact that often the disease is detected already in the late stages. After what time, HIV will make itself felt, depends on the individual characteristics of the organism of a particular man. Sometimes it manifests itself after a few months, and sometimes after a few years.

When it is necessary to take tests to identify the disease, the venereologist Ekaterina Vyacheslavovna Makarova will tell you:

How to find out about infection? The only way is to have a blood test. But one analysis may not be enough, since the incubation period of the disease, during which the virus is not detected by laboratory means, can be up to 6 months.

The main stages of development

There are 4 main stages in the development of HIV in a man.

Table 1. Stages of development of HIV infection

Stage	Characteristic
Latent form (incubation period)	As a rule, its duration is from 1 to 3 months, but sometimes it can be up to 1 year. At this time, the virus is actively spreading in the body of a man, affecting his immune system.
Onset of symptoms	At this stage, the synthesis of HIV antibodies occurs - the body's reaction to the introduction of the virus.
The ensuing consequences	Now HIV makes itself felt with characteristic symptoms. Moreover, all changes in a man's body are irreversible.
The final stage	At this stage, HIV turns into AIDS (acquired immunodeficiency syndrome). AIDS is always fatal.

Infection symptoms

Signs of HIV infection between a man and a woman who contracted it are usually the same. After about 1-2 months, a man may experience the following symptoms:

• Changes in body temperature (abnormal jumps).
• Constant chills.
• Very often, a man notes muscle weakness or soreness.
• Swollen lymph nodes.
• Headache.
• Excessive sweating, especially at night.

• Digestive upset (frequent diarrhea).
• Sore throat.
• Skin rash.
• Signs of thrush and mouth ulcers.
• Joint pain.
• Impaired concentration.

An alarming symptom of HIV in men is a rash on the body.

Table 2. The nature of the rash

In addition, the man constantly feels tired, his physical activity decreases. Depression may start. During palpation, the doctor will notice an increase in the size of the liver.

It is important that when such signs of HIV infection appear in a man, immediately consult a doctor, undergo the necessary examination and begin treatment with antiviral drugs, without which life expectancy is significantly reduced.

As HIV develops in the body, symptoms and initial manifestations intensify. There is a constant aching pain in the joints. After the lymph nodes are damaged, the infection begins to affect the internal organs (liver, spleen). Due to the inflammatory process in the esophagus, it is difficult for a man to eat.

The video describes the symptoms of the disease in men:

Over time, the symptoms of HIV in men in the early stages gradually disappear and the disease enters a latent phase. It is characterized by the absence of the main signs of the disease, despite the fact that the destruction of organs still occurs. The maximum period of the latent phase is no more than 10 years.

In the third stage of the disease, the internal organs are seriously affected. The immune system is no longer able to resist the cells of the virus. Signs of other emerging pathologies or even oncological processes are added to the symptoms of HIV. For men diagnosed with HIV, the following comorbidities are characteristic:

1. Oral thrush.
2. Herpes.
3. Lichen.
4. Seborrhea.
5. Fungus on hands or feet.

At the same time, the symptoms of these diseases in a man are manifested acutely, which is not typical for healthy people. Any disease can cause various complications; it cannot be cured for a long period of time.

The doctor of the first category Anna Viktorovna Maslennikova tells about the stages of the disease:

The last degree of HIV, when it turns into AIDS, is characterized by severe damage to the internal organs. Immunity is not able to fight even a small cold, so a man can die from absolutely any disease. The disease cannot be cured. The main therapy in this case will be aimed at relieving symptoms and alleviating the condition of the man. At this stage, such concomitant pathologies may arise:

• Cancer neoplasms.
• Sarcoma.
• Cryptococcosis.
• Pneumonia.
• Tuberculosis.

In addition to the destruction of internal organs, a man suffers from brain damage.

Treatment

It is impossible to cure a disease in a man. However, if HIV was detected at the initial stages of development (regardless of the presence of symptoms) and treatment was started on time, then the patient has a chance to prolong his life.

As a therapy, the patient is prescribed antiviral drugs, the main task of which is to slow down the development of the disease. In addition, he needs to take immunostimulating drugs. Additionally, the symptoms of concomitant pathologies are treated.

The likelihood of infection after 1 contact

There is an opinion that the chance of contracting HIV after 1 contact with an infected partner is zero. However, it is not. Of course, for men this percentage is lower than for women, but it is there. The risk of infection increases if the partner has any damage (erosion) on the genitals, diseases that can be transmitted sexually or during menstruation.

If we talk about anal sex, then the risk of infection increases. This is due to the fact that the mucous membrane can be easily injured and can be covered with small cracks, through which the virus invariably enters the body. This is related to the fact that a large number of infected men are of non-traditional sexual orientation.

Prophylaxis

Knowing the ways in which HIV is transmitted, doctors identify some principles of its prevention:

1. Avoid casual sexual intercourse, and in case of contact, be sure to use barrier methods of contraception. This is important to do regardless of the type of intercourse, since it has been proven that HIV can be transmitted not only through traditional, but also through anal or oral sex.
2. Avoid using used needles and syringes. Due to the disregard of this rule, there is a widespread disease among drug addicts who use the same syringe for injection.
3. During medical examinations or treatment, it is important to always use disposable or sterile instruments. The same applies to beauty salons, where all devices must be sterilized.

HIV infection is dangerous because it affects, first of all, the human immune system, as a result of which his body is not able to cope even with a common cold. In addition, HIV inevitably leads to acquired immunodeficiency syndrome - a disease that is incurable and leads to death within a short time.

In simple words about the prevention of HIV infection. Lecture by Dr. Makarova:

The insidiousness of the virus lies in the fact that it is impossible to detect it on your own. Also, for a long time, he may not give characteristic symptoms, so a man may not be aware of what is his carrier and continue to infect others at this time. Only special laboratory tests can detect the virus in the body, which were carried out several months after infection, since earlier the result may turn out to be negative, despite its presence in the body. Therefore, it is important for every man from 18 to 45 years old who has an active sex life to donate blood approximately once a year for an HIV test.

The same is recommended to be done when uncharacteristic colds and other diseases appear that cannot be cured for a long time or when symptoms characteristic of HIV appear. In the case when the infection can be detected at the initial stage of its development, the man has every chance to prolong his life, thanks to the special antiviral therapy.