HIV/AIDS - Symptoms and Causes

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HIV AIDS is one of the most feared diseases worldwide, affecting both your mental and physical wellbeing. Moreover, as the facts stand presently, there is no sure shot cure for HIV AIDS. Along with that, the only available treatment measures for AIDS are used to control the symptoms and effects of the virus on the body. The main goal of AIDS medicines is to reduce the viral load in your blood, i.e., the level of HIV present in the blood. Given the permanent nature of HIV AIDS and the pressure it may introduce, it is imperative to know and understand every aspect of it. Below is a complete guide about HIV AIDS introduction, HIV AIDS symptoms, treatment procedures, and prevention measures. 

What is AIDS? 

In a word, Acquired Immunodeficiency Syndrome, aka AIDS, is the final stage of HIV infection. At first, understand that the Human Immunodeficiency Virus is a virus that attacks the body's immune system. And if HIV infection is not controlled in time, it may lead to the condition we popularly know as AIDS. So, HIV infection in a body does not necessarily mean that a person has AIDS. AIDS only come forth when the infection is left untreated or uncontrolled for a while leading to severe immune system damage. However, if the infection is controlled in its early stages, acquired immunodeficiency syndrome does not occur, and the patient can lead a normal life, following necessary precautions. 

What is Human Immunodeficiency Virus?

HIV or Human Immunodeficiency Virus is a kind of virus that only attacks the body's immune system, weakening it over time until the infected person develops AIDS. In addition, HIV infection makes the body vulnerable to all other kinds of infections since the immune system becomes incapable of fighting off any unwanted microbes. For the worse, no vaccine or drug can effectively remove the presence of HIV from the human body. Meaning that if a person gets infected with HIV once, they will have to live with it for the rest of their lives. However, there are medicines and therapies to control the viral load of HIV; these drugs help keep the effects of HIV on the immune system under control and help prevent the further spread of the virus. 

Additionally, the HIV viruses are classified into two types: HIV 1 and HIV 2, based on characteristics of viral antigens. Also, note that the genome consists of two identical RNA molecule strands encapsulated within the viral particle. The virus can enter the human body through intact mucous membranes, injured skin, or foetal transmission. As per medical opinion, most HIV infections are still transmitted sexually. Transmission of HIV through blood or other transplanted organs can occur within 5 to 6 days in the regional lymph nodes. Apart from that, transmission from the mother to the child can happen shortly before or during birth, and it is also transmissible through breast milk.

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HIV AIDS in the UAE

The overall prevalence of AIDS and HIV infections in the UAE is low compared to other regions around the world. WHO estimates that approximately 2,300 people in the UAE are actively living with HIV infection. Most of these infections are found in the emirates of Dubai and Sharjah, given the high density of population. As far as global stats stand, more than 15 million people actively receive HIV care. The low prevalence of high health risk viruses like HIV deems well for all, true. However, the low stats may actually result from the low reporting rate given the limited awareness and the stigma surrounding the infection.  

AIDS and Health Insurance

HIV infections and AIDS are generally not included in health insurance plans, given their volatile nature. Since an HIV infection damages your immune system, you have a higher risk of sustaining other diseases which your body would have fought off in a normal situation. This makes you a very high-risk customer for the insurance company. And for the same reason, health insurance keeps HIV infections and AIDS as exclusion. However, some insurance providers in Dubai offer emergency care cover for HIV infection. 

HIV AIDS Symptoms

The symptoms of HIV AIDS after contracting HIV can differ as per the severity of the infection. Given below are the most prominent HIV AIDS symptoms in respect to the level of viral load in your body:

Primary HIV AIDS Symptoms 

  • Fever and headache
  • Joint and muscle pain 
  • Rashes 
  • Painful sores in the mouth and sore throat
  • Swollen lymph glands on the neck
  • Cough and night sweats
  • Diarrhoea and weight loss

Chronic HIV AIDS Symptoms

  • Persistent fever
  • Diarrhoea 
  • Swelling in lymph nodes
  • Sudden and significant weight loss 
  • Tiredness or fatigue
  • Shingles, aka herpes zoster
  • Oral yeast infection

Final Stage HIV AIDS Symptoms

  • Extreme and persistent tiredness
  • Swelling in lymph nodes on the neck
  • A severe case of diarrhoea 
  • Purple spots and bruises on the skin 
  • Difficulty in breathing
  • Unexplained weight loss
  • Pneumonia and night sweats
  • Yeast infection in mouth, pubic area or throat
  • Memory loss, depression, confusion, seizures, changes in behaviour, etc
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Diagnosis of HIV Infection

Progression of HIV infection to AIDS is a lengthy procedure. A few tests can be conducted to identify the presence of the virus and identify the stage of the infection. Following are those few tests:

  • Antigen Test: HIV carries antigen on it, which can be detected in tests a few weeks from the exposure. Thus, a simple blood test is sufficient to determine the presence of HIV antigens in the blood. A medical professional sends blood drawn from a vein for testing to find the presence of HIV antigen in the body.
  • Antibody Test: Our body makes antibodies whenever an alien virus enters it. The presence of these antibodies can direct us to the presence of the virus itself. So, the antibody test is used to detect HIV antibodies in the blood. Moreover, antibody tests can be taken by using self-testing kits as well. However, proper detection generally takes 3 to 12 weeks after HIV exposure. 
  • Nucleic Acid Tests: NAT is the test to detect the presence of HIV in your blood the earliest and the fastest. Nucleic acid tests detect the actual virus itself in the blood. A blood sample is required for these tests as well. Out of the three mentioned tests, NAT will show positive results before any other if you have been infected. 

Diagnosis of Stages of HIV Infection and AIDS

Diagnosis tests and markers to determine the stage of HIV infection are different from the tests used for HIV infection diagnosis. A person infected with the Human Immunodeficiency Virus is said to have progressed to the stage where they have AIDS, upon the satisfaction of the following conditions: 

  • CD4 Cell Count: When the number of CD4 cells falls underneath the count of 200 cells per cubic millimetre of blood. (To put things into context, a healthy count for this parameter is considered to be between 500 to 1600 cells per cubic millimetre). The CD4 cells are specifically white blood cells, and they may be contextually referred to as T-cells, lymphocytes, or helper cells.
    • The lower the CD4 cell count, the greater is the evidence that the immune system is weak and the higher the probability of its deterioration.
    • Once the treatment for HIV is initiated, you can rest assured that your CD4 count shall rise progressively over some time.
    • The CD4 cell count is variable for the same person depending on a few factors. For example, lack of exercise, sleep deprivation or smoking might cause fluctuations. Consequently, it is sensible to have the count consistently monitored over some time, especially at the same clinic.
  • Viral Load Tests: Viral load tests are done to determine the volume of the virus in your blood. A high viral load will lead to developing later stage HIV infection diseases like AIDS. But a low viral load would indicate that your infection is under control. Apart from that, viral load tests also determine your probability of transmitting the virus to others. An undetectable viral load would mean that you are nearly in perfect health concerning HIV infection and have low chances of transmitting the virus to others.
  • Drug Resistance Tests: This test does not determine the stage of HIV infection per se. However, doctors effectively use it to determine your course of treatment for HIV. Some HIV strains are immune to certain drugs, while others may develop immunity over time. Therefore, drug resistance tests can help your doctor determine the correct course of medication. 

What are the stages of HIV infection?

The following are the four main stages of HIV infection: 

  • Seroconversion Illness: The primary illness stage lasts for several weeks, during which the person might suffer from flu-like symptoms. At this stage, the immune system is starting to react to the infection by producing HIV specific antibodies and cytotoxic lymphocytes. This is what is referred to as seroconversion.
  • Asymptomatic Stage: The person is largely symptomless at this stage and will eventually start feeling better than the initial seroconversion stage. This is because the virus is specifically active within the lymph nodes during this stage, and it goes on an infectious spree, copying itself onto new cells. On average, this stage is expected to last around ten years, but it can even go to as high as fifteen years.
  • Symptomatic Stage: The symptoms start becoming more pronounced as the immune system fails. These symptoms during the symptomatic stage include diarrhoea, fever, weight loss. Also, note that this is also the time when cancer could strike.
  • Final Stage: The last stage of HIV infection is AIDS itself, which is a potentially life-threatening situation. The body's ability to fight infections and diseases is severely crippled at this stage as the immune system derogates to almost nothing. 

Opportunistic Infection

Opportunistic infection is a kind of infection that is caused by opportunistic organisms. These organisms are low pathogenicity and attack people with low immunity and natural strength to fight them off. Opportunistic organisms can be of different types. The patient develops an opportunistic infection irrespective of their CD4 count. Below are some key points you need to consider about these infections:

  • An opportunistic infection can develop in anyone. However, it only shows severe symptoms and increased treatment for people with weakened immune systems. In addition, opportunistic infection is usually caused by various microorganisms, including fungi, cytomegalovirus, or cryptosporidium. These infections can be transmitted through various means and methods, including air, water and food. 
  • Some of the HIV related opportunistic infections include pneumonia, salmonella infection, candidiasis and toxoplasmosis.
  • The primary pathogens responsible for opportunistic infection include Toxoplasma gondii, Cryptosporidium parvum, Pneumocystis jirovecii.
  • To prevent the onset of opportunistic infections, you need to avoid undercooked food such as eggs, unpasteurised dairy products or raw seed sprouts. The focus also needs to be on avoiding the germs which can cause the infection. In addition, the transmission can be controlled by avoiding contact with bodily fluids, faeces, etc.

How to Control Opportunistic Infections

  • Have a word with your doctor and get a prescription for opportunistic infection medications. 
  • Take a drug resistance test to see if your body has become resistant to the current ART medications. 
  • Avoid sharing needles and other surgical equipment with other people. 
  • You need to keep away from all kinds of germs since your immune system will not fight them effectively.
  • Food prohibitions will also apply here. This may include undercooked eggs and meat, raw milk, unpasteurised juice, etc. Speak to your doctor and find out which foods you need to avoid. Also, avoid drinking water from open sources like rivers and lakes while making sure that you only consume filtered water. 
  • Some common opportunistic infections may include candidiasis, invasive cervical cancer, cryptococcosis, coccidioidomycosis, herpes, etc. 

How is HIV Contracted?

Sexual Intercourse

Practising unprotected sex with someone who is already infected with HIV will lead to the transmission of the virus to a healthy person. Also, note that the transmission is possible via anal and vaginal intercourse since the exchange of bodily fluids is involved in both acts. Additionally, oral sex can also lead to HIV transmission; however, the risk is lower as compared to the other kinds of intercourses. Moreover, semen, vaginal fluids and menstrual fluids all can transmit HIV. Condoms are the only protection measure that can prevent transmission to an extent. Pay attention that anal sex is the riskiest form of intercourse when it comes to HIV transmission since the rectal lining is thinner than the vaginal lining of the body. 

Blood Transfusion

HIV transmission via blood transmission is very rare, or via any other kind of medical procedure for that matter. All medical providers maintain proper hygiene when dealing with blood donations and other procedures like an organ transplant. However, given that the medical professional does not maintain proper hygiene, there is a chance of transmission if the donor is HIV positive. Since HIV infection does not showcase any symptoms for many years, the infection may go undetected if the medical unit does not conduct all necessary screenings in real-time before donation. 

Prenatal Transmission

HIV can be transmitted from a carrier mother to the baby during the course of pregnancy, labour or even breastfeeding. However, prenatal transmission can be prevented if the mother is HIV positive and has been taking the due course of medicines and treatment. Since breastfeeding can also transmit the virus, HIV positive mothers are advised not to breastfeed the baby. 

Sharing Needles And Syringes

Whether for drug ingestion or medical purposes, sharing needles can effectively transmit HIV from an infected person to a healthy one. Sharing needles is actually a widespread way of HIV spreading around the world. Therefore, always make sure that your medical professional uses a fresh syringe and needle as well as other equipment used in the drug injection process. Overall, maintaining proper hygiene is an easy and highly effective way to prevent HIV spread. 

Other Rare Transmission Risk Factors

  • Workplace: The chances of transmission are zero if there has been zero exchange of bodily fluids. However, being cut by a sharp object used by an infected person at the workplace or using the same needles for medical purposes can transfer the infection. 
  • Pre-Chewed Food: This only prevails in infants and young children with HIV positive parents or guardians. Parents often pre-chew their child's food to make it easier for them to eat it. So, if one of the parents performing this task is HIV positive, the infection will transmit. 
  • Biting: If an HIV positive person happens to bite a healthy person and the skin breaks, HIV can be transmitted. However, if the skin has not been broken, you are safe from the transmission. 
  • Tattoos And Piercing: Since tattoos and piercings are also done by needles, HIV can be transmitted here as well. This only applies if the needles used in these procedures are not fresh. 

Necessary Pre-Satisfied Conditions for HIV Transmission

4 conditions must be satisfied for the infection to take place:

  • The virus survives only in bodily fluids, and it cannot thrive after a point in the open air or parts of the body with high acidic content.
  • The route of transmission through which the virus has entered must be clear. The usual routes include sexual intercourse, mother to child transmission and infected needles or syringes.
  • There must be a sufficient amount of virus in the bodily fluids.
  • Immune cells must be present near the entry point.

Ways Through Which HIV CAN NOT Be Transmitted

In addition to knowing the ways through which HIV can be transmitted, you must also be aware of the ways through which it cannot be transmitted. This is because HIV patients often face a lot of discrimination from the general public and medical care professionals solely because of a lack of awareness. Therefore, knowing the general things that cannot infect you with HIV can become a better support system for people already fighting this gruesome battle. Given below are the ways and contact points which do not transmit HIV infection:

  • Through the exchange of saliva, sweat or tears. For example, kissing an HIV positive person will only transmit the infection if the healthy person happens to come in contact with their blood. Meaning that the saliva alone will not transmit HIV infection
  • Sharing utensils, handshakes, hugging, sharing toiletries, social kissing or any kind of touching without an exchange of bodily fluids with someone with HIV infection
  • Through the means of air

Treatment options

In case you have been confirmed as HIV-positive, the best chance of preventing progression to AIDS is to initiate antiretroviral therapy as soon as possible. This therapy is not a permanent cure for the HIV infection, but it helps the body keep the infection in control so that the patient can lead as close to normal life as possible. In addition, the ART prevents the virus from replicating, and it helps to slow the natural progression of the virus; however, the person needs to continue taking the treatment because missing dosages would cause the progression of the disease. So, when taken as per the prescribed dosage, ART can even bring your viral load to be undetectable. This means that you will carry negligible transmission risks and lead a normal life. 

The drugs that are mainly used in the ART regimen are of the following seven types:

  • Non-nucleoside reverse transcriptase inhibitors
  • Fusion inhibitors
  • Post attachment inhibitors
  • CCR5 antagonists
  • Protease inhibitors
  • Nucleoside reverse transcriptase inhibitors
  • Integrase strand transfer inhibitors

The decisions for the HIV treatment regimen are taken based on several factors. These factors include other afflictions that the patient has, for instance, heart disease and the potential interaction of the HIV medicines with other pre-existing prescriptions. Another factor that is taken into consideration here is resistance to drugs. If you become resistant to the current medicine you are taking, the doctor will change the prescription. 

HIV Infection Prevention 

Preventing the spread of HIV to others is something one should always keep in mind. Since this is a disease that cannot be treated completely, prevention remains the only way to keep safe. Luckily, strategising to keep away from healthy people is not the only thing you can do to prevent HIV anymore. This is because technological advancements have finally allowed HIV infected people to lead a life as usual as any healthy person using advanced prevention medicines. Given below are all the ways one can prevent the spread of HIV infection:

  • Practice Safe Intercourse: Since unprotected intercourse of any kind and type is the most prominent way of HIV transmission, make sure you always practise safety methods. Remember that contraceptive drugs do not prevent HIV transmissions. Having said that, condoms are the only contraceptives to prevent HIV transmission. So, make sure you get indulged in activities that are low risk in terms of transmission if you or your partner is an HIV patient. 
  • Maintain Hygiene And Safety With Injections: Make it your responsibility to check and ensure that proper hygiene has been followed whenever you get injections. Using syringes and needles for medical or otherwise purposes must always come with sterile steps. New needles and syringes should be used for everyone at all times. 
  • Mother-To-Child Transmission: If you are HIV-infected, take steps to prevent prenatal transmission to your child. Use the prescribed drugs to keep the HIV viral load to a minimum at all times. In addition, undergo regular screenings. Once the child is born, get necessary tests done and avoid breastfeeding at all costs. Just a little bit of care and responsible steps will help you have a beautiful and healthy pregnancy. 
  • Post Exposure Prophylaxis: PEP refers to the act of taking medicines to stop HIV transmission if you have been exposed to it already. PEP can be effectively performed within 72 hours of potential HIV exposure and must only be conducted in emergencies. PEP is not recommended for people who may be exposed to HIV frequently, like healthcare workers. Moreover, PEP may have a few side effects, but they are easily treatable. 
  • Pre-Exposure Prophylaxis: PrEP is the course of drugs and medication you can take before being exposed to HIV. These medicines stop the potential spread of HIV and are extremely helpful for people who are frequently exposed to the virus. PrEP are extremely potent and effective against HIV transmission and are recommended over PEP. Side effects may be involved, but they are generally mild and easily treatable. Regular use of the prescribed dosage for 7 to 21 days offers maximum effects depending on the means of exposure. 
  • Keep Others Safe If You Get Infected: If you get infected, you have a responsibility towards yourself and others. Therefore, contact a doctor and get immediate medical assistance to start the treatment. The available treatments can help you reach an undetectable viral load which means a negligible risk of transmission. It generally takes 6 months to control viral load and bring to undetectable. Thus, make sure you practice all safety measures during that time and afterwards, too. 

Dealing with the stigma

Even with medications that can bring your general life back to normal medically, living as an HIV patient is hard. Over and above, managing to live with the stigma of having an HIV infection is much bigger than actually dealing with the infection itself and keeping it under control. Several doctors and medical professionals have reported that many HIV patients who are physically doing good succumb to the social discrimination and pressure they face in everyday life. Thus, the stigma of HIV is also one of the biggest reasons for unreported cases since people do not want to go through the rough patches. Moreover, depression, stress and anxiety prevail commonly among HIV positive patients. 

Having said that, the process of standing up to such stigma is to educate yourself clearly about the whole biological process and current medical understanding. You can try reaching out to some support groups or voluntary help organisations to better understand what other HIV positive people have to deal with. Apart from that, internal support from a group of people rowing the same boat can be huge. Besides support groups, you can also take advantage of occasions like world AIDS day to spread awareness and offer support. 

Furthermore, clarity about how HIV does not transmit should always be communicated since there are often several misconceptions about it. As explained above in detail, any kind of touching, kissing, sharing basic items like utensils and simply being in the company of an HIV positive person does not transmit the infection. Thus, you are safe as long as bodily fluids and blood are not exchanged. Therefore, spread awareness about these factors as much as you can as part of your social responsibility. Moreover, any patient dealing with HIV infection or AIDS require as many allies as possible. 

Family support

Emotional support is also an essential part of the coping strategy. For example, if someone in your family is infected, you should not entertain any talk or activities that would further the social stigma. There is absolutely nothing to fear from physically touching a person with HIV-AIDS.

Self-blame could be a major issue with a person who is infected with HIV-AIDS, especially if the infection happens when they are young. Apart from the medical processes, it is required that the person accept the circumstances at an individual level.

Living Life to the Fullest with HIV 

As evident, it is not impossible to have a normal, healthy and happy life after getting infected with HIV. You just need to care for a few things every day and a few changes that must be bought in your life. However, necessary changes and precautions are nothing different from leading a healthy lifestyle. 

  • Changing The Diet: Introducing a few changes in your diet is very important here. This is because your metabolism will take a hit because of the virus and the medicines you are taking for it. Therefore, only eat a highly nutritious diet. Food and beverages that can make for opportunistic infections or affect HIV treatment should be avoided non-negotiably. This includes undercooked eggs and meat, raw fish, unpasteurised milk, etc. Always try and eat fresh, hot food. 
  • Workout More Often: Working out can work wonders for not only your physical health but also your mental health. Exercising can reduce depression and stress and help you maintain a healthy weight. Working out will also boost your metabolism and improve immunity to some extent. Working out also lowers the chances of getting infected by opportunistic infections. 
  • HIV And Smoking: While smoking is harmful to all, healthy as well as sick people, it is awful for HIV patients, literally. Handicapped immunity will not help you in fighting diseases ideally here. Smoking increases your risk of developing diseases like lung cancer, cervical cancer, etc. In addition to that, smoking reduces the effect of ART, leads to AIDS and shorten the life span. 
  • Travelling: HIV patients can travel just like any other person. You just need to ensure that you have all your medications stocked and the potential health risk associated with your destination. So, buy a travel insurance plan that covers emergency evacuation to the home. Learn about any special rules for HIV positive visitors. Additionally, avoid raw foods, unsanitary drinks, and always eat a balanced hot meal. Also, keep away from unsanitary things like animal waste or animals in general. Moreover, avoid going to hospitals that have TB patients. 
  • Family Planning: Planning a family is not impossible, even if you have an HIV infection. Take proper medication to decrease the viral load enough to be undetectable. After that, visit your treating physician or specialist to discuss safe ways to conceive, keeping the viral load undetectable, PrEP and PEP medications and other essential things. 

Conclusion

What should be understood is that it is possible for people infected with HIV-AIDS to continue to lead healthy lives provided that proper care and support is available. Therefore, the focus needs to be on keeping the immune system as strong as possible through rigorous exercise, timely administration of antiretroviral therapy etc. Keeping your spirits up throughout the treatment course is also very important. Accepting yourself and making peace with your presence is the first step to leading a healthy life after HIV infection. Moreover, ask for support whenever you feel like it and try to extend the same level of help to others in a similar situation. 

Frequently asked questions

Q1: Does HIV stay in your blood throughout your life? 

Ans: Yes, even if HIV AIDS symptoms do not surface, once infected, it remains in the bloodstream throughout your life.

Q2: How can you reduce the risk of contracting HIV?

Ans: Use condoms every time you engage in sex, and make no exceptions whatsoever. Avoid drug usage. If it is compulsory for medical purposes, make sure that it is accompanied by sterile injections and fresh needles. If you are at risk of frequent exposure, consider taking Prep medications as prescribed by the doctors. If you have already been exposed to the virus, get PEP medication started within 72 hours of exposure. 

Q3: If a person is infected with HIV, how long do HIV AIDS symptoms appear?

Ans: Primary HIV AIDS symptoms might appear after an incubation period of around two to four weeks.

Q4: Can I initiate antiretroviral therapy during pregnancy or breastfeeding?

Ans: Yes, Antiretroviral therapy can be safely administered during pregnancy or breastfeeding.

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