HIV and AIDS: What is it, Transmission, Symptoms, Causes and Window period


HIV is a virus that damages the immune system making people much more vulnerable to infections and diseases where as AIDS is a medical condition that occurs at most advanced stage of HIV.

May 3, 2018

HIV and AIDS: What is it, Transmission, Symptoms, Causes and Window period

HIV is a virus that damages the immune system making people much more vulnerable to infections and diseases. The immune system helps the body fight off infections. Untreated HIV infects and kills CD4 cells, which are a type of immune cell called T cells. Over time, the body is more likely to get various types of infections and cancers as HIV kills more CD4 cells. HIV is found throughout all the tissues of the body. It is transmitted through the body fluids of an infected person which include semen, vaginal and rectal fluids, blood, and breast milk.The virus does not spread in air or water, or through casual contact.
Currently there is no cure for HIV. However, it is possible to manage HIV and live with the virus for many years with treatment called antiretroviral therapy and proper medical care. a person with HIV is likely to develop a serious condition called AIDS without treatment. At this point, the immune system is too weak to fight off other diseases and infections.
Untreated AIDS will have life expectancy of about three years. HIV can be well controlled with antiretroviral therapy and life expectancy can be as long as a person someone who has not contracted HIV.

What is AIDS?

AIDS is a medical condition that occurs at most advanced stage of HIV. HIV infection can cause AIDS to develop. But not necessarily a person having HIV will develop AIDS. It is possible to contract HIV without developing AIDS. But untreated HIV can progress and develop into AIDS in the vast majority of cases.
Generally a healthy adults will have a CD4 count of 500 to 1,500 per cubic millimeter. As CD4 cells are destroyed in a person with HIV, the CD4 count falls. If it is below 200 per cubic millimeter, the person will be diagnosed with AIDS.
A person can also be diagnosed with AIDS if they have HIV and develop an opportunistic infection such as pneumonia or cancer that is rare in people who don't have HIV. HIV can progress to AIDS within a decade if not treated. Without treatment, life expectancy after diagnosis is about three years. This may be even shorter if the person develops a severe opportunistic illness. These include:

  • pneumonia
  • tuberculosis
  • oral thrush, a fungal infection in the mouth or throat
  • cytomegalovirus (CMV) which is a type of herpes virus
  • toxoplasmosis, a brain infection caused by a parasite
  • cryptosporidiosis, an infection caused by an intestinal parasite
  • cryptococcal meningitis which is a fungal infection in the brain
  • cancer, including Kaposi's sarcoma (KS) and lymphoma

The immune system is severely compromised in AIDS. The weakened immune system can no longer fight off most diseases and infections which makes the person vulnerable to the above wide range of illnesses.
The shortened life expectancy is a result of the diseases and complications that arise from having an immune system weakened by AIDS. There is no cure for AIDS. However, treatment with antiretroviral drugs can prevent AIDS from developing. This is a drug therapy that slows or prevents the virus from developing. The rate of virus progression varies widely between individuals and depends on many factors including the age of the individual, ability of the body to defend against HIV, access to healthcare, the presence of other infections, the genetic inheritance of an individual, resistance to certain strains of HIV, and many more.
Treatment can increase CD4 count of a person to the point where they are considered to no longer have AIDS. This point is a count of 200 or higher. Treatment can also typically help manage opportunistic infections.
HIV and AIDS are related, but they are not the same thing.

HIV transmission:

Anyone can contract HIV. The virus is transmitted in bodily fluids that include semen, vaginal and rectal fluids, blood, and breast milk.
Some of the ways HIV is spread from person to person include:

  • through vaginal or anal sex which is the most common route of transmission, especially among men who have sex with men
  • by sharing needles, syringes, and other items for injection drug use
  • by sharing tattoo equipment without sterilizing it between uses
  • during pregnancy, labor, or delivery from a woman to her baby
  • during breastfeeding
  • through pre-mastication, or chewing a baby's food before feeding it to them
  • through exposure to the blood of someone living with HIV, such as through a needle stick
  • injecting drugs, sharing and reusing syringes contaminated with HIV infected blood

The virus can also be transmitted through a blood transfusion or organ and tissue transplant. However, this is very rare in developing countries as there is rigorous testing for HIV among blood, organ, and tissue donors.
In extremely rare cases, HIV can spread through:

  • oral sex , only if there are bleeding gums or open sores in the mouth of the person
  • being bitten by a person with HIV, only if the saliva is bloody or there are open sores in the mouth of the person
  • contact between broken skin, wounds, or mucous membranes and the blood of someone living with HIV

HIV does NOT spread through:

  • skin to skin contact
  • hugging, shaking hands, or kissing
  • air or water
  • sharing food or drinks, including drinking fountains
  • saliva, tears, or sweat, unless mixed with the blood of a person with HIV
  • sharing a toilet, towels, or bedding
  • mosquitoes or other insects

Causes of HIV:

HIV is a variation of a virus that infects African chimpanzees. The simian immunodeficiency virus (SIV) jumped from chimps to humans when people consumed infected chimpanzee meat. Once inside the human body, the virus mutated into HIV.
The virus migrated to other parts of the world from African over the course of several decades.

Causes of AIDS:

HIV infection can cause AIDS to develop. But not necessarily a person having HIV will develop AIDS. It is possible to contract HIV without developing AIDS. But untreated HIV can progress and develop into AIDS in the vast majority of cases.
Generally a healthy adults will have a CD4 count of 500 to 1,500 per cubic millimeter. As CD4 cells are destroyed in a person with HIV, the CD4 count falls. If it is below 200 per cubic millimeter, the person will be diagnosed with AIDS.
A person can also be diagnosed with AIDS if they have HIV and develop an opportunistic infection such as pneumonia or cancer that is rare in people who don't have HIV. In such cases even if the CD4 count is above 200, the person is diagnosed with AIDS.

Early symptoms of HIV:

After someone contracts HIV, the first few weeks is called the acute infection stage. During this period, the virus reproduces rapidly. The immune system of the person responds by producing HIV antibodies which are proteins that fight infection. At first there will be no symptoms. Many people experience symptoms in the first month or two after contracting the virus. However, symptoms of the acute stage can be very similar to those of the flu or other seasonal viruses. These can be mild to severe, may come and go, and may last from a few days to several weeks.
Early symptoms of HIV can include:

  • fever
  • chills
  • sore throat
  • swollen lymph nodes
  • general aches and pains
  • skin rash
  • nausea
  • headache
  • upset stomach

Because these symptoms are similar to common illnesses like the flu, diagnosis is very difficult in this stage. But even if there is no symptoms, the amount of HIV found in the bloodstream is very high during this period and can be easily transmitted to someone else. When a person enters the chronic, or clinical latency stage of HIV, symptoms of initial HIV stage usually resolve within a few months. This stage can last many years or even decades with treatment. HIV symptoms can vary from person to person.

HIV symptoms:

HIV enters the clinical latency stage after the first month. This stage can last from a few years to a few decades. Some people does not experience any symptoms during this period, while others may have minimal or nonspecific symptoms. A nonspecific symptom is a symptom that does not pertain to one specific disease or condition.
These nonspecific symptoms may include:

  • recurrent fevers
  • headaches and other aches and pains
  • swollen lymph nodes
  • skin rashes
  • fatigue
  • nausea
  • vomiting
  • diarrhea
  • weight loss
  • night sweats
  • recurrent oral or vaginal yeast infections
  • pneumonia
  • shingles

HIV is still infectious during this period even without any symptoms and can be transmitted to another person. At this stage, HIV symptoms may come and go, or they may progress rapidly. This progression can be slowed with the consistent use of antiretroviral therapy. Chronic HIV can last for decades and will likely not develop into AIDS, if treatment was started in early stage.

HIV symptoms in men:

Symptoms of HIV may vary from person to person. But they are similar in men and women. These symptoms can come and go or get progressively worse. A person with HIV is more likely exposed to other sexually transmitted infections (STIs), such as gonorrhea, chlamydia, syphilis, and trichomoniasis. These symptoms of STIs are more noticeable in men then women, such as sores on their genitals.

HIV symptoms in women:

Based on the different risks men and women face if they have HIV, symptoms may differ. Both men and women with HIV are at increased risk of sexually transmitted infections (STIs). However, women are less likely than men to notice small spots or other changes to their genitals.
In addition, women with HIV are at increased risk of:

  • recurrent vaginal yeast infections
  • other vaginal infections, including bacterial vaginosis
  • pelvic inflammatory disease (PID)
  • menstrual cycle changes
  • human papillomavirus (HPV), which can cause genital warts and lead to cervical cancer

The virus can be transmitted to a baby during pregnancy in case of women. However, antiretroviral therapy is considered safe during pregnancy. Women who are treated with antiretroviral therapy are at very low risk of passing HIV to their baby during pregnancy and delivery. The virus can also be passed to a baby through breast milk. Therefore recommended not to breastfeed the babies for a women with HIV.

AIDS symptoms:

Acquired immunodeficiency syndrome or AIDS is a condition where the immune system is weakened due to HIV that is typically untreated for many years. People with HIV may develop AIDS if their HIV is not diagnosed until late or not being treated for years. They may also develop AIDS if they have a type of HIV that doesn't respond to the antiretroviral treatment.
With AIDS, the immune system is quite damaged and is unable to fight off infection and disease. Symptoms of AIDS can include:

  • recurrent fever
  • chronic swollen lymph glands, especially of the armpits, neck, and groin
  • chronic fatigue
  • night sweats
  • recurrent or chronic diarrhea
  • rapid weight loss
  • dark splotches under the skin or inside the mouth, nose, or eyelids
  • sores, spots, or lesions of the mouth and tongue, genitals, or anus
  • bumps, lesions, or rashes of the skin
  • anxiety and depression
  • neurologic problems such as trouble concentrating, memory loss, and confusion
  • anxiety and depression

HIV Window Period:

As soon as someone contracts HIV, it starts to reproduce in their body. The immune system of a person reacts to the antigens by producing antibodies. Antibodies are cells that fight the virus. HIV window period is the time between exposure to HIV and when it becomes detectable in the blood. Most people develop detectable HIV antibodies within 23 to 90 days after infection.
HIV test will be negative during the window period. However, the virus can still get transmitted to others during this time. If someone thinks they may have been exposed to HIV but the test results are negative, they should repeat the test in a few months to confirm.   
Post-exposure prophylaxis (PEP) is a medication that should be taken after an exposure to prevent getting HIV. PEP needs to be taken as soon as possible after the exposure,no later than 72 hours.
Pre-exposure prophylaxis (PrEP) is a combination of HIV drugs taken before potential exposure to HIV. PrEP can lower the risk of contracting or spreading HIV when taken consistently.