Understanding HIV Infection

Understanding HIV Infection

Although an HIV infection causes symptoms, it can only be diagnosed through an HIV antibodies test. Find out about the follow-up after confirmation of HIV+ status.

When a person is infected by HIV (Human Immunodeficiency Virus), he/she is known as being HIV+. However, the infection is not immediately detectable after exposure to the virus. This is because HIV can take between one to three months to incubate, depending on the individual’s constitution. After that window period, there will be sufficient HIV antibodies in the person’s system to be detected through an HIV antibodies test. That test is the only method by which to diagnose and confirm the infection.

Symptoms of HIV Infection

One or more of the following symptoms may be present. These usually last from a week to as long as three months.

  • Adenopathy (swollen lymph nodes)
  • Diarrhea
  • Fever
  • Headache
  • Myalgia (muscle ache/pain)
  • Nausea
  • Neurological illnesses
  • Oral and genital ulcers
  • Oral thrush
  • Rash(es)
  • Sore throat
  • Vomiting
  • Weight loss

There is often under-diagnosis of the HIV infection because it does not present any specific or unique symptom(s). Those stated above can actually be caused by many other infections or diseases. Furthermore, HIV symptoms very often resolve spontaneously in most people. However, even after the resolution of symptoms, active viral replication continues inside the body, compromising the person’s immune system.

An HIV+ person remains infectious for the entire duration of the infection. However, he/she is the most infectious during:

a) Seroconversion upon initial infection, when the body is producing antibodies; and

b) Late-stage of the disease if left untreated.

What Happens After Diagnosis?

An HIV+ person has to regularly monitor the strength of his/her immune system. This can be checked using two tests.

CD4 (T4/T-helper) Cells Count Test

CD4 cells are a type of white blood cells that fights infection, and are a major target for HIV. As the virus gets into the cell and replicates, the number of CD4 cells in the blood gradually declines.

Normal CD4 counts in adults range from 500 to 1,500 cells per cubic millimeter of blood. However, a standard reference range is not available for this test. After diagnosis, a first test is done to determine the person’s CD4 count. That figure serves as the baseline measurement for monitoring purposes.

Viral Load Test

This test measures the level of HIV in the blood to determine the staging and outlook of the disease. Viral load refers to the number of HIV particles or copies of the virus present in the body.

Treatment should be considered for patients whose viral loads are higher than 30,000 copies per milliliter of blood (using the branched DNA test) or more than 55,000 copies (using the RT-PCR test).

Clearing Some Misconceptions about Being HIV+

  • Many who are HIV+ look healthy and normal, rather than sickly or weak. Since HIV infection does not have any physical manifestations, one should always practise safer sex rather than assume from external appearances that the other person is HIV-.
  • Medication is not immediately needed upon confirmation of one’s HIV status. However, regular monitoring is needed so that treatment can be prescribed when necessary.
  • One can still have sex after being HIV+. However, the practice of safer sexis a must so as to avoid infecting others and to protect oneself from other sexually-transmitted infections (STI).
  • Safer sex must be practiced even though both partners are HIV+. This is to prevent cross infection by different HIV strains and transmission of other STIs.
  • An HIV infection is not a death sentence. An HIV+ person can go on living many decades of productive life. Only the last stage of the HIV infection – AIDS (Acquired Immune Deficiency Syndrome) – is terminal.
Mark Riegel, MD

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