HIV/AIDS

• HIV attacks and destroys the CD4-T cells of the immune system.
• CD4-T-cells play a major role in protecting the body from infection and some cancers.
• HIV uses the cellular machinery of the CD4 cells to replicate and release virion that spread throughout the peripheral circulation. The HIV life-cycle is characterized by seven phases: 1) Attachment, 2) Fusion and uncoating, 3) Reverse transcription, 4) Nuclear entry and integration, 5) RNA replication, 6) protein synthesis and assembly, 7)  Budding and maturation.
• HIV antiretroviral therapies are designed to block HIV replication at each phase of the HIV life cycle.
• Recommended ART combines at least two different HIV drug classes which are taken every day. Because each class of drugs is designed to target a specific phase in the HIV life cycle, ART is very effective at preventing HIV from multiplying.

Stages of HIV infection ( https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection )

Untreated HIV infection typically progresses through three stages. HIV combined antiretroviral therapy medications can slow or prevent progression of the disease. With the advancements in treatment, progression to Stage 3 is less common today than in the early days of HIV.

Stage 1: Acute HIV Infection

• People have a large amount of HIV in their blood. They are very contagious.
  
• Some people have flu-like symptoms. This is the body’s natural response to infection.
  
• But some people may not feel sick right away or not at all.
  
• If you have flu-like symptoms and think you may have been exposed to HIV, seek medical care and ask for a test to diagnose acute infection.
  
• Only antigen/antibody tests or nucleic acid tests (NATs) can diagnose acute infection.

Stage 2: Chronic HIV Infection

• This stage is also called asymptomatic HIV infection or clinical latency.
• HIV is still active but reproduces at very low levels.
• People may not have any symptoms or minor symptoms during this phase.
• Without taking HIV medicine, this period may last a decade or longer, but some may progress faster.
• Untreated persons can transmit HIV in the "asymptomatic" phase.
• At the end of this phase, the amount of HIV in the blood (called viral load) goes up and the CD4 cell count goes down. The person may have symptoms as the virus levels increase in the body, and the person moves into Stage 3.
• People who take HIV medicine as prescribed can suppress viral replication below detectable levels and may never progress to Stage 3.

Stage 3: Acquired Immunodeficiency Syndrome (AIDS)

• The most severe phase of HIV infection.
  
• People receive an AIDS diagnosis when their CD4 cell count drops below 200 cells/ml
• CD4-T cell count below 200 cells/ml impairs the immune system resulting in a number of severe illnesses known as AIDS Defining Conditions which may include certain opportunistic infections.
  
• People with AIDS can have a high viral load and be very infectious.
  
• Without treatment, people with AIDS typically survive about three years

Acute Symptoms

Some people have flu-like symptoms within 2 to 4 weeks after infection (called acute HIV infection). These symptoms may last for a few days or several weeks. Possible symptoms include

• Fever,
• Chills,
• Rash,
• Night sweats,
• Muscle aches,
• Sore throat,
• Fatigue,
• Swollen lymph nodes, and
• Mouth ulcers.

References

National HIV curriculum. (2022). https://www.hiv.uw.edu/

CDC (n.d.) HIV Basics. Retrieved 5/17/2021 from https://www.cdc.gov/hiv/basics/whatishiv.html

CLINICAL INFO.HIV.GO. (n.d.) Glossary. Drug Classes. Retrieved 5/17/2021 from https://clinicalinfo.hiv.gov/en/glossary/drug-class.

U.S. Department of Health and Human Services. (n.d.). The stages of HIV infection. National Institutes of Health. https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection

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