HIV stands for human immunodeficiency virus. HIV infects and destroys cells of your immune system, making it hard to fight off other diseases. When HIV has severely weakened your immune system, it can lead to acquired immunodeficiency syndrome (AIDS).
Because HIV works backward to insert its instructions into your DNA, it is called a retrovirus.
AIDS is the final and most serious stage of an HIV infection. People with AIDS have very low counts of certain white blood cells and severely damaged immune systems. They may have additional illnesses that indicate that they have progressed to AIDS. Without treatment, HIV infections progress to AIDS in about 10 years.
Infections common to HIV/AIDS
Pneumocystis pneumonia (PCP): This fungal infection can cause severe illness. Although it's declined significantly with current treatments for HIV/AIDS, in the U.S., PCP is still the most common cause of pneumonia in people infected with HIV.
Candidiasis (thrush): Candidiasis is a common HIV-related infection. It causes inflammation and a thick, white coating on your mouth, tongue, esophagus or vagina.
Tuberculosis (TB): TB is a common opportunistic infection associated with HIV. Worldwide, TB is a leading cause of death among people with AIDS. It's less common in the U.S. thanks to the wide use of HIV medications.
Cytomegalovirus: This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.
Cryptococcal meningitis: Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus found in soil.
Toxoplasmosis: This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasites in their stools, which may then spread to other animals and humans. Toxoplasmosis can cause heart disease, and seizures occur when it spreads to the brain.
Cancers common to HIV/AIDS
Lymphoma: This cancer starts in the white blood cells. The most common early sign is painless swelling of the lymph nodes in your neck, armpit or groin.
Kaposi's sarcoma: A tumor of the blood vessel walls, Kaposi's sarcoma usually appears as pink, red or purple lesions on the skin and mouth. In people with darker skin, the lesions may look dark brown or black. Kaposi's sarcoma can also affect the internal organs, including the digestive tract and lungs.
HPV-related cancers: These are cancers caused by human papillomavirus (HPV) infection. They include anal, oral and cervical cancer.
Wasting syndrome: Untreated HIV/AIDS can cause significant weight loss, often accompanied by diarrhea, chronic weakness and fever.
Neurological complications: HIV can cause neurological symptoms such as confusion, forgetfulness, depression, anxiety and difficulty walking. HIV-associated neurocognitive disorders (HAND) can range from mild symptoms of behavioral changes and reduced mental functioning to severe dementia causing weakness and inability to function.
Kidney disease: HIV-associated nephropathy (HIVAN) is an inflammation of the tiny filters in your kidneys that remove excess fluid and wastes from your blood and pass them to your urine. It most often affects Black or Hispanic people.
Liver disease: Liver disease is also a major complication, especially in people who also have hepatitis B or hepatitis C.
The virus is spread (transmitted) person-to-person through certain body fluids:
HIV can be spread if these fluids come in contact with:
In the United States, HIV is mainly spread:
Less often, HIV is spread:
From mother to child: A pregnant woman can spread the virus to her fetus through their shared blood circulation, or a nursing mother can pass it to her baby through her breast milk.
Through needle sticks or other sharp objects that are contaminated with HIV (mainly health care workers).
The virus is NOT spread by:
HIV and blood or organ donation:
HIV is not spread to a person who donates blood or organs. People who donate organs are never in direct contact with the people who receive them. Likewise, a person who donates blood is never in contact with the person receiving it. In all of these procedures, sterile needles and instruments are used.
While very rare, in the past HIV has been spread to a person receiving blood or organs from an infected donor. However, this risk is very small because blood banks and organ donor programs thoroughly check (screen) donors, blood, and tissues.
Risk factors for getting HIV include:
The symptoms of HIV and AIDS vary, depending on the phase of infection.
Primary infection (Acute HIV)
Some people infected by HIV develop a flu-like illness within 2 to 4 weeks after the virus enters the body. This illness, known as primary (acute) HIV infection, may last for a few weeks.
Possible signs and symptoms include:
These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.
Clinical latent infection (Chronic HIV)
In this stage of infection, HIV is still present in the body and in white blood cells. However, many people may not have any symptoms or infections during this time.
This stage can last for many years if you're receiving antiretroviral therapy (ART). Some people develop more severe diseases much sooner.
Symptomatic HIV infection
As the virus continues to multiply and destroy your immune cells, the cells in your body that help fight off germs, you may develop mild infections or chronic signs and symptoms such as:
Access to better antiviral treatments has dramatically decreased deaths from AIDS worldwide, even in resource-poor countries. Thanks to these life-saving treatments, most people with HIV in the U.S. today don't develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.
When AIDS occurs, your immune system has been severely damaged. You'll be more likely to develop diseases that wouldn't usually cause illness in a person with a healthy immune system. These are called opportunistic infections or opportunistic cancers.
The signs and symptoms of some of these infections may include:
Several different tests can be used to diagnose HIV. Healthcare providers determine which test is best for each person.
Other antibody tests can be done at home:
Note 1: In addition to standard therapies and regimens, the term “approved medication(s)” includes treatment regimens and medications prescribed as part of a research protocol at an accredited medical institution.
Note 2: Diagnosed psychiatric illness, central nervous system manifestations, opportunistic infections, and neoplasms may be rated separately under the appropriate diagnostic codes if a higher overall evaluation results, provided the disability symptoms do not overlap with evaluations otherwise assignable above.
Note 3: The following list of opportunistic infections are considered AIDS-defining conditions, that is, a diagnosis of AIDS follows if a person has HIV and one more of these infections, regardless of the CD4 count--candidiasis of the bronchi, trachea, esophagus, or lungs; invasive cervical cancer; coccidioidomycosis; cryptococcosis; cryptosporidiosis; cytomegalovirus (particularly CMV retinitis); HIV-related encephalopathy; herpes simplex-chronic ulcers for greater than one month, or bronchitis, pneumonia, or esophagitis; histoplasmosis; isosporiasis (chronic intestinal); Kaposi's sarcoma; lymphoma; mycobacterium avium complex; tuberculosis; pneumocystis jirovecii (carinii) pneumonia; pneumonia, recurrent; progressive multifocal leukoencephalopathy; salmonella septicemia, recurrent; toxoplasmosis of the brain; and wasting syndrome due to HIV.
AIDS with recurrent opportunistic infections (see Note 3) or with secondary diseases afflicting multiple body systems; HIV-related illness with debility and progressive weight loss,
Refractory constitutional symptoms, diarrhea, and pathological weight loss; or minimum rating following development of AIDS-related opportunistic infection or neoplasm
Recurrent constitutional symptoms, intermittent diarrhea, and use of approved medication(s); or minimum rating with T4 cell count less than 200of AIDS-related
Following development of HIV-related constitutional symptoms; T4 cell count between 200 and 500; use of approved medication(s); or with evidence of depression or memory loss with employment limitations
Asymptomatic, following initial diagnosis of HIV infection, with or without lymphadenopathy or decreased T4 cell count
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