HIV (Human Immunodeficiency Virus)/AIDS (Acquired Immunodeficiency Syndrome)

Overview

HIV is a retrovirus that infects the blood and attacks the immune system. Over time the immune system may grow weak and an infected person can become sick with different illnesses. Eventually the immune system will no longer be able to defend the body from infections diseases or deadly cancers. This advanced stage of the HIV disease is called AIDS.

According to the World Health Organization AIDS has become the most devastating disease humankind has ever faced. Globally the number of people living with HIV continues to grow - from 38 million in 2003 to 40.3 million today. In 2005 alone almost five million more people became newly infected with HIV the greatest number in any one year since the beginning of the epidemic. More than three million were killed by AIDS in 2005; over 25 million have died since the first cases of AIDS were identified in 1981.

There are an estimated 50000 people living with HIV/AIDS in Canada. Of these 30% are unaware that they are infected. Ontario has the highest number of positive HIV test reports with a total of 23863 (1985 - June 2003).

Causes

HIV primarily infects the body's CD4 cells using the materials in them to replicate multiple copies of themselves until a cell dies and the new viruses infect another cell and begin the process again. The immune system cannot stop the spread of the virus and eventually an HIV infection seriously depletes the body of CD4 cells. Since these cells are themselves an integral part of the immune response the entire immune system is weakened leaving a person vulnerable to infections and cancers that a healthy person can normally fight off.

The blood vaginal fluid semen and breast milk of people infected with HIV has enough of the virus in it to infect other people. Most people get the HIV virus by:

  • Having sex with an infected person.
  • Sharing a needle (shooting drugs) with someone who's infected
  • Being born when the mother is infected or drinking the breast milk of an infected woman.

Getting a transfusion of infected blood used to be a way people got AIDS but now the blood supply is screened very carefully and the risk is extremely low. There are no documented cases of HIV being transmitted by tears or saliva but it is possible to be infected with HIV through oral sex or in rare cases through deep kissing especially if you have open sores in your mouth or bleeding gums.

Symptoms

Some people initially have no symptoms. Others get fever headache sore muscles and joints stomach ache swollen lymph glands or a skin rash for one or two weeks after becoming infected. They may think they have the flu.

The virus will multiply for a few weeks or even months before the immune system responds. During this time an infected person won't test positive for HIV but they can infect other people. When the immune system does respond it starts to make antibodies. When this happens you will test positive for HIV.

Being HIV-positive is not the same as having AIDS. Many people are HIV-positive but don't get sick for many years. As HIV disease continues it slowly wears down the immune system. As this happens a variety of complications start to take over. For many people the first signs of infection are large lymph nodes or "swollen glands" that may be enlarged for more than 3 months. Other symptoms often experienced months to years before the onset of AIDS include:

  • Lack of energy
  • Weight loss
  • Frequent fevers and sweats
  • Persistent or frequent yeast infections (oral or vaginal)
  • Persistent skin rashes or flaky skin
  • Pelvic inflammatory disease in women that does not respond to treatment
  • Short-term memory loss

Some people develop frequent and severe herpes infections that cause mouth genital or anal sores or a painful nerve disease called shingles. Children may grow slowly or be sick a lot.

Viruses parasites fungi and bacteria that usually don't cause any problems can make you very sick if your immune system is damaged. These are called "opportunistic infections" and include many deadly cancers.

AIDS is different in every infected person. Some people die soon after getting infected while others live fairly normal lives for many years even after they "officially" have AIDS. A few HIV-positive people stay healthy for many years even without taking anti-HIV medications.

Treatment

If you think you may have HIV you can have a test done. You can be tested anonymously if you are concerned about confidentiality.

For the location of a sexual health clinic near you in Ontario call the AIDS and Sexual Health Infoline at 1-800-668-2437.

It takes three months for antibodies to the virus to show up in your blood after exposure so to determine whether you have been recently infected (acute infection) your health care provider can screen you for the presence of HIV genetic material. Direct screening is extremely critical in order to prevent transmission of HIV from recently infected individuals.

If the test is positive you will be referred to a doctor who knows a lot about treating HIV. Do not engage in unprotected sex until you are tested and can be sure that you will not spread the infection to others. Condoms help prevent the spread of all sexually transmitted diseases including HIV/AIDS.

There is no vaccine that prevents HIV transmission and there is no cure for AIDS. There are drugs that can slow down the HIV virus and slow down the damage to your immune system allowing many people to delay the onset of AIDS and lead longer and healthier lives. But there is no way to get all the HIV out of your body.

There are other drugs that you can take to prevent or to treat opportunistic infections. In most cases these drugs work very well. The newer stronger anti-HIV drugs have also helped reduce the rates of most opportunistic infections. A few however are still very difficult to treat.

If a woman has HIV and gets pregnant she can take medication which will reduce the chance of her baby's getting it. She should not breastfeed her baby. Consider getting tested before you start a pregnancy.

Prevention

Because no vaccine for HIV is available the only way to prevent infection by the virus is to avoid behaviors that put you at risk of infection such as having unprotected sex and sharing needles.

Many people infected with HIV have no symptoms. Therefore there is no way of knowing with certainty whether your sexual partner is infected unless he or she has repeatedly tested negative for the virus and has not engaged in any risky behavior. You should either abstain from having sex or use male latex condoms or female polyurethane condoms which may offer partial protection during oral anal or vaginal sex. Only water-based lubricants should be used with male latex condoms.

Additional Resources

Canadian AIDS Society

Canadian HIV Trials Network

Canadian HIV/AIDS Information Centre (Canadian Public Health Association)

CATIE - Canadian AIDS Treatment Information Exchange

Ontario AIDS and Sexual Health Information