HIV and AIDS

WEB EXCLUSIVE / JULY 2005
POSTGRADUATE MEDICINE
Update of a handout originally published in April 2000

Download this Patient Note in PDF format

Up to 950,000 people in the United States are estimated to be infected with the human immunodeficiency virus (HIV), and more than 43,000 have the disease it causes, acquired immunodeficiency syndrome (AIDS). In 2003, about 14,000 people in this country died of AIDS. Globally, about 39.4 million people were reported to have HIV infection or AIDS as of 2004; 3.1 million died of AIDS that year.

AIDS is a progressive, devastating disease. Fortunately, new treatments have prolonged survival and improved the quality of life for people infected with the virus and those with full-blown AIDS.

What is the difference between HIV infection and AIDS?
HIV infection is a chronic condition that slowly but persistently destroys helper T cells, which direct the immune system's response against infection and some tumors.

AIDS is defined as the presence of HIV infection, plus one or both of the following:

• A helper T cell count of less than 200. The normal count is 600 to 1,000.
• Development of an opportunistic infection that occurs when the immune system is not working correctly. Examples of opportunistic infections are specific types of pneumonia and eye diseases, encephalitis, and herpes zoster (shingles). Some tumors, such as Kaposi sarcoma, are also associated with AIDS.

Who is at high risk for HIV infection and AIDS?

• Anyone who has sexual intercourse with an HIV-infected person
• Anyone who has received infected blood (even a very small amount), such as from a blood transfusion, shared intravenous drug syringe, or dirty tattoo needle
• Any infant exposed to HIV before birth

How can I minimize the risk?
The safest way, other than abstaining from sex, is to maintain a monogamous sexual relationship with an uninfected and monogamous partner. The more sexual partners, the greater the risk. A condom provides some protection against HIV infection, but it is not foolproof.

People who take drugs through a needle or syringe--whether medicinal or street drugs--should use only their own needles and syringes and should never share the equipment with anyone.

Blood transfusions pose very little risk of infection today, because tests can detect HIV in donor blood. However, transfusions still present a small risk because the virus may not be detectable in the blood of a newly infected person.

Early detection is important
Recent advances in technology have led to accurate rapid tests for HIV. These yield results in only 10 to 20 minutes rather than the 3 or 4 days required by conventional testing with the screening test ELISA. However, the rapid tests are generally used only in certain situations. A positive result with either a rapid test or an ELISA must be confirmed with a Western blot test, which takes 5 to 7 days to yield a result.

Early detection of HIV infection allows the patient to start taking antiretroviral drug therapy, which can help preserve the immune system and prevent opportunistic infections. It also alerts the patient that he or she must avoid risky behavior that could spread the disease. HIV testing can be done at most hospitals, clinics, or doctors' offices. Anonymous testing is available to protect confidentiality.

Prevention remains key
No vaccine prevents HIV infection, and no cure is known at this time. The only preventive steps are to avoid risky behavior and to ensure that HIV-infected blood, semen, vaginal fluid, or breast milk does not enter your body.

Treatment has improved
Current antiretroviral drug regimens have greatly improved the treatment of HIV infection. Rather than meaning a rapid death, HIV infection is now considered a chronic disease that can be managed for greater lengths of time.

Several different types of antiretroviral drugs are available, and they are used in many different combinations, depending on the individual patient's needs.

To prevent HIV infection and AIDS Abstain from sex with people whose sexual history and current behavior are uncertain. If you choose to have sex, use a latex condom every time. Never share injection equipment. If you use a needle to inject a drug (steroids, hormones, insulin, or illegal drugs), keep it clean and don't share it with anyone. Do not share razors or toothbrushes. You cannot get HIV infection and AIDS from being in contact with insects, sweat, or tears; sharing food, utensils, towels, or bedding; using swimming pools, telephones, or toilet seats; or hugging or kissing someone with HIV infection or AIDS.

For more information on HIV infection and AIDS Detailed information on HIV infection and its prevention, diagnosis, and treatment, as well as ongoing research, can be found at the following sites: Centers for Disease Control and Prevention Technical Information and Communications Branch Divisions of HIV/AIDS Prevention National Center for HIV, STD and TB Prevention Mail Stop E-49 1600 Clifton Rd NE Atlanta, GA 30333 800-232-4636 (AIDS hotline for answers to personal health questions) 800-448-0440 (For information on treatment of HIV infection or AIDS, clinical trials, or vaccines) http://www.cdc.gov/hiv/dhap.shtml National Institute of Allergy and Infectious Diseases National Institutes of Health 9000 Rockville Pike Bethesda, MD 20892 301-496-5717 http://health.nih.gov/result.asp/15/11 Joint United Nations Programme on HIV/AIDS (UNAIDS) E-mail: unaids@unaids.org http://www.unaids.org/en/default.asp World Health Organization http://www.who.int/topics/hiv_infections/en/

This information is not a substitute for medical treatment.

Please send technical questions related to the Web site to Ann Harste