The Lambda Clinic - Sexual Health Advice - Patient Information Leaflet
http://www.lambdaclinic.co.uk/hiv-aids.html
HIV and AIDS
What are HIV and AIDS?
HIV stands for Human Immunodeficiency Virus. It is a retrovirus that destroys cells in the body called CD4 T-cells. These cells are an important part of the body's immune system and when they are destroyed the body can no longer fight off infection and diseases.
AIDS stands for Acquired Immunodeficiency Syndrome. This is a term which covers the range of infections and illnesses which can result from a ‘weakened' immune system caused by the HIV virus.
When you are first infected with HIV you do not get AIDS as there is usually a time lag of several years between first being infected with HIV and then developing AIDS and AIDS related problems.
How is HIV passed on?
HIV is passed from one person to another if the blood, vaginal fluids, semen or breast milk of a HIV infected person enters the body of an uninfected person. This can occur:
· By having unprotected oral, vaginal or anal sex or sharing sex toys with someone who has the HIV virus.
· By sharing syringes and needles which has already been used by a HIV infected person.
· During childbirth when a woman with HIV infection passes on the virus to her baby or by breastfeeding.
· By being in contact with infected blood, blood products or donated organs. This is now very rare in the UK as all blood products are checked for HIV infection.
· You cannot catch HIV virus from ordinary contact with someone with HIV such as holding hands, hugging, kissing, sharing baths or towels, from swimming pools or toilet seats or sharing eating utensils.
How common is HIV?
In the UK over 60,000 cases of HIV infection have been diagnosed since 1982. However, the number of AIDS related deaths in the UK has fallen significantly since 1995 due to improved medical treatment.
Homosexuals e.g. men who have sex with men are the most commonly affected group in the UK. However, more heterosexual men and women are being diagnosed as most of these people were infected with the HIV virus outside the UK i.e. in countries with very high rates of HIV, such as African countries.
How can I protect myself from HIV?
Always:
· Use a male or female condom every time you have vaginal sex. It is important to not use the spermicide nonoxynal 9 which is used to lubricate some condoms. This compound does not protect against the HIV virus and may even increase the risk of infection.
· Use condoms for anal sex. Water-based lubricants are recommended as condoms containing nonoxynol 9 may increase the risk of infection spread.
· For oral sex it is important to cover the penis with a condom or the female genitals with a latex / polyurethane plastic dam.
· avoid ejaculation into the mouth
· avoid oral sex with a woman during her period
· avoid oral sex if your throat or mouth is inflamed or if you have sores, cuts or abrasions in your mouth or gums
· avoid brushing or flossing your teeth before oral sex
Symptoms of AIDS
The term AIDS is used to describe the most advanced stages of HIV infection. AIDS is a general term which includes various diseases which can result from a severely weakened immune system. Typically, a person with AIDS has:
Very low levels of CD4 T-cells (< 200 cells per cubic millimetre), and/or:
· One or more types of severe opportunistic infections such as severe fungal infections, pneumocystic carnii pneumonia, tuberculosis (TB), severe thrush in the vagina or mouth, mycobacterium avium complex, serious eye infection. These infections are a result of a weak immune system and a range of symptoms such as fever, sweats, cough, weight loss, diarrhoea, tiredness and generally feeling unwell. Worldwide TB infection is one of the most common causes of death in people with HIV.
· Certain cancers almost unique in people with AIDS such as the Kaposi's sarcoma. There is also an increased risk of developing cancer of the cervix and lymphoma.
· HIV encephalopathy or AIDS dementia.
How will I know if I have the HIV virus?
You will not know unless you have a test for HIV which involves taking a blood sample. There are a number of tests available:
HIV antibody test
The body's immune system produces antibodies to fight off the HIV virus.
If HIV antibodies are found this means you are infected with HIV i.e. HIV positive. It can take between 3 weeks and 3 months for the antibodies to give a positive HIV test. This means that if you are worried about something that happened a few days ago, it can be up to 3 months before a HIV antibody test can give a definitive result. Therefore to be absolutely certain two blood tests taken 3 months apart should be done.
HIV p24 antigen test
The p24 antigen is a protein that is part of the HIV virus and therefore the p24 antigen test can detect HIV infection before the HIV antibody test is positive. It is, however, best to carry out the p24 antigen test 2 – 3 weeks after possible risk exposure.
Combined HIV antigen and antibody test
This gives a more accurate HIV detection and can be done 2 – 3 weeks after a possible risk exposure. The result of the test will usually be known within 3 days. However, if you are found to have a positive HIV test a repeat test will be performed to confirm the result.
Can HIV be treated?
Once HIV is diagnosed a number of tests to monitor the level infection can dictate what treatments should be started.
At present there is no cure for HIV or AIDs. However, there are a number of antiretroviral drugs that can help reduce or even stop the HIV virus from replicating. These drugs reduce the level of HIV virus in the blood and delay the development of AIDs. Most people who are treated with these drugs have a better prognosis. Often a combination of drugs may have to be used but they can have unpleasant side effects.
If you are HIV positive and pregnant you can benefit from antiretroviral treatments to help prevent passing on the HIV virus to your baby before and during birth. You may be advised to have a Caesarean section and not to breast feed. Breast feeding does carry the HIV virus and you can pass on the infection to your baby.
Does HIV resolve on its own?
No. Once you are infected with the HIV virus you will remain infected for the rest of your life. Although antiretroviral drugs reduce the amount of HIV virus, you are still at risk of spreading the HIV virus and therefore you should use condoms (without the spermicide nonoxynal 9) for oral, vaginal and anal sex.
How will I know how long I have had the HIV virus for?
It can be impossible to know, particularly as there are usually no symptoms. This can be difficult hard to handle. Do not be afraid to talk to the Lambda Clinic staff about any concerns. They are professional staff able to help you with your concerns and queries.
Should I tell my partner about my HIV infection?
If you have HIV, or think you might be at risk of having HIV, then it is very important that your current sexual partner and other partners are also given the opportunity to consider having a test. If you feel it is too difficult the Lambda Clinic can contact your partner(s) for you. They will explain to the person that may have been exposed to a sexually transmitted infection (STI) and recommend they go for a check up. They will not give our or your name, so your confidentiality will be protected.
Does anyone else need to know that I have had a HIV test?
You can decide who to tell. Information about your HIV test (whatever your result) will only be passed on to someone else with your permission.
There are some circumstances where you might be asked if you have ever had a test e.g. when applying for life insurance, jobs or mortgage. Nowadays, it is common to be asked if you have had a positive HIV test or if you are having treatment for HIV. It is important to understand how the answers to these questions might affect you. Before you decide to have a test you may wish to discuss these matters with someone about the implications that this could have in all aspects of your life. The Lambda Clinic staff can help you with this.
What is the prognosis of HIV infection?
Before the mid 1990s, most people did not survive more than 1 – 2 years after AIDS had developed. Since the introduction of antiretroviral drugs in the mid 1990s the outlook has improved greatly particularly for those who have access to these drug treatments.
What are the symptoms of HIV and AIDS?
Primary infection with HIV
When you first become infected with HIV it is known as the ‘primary infection'. At this time you may not have any symptoms but symptoms similar to flu or glandular fever commonly occur 2 – 6 weeks after getting the HIV virus. This is called ‘seroconversion illness' as it is the time when antibodies first appear in the blood stream (see below). Signs and symptoms may include: sore throat, fever, nausea, blotchy red rash, diarrhoea, swollen glands, tiredness and general aches and pains. These symptoms only last about a week. This is not AIDS but just an initial reaction to being infected with the HIV virus.
After the primary infection
After any primary infection settles, without any treatment, you can remain without any symptoms for several years. As there are often no symptoms during this time, many people do not realise that they are infected with the HIV virus. However, as the HIV virus replicates, the number of CD4 T-cells gradually falls. During this time develop persistent swollen lymph glands around the body and / or night sweats. In advanced stages recurring herpes or shingles, thrush in the mouth and vagina, recurring mouth ulcers, seborrhoeic dermatitis, tuberculosis (TB) infection may develop.
BMI The Edgbaston Hospital
22 Somerset Road
Edgbaston
B15 2QQ
Telephone: 0121 452 2815