HIV (Human Immunodeficiency Virus) is a virus that is transmitted through blood and unprotected sexual contact and can settle in various tissues of the body, but shows its main effects on the immune system.
HIV basically destroys white blood cells called CD4+ T lymphocytes (CD4 cell for short), suppressing the immune system and leaving the body vulnerable to infections. As a result, diseases such as tuberculosis, diarrhea, meningitis, and pneumonia, which can be treated under normal conditions, cause serious damage to the body, and in some cases, cancers can be seen.
Today, drugs developed for HIV prevent the virus from multiplying in the body and its immune-suppressing effect, allowing HIV-positive people to live a long and healthy life. For this, it is important to start treatment early and continue regularly under the control of a doctor.
What is AIDS?
AIDS is an abbreviation for Acquired Immune Deficiency Syndrome. AIDS, caused by the HIV virus, is the stage in which the immune system is vulnerable to infections and cancers and is life-threatening. Contrary to misconceptions, not every HIV-positive person develops AIDS.
Thanks to antiretroviral drugs developed against the HIV virus, the immune system can fight infections without serious damage, that is, body resistance does not decrease. After being infected with HIV, in addition to drug treatment, AIDS may not occur depending on the living conditions and body resistance of the person, and there is a possibility that it will occur 5-15 years or more.
Prevalence of HIV in the World and in Turkey HIV is a contagious infection that is common all over the world today. According to the World Health Organization, 37 million people in the world are infected with HIV. 60 percent of HIV-positive people receive antiretroviral therapy.
In our country, with the increase in awareness about HIV and testing opportunities, an increase is observed in the number of people diagnosed. On the other hand, Turkey is considered among the countries where AIDS is not common. According to the research conducted by the Ministry of Health between 1985 and 2018,
The number of HIV carriers in Turkey is 18, 557 and there are 1736 AIDS cases. The age group with the highest incidence of cases is 30-34 and 25-29 age groups.
Considering the distribution according to the mode of transmission, it is seen that 49% of the cases are sexually transmitted, and 6% of these cases, which are reported to be sexually transmitted, are heterosexual sexual intercourse.
The number of people diagnosed as HIV positive in 2018 was 2199 and 83 percent of these people were men. Among those diagnosed, those aged 25-29 are higher than other age groups. There has been an increase in the trend of HIV prevalence over the years.
Importance of Early Diagnosis
As in many diseases, early diagnosis and, accordingly, early treatment are important in the treatment and course of HIV infection. Early diagnosis not only prolongs life expectancy, but also reduces transmission rates.
Those who have unprotected sexual intercourse, those who have sexual contact with HIV-positive blood or contact with open skin, and those who use non-sterile needles or piercing tools, must have an HIV test.
For the test to be accurate, antibodies must form in the blood, so the HIV test gives the most accurate results 4-6 weeks after contact with the virus.
In our country, HIV testing is carried out with full consideration of the privacy of the person. Information about the identity of patients who have applied to health institutions due to HIV/AIDS, who have undergone treatment and tests, or newly identified HIV-positive persons are reported by coding.
If the person is HIV positive, notification to the Ministry of Health is obligatory, but it is done by considering the rules mentioned above. In the treatment of HIV-positive people, psycho-social support is important for themselves and their relatives.
There are many associations in our country that will provide social and legal support for HIV-positive people and their relatives. HIV testing is among the mandatory tests before marriage, but being HIV positive does not prevent marriage.
Transmission Routes
HIV is transmitted from person to person. The virus is found in the blood, semen, vaginal secretions and breast milk of HIV-positive individuals. It can be transmitted from both men and women.
The ways of transmission of HIV are:
Sexual Contact
80-85 percent of HIV infection in the world is transmitted through unprotected sexual intercourse. It is transmitted by contact of blood, semen or vaginal fluid with the mucous membrane of the penis, vagina, anus, or damaged tissues, cuts and cracks in the mouth and skin. The virus can be transmitted sexually from male to female, female to male, male to male, female to female. HIV can be transmitted through vaginal, oral and anal sexual contact. A single unprotected sexual contact with an HIV-positive person is sufficient for transmission. As the number of unprotected sexual intercourse increases, the risk of transmission increases.
Blood products
HIV is more concentrated in the blood. The virus can be transmitted through blood and blood products taken from HIV-positive people. Possible situations are:
By contacting the blood of an HIV-positive person with the blood of another person,
With untested blood transfusion,
- With the transfer of organs, tissues and sperm carrying the HIV virus,
- With used and non-disinfected syringes, needles, surgical instruments, dental instruments, cutting and piercing tools (razor, scissors), tattoo tools and acupuncture needles,
- Intravenous (injection of a virus-infected syringe into a vein, intravenous drug use with a common syringe, etc.)
- Bleeding from the genitals or menstrual blood of HIV-positive men and women into the penis,
- It can also be transmitted by contact with the vagina or mouth.
- Since 1985, all blood and blood products have been screened for HIV in the world and since 1987 in Turkey. Blood donors are also tested. Therefore, transmission through blood is very rare.
Mother-to-Baby Transmission
A mother who is a carrier of HIV during pregnancy can pass the virus to her baby during pregnancy, during childbirth and in the postpartum period. During breastfeeding, this virus can pass from mother to baby at a rate of about 20-30%.
It is important that the birth is made by cesarean section and that the mother does not breastfeed after the birth. HIV-positive treatment is started in the last three months of pregnancy in the mother and after birth in the baby. It is very important to take precautions because it is passed from mother to baby (horizontal transmission) at a rate of 35 percent.
HIV Is Not Transmitted In The Following Situations
- Being in the same social environment, room, school, workplace
- Don't breathe the same air
- sneezing, cough
- Body outputs such as saliva, tears, sweat, urine, feces
- Handshake, social kissing, holding hands, hugging, skin touching, caressing, hugging, kissing
- Blood contact with intact skin
- Eating from the same bowl, consuming drinks from the same glass, using common forks, spoons, glasses, plates, telephones
- Using the same toilet, shower and faucet
- Swimming in the same swimming pool, using common areas such as the sea, sauna, Turkish bath, and shared towels
- Mosquito and similar insect bites, animal bites. Living with animals such as cats and dogs.
While false beliefs and prejudices about HIV made the lives of HIV-positive people difficult and prevented them from participating in social and business life in the past, awareness-raising studies on HIV have reduced these prejudices.
symptoms
What are the HIV Acute Infection Period and AIDS Symptoms?
In the acute infection period, in the first few weeks after the virus enters the body, there will be no symptoms, and in the first 2-4 weeks, flu-like complaints with fever, sore throat, headache and rash symptoms can be seen. HIV is most contagious This is the period.
Common Symptoms Are:
- Fire
- Sore throat and inflammation of the throat
- Headache
- enlargement of lymph nodes
- Rash on the body (usually on the face and trunk, more rarely on the palms and soles 5-10 mm in diameter and blisters) – Dermatitis
- Sores in the mouth, esophagus and genital organs,
- muscle and joint pain,
- Untreated diarrhea lasting more than a month
- Headache,
- Nausea and vomiting.
When treatment is not started, 7-10 kg of weight loss can be seen in less than two months.
Quiet – Asymptomatic Period (AIDS)
After an acute period of several weeks HIV carriers They live an average of 8-10 years of healthy life without any symptoms. But a lifetime HIV virus carrier and contagious. Noticeable enlargements can be seen in the lymph nodes.
This period can be as short as a few years or more than 10 years. HIV diagnosis When people take medication, they protect their immune systems and reduce the effect of the virus in their bodies.
Advanced Period (AIDS)
HIV infection It is the most advanced stage and the immune system is gradually weakened. Patients who have not been treated until this period lose all their resistance against infections and cancer, and their organs are damaged due to various diseases.
- swollen lymph nodes
- Fatigue
- Weight loss
- short term memory loss
- Fungal infections
- persistent rashes
- One or more opportunistic infections
For example;
- lymphoma
- Tuberculosis
- Bacterial pneumonia
- Valley fever – Rift Valley fever (RVF)
- Candidiasis of the respiratory system and mucous membranes (thrush)
- Encephalitis (brain infection)
- herpes virus
- Kaposi's sarcoma of the skin and internal organs
- Diarrhea from various bacteria and parasites.
Diagnostic Methods
HIV (AIDS) Diagnosis
HIV virus It is detected by a blood test and there is a period of time to wait for the test after the virus is infected. By looking at the antibodies the body produces against the virus HIV diagnosis is put. Therefore, it is important to test at the right time when antibodies are formed.
Pre-Test Consulting
Before the test, the person should definitely get HIV counseling from a sexual health counselor or doctor. In this way, it is explained to the person whether the test is done at the right time, other people in unprotected intercourse are also directed to the test, that HIV is not a situation to be afraid of and that treatment can be started immediately.
In addition, it is very important for the person to receive counseling before and after the test in order to reach psycho-social support due to the risk of HIV positivity or diagnosis.
What is the HIV Test? When is it done?
for diagnosis ELISA test known as a blood test. 3-8 weeks after HIV enters the body, the body produces substances called antibodies to fight the virus. A period of 3 months is required for these antibodies to reach a measurable level. This first trimester is called the 'window period'.
Therefore, the test should be done at least 4-6 weeks after contamination. Measuring blood antibody levels by ELISA method Anti-HIV test is named. However, during the window period, antibodies are not yet fully formed. Anti-HIV The test may be misleading.
A positive result with this test may need to be confirmed by repeating the Western-Blotting method. In this way, HIV positive diagnosis is made. The duration of the window period can vary from person to person.
Antibodies may develop in a shorter time, or it may take longer than 4 weeks. For this reason, it is recommended to have a retest on the 90th day after unprotected intercourse or contact. Negative results obtained after 90 days in antibody tests should be trusted.
Treatment Methods
Thanks to advances in medical science, retrovirus 4 different types of drugs called Anti-Retroviral, which are effective against HIV in the group, have been developed. These drugs function in different mechanisms of the body, and the treatment of HIV can be planned with a combination of several of these drugs.
definitive treatment of HIV In other words, the virus cannot be completely destroyed in the body, but it can be controlled with drugs. The purpose of the treatment; to prevent the virus from reoccurring. Thus, the probability of the virus developing many mutations that may be resistant to treatment is reduced.
With treatment, the value called viral load, which indicates the amount of virus in the blood, is minimized, the immune system is protected and HIV positive The person's quality of life and expectation are increased. Treatment also reduces the risk of transmission as it reduces the amount of HIV virus.
Risky Situation / Post Behavior Protection
PEP (Post-Exposure Prophylaxis) is a preventive treatment that reduces a person's risk of becoming infected when exposed to HIV for any reason, using antiretroviral drugs (ART). PEP should only be used in emergencies and should be initiated within 72 hours of exposure to HIV.
These drugs are taken for 1-3 months. Besides having serious side effects of drugs, they are not 100 effective. For this reason, you should consult an infectious diseases specialist as soon as possible after encountering an event that you think will cause HIV transmission.
Ways to Avoid HIV
- Using a condom during sexual intercourse is the most effective way to protect against HIV today. However, it is very important that the condom is put on before contact and that there is no hole on it and that it is not torn.
- The contraceptive pill, injections and subcutaneous patches, IUDs and other contraceptive methods do not protect against HIV.
HIV and Pregnancy
Being HIV-positive is not an obstacle to having children. if male HIV carrier If the sperm is taken, it is cleaned from the virus in the external environment and placed in the mother's womb. HIV positive woman There is no harm in getting pregnant.
The fact that the follow-up and treatment is carried out under appropriate conditions and the viral load is at an unmeasurable level significantly reduces the transmission of HIV to the baby. The fact that the HIV RNA level in the blood of the person cannot be measured for at least 6 months before becoming pregnant reduces the transmission.
HIV positive pregnant women With the use of antiretroviral treatment, planned cesarean section and feeding the baby with ready-made formula, the transmission rate has decreased to 1-2%, especially in developed countries. In case of contamination, the baby is treated with syrups given orally after birth.
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