AIDS virus(abbreviation HIV) was discovered in 1983 while researching the causes of AIDS - syndrome immunodeficiency. The first official publications about AIDS appeared back in 1981; the new disease was associated with sarcoma Kaposi and unusual pneumonia in homosexuals. The designation AIDS (AIDS) was established as a term in 1982, when similar symptoms identified in drug addicts, homosexuals and patients with hemophilia were combined into a single acquired immune deficiency syndrome.

Modern definition of HIV infection: a viral disease based on immunodeficiency, which causes the development of concomitant (opportunistic) infections and oncological processes.

AIDS is the last stage of HIV infection, congenital or acquired.

How can you become infected with HIV?

The source of infection is an HIV-infected person, at any stage of the disease and for life. Large quantities of the virus are contained in blood (including menstrual fluid) and lymph, semen, saliva, vaginal secretions, breast milk, liquor– cerebrospinal fluid, tears. Endemic(with reference to location) an HIV outbreak has been identified in West Africa; monkeys are infected with type 2 virus. No natural site of type 1 virus has been found. HIV is transmitted only from person to person.

During unprotected sexual intercourse the possibility of contracting HIV increases if there is inflammation, microtrauma of the skin or mucous membranes of the genitals, anus. At the only one Infection occurs rarely during sexual intercourse, but with each subsequent sexual intercourse the likelihood increases. During any type of intercourse receiving the sexual partner is at greater risk of acquiring HIV (from 1 to 50 per 10,000 episodes of unprotected sex) than the transmitting partner (0.5 – 6.5). Therefore, the risk group includes prostitutes with their clients and "barebackers"– gays who deliberately do not use condoms.

HIV transmission routes

A child can become infected with HIV in utero from an infected mother, if there are defects in the placenta and the virus enters the blood of the fetus. During childbirth, infection occurs through the injured birth canal, and later through breast milk. Between 25 and 35% of children born to HIV-infected mothers may become carriers of the virus or develop AIDS.

For medical reasons: transfusion of whole blood and cell mass (platelets, red blood cells), fresh or frozen plasma to patients. Among medical staff, accidental injections with a contaminated needle account for 0.3-0.5% of all cases of HIV infection, so doctors are at risk.

With intravenous injections with a “public” needle or syringe, the risk of contracting HIV is more than 95%, therefore at the moment the majority of carriers of the virus and an inexhaustible source of infection are drug addicts, constituting the main risk group for HIV.

HIV CANNOT be contracted through everyday contact. as well as through water in pools and baths, insect bites, air.

Spread of HIV

Features are a variable incubation period, unequal speed of onset and severity of symptoms, which directly depend on the state of human health. People weakened(asocials, drug addicts, residents of poor countries) or with accompanying chronic or acute STDs(, etc.), get sick more often and more severely, HIV symptoms appear faster, and life expectancy is 10-11 years from the moment of infection.

In a prosperous social environment, in practically healthy people, the incubation period can last 10-20 years, the symptoms are erased and progress very slowly. With adequate treatment, such patients live a long time, and death occurs from natural causes - due to age.

Statistics:

• At the beginning of 2014, there were 35 million people in the world diagnosed with HIV;
• The increase in people infected in 2013 was 2.1 million, deaths from AIDS - 1.5 million;
• The number of registered HIV carriers among the entire world population is approaching 1%;
• In the Russian Federation in 2013, there were 800 thousand infected and sick people, that is, about 0.6% of the population is affected by HIV;
• 90% of all AIDS cases in Europe occur in Ukraine (70%) and the Russian Federation (20%).

HIV prevalence by country (percentage of virus carriers among adults)

Data:

1. HIV is more often detected in men than in women;
2. In the last 5 years, cases of HIV detection in pregnant women have become more frequent;
3. Residents of northern European countries become infected and suffer from AIDS much less frequently than southerners;
4. Africans are most susceptible to the immunodeficiency virus, approximately 2/3 of all sick and infected people are in Africa;
5. Those infected with the virus over the age of 35 develop AIDS 2 times faster than younger people.

Characteristics of the virus

HIV belongs to the group retroviruses HTLV groups and genus lentiviruses(“slow” viruses). It has the appearance of spherical particles, 60 times smaller in size than a red blood cell. It dies quickly in an acidic environment, under the influence of 70% ethanol, 3% hydrogen peroxide or 0.5% formaldehyde. Sensitive to heat treatment– becomes inactive after 10 minutes. already at +560°C, at 1000°C – within a minute. Resistant to ultraviolet radiation, radiation, freezing and drying.

Blood with HIV that gets on various objects remains infectious for up to 1-2 weeks.

HIV constantly changes its genome, each subsequent virus differs from the previous one by one step of the RNA - nucleotide chain. The HIV genome is 104 nucleotides long, and the number of errors during reproduction is such that after about 5 years nothing remains of the original combinations: HIV mutates completely. Consequently, previously used drugs become ineffective, and new ones have to be invented.

Although in nature there are not even two absolutely identical HIV genomes, some groups of viruses have typical signs. Based on them, all HIV are classified into groups, numbered 1 to 4.

• HIV-1: the most common, this group was the first to be discovered (1983).
• HIV-2: Less likely to be contracted than HIV-1. Those infected with type 2 do not have immunity to type 1 of the virus.
• HIV-3 and 4: rare variations, do not particularly affect the spread of HIV. In the formation of a pandemic (a general epidemic covering countries on different continents), HIV-1 and 2 are of primary importance, with HIV-2 being more common in West African countries.

Development of AIDS

Normally, the body is protected from the inside: the main role is played by cellular immunity, in particular lymphocytes. T lymphocytes produced by the thymus (thymus gland), according to their functional responsibilities they are divided into T-helpers, T-killers and T-suppressors. Helpers“recognize” tumor cells and cells damaged by viruses, and activate T-killers, which destroy atypical formations. Suppressor T cells regulate the direction of the immune response, preventing it from launching a reaction against its own healthy tissues.

A T-lymphocyte affected by a virus becomes atypical, the immune system reacts to it as a foreign formation and “sends” T-killers to help. They destroy the former T-helper, the capsids are released and take with them part of the lipid membrane of the lymphocyte, becoming unrecognizable to the immune system. Then the capsids disintegrate, and new virions are introduced inside other T helper cells.

Gradually, the number of helper cells decreases, and inside the human body, the “friend or foe” recognition system ceases to function. In addition to this, HIV activates the mechanism of mass apoptosis(programmed death) of all types of T-lymphocytes. The result is active inflammatory reactions to resident (normal, permanent) and conditionally pathogenic microflora, and at the same time an inadequate response of the immune system to truly dangerous fungi and tumor cells. Immunodeficiency syndrome develops, and characteristic symptoms of AIDS appear.

Clinical manifestations

Symptoms of HIV depend on the period and stage of the disease, as well as on the form in which the impact of the virus primarily manifests itself. Periods of HIV They are divided into incubation, when there are no antibodies to the virus in the blood, and clinical - antibodies are detected, the first signs of the disease appear. IN clinical differentiate stages HIV:

1. Primary, including two forms– asymptomatic and acute infection without secondary manifestations, with concomitant diseases;
2. Latent;
3. AIDS with secondary diseases;
4. Terminal stage.

I. Incubation period The time from HIV infection to the onset of symptoms is called the serological window. Serum reactions to the immunodeficiency virus are negative: specific antibodies have not yet been determined. The average incubation duration is 12 weeks; the period can be reduced to 14 days with concomitant STDs, tuberculosis, general asthenia, or increased to 10-20 years. During the entire period the patient dangerous as a source of HIV infection.

II. Stage of primary manifestations of HIV characterized seroconversion– the appearance of specific antibodies, serological reactions become positive. The asymptomatic form is diagnosed only by a blood test. Acute HIV infection occurs 12 weeks after infection (50-90% of cases).

First signs manifested by fever, various types of rash, lymphadenitis, sore throat (pharyngitis). Possible intestinal upset - diarrhea and abdominal pain, enlarged liver and spleen. A typical laboratory sign: mononuclear lymphocytes, which are found in the blood at this stage of HIV.

Secondary diseases appear in 10-15% of cases against the background of a transient decrease in the number of T-helper lymphocytes. The severity of the diseases is average, they are treatable. The duration of the stage is on average 2-3 weeks, in most patients it becomes latent.

Forms acute HIV infections:

III. Latent stage of HIV, lasts up to 2-20 years or more. Immunodeficiency progresses slowly, HIV symptoms are expressed lymphadenitis– enlarged lymph nodes. They are elastic and painless, mobile, the skin retains its normal color. When diagnosing latent HIV infection, the number of enlarged nodes is taken into account - at least two, and their location - at least 2 groups not connected by a common lymph flow (with the exception of inguinal nodes). Lymph moves in the same direction as venous blood, from the periphery to the heart. If 2 lymph nodes are enlarged in the head and neck area, then this is not considered a sign of the latent stage of HIV. A combined increase in groups of nodes located in the upper and lower parts of the body, plus a progressive decrease in the number of T-lymphocytes (helper cells) testify in favor of HIV.

IV. Secondary diseases, with periods of progression and remission, depending on the severity of manifestations, it is divided into stages (4 A-B). Persistent immunodeficiency develops against the background of massive death of T-helper cells and depletion of lymphocyte populations. Manifestations - various visceral (internal) and skin manifestations, Kaposi's sarcoma.

V. Terminal stage irreversible changes are inherent, treatment is ineffective. The number of T helper cells (CD4 cells) falls below 0.05x109/l, patients die weeks or months from the onset of the stage. In drug addicts who have been using psychoactive substances for several years, CD4 levels may remain almost within normal limits, but severe infectious complications (abscesses, pneumonia, etc.) develop very quickly and lead to death.

Kaposi's sarcoma

Sarcoma ( angiosarcoma) Kaposi is a tumor arising from the connective tissue and affecting the skin, mucous membranes and internal organs. Triggered by the herpes virus HHV-8; more common in men infected with HIV. The epidemic type is one of the reliable signs of AIDS. Kaposi's sarcoma develops in stages: it begins with the appearance spots 1-5 mm in size, irregular in shape, bright bluish-red or brown in color, with a smooth surface. In AIDS, they are bright, localized on the tip of the nose, hands, mucous membranes and on the hard palate.

Then they are formed tubercles– papules, round or semicircular, up to 10 mm in diameter, elastic to the touch, can merge into plaques with a surface similar to an orange peel. Tubercles and plaques transform into nodular tumors 1-5 cm in size, which merge with each other and are covered ulcers. At this stage, sarcoma can be confused with syphilitic gummas. Syphilis is often combined with the immunodeficiency virus, like hepatitis C, shortening the incubation period and provoking the rapid development of acute symptoms of AIDS - lymphadenitis, damage to internal organs.

Kaposi's sarcoma is clinically divided into forms– acute, subacute and chronic. Each is characterized by the rate of tumor development, complications and prognosis regarding the duration of the disease. At acute form, the process quickly spreads, the cause of death is intoxication and extreme exhaustion ( cachexia), life time from 2 months to a maximum of 2 years. At subacute During the course of the disease, symptoms increase more slowly, life expectancy is 2-3 years; for the chronic form of sarcoma – 10 years, possibly more.

HIV in children

Incubation period lasts about a year if HIV was transmitted from mother to fetus. If infected through blood (parenterally) – up to 3.5 years; After transfusion of contaminated blood, the incubation is short, 2-4 weeks, and the symptoms are severe. HIV infection in children primarily affects the nervous system(up to 80% of cases); long-term, lasting up to 2-3 years, bacterial inflammation; with damage to the kidneys, liver and heart.

Very often develops Pneumocystis or lymphocytic pneumonia, inflammation of the parotid salivary glands ( mumps, he's a pig). HIV manifests itself at congenital dysmorphic syndrome– impaired development of organs and systems, in particular microcephaly – reduced size of the head and brain. A decrease in the blood level of gamma globulin fraction proteins is observed in half of those infected with HIV. Very rare Kaposi's sarcoma and hepatitis C, B.

Dysmorphic syndrome or HIV embryonopathy determined in children infected with early timing of pregnancy. Manifestations: microcephaly, nose without membranes, the distance between the eyes is increased. The forehead is flat, the upper lip is split and protrudes forward. Strabismus, eyeballs protruding outward ( exophthalmos), the cornea is bluish in color. There is growth retardation, development does not correspond to norms. Prognosis for life in general negative, mortality is high during 4-9 months of life.

Manifestations of neuro-AIDS: chronic meningitis, encephalopathy(damage to brain tissue) with the development of dementia, damage to peripheral nerves with symmetrical disorders of sensitivity and trophism in the arms and legs. Children are significantly behind their peers in development, prone to convulsions and muscle hypertonicity, and may develop paralysis of the limbs. Diagnosis of HIV neuro-symptoms is based on clinical signs, blood tests and CT scan results. Layer-by-layer images reveal atrophy(reduction) of the cerebral cortex, expansion of the cerebral ventricles. HIV infection is characterized by calcium deposits in the basal ganglia of the brain. Progression of encephalopathy leads to death within 12-15 months.

Pneumocystis pneumonia: in children of the 1st year of life it is observed in 75% of cases, over a year - in 38%. Often, pneumonia develops by the age of six months; symptoms include high fever, rapid breathing, and a dry and persistent cough. Increased sweating, especially at night; weakness that only gets worse over time. Pneumonia is diagnosed after auscultation (according to the stages of development, weakened breathing is heard first, then small dry rales, in the resolution stage - crepitus, the sound is heard at the end of inspiration); X-ray (enhanced pattern, infiltration of pulmonary fields) and microscopy of biomaterial (pneumocystis are detected).

Lymphocytic interstitial pneumonia: a unique disease associated specifically with childhood AIDS; there are no concomitant infections. The partitions between the alveoli and the tissue around the bronchi become denser, where lymphocytes and other immune cells are found. Pneumonia begins unnoticed, develops slowly, and the initial symptoms include a long, dry cough and dry mucous membranes. Then shortness of breath appears and respiratory failure increases sharply. The X-ray image shows thickening of the lung fields, enlarged lymph nodes in the mediastinum - the space between the lungs.

Laboratory tests for HIV

The most common method for diagnosing HIV is (ELISA or ELISA test), which is used to detect the immunodeficiency virus. Antibodies to HIV are formed between three weeks and 3 months after infection and are detected in 95% of cases. After six months, HIV antibodies are found in 9% of patients, later - only in 0.5-1%.

As biomaterial use blood serum taken from a vein. You can get a false-positive ELISA result if HIV infection is accompanied by autoimmune (lupus, rheumatoid arthritis), cancer or chronic infectious diseases (tuberculosis, syphilis). A false negative response occurs during the so-called period. seronegative window, when antibodies have not yet appeared in the blood. In this case, to control HIV, you need to donate blood again, after a pause of 1 to 3 months.

If the ELISA is assessed as positive, the HIV test is duplicated using a polymerase chain reaction, determining the presence of viral RNA in the blood. The technique is highly sensitive and specific and does not depend on the presence of antibodies to the immunodeficiency virus. Immunoblotting is also used, which makes it possible to detect antibodies to HIV protein particles with precise molecular weights (41, 120 and 160 thousand). Their identification gives the right to make a final diagnosis without confirmation by additional methods.

HIV test Necessarily This is done only during pregnancy; in other cases, a similar examination is voluntary. Doctors do not have the right to disclose the diagnosis; all information about patients and people infected with HIV is confidential. Patients have the same rights as healthy people. Criminal punishment is provided for the deliberate spread of HIV (Article 122 of the Criminal Code of the Russian Federation).

Principles of treatment

HIV treatment is prescribed after a clinical examination and laboratory confirmation of the diagnosis. The patient is constantly monitored, repeated blood tests are carried out during antiviral therapy and after treatment of HIV manifestations.

A cure for HIV has not yet been invented, and there is no vaccine. It is impossible to remove the virus from the body, and this is a fact at this time. However, one should not lose hope: active antiretroviral therapy (HAART) can reliably slow down and even practically stop the development of HIV infection and its complications.

The life expectancy of patients receiving modern treatment is 38 years (for men) and 41 years (women). The exception is the combination of HIV with hepatitis C, when less than half of the patients reach the 5-year survival threshold.

HAART– a technique based on the use of several pharmaceuticals at once that affect various mechanisms of the development of HIV symptoms. Therapy combines several goals at once.

1. Virological: block the reproduction of the virus to reduce the viral load (the number of HIV copies in 1 ml3 of blood plasma) and keep it at a low level.
2. Immunological: Stabilize the immune system to raise T-lymphocyte levels and restore the body's defenses against infections.
3. Clinical: to increase the full life span of those infected with HIV, to prevent the development of AIDS and its manifestations.

Virological treatment

The human immunodeficiency virus is treated with drugs that prevent it from attaching to a T-lymphocyte and penetrating inside - this is inhibitors(suppressors) penetration. A drug Celzentry.

The second group of drugs consists of viral protease inhibitors, which is responsible for the formation of full-fledged viruses. When it is inactivated, new viruses are formed, but they cannot infect new lymphocytes. Drugs Kaletra, Viracept, Reyataz and etc.

The third group is inhibitors of reverse transcriptase, an enzyme that helps reproduce viral RNA in the lymphocyte nucleus. Drugs Zinovudine, Didanosine.They also use combination medications against HIV, which need to be taken only once a day - Trizivir, Combivir, Lamivudine, Abacavir.

With simultaneous exposure to drugs, the virus cannot enter the lymphocytes and “multiply”. Upon appointment tritherapy The ability of HIV to mutate and develop insensitivity to drugs is taken into account: even if the virus becomes immune to one drug, the remaining two will still work. Dosage calculated for each patient, taking into account the state of health and possible side effects. A separate regimen is used for pregnant women, and after using HAART, the frequency of HIV transmission from mother to child decreases from 20-35% to 1-1.2%.

It is important to take your medications at the same time for the rest of your life.: if the schedule is violated or the course is interrupted, treatment completely loses its meaning. Viruses quickly change their genome, becoming immune ( resistant) to therapy, and form numerous resistant strains. With such a development of the disease, choosing antiviral treatment is very problematic, and sometimes simply impossible. Cases of the development of resistance are more often observed among HIV-infected drug addicts and alcoholics, for whom strict adherence to the treatment schedule is unrealistic.

The drugs are effective, but their prices are high. For example, the cost of one-year treatment with Fuzeon (a group of penetration inhibitors) reaches $25 thousand, and the monthly cost when using Trizivir ranges from $1000.

note, that farm. funds almost always have two names - according to the active substance and the commercial name of the drug, which was given to it by the manufacturer. The prescription must be written exactly according to active substance, indicating its quantity in a tablet (capsule, ampoule, etc.). Substances with identical effects are often presented under different names. commercial names and may vary significantly in price. The pharmacist’s job is to offer the patient several options to choose from and guide them regarding the cost. Generics- analogues of original developments, always cost much less than “branded” drugs.

Immunological and clinical treatment

Using an immunostimulant drug Inosine pranobex, due to which the level of lymphocytes increases, the activity of certain fractions of leukocytes is stimulated. The antiviral effect indicated in the annotation does not apply to HIV. Indications, relevant for HIV-infected people: viral hepatitis C, B; immunodeficiency states; cytomegalovirus; herpes simplex virus type 1; mumps. Dosages: adults and children 3-4 times/day. at the rate of 50-100 mg/kg. Well 5-15 days, can be repeated many times, but only under the supervision of an infectious disease specialist. Contraindications: increased levels of uric acid in the blood ( hyperuricemia), kidney stones, systemic diseases, pregnancy and breastfeeding.

Interferon group drug Viferon has antiviral and immunomodulatory activity. In the case of HIV (or AIDS), it is used for Kaposi's sarcoma, mycoses and hairy cell leukemia. The effect of the drug is complex: interferon enhances the activity of T-helper cells and increases the production of lymphocytes, and blocks the proliferation of viruses in several ways. Additional components - vitamin C, E - protect cells, and the effectiveness of interferon increases 12-15 times (synergistic effect). Viferon can be taken in long courses, its activity does not decrease over time. In addition to HIV, indications include any viral infections, mycoses (including internal organs), hepatitis C, B or D. When administered rectally the drug is used twice a day for a course of 5-10 days; ointment is not used for HIV. Pregnant women are prescribed starting from the 14th week.

Treatment of pulmonary manifestations

The main early manifestation of HIV infection is inflammation of the lungs.to their caused by pneumocystis (Pneumocystis carina), single-celled organisms similar to fungi and protozoa at the same time. In patients with AIDS, untreated Pneumocystis pneumonia is fatal in 40% of cases, and correct and timely prescribed therapeutic regimens help reduce the mortality rate to 25%. With the development of a relapse, the prognosis worsens, repeated pneumonia is less sensitive to treatment, and mortality reaches 60%.

Treatment: basic drugs – biseptol (bactrim) or pentamidine. They act in different directions, but ultimately lead to the death of pneumocystis. Biseptol is taken orally, pentamidine is injected into the muscles or into a vein. The course is from 14 to 30 days; for AIDS, it is preferable to use pentamidine. The drugs are not prescribed together, because their toxic effect increases without a noticeable increase in the therapeutic effect.

Low toxic drug DFMO (alpha-difluoromethylornithine) acts on pneumocystis and simultaneously blocks the reproduction of retroviruses, which include HIV, and also has a beneficial effect on lymphocytes. The course is 2 months, the daily dosage is calculated based on 6 g per 1 square meter. meter of body surface and divide it into 3 steps.

With adequate treatment of pneumonia, improvement is noticeable already on days 4-5 from the start of therapy; after a month, in a quarter of patients, pneumocystis are not detected at all.

Immunity to HIV

Statistics of confirmed HIV resistance: among Europeans, 1% are completely immune to the immunodeficiency virus, up to 15% are partially immune. In both cases the mechanisms are unclear. Scientists associate this phenomenon with the bubonic plague epidemics in Europe in the 14th and 18th centuries (Scandinavia), when, perhaps, in some people early genetic mutations became established in heredity. There is also a group of so-called. “non-progressors”, who make up about 10% of those infected with HIV, in whom AIDS symptoms do not appear for a long time. In general, there is no immunity to HIV.

A person is immune to the HIV-1 serotype if his body produces the TRIM5a protein, which is able to “recognize” the viral capsid and block the replication of HIV. The CD317 protein can keep viruses on the surface of cells, preventing them from infecting healthy lymphocytes, and CAML makes it difficult for new viruses to be released into the blood. The beneficial activity of both proteins is disrupted by hepatitis C and simplex viruses, therefore, with these concomitant diseases, the risks of HIV infection are higher.

Prevention

The fight against the AIDS epidemic and its consequences has been declared by WHO:

HIV prevention among drug addicts means explaining the dangers of infection through injections, providing disposable syringes and exchanging used ones for sterile ones. The latest measures seem strange and are associated with the spread of drug addiction, but in this case it is easier to at least partially stop the routes of HIV infection than to wean a huge number of drug addicts.

An HIV first aid kit will be useful to everyone in everyday life, in the workplace - for doctors and rescuers, as well as people in contact with people infected with HIV. Medicines are accessible and basic, but their use really reduces the risk of infection with the immunodeficiency virus:

• Alcohol solution of iodine 5%;
• Ethanol 70%;
• Dressing supplies (pack of sterile gauze swabs, bandages, plaster) and scissors;
• Sterile distilled water – 500 ml;
• Crystals of potassium permanganate (potassium permanganate) or hydrogen peroxide 3%;
• Eye pipettes (sterile, in packaging or in a case);
• Specific medications are provided only for physicians working at blood collection stations and in hospital emergency departments.

Blood that got into on the skin from an HIV-infected person, you should immediately wash it off with soap and water, then treat it with a swab soaked in alcohol. For an injection or cut through gloves they need to be removed, the blood squeezed out, hydrogen peroxide applied to the wound; then blot the foam, cauterize the edges of the wound with iodine and, if necessary, apply a bandage. Hit in the eyes: Rinse first with water, then with potassium permanganate solution (faint pink). Oral cavity: rinse with poor pink potassium permanganate, then with 70% ethanol. After unprotected intercourse: if possible, shower, then treat (douching, washing) the genitals with a rich pink solution of potassium permanganate.

AIDS prevention will be more effective if every person becomes conscious of their health. It is much easier to use a condom during sexual intercourse and avoid unwanted acquaintances (prostitutes, drug addicts) than to undergo long and expensive treatment later. To understand the picture of the danger of HIV, just compare the statistics: per year from fever Ebola About 8,000 people died, and more than 1.5 million died from HIV! conclusions are obvious and disappointing - in the modern world, the immunodeficiency virus has become a real threat to all humanity.

Video: educational film about HIV

Video: AIDS in the program “Live Healthy!”

HIV is the abbreviated name for the human immunodeficiency virus, i.e. a virus that attacks the immune system. By destroying the human immune system, this virus contributes to the development of other infectious diseases, since the immune system loses the ability to protect the body from pathogens. A person infected with HIV becomes more susceptible over time even to microorganisms that pose no danger to healthy people.

A person who becomes infected with HIV is called HIV-infected, or HIV-positive, or HIV-seropositive.

How can you become infected with HIV?

The human immunodeficiency virus, or HIV, is transmitted from person to person. In other words, you can only become infected with HIV from another person.

A person infected with HIV has large amounts of the virus in their blood, semen, vaginal secretions, and breast milk. In this case, external manifestations of the disease may initially be absent. Quite often, many people do not even know that they are infected with HIV and are dangerous to other people.

HIV infection occurs when HIV-infected blood, semen, vaginal secretions, or breast milk enters the body of a healthy person. This can happen when these body fluids come into contact with a wound on the skin, genitals, or mouth.

At-risk groups

Until recently, people with homosexual contacts were considered the main risk group. However, Russian statistics for the last two to three years show that the risk of HIV infection is also high among intravenous drug users and prostitutes. The number of people infected through sexual contact with representatives of these groups is growing. Below we describe in detail the routes of HIV infection.

Upon contact with the patient's blood

HIV-infected blood enters the blood of another person in different ways
ways. This can happen, for example:

• by transfusion of blood contaminated with HIV. Currently in Russia, all blood used for transfusion is tested for the presence of antibodies to HIV, i.e., it is determined whether it is infected with HIV or not. But we must remember that within 3-6 months after infection with HIV, there are still no antibodies to the virus in the donor’s blood, and even with a negative test result, such blood may actually be infected;


• when sharing needles, syringes and other materials for intravenous drug administration;


• when HIV passes from the blood of an HIV-infected mother to her child during pregnancy and childbirth.

In contact with sperm or vaginal secretions of a sick person

• This can happen during sex without using a condom. A small wound in the vagina, rectum, oral mucosa or penis is enough for HIV infection to occur if sexual contact occurs without a condom.

When a child is breastfed by an HIV-infected woman.

• The danger of infection arises only through contact with contaminated blood, semen, vaginal secretions and mother's milk. HIV is also present in urine, feces, vomit, saliva, tears and sweat, but in such small quantities that there is no danger of infection. The only exception is if visible blood is found in the above human secretions. HIV infection cannot be contracted by touching, shaking hands, kissing, massage, sharing the same bed, using the same bed linen, or drinking from the same glass. You also cannot become infected through a toilet seat, coughing, sneezing, or mosquito bite.

Donation is prohibited

Since HIV infection occurs through blood, an HIV-infected person cannot be a donor. The same restrictions exist for donors of sperm, bone marrow, and other organs for transplantation, since HIV infection can also occur during organ transplantation.

What happens during HIV infection

The fact that a person has become infected with a virus, i.e., has become HIV-infected, does not mean that he has AIDS. It usually takes a long time before AIDS develops (on average 10-12 years). Below we will describe in detail how HIV infection occurs.

At first the person may not feel anything

When infected with HIV, most people do not experience any sensations. Sometimes, a few weeks after infection, a flu-like condition develops (fever, skin rashes, swollen lymph nodes, diarrhea). For many years after infection, a person may feel healthy. This period is called the latent stage of the disease. However, it is wrong to think that nothing happens in the body at this time. When a pathogen, including HIV, enters the body, the immune system mounts an immune response. She tries to neutralize the pathogen and destroy it. To do this, the immune system produces antibodies. Antibodies bind to the pathogen and help destroy it. In addition, special white blood cells (lymphocytes) also begin to fight the pathogen. Unfortunately, when fighting HIV, all this is not enough - the immune system cannot neutralize HIV, and HIV, in turn, gradually destroys the immune system.

HIV test

A blood test to check for antibodies to HIV is called an HIV test. Antibodies that appear in the blood after HIV infection can be detected with a special blood test. The detection of antibodies indicates that a person is infected with HIV, i.e., HIV seropositive. However, antibodies can only be detected in the blood 3-6 months after HIV infection, so sometimes a person who has been infected with HIV for several months will have negative blood test results.

HIV seropositivity

There is often sad confusion regarding the term "seropositivity".

"Seropositivity" means that antibodies to HIV are present in a person's blood. Only children born to HIV-infected mothers can experience transient carriage of maternal antibodies to HIV, i.e., the antibodies disappear over time. These children may be temporarily seropositive, although not infected with HIV. An AIDS patient also has antibodies to HIV in his blood, so he is also seropositive. Thus, the term “HIV-seropositive” means that a person is infected with HIV, there are antibodies to this virus in his blood, but there are still no external manifestations of the disease.

AIDS

AIDS is spoken of when a person infected with HIV develops infectious diseases caused by the ineffective functioning of the immune system destroyed by the virus.

AIDS is the abbreviation for acquired immunodeficiency syndrome.

A syndrome is a stable combination, a set of several signs of a disease (symptoms).

Acquired means that the disease is not congenital, but developed during life.

Immunodeficiency is a deficiency of the immune system. Thus, AIDS is a combination of diseases caused by insufficient functioning of the immune system due to its defeat by HIV.

HIV treatment

When a person becomes infected with HIV, treatment is prescribed that can help delay the development of AIDS and opportunistic diseases, and some of the latter can be cured. The following drugs are used to treat HIV infection:

1. medications that directly affect the virus, its life cycles, interfering with its reproduction (antiretroviral drugs);
2. medicines for the treatment of opportunistic diseases;
3. medications intended to prevent the development of opportunistic infections (drugs for prophylaxis - preventive therapy).

Treatment of an HIV-infected patient begins much earlier than AIDS develops. The fact is that even in the absence of signs of the disease that are noticeable to the patient or the doctor, HIV actively affects the body. Therefore, timely treatment helps a person feel healthy longer and prevents the development of opportunistic infections and tumor diseases.

Antiretroviral drugs

There are a large number of medications that inhibit the replication of HIV. However, if any of these medications are used alone, over time they will no longer work against HIV. The virus becomes insensitive to it (doctors call this phenomenon drug resistance, or viral resistance). By using several drugs in combination at the same time, the risk of developing viral resistance can be minimized. This treatment method is called combination antiretroviral therapy.

If the virus nevertheless becomes resistant to the drug combination used, a new active drug combination is prescribed. Combination therapy is described in detail in the "Medicines" section.

Preventive therapy

Preventive therapy is treatment aimed at preventing the development of opportunistic infections.

Over time, HIV infection weakens the immune system to such an extent that opportunistic infections become more likely to develop. To prevent this, prophylactic (preventive) treatment is prescribed, mainly with antimicrobial drugs.

Such drugs do not act on the immunodeficiency virus itself. They serve only to prevent the development of opportunistic infections.

Ways to prevent other infections

Individuals infected with HIV become more susceptible not only to opportunistic infections, but also to other common infectious diseases.

To prevent the development of these diseases, preventive measures are also taken.

Vaccination (immunization)

Vaccines can protect the body from certain infectious diseases. Vaccination is effective if the person’s immune system is still slightly damaged. This is why people living with HIV are advised to get vaccinated against certain diseases as early as possible.

Below we describe those diseases against which it is advisable to vaccinate.

FLU

Every year, countless people receive flu vaccinations. However, for people living with HIV, it is not entirely clear whether all of them should receive these vaccinations. Those who get the flu frequently should probably get immunized. It is best to consult your doctor on this issue.

Inflammation of the lungs (pneumonia)

Anti-pneumococcal vaccine is not produced in Russia, but the Ministry of Health of the Russian Federation has approved some foreign vaccines for use.

Vaccinations against other diseases

There are certain features of immunization of children; in addition, a number of vaccinations are required when traveling to other countries.

Other infectious diseases

HIV-infected people are more susceptible to some infectious diseases than healthy people. In this case, we are talking about those patients whose immune system is still preserved. Below we describe such infections.

Salmonellosis

People with HIV infection are more likely to become infected with salmonellosis. Salmonella is a bacterium that causes a dangerous disease of the gastrointestinal tract, which is accompanied by fever and diarrhea. In Russia, bird eggs and poultry meat are contaminated with salmonella. Do not eat raw poultry eggs; eat only well-cooked poultry meat and poultry products.

Tuberculosis

People infected with HIV are more likely than others to develop tuberculosis. In Russia, the incidence of tuberculosis has increased sharply in recent years. When visiting some countries, you are also at risk of contracting tuberculosis. Before traveling or business trips, consult your doctor.

Course and prognosis of HIV infection

When a person finds out that he has HIV infection or AIDS, the first questions he most often asks are: “How long do I have left to live?” and “How will my illness progress?” Since HIV infection and AIDS progress differently for everyone, these questions cannot be answered unambiguously. However, we can provide some general information.

People with HIV infection and AIDS these days are living much longer than before.

Treatment of HIV infection and AIDS is becoming increasingly successful. With treatment, people with HIV infection feel healthy for a longer period of time, and AIDS patients live longer and, compared to previous years, not only have fewer manifestations of the disease, but it is much easier.

At the beginning of the epidemic (1981-1986), AIDS developed in patients on average 7 years after infection with the virus. After this, the person could live for about another 8-12 months. Since the introduction of combination antiretroviral therapy in 1996, the lives of people living with HIV and AIDS have become much longer. Some people who develop AIDS may live 10 years or longer. First of all, such progress is ensured by drugs that act on the virus itself - antiretroviral drugs. Life is also extended due to the fact that with the help of combination therapy it is possible to prevent the development of many opportunistic infections, which are the direct cause of death in HIV infection.

The search for new treatment methods continues. There is no doubt that even more drugs effective in combating this infection will soon become available.

HIV infection progresses differently for everyone

For each period of illness, we present only average figures. This means that some people experience the disease more quickly, while others feel fine for a long time. Some people have been living with HIV for more than 15 years. still has not developed AIDS. There are cases where people with AIDS. live without treatment for 10 years or longer.

As a rule, the diagnosis of HIV infection causes psychological shock. However, this does not mean that a person will constantly feel his illness. Thanks to modern methods of treatment, combination therapy, if it is well tolerated, he will feel completely healthy.

More information about your illness

How can you tell how damaged your immune system is? HIV gradually destroys the immune system. How damaged the immune system is and how quickly the disease develops can be determined by various methods.

Viral load

When testing blood, you can determine not only the presence of antibodies to HIV in it, but also the amount of the virus itself. This method is called “viral load testing”. The higher the test results, the more active the HIV infection.

Immune status

Using a laboratory test, you can find out about the state of the immune system. The so-called T-lymphocytes, or CD4 + lymphocytes, play an important role in its functioning. Usually these cells are found in large numbers in the blood, but in those affected by HIV they die and their number gradually decreases. By measuring the number of CD4+ lymphocytes in the blood, your doctor can tell how much your immune system is affected (see HIV and the Immune System section).

Additional information about vaccinations

After vaccination against influenza or other infectious diseases, viral load levels may increase in the same way as after flu or other infections. There is no need to be upset, as this is a temporary increase in the indicator. If you have not been vaccinated and have not had infectious diseases (for example, influenza), and your viral load has increased significantly, this means that your condition has worsened. If there are less than 100 cells per mm3 of CD4 + lymphocytes in the blood, vaccination against influenza (or other infectious diseases) may be useless.

Which is one of the most dangerous in the world. Its insidiousness is expressed in the fact that for a long time it may not manifest itself in any way, and its presence in the body can only be determined using a special test. Over time, the infection leads to the development of AIDS, which already manifests itself with certain signs. According to statistics, the mortality rate from this terrible disease is extremely high: about 40–65% die in the first year, 80% in two years, and almost 100% in three years. Scientists and specialists distinguish four stages in the course of HIV infection:

• incubation period;
• first signs;
• secondary diseases;
• AIDS.

In our article we will tell you about the period of time after which the first symptoms appear and what the first signs of AIDS occur in women and men.

After what period of time do the first symptoms of HIV and AIDS begin to appear?

The first symptoms of HIV infection are nonspecific and resemble ARVI: fever, general weakness, muscle pain, enlarged cervical lymph nodes.

From the moment of HIV infection to the development of AIDS itself, quite a long time can pass, and this period is very different. Scientists still cannot explain why one person develops the disease a year after infection, while another does not develop symptoms for 20 years or more. On average, AIDS appears within 10–12 years. We recommend reading our.

When infected with HIV, a person does not find out about it in the first days after infection. Its early signs can become apparent after 2–6 weeks. In most cases they are expressed as ARVI or. In the stage of primary manifestations of AIDS, some patients experience:

• temperature increase;
• chills;
• muscle pain;
• enlarged cervical lymph nodes.

Some people who become infected do not have these symptoms, and this course of HIV infection is called the asymptomatic stage of the disease. Scientists cannot yet explain the reason for this development of the disease.

Sometimes in patients with HIV, lymph nodes enlarge occasionally but continuously for a long period of time. After this, they decrease, and the disease is asymptomatic. This form of HIV is called persistent generalized lymphadenopathy.

In the first few weeks after the onset of the disease, a blood test for HIV may give negative results - this period is called the “window period”. Only more modern diagnostic methods - PCR and an HIV test - can detect the virus at this stage.

After the stage of primary manifestations, there comes a period during which HIV symptoms are completely absent. It can last for many years and is accompanied by the development of immunodeficiency.

The lack of antiviral treatment at the initial stage of this terrible disease leads to its faster development. That is why it is extremely important to detect AIDS at the earliest stages when the first signs of HIV infection occur.

The first signs of HIV in women

The very first sign of HIV in women, which appears several weeks after infection, is an absolutely causeless increase in temperature to 38–40 °C. The period of hyperthermia can last from 2 to 10 days. It is accompanied by catarrhal symptoms characteristic of ARVI or influenza: cough and sore throat.

The patient experiences symptoms of general intoxication:

• general weakness;
• headache;
• muscle pain;
• sweating (especially at night).

In many women, superficial lymph nodes enlarge in the occipital region, then in the back of the neck, in the groin and in the armpits. This sign may be generalized.

In some cases, women may experience severe nausea and vomiting, anorexia and severe cramping pain. With significant damage to the respiratory system, the cough can be intense and end in attacks of suffocation.

When HIV infection affects the nervous system, the following symptoms sometimes appear:

• severe headaches;
• significant weakness;
• vomit;
• stiff neck.

Many women are prone to diseases of the genitourinary system during this period. They have:

• a sharp increase in inguinal lymph nodes;
• abundant and frequent mucous discharge from the genital tract;

All of the above symptoms are nonspecific and may not always indicate HIV infection, but their prolonged manifestation should alert the woman and become a reason for undergoing examination at an AIDS center.

The first signs of HIV in men

About a week after HIV infection, a petechial (pinpoint), macular, or papular (raised above healthy skin) rash appears on a man’s body.

The first signs of HIV in men are in many ways similar to the first symptoms of this disease in women, but they also have some differences.

5–10 days after infection, a man develops discolored patches of skin all over his body. The rash can be petechial, urticarial or papular in nature. It is simply impossible to hide such a sign.

A few weeks after infection, their temperature rises to high levels, flu or ARVI symptoms are obvious, a severe headache appears and the lymph nodes in the neck, groin and armpits become enlarged. The patient feels completely overwhelmed, constant drowsiness and apathy.

Often, after infection in the initial stages, the patient may experience diarrhea. It may also be detected. The frequent and unexplained occurrence of such symptoms should be a reason to conduct an HIV test in a specialized center.

The first signs of AIDS in men and women

After the stage of primary manifestations of HIV, which can last about three weeks, the patient often experiences a prolonged low-grade fever. Some infected people may remain unaware of the disease for many years. Then they develop immunodeficiency, which leads to a long course of any disease.

The first signs of AIDS are the same for both men and women. Only the symptoms of diseases of the reproductive system can be different. The first sign of its onset may be long-term non-healing cuts and wounds. In such patients, even a slight scratch can bleed and fester for a long time.

• pulmonary – the patient develops Pneumocystis pneumonia, which is characterized by a long and severe course;
• intestinal - first the patient develops diarrhea, signs of dehydration, rapid and significant weight loss;
• with damage to the skin, mucous membranes and tissues of the body - the patient develops ulcers and erosions on the mucous membranes or skin, which progress, become infected and grow into muscle tissue;
• with damage to the nervous system - the patient’s memory deteriorates, constant apathy appears, brain atrophy and epileptic seizures develop, the condition can be complicated by malignant brain tumors or encephalitis.

AIDS lasts about six months or two years and ends in death (few patients live for three years).

Rapid detection of AIDS is complicated by the fact that the first signs of HIV infection are nonspecific and can be attributed to many other ailments. Frequent and unfounded appearance of temperature and enlarged lymph nodes should necessarily alert the patient and his doctor. In such cases, the only correct solution may be to conduct an HIV test in a specialized center. The need for timely diagnosis of this deadly disease is beyond doubt, since earlier initiation of antiviral therapy can delay the transition of HIV to AIDS, and therefore prolong the life of an infected person.

Good day, dear readers!

In today's article we will look at such a serious disease as HIV infection, and everything connected with it - causes, how it is transmitted, first signs, symptoms, stages of development, types, tests, tests, diagnosis, treatment, medications, prevention and other useful information. So…

What does HIV mean?

HIV infection in children

HIV infection in children is in many cases accompanied by developmental delays (physical and psychomotor), frequent infectious diseases, pneumonitis, encephalopathy, hyperplasia of the pulmonary lymphatics, and hemorrhagic syndrome. Moreover, HIV infection in children acquired from infected mothers is characterized by a more rapid course and progression.

The main cause of HIV infection is infection with the human immunodeficiency virus. The cause of AIDS is also the same virus, because AIDS is the last stage of development of HIV infection.

is a slowly developing virus belonging to the family of retroviruses (Retroviridae) and the genus of lentiviruses (Lentivirus). It is the word “lente” translated from Latin that means “slow”, which partially characterizes this infection, which develops quite slowly from the moment it enters the body until the last stage.

The size of the human immunodeficiency virus is only about 100-120 nanometers, which is almost 60 times smaller than the diameter of a blood particle - an erythrocyte.

The complexity of HIV lies in its frequent genetic changes during the process of self-reproduction - almost every virus differs from its predecessor by at least 1 nucleotide.

In nature, as of 2017, 4 types of virus are known - HIV-1 (HIV-1), HIV-2 (HIV-2), HIV-3 (HIV-3) and HIV-4 (HIV-4), each of which differs in genome structure and other properties.

It is HIV-1 infection that plays a role in the disease of most HIV-infected people, therefore, when the subtype number is not indicated, 1 is implied by default.

The source of HIV is people infected with the virus.

The main routes of infection are: injections (especially injection drugs), transfusions (blood, plasma, red blood cells) or organ transplantation, unprotected sexual contact with a stranger, unnatural sex (anal, oral), trauma during childbirth, feeding a baby with breast milk (if the mother is infected), trauma during childbirth, the use of undisinfected medical or cosmetic items (scalpel, needles, scissors, tattoo machines, dental and other instruments).

For HIV infection and its further spread throughout the body and development, it is necessary that the infected blood, mucus, sperm and other biomaterials of the patient enter the human bloodstream or lymphatic system.

An interesting fact is that some people have an innate defense against the human immunodeficiency virus in their bodies, so they are resistant to HIV. The following elements have such protective properties: the CCR5 protein, the TRIM5a protein, the CAML protein (calcium-modulated cyclophilin ligand), as well as the interferon-inducible transmembrane protein CD317/BST-2 (“tetherin”).

By the way, the CD317 protein, in addition to retroviruses, also actively counteracts arenaviruses, filoviruses and herpesviruses. The cofactor for CD317 is the cellular protein BCA2.

HIV Risk Groups

• Drug addicts, mainly injecting drug users;
• Sexual partners of drug addicts;
• Persons who are promiscuous, as well as those who engage in unnatural sex;
• Prostitutes and their clients;
• Donors and people in need of blood transfusion or organ transplantation;
• People suffering from sexually transmitted diseases;
• Doctors.

The classification of HIV infection is as follows:

Classification by clinical manifestations (in the Russian Federation and some CIS countries):

1. Incubation stage.

2. The stage of primary manifestations, which, depending on the course options, can be:

• without clinical manifestations (asymptomatic);
• acute course without secondary diseases;
• acute course with secondary diseases;

3. Subclinical stage.

4. The stage of secondary diseases caused by damage to the body by viruses, bacteria, fungi and other types of infection that develop against the background of weakened immunity. Downstream it is divided into:

A) body weight decreases by less than 10%, as well as frequently recurring infectious diseases of the skin and mucous membranes - pharyngitis, otitis media, herpes zoster, angular cheilitis ();

B) body weight decreases by more than 10%, as well as persistent and often recurring infectious diseases of the skin, mucous membranes and internal organs - sinusitis, pharyngitis, herpes zoster, or diarrhea (diarrhea) for a month, localized Kaposi's sarcoma;

C) body weight is significantly reduced (cachexia), as well as persistent generalized infectious diseases of the respiratory, digestive, nervous and other systems - candidiasis (trachea, bronchi, lungs, esophagus), Pneumocystis pneumonia, extrapulmonary tuberculosis, herpes, encephalopathy, meningitis, cancer tumors (disseminated Kaposi's sarcoma).

All options for the course of the 4th stage have the following phases:

• progression of pathology in the absence of highly active antiretroviral therapy (HAART);
• progression of pathology during HAART;
• remission during or after HAART.

5. Terminal stage (AIDS).

The above classification largely coincides with the classification approved by the World Health Organization (WHO).

Classification by clinical manifestations (CDC - US Center for Disease Control and Prevention):

The CDC classification includes not only the clinical manifestations of the disease, but also the number of CD4 + T-lymphocytes in 1 μl of blood. It is based on the division of HIV infection into only 2 categories: the disease itself and AIDS. If the following parameters meet criteria A3, B3, C1, C2 and C3, the patient is considered as having AIDS.

Symptoms according to CDC category:

A (acute retroviral syndrome) – characterized by an asymptomatic course or generalized lymphadenopathy (GLAP).

B (AIDS-associated complex syndromes) - may be accompanied by oral candidiasis, herpes zoster, cervical dysplasia, peripheral neuropathy, organic lesions, idiopathic thrombocytopenia, leukoplakia or listeriosis.

C (AIDS)-can be accompanied by candidiasis of the respiratory tract (from oropharynx to lungs) and/or esophagus, pneumocystosis, pneumonia, herpetic esophagitis, HIV-enemyption, isosporosis, histoplasmosis, mycobacteriosis, cytomegalovirus infection, cryptocydiasis, coccyidia, coccyidia, and coccydoids, and coccyxia coccyxia uterus, sarcoma Kaposi, lymphoma, salmonellosis and other diseases.

Diagnosis of HIV infection

Diagnosis of HIV infection includes the following examination methods:

• Anamnesis;
• Visual examination of the patient;
• Screening test (detection of blood antibodies to infection using enzyme-linked immunosorbent assay - ELISA);
• A test confirming the presence of antibodies in the blood (blood testing using the immune blotting method (blot)), which is carried out only if the result of the screening test is positive;
• Polymerase chain reaction (PCR);
• Tests for immune status (counting CD4 + lymphocytes - performed using automatic analyzers (flow cytometry method) or manually using microscopes);
• Viral load analysis (counting the number of HIV RNA copies per milliliter of blood plasma);
• Rapid tests for HIV - diagnosis is made using ELISA on test strips, agglutination reaction, immunochromatography or immunological filtration analysis.

Tests alone are not enough to diagnose AIDS. Confirmation occurs only with the additional presence of 2 or more opportunistic diseases associated with this syndrome.

HIV infection - treatment

Treatment of HIV infection is possible only after a thorough diagnosis. However, unfortunately, as of 2017, officially, adequate therapy and medications that would completely eliminate the human immunodeficiency virus and cure the patient have not been established.

The only modern treatment for HIV infection today is highly active antiretroviral therapy (HAART), which is aimed at slowing the progression of the disease and stopping its transition to the AIDS stage. Thanks to HAART, a person’s life can be extended for several decades; the only condition is lifelong use of appropriate medications.

The insidiousness of the human immunodeficiency virus is also its mutation. So, if anti-HIV medications are not changed after some time, which is determined based on constant monitoring of the disease, the virus adapts and the prescribed treatment regimen becomes ineffective. Therefore, at different intervals, the doctor changes the treatment regimen, and with it the medications. The reason for changing the drug may also be the patient’s individual intolerance to it.

Modern drug development is aimed not only at achieving the goal of effectiveness against HIV, but also at reducing side effects from them.

The effectiveness of treatment also increases with changes in a person’s lifestyle, improving its quality - healthy sleep, proper nutrition, avoiding stress, an active lifestyle, positive emotions, etc.

Thus, the following points can be highlighted in the treatment of HIV infection:

• Drug treatment of HIV infection;
• Diet;
• Preventive actions.

Important! Before using medications, be sure to consult your doctor for advice!

1. Drug treatment of HIV infection

At the beginning, we must immediately remind you once again that AIDS is the last stage of the development of HIV infection, and it is at this stage that a person usually has very little time left to live. Therefore, it is very important to prevent the development of AIDS, and this largely depends on timely diagnosis and adequate treatment of HIV infection. We also noted that the only method of treating HIV today is considered to be highly active antiretroviral therapy, which, according to statistics, reduces the risk of developing AIDS to almost 1-2%.

Highly active antiretroviral therapy (HAART)– a method of treating HIV infection based on the simultaneous use of three or four drugs (tritherapy). The number of drugs is related to the mutagenicity of the virus, and in order to bind it at this stage for as long as possible, the doctor selects a complex of drugs. Each of the drugs, depending on the principle of action, is included in a separate group - reverse transcriptase inhibitors (nucleoside and non-nucleoside), integrase inhibitors, protease inhibitors, receptor inhibitors and fusion inhibitors (fusion inhibitors).

HAART has the following goals:

• Virological – aimed at stopping the reproduction and spread of HIV, which is indicated by reducing the viral load by 10 times or more in just 30 days, to 20-50 copies/ml or less in 16-24 weeks, as well as maintaining these indicators for as long as possible;
• Immunological – aimed at restoring the normal functioning and health of the immune system, which is due to the restoration of the number of CD4 lymphocytes and an adequate immune response to infection;
• Clinical – aimed at preventing the formation of secondary infectious diseases and AIDS, which makes it possible to conceive a child.

Medicines for HIV infection

Nucleoside reverse transcriptase inhibitors– the mechanism of action is based on the competitive suppression of the HIV enzyme, which ensures the creation of DNA, which is based on the RNA of the virus. It is the first group of drugs against retroviruses. Well tolerated. Side effects include: lactic acidosis, bone marrow suppression, polyneuropathy and lipoatrophy. The substance is excreted from the body through the kidneys.

Nucleoside reverse transcriptase inhibitors include abacavir (Ziagen), zidovudine (Azidothymidine, Zidovirine, Retrovir, Timazid), lamivudine (Virolam, Heptavir-150, Lamivudine-3TC ", "Epivir"), stavudine ("Aktastav", "Zerit", "Stavudin"), tenofovir ("Viread", "Tenvir"), phosphazide ("Nikavir"), emtricitabine ("Emtriva"), as well as complexes abacavir + lamivudine (Kivexa, Epzicom), zidovudine + lamivudine (Combivir), tenofovir + emtricitabine (Truvada) and zidovudine + lamivudine + abacavir (Trizivir).

Non-nucleoside reverse transcriptase inhibitors– delavirdine (Rescriptor), nevirapine (Viramune), rilpivirine (Edurant), efavirenz (Regast, Sustiva), etravirine (Intelence).

Integrase inhibitors— the mechanism of action is based on blocking the viral enzyme, which is involved in the integration of viral DNA into the genome of the target cell, after which a provirus is formed.

Integrase inhibitors include dolutegravir (Tivicay), raltegravir (Isentress), and elvitegravir (Vitecta).

Protease inhibitors— the mechanism of action is based on blocking the viral protease enzyme (retropepsin), which is directly involved in the cleavage of Gag-Pol polyproteins into individual proteins, after which the mature proteins of the human immunodeficiency virus virion are actually formed.

Protease inhibitors include amprenavir (“Agenerase”), darunavir (“Prezista”), indinavir (“Crixivan”), nelfinavir (“Viracept”), ritonavir (“Norvir”, “Ritonavir”), saquinavir-INV (“ Invirase"), tipranavir ("Aptivus"), fosamprenavir ("Lexiva", "Telzir"), as well as the combination drug lopinavir + ritonavir ("Kaletra").

Receptor inhibitors— the mechanism of action is based on blocking the penetration of HIV into the target cell, which is due to the effect of the substance on the coreceptors CXCR4 and CCR5.

Receptor inhibitors include maraviroc (Celsentri).

Fusion inhibitors (fusion inhibitors)— the mechanism of action is based on blocking the last stage of the introduction of the virus into the target cell.

Among the fusion inhibitors, one can highlight enfuvirtide (Fuzeon).

The use of HAART during pregnancy reduces the risk of transmission of infection from an infected mother to a child to 1%, although without this therapy the percentage of infection of the child is about 20%.

Side effects from the use of HAART medications include pancreatitis, anemia, skin rashes, kidney stones, peripheral neuropathy, lactic acidosis, hyperlipidemia, lipodystrophy, as well as Fanconi syndrome, Stevens-Johnson syndrome and others.

The diet for HIV infection is aimed at preventing the patient from losing weight, as well as providing the body’s cells with the necessary energy and, of course, stimulating and maintaining the normal functioning of not only the immune system, but also other systems.

It is also necessary to pay attention to the certain vulnerability of an immune system weakened by infection, so protect yourself from infection with other types of infection - be sure to follow the rules of personal hygiene and cooking rules.

Nutrition for HIV/AIDS should:

2. Be high in calories, which is why it is recommended to add butter, mayonnaise, cheese, and sour cream to food.

3. Drink plenty of fluids, it is especially useful to drink decoctions and freshly squeezed juices with plenty of vitamin C, which stimulates the immune system - decoction, juices (apple, grape, cherry).

4. Be frequent, 5-6 times a day, but in small portions.

5. Water for drinking and cooking must be purified. Avoid eating expired foods, undercooked meat, raw eggs, and unpasteurized milk.

What can you eat if you have HIV infection:

• Soups - vegetable, cereal, with noodles, meat broth, maybe with the addition of butter;
• Meat - beef, turkey, chicken, lungs, liver, lean fish (preferably sea);
• Cereals – buckwheat, pearl barley, rice, millet and oatmeal;
• Porridge - with the addition of dried fruits, honey, jam;
• Bread;
• Fats – sunflower oil, butter, margarine;
• Plant foods (vegetables, fruits, berries) - carrots, potatoes, cabbage, zucchini, pumpkin, legumes, peas, apples, grapes, plums and others;
• Sweets - honey, jam, marmalade, jam, marmalade, pastille, sugar, sweet pastries (no more than once a month).

Also, with HIV infection and AIDS, there is a shortage of such and

3. Preventive measures

Preventive measures for HIV infection that must be followed during treatment include:

• Avoiding repeated contact with infection;
• Healthy sleep;
• Compliance with personal hygiene rules;
• Avoiding the possibility of infection with other types of infection -, and others;
• Avoiding stress;
• Timely wet cleaning in the place of residence;
• Avoidance of prolonged exposure to sunlight;
• Complete cessation of alcoholic beverages and smoking;
• Good nutrition;
• Active lifestyle;
• Holidays at sea, in the mountains, i.e. in the most environmentally friendly places.

We will look at additional HIV prevention measures at the end of the article.

Important! Before using folk remedies against HIV infection, be sure to consult your doctor!

St. John's wort. Pour well-dried chopped herbs into an enamel pan and fill it with 1 liter of soft purified water, then put the container on the fire. After the product boils, cook the product for another 1 hour over low heat, then remove, cool, strain and pour the broth into a jar. Add 50 g of sea buckthorn oil to the decoction, mix thoroughly and set aside in a cool place to infuse for 2 days. You need to take the product 50 g 3-4 times a day.

Licorice. Pour 50 g of chopped into an enamel pan, fill it with 1 liter of purified water and place on the stove over high heat. After bringing to a boil, reduce the heat to minimum and simmer for about 1 hour. Then remove the broth from the stove, cool it, strain, pour into a glass container, add 3 tbsp. spoons of natural, mix. You need to drink 1 glass of the decoction in the morning, on an empty stomach.

Propolis. Pour 10 g of crushed powder into half a glass of water and place the product in a water bath to simmer for 1 hour. Afterwards, cool the product and take it 1-3 times a day, 50 g each.

Syrup from berries, apples and nuts. Mix together in an enamel pan 500 g of fresh red berries, 500 g of lingonberries, 1 kg of chopped green apples, 2 cups of chopped apples, 2 kg of sugar and 300 ml of purified water. Set aside until the sugar dissolves, then put the product on low heat for 30 minutes and cook syrup from it. Afterwards, the syrup must be cooled, poured into a jar and taken in the morning, on an empty stomach, 1 tbsp. spoon, which can be washed down with a sip of boiled water.

HIV prevention includes:

• Compliance ;
• Blood and organ donor examinations;
• Examination of all pregnant women for the presence of antibodies to HIV;
• Monitoring the birth of children in HIV-positive women and preventing breastfeeding;
• Conducting lessons to inform young people about the consequences of certain sexual relationships;
• There are movements to work with drug addicts, the goal of which is psychological assistance, teaching about safe injections and exchanging needles and syringes;
• Reducing drug addiction and prostitution;
• Opening of rehabilitation centers for drug addicts;
• Promoting safe sex practices;
• Refusal of unnatural sexual relations (anal, oral sex);
• Compliance by medical workers with all safety rules for working with biomaterials of infected people, incl. diseases such as;
• If a healthcare worker has contact of mucous membranes or blood (cut, puncture of the skin) with an infected biomaterial, the wound must be treated with alcohol, then washed with laundry soap and treated with alcohol again, and after that, in the first 3-4 hours, take drugs from the HAART group ( for example - “Azidothymidine”), which minimizes the possibility of developing HIV infection, and be observed by an infectious disease specialist for 1 year;
• Mandatory treatment of sexually transmitted diseases (STDs) so that they do not become chronic;
• Refusal to get a tattoo, as well as visiting unverified beauty salons, cosmetologists at home, little-known dental clinics with a dubious reputation;
• As of 2017, a vaccine against HIV and AIDS has not yet been officially developed; at least some drugs are still undergoing preclinical trials.

The expression “People living with HIV” (PLHIV) is used to refer to a person or group of people who are HIV-positive. This term was coined due to the fact that PLHIV can live in society for several decades and die not from the infection itself, but from the natural aging of the body. PLHIV should never be a stigma to be shunned and kept in isolation. Also, PLHIV have the same rights as an HIV-negative person - to medical care, education, work, and the birth of a child.

Which doctor should I see if I have HIV infection?

HIV infection - video

HIV infection is a disease caused by the human immunodeficiency virus, characterized by acquired immunodeficiency syndrome, which contributes to the occurrence of secondary infections and malignancies due to the profound inhibition of the body's protective properties.

A feature of the virus that causes HIV infection is the development of a sluggish infectious-inflammatory process in the human body, as well as a long incubation period. We will look in more detail about what kind of disease this is, what are the causes of its development, symptoms and routes of transmission, as well as what is prescribed as treatment.

What is HIV infection?

HIV infection is a slowly progressive viral disease that affects the immune system, the extreme stage of development of which is AIDS (acquired immunodeficiency syndrome).

HIV (human immunodeficiency virus) is a retrovirus from the genus of lentiviruses, infection with which suppresses the activity of the immune system and leads to the development of a slowly progressive disease, HIV infection.

In the human body, nature has a mechanism through which immune cells produce antibodies that can resist microorganisms with foreign genetic information.

When antigens enter the body, lymphocytes begin to work in it. They recognize the enemy and neutralize it, but when the body is infected by the virus, the protective barriers are destroyed and the person can die within a year of infection.

Main types of HIV infection:

• HIV-1 or HIV-1 – causes typical symptoms, is very aggressive, and is the main causative agent of the disease. Discovered in 1983, it is found in Central Africa, Asia and Western Europe, North and South America.
• HIV-2 or HIV-2 – HIV symptoms are less intense and is considered a less aggressive strain of HIV. Discovered in 1986, it is found in Germany, France, Portugal and West Africa.
• HIV-2 or HIV-2 is extremely rare.

Causes and routes of transmission

The higher the immune status of a healthy person, the lower the risk of getting an infection when in contact with an HIV-infected patient. And vice versa - weak immunity will lead to an increased risk of infection and a severe course of the resulting disease.

A high viral load in a person with HIV in his body increases his danger as a carrier of the disease several times.

Methods of transmission of HIV to humans:

1. During sexual intercourse without using a condom. And also during oral sex, if there are cuts or damage.
2. Using an injection syringe, a medical instrument after a person infected with HIV.
3. The entry into the human body of blood already infected with the virus. Occurs during treatment and blood transfusion.
4. Infection of a child from a sick mother in the womb during childbirth or lactation.
5. Using an instrument after an HIV-infected person during cosmetic procedures, manicure or pedicure, tattooing, piercing, etc.
6. Using other people's personal hygiene items in everyday life, for example, razors, toothbrushes, toothpicks, etc.

How can you avoid becoming infected with HIV?

If there is an HIV-infected person in your environment, you must remember that you cannot become infected with HIV if:

• Coughing and sneezing.
• Handshake.
• Hugs and kisses.
• Consumption of shared food or drinks.
• In swimming pools, baths, saunas.
• Through “injections” in transport and the metro. Information about possible infection through infected needles that HIV-infected people place on seats, or try to inject people in a crowd with them, is nothing more than myths. The virus does not persist in the environment for very long; in addition, the virus content at the tip of the needle is too small.

HIV is an unstable virus, it dies quickly outside the host’s body, is sensitive to temperature (reduces infectious properties at a temperature of 56 ° C, dies after 10 minutes when heated to 70-80 ° C). It is well preserved in blood and its preparations prepared for transfusion.

At-risk groups:

• intravenous drug users;
• persons, regardless of orientation, who use anal sex;
• recipients of blood or organs;
• medical workers;
• persons involved in the sex industry, both prostitutes and their clients.

Without highly active antiretroviral therapy, the life expectancy of patients does not exceed 10 years. The use of antiviral drugs can slow down the progression of HIV and the development of acquired immunodeficiency syndrome - AIDS. Signs and symptoms of HIV at different stages of the disease have their own colors. They are varied and increase in severity of manifestation.

The first signs of HIV in adults

Human immunodeficiency virus is a retrovirus that causes HIV infection. Depending on the clinical signs of HIV infection, the following stages are distinguished:

• Incubation period.
• Primary manifestations: acute infection; asymptomatic infection; generalized lymphadenopathy.
• Secondary manifestations. damage to the skin and mucous membranes; persistent damage to internal organs; generalized diseases.
• Terminal stage.

HIV has no symptoms of its own and can masquerade as any infectious disease. In this case, blisters, pustules, and seborrheic dermatitis appear on the skin. The virus can only be detected using tests: an HIV test.

The first signs you need to pay attention to:

• Fever of unknown origin for more than 1 week.
• Enlargement of various groups of lymph nodes: cervical, axillary, inguinal - for no apparent reason (no inflammatory diseases), especially if lymphadenopathy does not go away within several weeks.
• Diarrhea for several weeks.
• The appearance of signs of candidiasis (thrush) of the oral cavity in an adult.
• Extensive or atypical localization of herpetic eruptions.
• A sharp decrease in body weight, regardless of any reason.

Symptoms of HIV infection

The course of HIV infection is quite diverse; all stages do not always occur; certain clinical signs may be absent. Depending on the individual clinical course, the duration of the disease can range from several months to 15-20 years.

Main symptoms of HIV infection:

• Enlargement of 2 or more lymph nodes, unconnected, which are painless, and the skin over them does not change its color;
• Increased fatigue;
• A gradual decrease in CD4 lymphocytes, at a rate of approximately 0.05-0.07 × 10 9 / l per year.

Such symptoms accompany the patient for approximately 2 to 20 years or more.

In the human body, HIV goes through 5 stages, each of which is accompanied by certain signs and symptoms.

Stage 1 human immunodeficiency virus

HIV infection stage 1 (window period, seroconversion, incubation period) – the period from infection of the body with the virus until the appearance of the first antibodies detected in it. Usually ranges from 14 days to 1 year, which largely depends on the health of the immune system.

Stage 2 (acute phase)

The appearance of primary symptoms, which are divided into periods A, B, C.

• Period 2A - no symptoms.
• Period 2B - the first manifestations of infection, similar to the course of other infectious diseases.
• 2B - manifests itself in the form of herpes, pneumonia, but at this stage of development of the disease, infections respond well to treatment. Period 2B lasts 21 days.

Latent period and its symptoms

The latent stage of HIV lasts up to 2-20 years or more. Immunodeficiency progresses slowly, HIV symptoms are expressed by enlarged lymph nodes:

• They are elastic and painless, mobile, the skin retains its normal color.
• When diagnosing latent HIV infection, the number of enlarged nodes is taken into account - at least two, and their location - at least 2 groups not connected by a common lymph flow (with the exception of inguinal nodes)

Stage 4 (pre-AIDS)

This stage begins when the level of CD4+ lymphocytes drops critically and approaches 200 cells in 1 μl of blood. As a result of such suppression of the immune system (its cellular component), the patient develops:

• recurrent herpes and genitals,
• hairy leukoplakia of the tongue (whitish raised folds and plaques on the lateral surfaces of the tongue).

In general, any infectious disease (for example, tuberculosis, salmonellosis, pneumonia) is more severe than in the general population.

Stage 5 HIV infection (AIDS)

The terminal stage is characterized by irreversible changes, treatment is ineffective. The number of T helper cells (CD4 cells) falls below 0.05x109/l, patients die weeks or months from the onset of the stage. In drug addicts who have been using psychoactive substances for several years, CD4 levels may remain almost within normal limits, but severe infectious complications (abscesses, etc.) develop very quickly and are fatal.

The number of lymphocytes decreases so much that infections that otherwise would never have arisen begin to cling to a person. These diseases are called AIDS-associated infections:

• Kaposi's sarcoma;
• brain;
• , bronchi or lungs;
• Pneumocystis pneumonia;
• pulmonary and extrapulmonary tuberculosis, etc.

Pathogenic factors that accelerate the development of the disease from stage 1 to AIDS:

• Lack of timely and adequate treatment;
• Coinfection (addition of other infectious diseases to HIV infection);
• Stress;
• Poor quality food;
• Elderly age;
• Genetic characteristics;
• Bad habits – alcohol, smoking.

HIV has no symptoms of its own and can camouflage for any infectious diseases. At the same time, blisters, pustules, lichen, appear on the skin. The virus can only be detected using tests: an HIV test.

Diagnosis and test for HIV

If you suspect HIV infection, you should contact an infectious disease specialist. The test can be taken anonymously at the AIDS Prevention and Control Center, which is located in every region. There, doctors also provide consultations on all issues related to HIV infection and AIDS.

Considering the fact that the course of the disease is characterized by a duration of absence of severe symptoms, diagnosis is possible only on the basis of laboratory tests, which boil down to identifying antibodies to HIV in the blood or directly upon detection of the virus.

The acute phase mainly does not determine the presence of antibodies, however, three months after infection, they are detected in about 95% of cases.

HIV diagnosis consists of special tests:

1. 1test - enzyme immunoassay (ELISA). This is the most common diagnostic method. Three months after the virus enters the bloodstream, the amount of antibodies that can be determined by an enzyme immunoassay accumulates in the human body. It gives false positive or false negative results in about 1% of cases.
2. 2nd test - immunoblot (Immune Blotting). This test determines the presence of specific antibodies to HIV. The result can be positive, negative and doubtful (or uncertain). An indeterminate result may mean that HIV is present in a person’s bloodstream, but the body has not yet produced the full range of antibodies.
3. PCR or polymerase chain reaction used to determine any infectious pathogen, including the HIV virus. In this case, its RNA is detected, and the pathogen can be detected at very early stages (at least 10 days must pass after infection).
4. Rapid tests, thanks to which you can determine the presence of HIV infection within 15 minutes. There are several types of them:
   • The most accurate test is immunochromatographic. The test consists of special strips onto which capillary blood, urine or saliva is applied. If antibodies to HIV are detected, the strip has a colored line and a control line. If the answer is no, only the line is noticeable.
   • Home use kits "OraSure Technologies1". Developer - America. This test was approved by the FDA.

Incubation period HIV virus life is 90 days. During this period, it is difficult to detect the presence of pathology, but this can be done using PCR.

Even after the final diagnosis of HIV infection, throughout the entire period of the disease, it is necessary to conduct regular laboratory tests of the patient in order to monitor the course of clinical symptoms and the effectiveness of treatment.

Treatment and prognosis

A cure for HIV has not yet been invented, and there is no vaccine. It is impossible to remove the virus from the body, and this is a fact at this time. However, one should not lose hope: active antiretroviral therapy (HAART) can reliably slow down and even practically stop the development of HIV infection and its complications.

Treatment is predominantly etiotropic and involves the prescription of drugs that reduce the reproductive capabilities of the virus. In particular, these include the following drugs:

• nucleoside transcriptase inhibitors (otherwise known as NRTIs), corresponding to various groups: Ziagen, Videx, Zerit, combination drugs (combivir, trizivir);
• nucleotide reverse transcriptase inhibitors (otherwise known as NTRTIs): stocrine, viramune;
• fusion inhibitors;
• protease inhibitors.

The main task of the treating specialist when selecting a drug regimen for antiviral treatment of HIV is to minimize adverse reactions. In addition to the use of specific medications, the patient must correct eating behavior, as well as work and rest patterns.

In addition, it should be taken into account that some HIV-infected people belong to the category of non-progressors, who have viral particles in their blood, but the development of AIDS does not occur.

Factors that slow down the transition of HIV infection to the AIDS stage:

• Timely initiation of highly active antiretroviral therapy (HAART). In the absence of HAART, the patient's death occurs within 1 year from the date of diagnosis of AIDS. It is believed that in regions where HAART is available, the life expectancy of HIV-infected people reaches 20 years.
• No side effects from taking antiretroviral drugs.
• Adequate treatment of concomitant diseases.
• Adequate food.
• Rejection of bad habits.

HIV infection is completely incurable; in many cases, antiviral therapy gives little result. Today, on average, HIV-infected people live 11-12 years, but careful therapy and modern medications will significantly extend the life of patients.

The main role in containing the developing AIDS is played by the psychological state of the patient and his efforts aimed at complying with the prescribed regimen.

This is all about HIV infection: what are the first symptoms in women and men, how to treat the disease. Do not be ill!