Md. Jahangir Alam:

Human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome (AIDS). HIV gradually weakens the immune system by destroying CD4 (T-helper) cells, leaving the body vulnerable to infections and certain cancers. Early testing and treatment greatly improve outcomes, allowing people living with HIV to lead long and healthy lives.

What is HIV?

HIV stands for Human Immunodeficiency Virus. It attacks and destroys cells of the immune system, particularly CD4 cells, which help the body fight infections. HIV is a retrovirus, meaning it inserts its genetic material into the DNA of the host cells to replicate itself.

What is AIDS?

AIDS, or Acquired Immunodeficiency Syndrome, is the most severe stage of HIV infection. People with AIDS have very low immune cell counts and are prone to opportunistic infections and certain cancers. Without treatment, HIV can progress to AIDS in approximately 10 years.

Differences Between HIV and AIDS

• HIV: The virus that causes immune system weakening.
• AIDS: A condition resulting from advanced HIV infection, marked by severely weakened immunity and additional illnesses.

Effects of HIV on the Body

HIV attacks CD4 cells, gradually reducing their numbers and leaving the immune system weakened. Symptoms can vary:

• Early infection: Flu-like symptoms such as fever, fatigue, sore throat, and swollen lymph nodes.
• Chronic stage: The virus may remain in the body without noticeable symptoms, while slowly weakening the immune system.
• AIDS stage: Severe weight loss, extreme fatigue, fevers, night sweats, skin changes, and opportunistic infections.

Transmission of HIV

HIV spreads through certain body fluids, including blood, semen, vaginal fluids, rectal fluids, and breast milk. Common routes of transmission include:

• Unprotected sexual contact
• Sharing needles for drug use
• Mother-to-child transmission during pregnancy, childbirth, or breastfeeding

HIV is not spread through casual contact, kissing (except in rare cases with open sores), bug bites, or shared utensils.

Diagnosis of HIV

HIV can be diagnosed through blood or saliva tests:

• Antigen/antibody tests: Detect both the virus and antibodies; usually detectable 18–45 days after exposure.
• Antibody tests: Detect antibodies to HIV; detectable 23–90 days after exposure.
• Nucleic acid tests (NATs): Detect HIV itself; usually detectable 10–33 days after exposure.

At-home tests are also available. Positive results should be confirmed by a healthcare provider.

Stages of HIV

1. Acute HIV: Early symptoms, typically flu-like.
2. Chronic/Latent HIV: Virus is present but may not cause symptoms.
3. AIDS: Severe immune deficiency with opportunistic infections or AIDS-defining illnesses such as Kaposi sarcoma, Pneumocystis pneumonia, and certain lymphomas.

Treatment and Management

There is no cure for HIV, but treatment with antiretroviral therapy (ART) can control the virus and prevent progression to AIDS. ART involves a combination of medications that:

• Reduce viral load to undetectable levels
• Preserve immune system function
• Prevent transmission to others

Treatment adherence is critical. Missing doses can lead to drug resistance.

Prevention

HIV prevention strategies include:

• Using condoms for all sexual activity
• Avoiding sharing needles
• Taking PrEP if at high risk
• Using PEP within 72 hours after possible exposure
• Regular HIV testing

Living with HIV

People living with HIV can have full, healthy lives with proper care. Key points include:

• Take ART medications consistently
• Attend all medical appointments
• Communicate openly with partners
• Follow strategies to reduce transmission risk

Pregnancy is possible for people living with HIV, and proper treatment reduces the risk of mother-to-child transmission.

Prognosis

• With early diagnosis and effective treatment, life expectancy is near normal.
• Untreated HIV may progress to AIDS in about 10 years; untreated AIDS may reduce life expectancy to around three years.

Conclusion

HIV and AIDS are serious but manageable conditions. Early detection, effective treatment, and preventive measures significantly improve quality of life and reduce transmission risk. Social support, stigma reduction, and access to healthcare are essential for those living with HIV.