Table of contents
Introduction
In 2008, a man was cured of HIV. In over 70 million HIV cases this was the first and last time a person was cured. Scientists really don’t know how this happened and couldn’t come up with a conclusion on this case. In the US, HIV claims over more than 10,000 lives per year. As of 2020, AIDS has killed 32 million people and there are almost 38 million people living with HIV today and more than half of them live in sub-Saharan Africa.
History
HIV infection in humans came from a type of chimpanzee in Central Africa. The chimpanzee version of the virus (called simian immunodeficiency virus) was probably passed to humans when humans hunted these chimpanzees for meat and came in contact with their infected blood. Studies show that HIV jumped from chimpanzees to humans as far back as the late 1800s. By this, HIV slowly spread across Africa and later on spread into other parts of the world.
What is HIV?
HIV (Human immunodeficiency Virus) is a retrovirus, which means it can write its genetic code into the genome of infected cells, making them to duplicating more copies of themselves. In simple words, it attacks the body’s immune system and if this is not treated, it can lead to AIDS (acquired immunodeficiency syndrome). Most of the HIV cases don’t develop into AIDS because taking HIV medicine every day as prescribed stops the progression of the disease.
Understanding HIV
HIV spreads through the exchange of bodily fluids. Once inside the body, HIV infects cells that are part of the immune system. It targets the T cells which help defend the body against bacterial and fungal infections.
During the first stage, the virus replicates within the helper T cells, destroying many of them in the process. This lasts for a few months to few years where this virus continues to replicate and destroy T cells. This eventually lowers T cells to dangerous levels. This brings a serious danger to the patient of contracting deadly infections that healthy immune cells can normally handle. This is the stage where HIV turns into AIDS.
How does it spread?
Unprotected sex and contaminated needles are the leading cause of transmission. Do note that it cannot spread through the air, water, or casual contact.
It is possible to get HIV from tattooing or body piercing if the equipment used for these procedures has someone else blood in it or if the ink is shared.
Although rare, transmission can occur if both partners have sores or bleeding gums, and blood from the partner with HIV gets into the bloodstream of the HIV-negative partner.
Contamination can occur when blood from a caregiver's mouth mixes with food that is pre-chewed before feeding to an infant.
People who inject drugs are also at risk for getting HIV because it may contain someone else blood on them, and that blood can carry HIV.
Mother-to-child transmission is the most common way that children get HIV. It is recommended to test all pregnant women for HIV and start treatment.
Ways HIV is not transmitted
HIV does not survive long outside the human body, and it cannot reproduce outside a human host.
It is not transmitted:
By mosquitoes or other insects
Through saliva, tears, or sweat
By hugging, shaking hands, sharing toilets, sharing dishes, or closed-mouth or social kissing.
Any activity that doesn’t involve the exchange of body fluids.
What are its Symptoms
During the initial phase, patients often experience flu-like symptoms but are not that dangerous yet. There is a period from few months to few years, the patient may look and feel completely healthy.
In the chronic HIV infection stage, the person might not feel sick or have any symptoms. People can stay in this stage for 10 to 15 years without any symptoms.
Possible symptoms include fever, chills, rash, muscle aches, sore throat, fatigue, mouth ulcers. But this doesn’t mean you have HIV; it can be due to other illnesses as well.
If HIV develops further and weakens your immune system, then you might progress into AIDS. This is the last stage of HIV infection. Some of the symptoms include rapid weight loss, recurring fever, extreme tiredness, prolonged swelling of the lymph glands, diarrhea that lasts for more than a week, sores of the mouth, Pneumonia, blotches on or under the skin or inside the mouth, memory loss, depression, and neurologic disorders.
It is always good to get an HIV test if you have been exposed to HIV.
Treatments
There are drugs that are highly effective in managing levels of HIV which prevent T cell count from getting low enough for the disease to progress to AIDS. These drugs prevent the viral genome from being copied and incorporated into a host cell’s DNA. Another way is to prevent HIV to stop it from infecting other new cells in our body.
Antiretroviral Therapy
With this therapy, most people can expect to live longer with healthy lives. These people are much less likely to infect others. But these patients need to keep on taking the drug for the rest of their lives. If we break this, there are chances the virus can make a deadly comeback.
CCR5 Gene therapy
The only person treated with HIV who got cured was injected with bone marrow of that 1% of people who carried the ccr5 gene (HIV resistant people) and luckily it worked for him. He was cured of HIV in 2008. Again, with the same bone marrow transplant technique, 2 more people got cured in 2020.
Future Treatments
Another way is looking to use genetic tools to cut the HIV DNA out of the cell genome. This is called CRISPR, a kind of molecular scissors for cutting and gene editing. Thus, we can do this to the ccr5 gene and put it into a person’s own blood stem cells. Steam cells then pass down this to all blood and immune cells including the T cells which is the primary target for HIV infection.
Why is it difficult to cure?
The Virus
Most of the T cells die shortly after they get infected. But a tiny percentage have the instruction for making more HIV lies dormant, sometimes for years. So even if we could kill all the HIV virus from an infected person’s body, one of these T cells could activate and start spreading the virus again.
Accessibility
Not everyone in the world has access to these therapies that could save their lives. In Sub-Saharan Africa, which accounts for over 70% of HIV patients worldwide, antiretroviral reaches only about one in three HIV-positive patients. About 15 million people infected with HIV still do not have access to life-saving antiretroviral medications.
A mix of political, cultural, and economic barriers prevent people from the effective prevention and treatment of HIV worldwide.
FACT: About 1% of people in Europe carry a pair of rare ccr5 genes that are broken or mutated. This mutation jams and traps doors shutting the HIV virus from getting in. These people with this mutation cannot get HIV or develop AIDS.
If people can be cured with HIV-resistant people, then why is it difficult? This is because there are far too many HIV people than the rare HIV-resistant people. And this requires sophisticated treatment, money, doctors, donor for this kind of cure to reach millions of people infected with HIV.
How can we Prevent HIV?
Today, there are more tools than ever available to prevent HIV.
Prevent sexual activities that involve direct contact with body fluids (semen, vagina fluid, or blood). Choose sex that is less risky than anal or vaginal sex. There is little to no risk of getting HIV through oral sex.
Condoms are highly effective in preventing HIV and other sexually transmitted diseases like gonorrhea and chlamydia.
Prep (pre-exposure prophylaxis) is a medicine people at risk for HIV take to prevent HIV. If this is taken as prescribed, it can be highly effective.
PEP (Post-exposure prophylaxis) means taking the medicine to prevent HIV after a possible exposure. This should only be used in emergency situations and must be started within 72 hours after a recent possible exposure to HIV.
Getting tested and treated for other STDs (Sexually transmitted diseases) can lower your chance of getting HIV.
Never share needles, syringes, and other drug injection equipment. Always use new, clean syringes and equipment every time you inject.
The earlier HIV is diagnosed and treated the more effective HIV medicine will prevent transmission to your baby. Encourage your partner to get tested for HIV.
Conclusion
HIV stigma is negative attitudes and beliefs about people with HIV. It is the belief that comes with labeling an individual as socially unacceptable. This creates people into making moral judgments about people who take steps to prevent HIV transmission. Making them feel that person deserves to get HIV because of their choice.
Discrimination between people living with HIV differently than those without HIV is a growing concern in our society. This includes health care professionals refusing to give service to a person with HIV. Refusing causal contact and socially isolating them from a community.
HIV stigma affects the emotional well-being and mental health of people living with HIV. This creates a negative image and fear among these people judging them negatively. There are still misconceptions about how HIV is transmitted, lack of information, and awareness bringing fear among people getting infected by HIV.
Talking openly about HIV can help normalize this subject. This provides opportunities to correct the misconception and help learn more about HIV. Let us spread awareness about HIV to people. It is up to us to end the HIV stigma through our words and actions in our everyday lives.
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