Chronic Hiv Infection With Antiretroviral Treatment
If you take effective HIV treatment, you can live with HIV as a chronic, manageable condition. A chronic health condition is one which continues for a long period of time.
This stage is not included in most descriptions of the stages of infection, which only describe disease progression in the absence of treatment.
However, most people living with HIV who have access to good healthcare are living with HIV as a chronic condition and will continue to do so for the rest of their lives. They are unlikely to fall ill or die as a direct result of HIV.
In order to reach this stage and to remain in it, you need to take HIV treatment and continue to take it, on an ongoing basis. These medications reduce levels of HIV in your body and strengthen the immune system. This usually prevents the symptoms and opportunistic infections described above from occurring.
One of the benefits of effective HIV treatment is that is stops HIV from being passed on. Treatment drastically reduces the amount of HIV in body fluids to the point where there is not enough HIV to transmit the virus to sexual partners.
The chronic infection phase can last for decades. People who start HIV treatment as soon as possible, are able to stick with it and have access to good healthcare are likely to have a similar life expectancy to their peers who dont have HIV.
What Are The Four Stages Of Hiv
The World Health Organization classifies human immunodeficiency virus into four stages
- Stage 1 : The CD4+ cell count is at least 500 cells per microliter.
- Stage 2 : The CD4+ cell count is 350 to 499.
- Stage 3 : The CD4+ cell count is 200 to 349.
- Stage 4 : The CD4+ cell count is less than 200.
The normal CD4+ cell count should be between 500 and 1600 cells per microliter. The higher the CD4+ cell count, the lower the chances of opportunistic diseases.
How Do You Know If You Have Aids
In an official medical sense, AIDS is diagnosed when:
- An individual tests HIV-positive
- The respective HIV-positive individual has a CD4 cell count of less than or equal to 200cells/mm3
- 20 or more opportunistic infections are present in the respective HIV-positive persons body
It may not be that all qualifying criteria for the diagnosis of AIDS occurs simultaneously in the same person.
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Donor Testing And Significance
In Germany, both HIV antibody and HIV NAT testing are mandatory.
2.3.1 HIV Antibody Testing
Initial testing of a donation is carried out with antibody screening test systems approved in Europe according to the German Medicinal Products Act in connection with the In Vitro Diagnostics Directive . Tests used in Germany recognise antibodies to all known HIV-1 groups and HIV-2. Reactive screening test results must be followed by a serologic confirmation test or a NAT assay. An additional second blood sample has to be investigated for confirmation of an HIV infection . Until the results are clarified, the donation is separated and should be preserved for additional investigations. The donor is deferred until the final results are available . According to current knowledge, the vast majority of reactive HIV antibody screening test results of blood donors are non-specific, i.e. false-positive, and have other causes, e.g., immune complexes in the specimen .
2.3.2 Detecting HIV RNA by NAT
The diagnostic window period, which is between 3 and 6 weeks for antibody screening tests, can be shortened by application of NAT. Depending on the level of viraemia, the sensitivity of the assay used and the infecting HIV, an infection can be detected as early as about 11 days post infection . The HIV NAT enables sensitive detection also of non-HIV-1 M:B. Reference materials for the detection of different HIV-1 genotypes are available .
Understanding Hiv And Aids
Generally speaking, the time it takes to go from HIV infection to AIDS is around five to 10 years if no medical intervention is made. Differences in time can be due to any number of factors, including:
- The genetic strain of HIV a person living with the virus has been infected with
- The general health of the individual
- The place where the person lives
- A person’s genetics or family history
- Smoking and other personal lifestyle choices
This is, of course, if the person receives no treatment. The picture changes entirely if they do.
Since 1996, the introduction of antiretroviral drugs has dramatically altered the natural progression of HIV infection. While HIV still cannot be cured, people newly diagnosed with HIV who get treated and stay in care can be expected to have near-normal to normal life expectancies. As with other chronic diseases, early detection is key to identifying and treating the virus as soon as possible.
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Lack Of Symptoms In Early Stages
ARS is common once a person has HIV. Still, this isnt the case for everyone. Some people have HIV for years before they know they have it. According to HIV.gov, symptoms of HIV may not appear for a decade or longer. This doesnt mean that cases of HIV without symptoms are less serious. Also, a person who doesnt experience symptoms could still transmit HIV to others.
Symptoms in early HIV tend to appear if the rate of cell destruction is high. Not having symptoms can mean that not as many CD4 cells, a type of white blood cell, are killed early on in the disease. Even though a person has no symptoms, they still have the virus. Thats why regular HIV testing is critical to prevent transmission. Its also important to understand the difference between a CD4 count and a viral load.
How Long Does It Take For Hiv To Progress To Aids
How long does it take for HIV to progress to AIDS? In all but a few rare cases, if left untreated, HIV will progress to a stage of infection called AIDS. This is when the immune defenses have been compromised, and the body is less able to defend itself against potentially life-threatening infections.
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S For Removal And Inactivation Of The Infectious Agent
The production and purification of individual proteins from plasma is not sufficient to completely rem ove HIV. Therefore additional validated procedures for an effective depletion and inactivation of viruses must be applied . No transmissions of HIV by plasma derivatives have been reported since the consistent implementation of effective methods for removing and inactivating viruses in the production process. Accordingly, the experimentally determined inactivation capacity of the manufacturing process is supported by epidemiologic data.
HIV is sensitive to heat and detergents . HIV can be inactivated by the solvent-detergent technique, with reagents such as tri-n-butyl phosphate and Triton X-100 or polysorbate 80 . Pasteurisation at 60 °C for 10 h reliably inactivates HIV even in the presence of stabilisers . Heat treatment of lyophilized products inactivates HIV, provided there is appropriate residual moisture of about 1% .
Because of the heat sensitivity of plasma proteins the inactivation procedures must be carried out under appropriate validated conditions . The product should optimally maintain its biologic activity and native conformation, while potentially contaminating viruses should be inactivated under the production conditions . Treatment with -propiolactone and UV light is effective when applied at low protein concentrations, but not in plasma . The transmission of HIV by PCC preparations was not prevented by treatment with -propiolactone .
When And Who Should Get Tested
The CDC recommends that anyone between ages 13 and 64 should have them tested for the infection. It is important to undergo a repeat test if you have changed your sexual partner. In most cases, you should have your HIV test after 3 months of engaging in sexual activity with a new partner. Some people are at high risk for contracting the virus this is true for IV drug users, homosexual males, and those who change sex partners often. For them, it is important to go for HIV testing every 6-12 months.
Your body may have enough antibodies after 3 months of becoming infected some people may have those antibodies within 20 days of becoming infected. Therefore, it is a good idea to go for testing every six months, especially if you have had unprotected oral, anal, or vaginal sex with a different partner during this time. To get tested, you can go to your local health department, doctor’s office, or hospital. Nowadays, special sites are set up to help you with HIV testing these testing sites keep your data private and share it only with medical experts authorized to see your record.
Risk of HIV
It is worth mentioning that certain factors put you at an increased risk of becoming infected. For instance, you are likely to contract the HIV virus if:
You should talk to your healthcare provider to get more information regarding how long can HIV go undetected and how often you should go for HIV testing.
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Antiretroviral Treatment And The Hiv Lifecycle
Antiretroviral treatment for HIV combines several different types of drugs, each of which targets a different stage in the HIV lifecycle. This means that the replication of HIV is stopped on multiple fronts, making it very effective.
If taken correctly, it keeps the immune system healthy, prevents the symptoms and illnesses associated with AIDS from developing, and means that people can enjoy long and healthy lives.
If someone doesnt take their treatment correctly or consistently , the level of HIV in their blood may increase and the drugs may no longer work. This is known as developing drug resistance.
The Four Stages Of Hiv Explained
Although there is no cure for HIV, early detection and effective treatment can enable a person with HIV to lead a normal life. However, if HIV is left untreated, it can advance through four serious stages. Therefore, it is important to get tested for HIV if you are concerned that you may have been at risk.
Human Immunodeficiency Virus attacks a persons immunesystem, impacting their ability to fight diseases and infections. Therefore, withouttreatment, HIV can be life-threatening. The early signs and symptoms of HIV vary from person-to-personand can easily be mistaken for other illnesses. Testing for HIV regularly helpsto minimise the long-term health consequences that HIV can have.
If left untreated,HIV usually progresses through four stages. With access to treatment, mostpeople with HIV will remain healthy and will never experience the late stage.This does depend on how early HIV was detected and how well a person respondsto treatment, amongst other lifestyle factors.
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Assessment And Monitoring Of A Newly Diagnosed Hiv Positive Individual
Thorough assessment of a newly diagnosed HIV positive patient is essential, which serves the following purposes:
Determination of disease stage and treatment strategy – this is done by history, physical and laboratory tests
Education about risk reduction and lifestyle management – this involves the consideration of pregnancy, condom use, accommodation at work, disclosure of HIV status.
Addressing issues unique to special groups – the needs of, for example, women, haemophiliacs, drug users and other marginalised communities should be noted.
HIV disease progresses to AIDS after a median of 11 years. However, the rate of progression is very variable. There are long term survivors who are free of clinical AIDS after 20 years. On the other end of the spectrum, there are those who manifest AIDS and die within 2 to 3 years. Researches have been conducted to determine factors that influence the rate of disease progression. Both viral and immune factors are important in this regard. Nevertheless, the two most commonly used parameters for disease prognosis and monitoring in day-to-day patient management are the CD4 lymphocyte count and viral load.
Severity And Course Of The Disease
The course of an HIV infection is always chronic, ending fatally without antiretroviral therapy. CD4 cell disintegration and clinical symptoms can be decelerated or suppressed by antiretroviral therapy for decades . In untreated HIV-1 infections, AIDS-defining symptoms appear after a mean of about 10 years, with a range of 2-25 years. HIV-2-induced AIDS becomes apparent after a mean of approximately 15 years . With antiviral therapy it is possible to extend the phase without or with only slight symptoms for many years .
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How Many Stages Are There In Hiv
An HIV infection can be divided into three stages. Each person has different symptoms and severity depending on their type and severity. It is possible to feel flu-like symptoms after an initial infection, but not everyone will experience this. People who are in stage 2 usually begin to feel better and may last for a long time.
Donor Information And Counselling
Recommendations on how to inform a donor with positive HIV test results are given in the vote on look-back procedures of the Arbeitskreis Blut . HIV-infected donors should be informed in person and in writing by the blood establishment. HIV-infected donors should be counselled and referred to a general practitioner or a specialised centre for further care. The counselling should include information about the HIV transmission routes and the possibility of antiretroviral therapy . The information given should also include the fact that they are no longer suitable as a blood, plasma or organ donor in Germany.
In South Africa, the possibility of exceptions in cases of kidney transplantation to HIV-infected recipients is suggested .
Clarification of the possible origin of the donor’s infection is of epidemiologic interest. Efforts should be made in the donor interview to identify the route and the cause of infection, especially in order to prevent further transmission of the HIV infection. Such data are also required for the anonymous reporting of HIV diagnoses according to the German Transfusion Act and IfSG. A template provided by the Robert Koch Institute with a standardized questionnaire simplifies clarification and supports a nationwide standardised registration system of HIV transmission modes in the donor population.
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What Are The Stages Of Hiv
HIV disease has a well-documented progression. Untreated, HIV is almost universally fatal because it eventually overwhelms the immune systemresulting in acquired immunodeficiency syndrome . HIV treatment helps people at all stages of the disease, and treatment can slow or prevent progression from one stage to the next.
A person can transmit HIV to others during any of these stages:
Acute infection: Within 2 to 4 weeks after infection with HIV, you may feel sick with flu-like symptoms. This is called acute retroviral syndrome or primary HIV infection, and its the bodys natural response to the HIV infection.
During this period of infection, large amounts of HIV are being produced in your body. The virus uses important immune system cells called CD4 cells to make copies of itself and destroys these cells in the process. Because of this, the CD4 count can fall quickly.
Your ability to spread HIV is highest during this stage because the amount of virus in the blood is very high.
Eventually, your immune response will begin to bring the amount of virus in your body back down to a stable level. At this point, your CD4 count will then begin to increase, but it may not return to pre-infection levels.
What Is A Latent Hiv Reservoir
A latent HIV reservoir is a group of immune system cells in the body that are infected with HIV but are not actively producing new virus.
HIV attacks immune system cells in the body and uses the cells own machinery to make copies of itself. However, some HIV-infected immune cells go into a resting or latent state. While in this resting state, the infected cells do not produce new virus. HIV can hide inside these cells for years, forming a latent HIV reservoir but, at any time, cells in the latent reservoir can become active again and start making more virus.
To find out more about how HIV attacks cells, read the HIV Life Cycle fact sheet from HIVinfo.
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The Third Stage Of Hiv: Early Symptomatic Disease
During this, the third stage of infection, your immune system is engaged in a constant battle with the rapidly replicating virus. Approximately 50 million to 2 billion new virus particles are created each day. The immune system responds by replenishing the peripheral blood with up to 2 billion new CD4 cells per day.
The immune system can hold HIV in check for many years, but will eventually begin to lose the battle. The virus begins to destroy the CD4 cell population. As that happens, the CD4 counts continue to drop, and signs and symptoms more specific to HIV/AIDS arise.
These signs and symptoms are:
- Persistent generalised lymphadenopathy .
- Oral lesions .
- Shingles .
- Thrombocytopenia .
- Early stages of neurological disease .
Third Stage: Aids Symptoms
AIDS is the advanced stage of HIV infection. This is usually when your CD4 T-cell number drops below 200 and your immune system is badly damaged. You might get an opportunistic infection, an illness that happens more often and is worse in people who have weakened immune systems. Some of these, such as Kaposi’s sarcoma and pneumocystis pneumonia , are also considered âAIDS-defining illnesses.â
If you didn’t know earlier that you were infected with HIV, you may realize it after you have some of these symptoms:
- Being tired all the time
- Swollen lymph nodes in your neck or groin
- Fever that lasts more than 10 days
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Definition Of Exclusion Criteria
Blood donor eligibility is regulated by the Guidelines on the Collection of Blood and Blood Components and on Use of Blood Products . Criteria are defined for the permanent or temporary deferral from donation with respect to the transmission of HIV. Permanently deferred from donation are the following:
Persons with a confirmed HIV infection.
Persons with non-prescribed IV or IM drug use.
Persons whose sexual behaviour puts them at high risk of acquiring severe infectious diseases like HBV, HCV or HIV that can be transmitted by blood:
heterosexual persons with high-risk sexual behaviour, i.e. sexual contacts with multiple sex partners,
men who have sexual contacts with men
male and female sex workers.
Temporary deferral from donating blood is valid for persons:
who entered Germany from a country or a region, where they had been continuously resident for more than 6 months, with a comparatively high prevalence of HBV, HCV, HIV or HTLV-1/-2 infections,
who had sexual contacts with persons belonging to a group with an enhanced risk of infection with HBV, HCV, HIV and/or HTLV-1/-2 ,
with tattoos or body piercing.