Treatment To Prevent Hiv Infection
Also, medicine may prevent HIV infection in a person who has been raped or was accidentally exposed to the body fluids of a person who may have HIV.footnote 12 This type of treatment is usually started within 72 hours of the exposure.
And studies have shown that if you are not infected with HIV, taking antiretroviral medicines can protect you against HIV.footnote 13, footnote 14, footnote 15 But to keep your risk low, you still need to use safer sex practices.
How Hiv Is Not Spread
The virus doesn’t survive well outside the body. So HIV cannot be spread through casual contact with an infected person, such as by sharing drinking glasses, by casual kissing, or by coming into contact with the person’s sweat or urine.
It is now extremely rare in the United States for HIV to be transmitted by blood transfusions or organ transplants.
What Research Is Being Done
Within the Federal government, the National Institute of Neurological Disorders and Stroke , a component of the National Institutes of Health , supports research on the neurological consequences of HIV and AIDS. NINDS works closely with its sister agencies, the National Institute of Allergy and Infectious Diseases and the National Institute of Mental Health , to fund research related to HIV and AIDS. The Office of AIDS Research coordinates AIDS research across NIH.
NINDS conducts research into how the weakened immune systems of individuals with AIDS lead to neurological illnesses. NINDS investigators are studying the JC virus, which can reproduce in the brains of people with impaired immune systems and cause progressive multifocal leukoencephalopathy . In one small NINDS study, the anti-cancer drug pembrolizumab showed promise in slowing or stopping the progression of PML. Additional research is needed to confirm results, which could lead to new investigations that help revolutionize treatment for similar chronic infections in immune compromised individuals.
Many individuals whose infection is successfully suppressed with cART experience a reactivation of the virus upon stopping treatment. Researchers are studying how a reservoir of inactive HIV is maintained in the brain. This research is a first step toward developing a means to render the virus permanently dormant or even to rid the brain of all traces of the virus.
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How Can I Know If I Have Hiv
You cant tell if someone has HIV just by looking at them, and you may not have any symptoms if youre infected by HIV. The only way to know if you have HIV is to take an HIV test.
Since nearly 1 out of 7 people with HIV dont know it, the U.S. Centers for Disease Control & Prevention recommends screening people between the ages of 13 to 64 at least once as part of routine healthcare. This test is voluntary and confidential.
How Can I Reduce My Risk Of Getting Hiv
The best way to reduce your risk of HIV is to be aware of how it spreads and protect yourself during certain activities. Having sex without a condom and sharing needles to take drugs are the most common ways that HIV spreads.
These are some ways to reduce your risk:
- Use latex condoms whenever you have any type of sex .
- Don’t use condoms made from animal products .
- Use water-based lubricants .
- Never share needles to take drugs.
- Get tested and treated for other STDs. Other STDs can put you at higher risk for an HIV infection.
- Avoid getting drunk or high. Intoxicated people might be less likely to protect themselves.
- If you are at high risk of HIV exposure, ask your healthcare provider if you should be taking pre-exposure prophylaxis .
- If you think youve been exposed to HIV, contact your healthcare provider as soon as possible to see if you should take post-exposure prophylaxis .
- Consider getting tested to know if you can pass HIV to others.
It’s important to use a condom correctly to protect yourself against HIV. Use a male condom for any sex act that involves your penis.
You can also protect the vagina or anus with dental dams or internal condoms. Dental dams are flat pieces of polyurethane or latex that you can put over your vagina or anus if you are having oral sex. An internal condom can be used by insertion into your vagina or anus.
You should only use one type of condom at a time. Do not use both a male condom and an internal condom.
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How Are These Disorders Treated
No single treatment can cure the neurological complications of HIV/AIDS. Some disorders require aggressive therapy while others are treated as symptoms arise.
Neuropathic painchronic pain caused by damage to the nervous systemis often difficult to control. Medicines range from over-the-counter pain killers to anticonvulsant drugs, opiates, and some classes of antidepressants. Inflamed tissue caused by autoimmune or other conditions can press on nerves, causing pain. Such illnesses may be treated with corticosteroids or procedures such as plasma exchange, formally known as plasmapheresis, that clear the blood of harmful substances that cause inflammation.
Treatment options for AIDS- and HIV-related neuropsychiatric or psychotic disorders include antidepressants and anticonvulsants. Psychostimulants may also improve depression and reduce fatigue. Drugs such as cholinesterase inhibitors, which can temporarily improve or stabilize memory and thinking skills in people with dementia, may relieve confusion and slow mental decline. Benzodiazepines may be prescribed to treat anxiety. Psychotherapy may also help some individuals.
Other treatments may include physical therapy and rehabilitation, radiation therapy and/or chemotherapy to shrink cancerous brain tumors that may be related to HIV, antifungal or antimalarial drugs to combat certain bacterial infections associated with the disorder, and penicillin to treat neurosyphilis.
Hiv Effects On The Nervous System
About half of people with AIDS have nerve problems related to the virus. Infection or inflammation can damage your spinal cord or brain and keep your nerve cells from working the way they should. Some medications can also affect your nervous system.
Inflammation in your brain and spinal cord can lead to confusion and other thinking problems as well as weakness, headaches, seizures, and balance problems.
When AIDS is far along, you might get dementia and have problems remembering things.
Having HIV can also affect your mental health. Many people living with it have depression or anxiety. Mental health professionals and support groups can help you work through your concerns and manage your life with HIV.
The opportunistic infection cytomegalovirus can attack your nerves, making it hard for you to control your arms and legs or your bladder.
Itâs common for tiny holes to form in spinal fibers when people with AIDS donât get treatment. This is called vacuolar myelopathy and causes trouble walking.
HIV or the drugs that treat it can also damage nerves all over your body, causing neuropathy. You might have pain, numbness, weakness, burning, stiffness, or tingling.
Antiretroviral therapy to treat HIV can lower your risk of getting these conditions or complications. If a medication is causing the problems, your doctor might switch you to a different one.
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How Can You Tell If You Have Hiv
The only way to know for sure if you have HIV is to get tested. You cant rely on symptoms to tell whether you have HIV.
Knowing your HIV status gives you powerful information so you can take steps to keep yourself and your partner healthy:
- If you test positive, you can take medicine to treat HIV. People with HIV who take HIV medicine as prescribed and get and keep an undetectable viral load can live long and healthy lives and will not transmit HIV to their HIV-negative partners through sex. An undetectable viral load is a level of HIV in the blood so low that it cant be detected in a standard lab test.
- If you test negative, you have more HIV prevention tools available today than ever before, like pre-exposure prophylaxis , medicine people at risk for HIV take to prevent getting HIV from sex or injection drug use, and post-exposure prophylaxis , HIV medicine taken within 72 hours after a possible exposure to prevent the virus from taking hold.
- If you are pregnant, you should be tested for HIV so that you can begin treatment if you’re HIV-positive. If you have HIV and take HIV medicine as prescribed throughout your pregnancy and childbirth and give HIV medicine to your baby for 4 to 6 weeks after giving birth, your risk of transmitting HIV to your baby can be less than 1%. HIV medicine will protect your own health as well.
Who Does Hiv Affect
Its a myth that HIV only infects certain people. Anyone can get HIV if theyre exposed to the virus. Having sex without a condom or sharing needles to inject drugs are the most common ways that HIV spreads.
Some populations are statistically more affected by HIV than others. Groups disproportionately affected by HIV include:
- People who identify as gay, bisexual and men who have sex with men .
- Certain races such as people who are Black or Hispanic.
- Those who exchange sex for money or other items are also at high risk for HIV infection.
While these arent the only populations impacted by HIV, its important to consider that they face unique barriers to accessing preventative care, getting tested, and receiving comprehensive treatment. Homophobia, racism, poverty, and social stigmas around HIV continue to drive inequities and keep people from accessing high-quality healthcare.
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How Antiretroviral Drugs Affect The Body
While there is no cure for HIV, antiretroviral therapy can reduce the amount of the virus in the blood to very low levels. By doing this, it keeps the person healthy and prevents the transmission of the virus to other people.
A very low, or undetectable, viral load means that the risk of transmission to others is virtually zero, which has led to the phrase: undetectable = untransmittable .
Experts encourage all people with HIV, regardless of their CD4 T-cell count, to start taking antiretroviral drugs as soon as possible after their diagnosis. Early treatment is key to a good outcome.
As with other medications, antiretroviral drugs can cause side effects in some people. However, modern drugs tend to produce fewer and less severe side effects than older drugs.
Possible side effects of antiretroviral drugs include:
Some side effects may last for a few days or weeks after the person starts treatment. Others may start later or last longer.
If a person experiences severe side effects that make them consider stopping treatment, they can talk to their healthcare provider. Stopping treatment or skipping doses can lead to drug resistance and limit a persons treatment options.
Some people can reduce some side effects by taking the medication 2 hours before going to bed. Other people may prefer to take it in the morning to prevent sleep disturbances.
Certain HIV drugs may also lead to less obvious changes, such as:
Can Neurological Complications Develop In Individuals Treated With Antiretroviral Therapy
Even when HIV is well controlled with ART, many infected individuals still develop HIV-associated neurological and cognitive difficulties. This is because many drugs used to combat HIV cannot cross the protective layer called the blood-brain barrier and enter the brain, and even those that can may not completely control the virus in the brain. Antiretroviral drugs can also become toxic after long-term use and cause neurological side effects.
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Neurological Complications Of Hiv
HIV is the virus that causes AIDS. HIV weakens and slowly destroys the bodys immune system, leaving you vulnerable to life-threatening complications from an infection or certain cancers.
As HIV and AIDS battle your immune system, your central nervous system is also affected. HIV and AIDS both cause a number of neurological complications, particularly if HIV progresses to AIDS.
Today, antiretroviral medicineswhen taken correctly and promptlyhelp to slow down the progression of HIV. They also help to delay the onset of or to decrease the risk of progression to AIDS. Controlling HIV can also reduce your risk for neurological complications of HIV.
How Long Does It Take To Develop The Disease
There is no fixed period between the first contact with HIV and the development of the disease. Signs and symptoms resulting from infection with HIV develop in stages. Many infected individuals may have no symptoms for several years. But others may develop symptoms within three years from the time of infection.
Symptoms of HIV infection are fever, swollen lymph glands in the neck and armpits, sweating, aches, fatigue, unexplained weight loss and diarrhea.
Within eight years, about 50 percent of all infected people develop specific conditions categorized as AIDS. These conditions include a lung disease called “pneumocystis carinii pneumonia,” skin tumours called “Kaposi’s sarcoma,” fungal and viral infections such as candidiasis and herpes zoster, and severe diarrhea.
Some AIDS patients also suffer from dementia resulting in problems with memory and thinking. AIDS patients are prone to various infections of the brain, just as they suffer from an unusually high number of cancers, bacterial and viral infections of other parts of the body.
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Can Hiv Be Prevented Or Avoided
The best way to prevent HIV is to not have sex with a person who has HIV, or share a needle with a person who has HIV. However, there is also a medicine called PrEP that people can take before coming into contact with HIV that can prevent them from getting an HIV infection.
PrEP stands for pre-exposure prophylaxis. It is for people who are at long-term risk of getting HIV either through sexual activity or by injecting drugs. If youre taking PrEP and come into contact with HIV, the medicine makes it difficult for HIV to develop inside your body.
Other ways to prevent HIV include:
- When you have sex, practice safer sex by using a condom. The best condom is a male latex condom. A female condom is not as effective but does offer some protection.
- Do not share needles and syringes.
- Never let someone elses blood, semen, urine, vaginal fluid, or feces get into your anus, vagina, or mouth.
Central Nervous System Disease Associated With Hiv
HIV causes significant inflammation in the body. This inflammation can cause neurological complications by damaging the spinal cord and brain, which make up the central nervous system.
Antiretroviral therapy , a combination of HIV medications taken daily, helps stop HIV from replicating and spreading in the body. Despite effective ART, people living with HIV are still at risk for central nervous system diseases associated with HIV. These diseases can be neurological or neurocognitive .
Severe neurological impairments such as dementia, brain atrophy, and encephalitis are less common in people who use ART, compared to people living with HIV who are not on ART. However, there are still less severe forms of central nervous system diseases associated with HIV.
Researchers are working to better understand how HIV affects the central nervous system this information will be helpful to develop new treatments to improve the lives of people living with HIV. Understanding which types of cells in the central nervous system are targeted by the HIV infection and how those cells are damaged may help shape efforts to prevent, treat, and cure HIV. Research efforts also focus on understanding why HIV is harder to eliminate in some tissues in the body and what strategies might be more effective on those cells.
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How Are These Disorders Diagnosed
Based on an individuals medical history and findings from a general physical exam, a physician will conduct a thorough neurological exam to assess various functions: motor and sensory skills, nerve function, hearing and speech, vision, coordination and balance, mental status, and changes in mood or behavior. The physician may order laboratory tests andone or more of the following procedures to help diagnose neurological complications of AIDS.
Brain imaging can reveal signs of brain inflammation, tumors and CNS lymphomas, nerve damage, bleeding, white matter irregularities, and other abnormalities. Several painless imaging procedures are used to help diagnose neurological complications of AIDS.
- Computed tomography uses x-rays and a computer to produce two-dimensional images of bone and tissue to show inflammation, certain brain tumors and cysts, brain damage from head injury, and other abnormalities. It provides more details than an x-ray alone.
- Magnetic resonance imaging uses a computer-generated radio waves, and a powerful magnetic field to produce either a detailed three-dimensional picture or a two-dimensional slice of body structures, including tissues, organs, bones, and nerves. It does not use the ionizing radiation that an x-ray does and provides a better look at tissue located near bone.
How Is Hiv Transmitted
HIV is transmitted from an infected person by body fluids such as blood, semen, breast milk, rectal fluids, vaginal fluids or other blood-containing secretions. Transmission occurs when these fluids come in contact with the various mucous membranes of the body, through cuts/openings of the skin, or directly injected into the bloodstream. As a result, anyone who is occupationally exposed to these body fluids risks contracting the disease. Preventive measures include wearing protective clothing, gowns, gloves, masks and goggles to control the spread of HIV among workers who may be at risk.
Unprotected sexual intercourse with infected people poses the single most important risk of infection. HIV can also be passed from one partner into the bloodstream of the other through tiny cuts or scratches.
Intravenous drug abusers may contract HIV if they share needles with infected people. Hemophiliacs requiring frequent transfusions or blood products are at risk due to the possibility of receiving contaminated blood. Since 1985, Canada’s Red Cross has been screening all blood donations for HIV antibodies.
If an individual is struck with a HIV-contaminated needle or sharp object can also pose an opportunity for transmission. Health care workers are at high risk for this type of exposure.
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