Stage : Clinical Latency
In this stage, the virus still multiplies, but at very low levels. People in this stage may not feel sick or have any symptoms. This stage is also called chronic HIV infection.
Without HIV treatment, people can stay in this stage for 10 or 15 years, but some move through this stage faster.
If you take HIV medicine every day, exactly as prescribed and get and keep an undetectable viral load, you can protect your health and have effectively no risk of transmitting HIV to your sexual partner.
But if your viral load is detectable, you can transmit HIV during this stage, even when you have no symptoms. Its important to see your health care provider regularly to get your viral load checked.
What Can Cause Hiv
The exact cause of HIV-associated Wasting isnt known, but experts believe it can be caused by one or more of the following:
- Infections may cause changes in metabolism and increase the bodys caloric needs
- The need for increased energy coupled with decreased nutrient intake may result in unintentional weight loss and energy loss
- Due to their compromised immune systems, people living with HIV may be at a greater risk for infection. cART is unable to restore the immune system or resolve the infection
- Inflammation is a natural response to infection, stress, trauma, or cell injury in the body
- Even when the virus is controlled, inflammation may continue to occur
- Chronic inflammation can cause the breakdown of muscle tissue and decreased appetite, leading to weight loss and loss of lean body mass
- Metabolism is how the body turns food into energy
- When metabolism becomes abnormal, the body may break down carbohydrates and proteins at an excessive rate
- If this happens, energy is drawn from lean body mass, which means a loss of muscle, organ tissue, blood cells, bone, and water
- GH is made up of several substances secreted by the pituitary gland that support growth of the body
- GH helps maintain bone and skeletal muscle in the body
- GH resistance is a failure to process and respond to GH that occurs naturally in the body
- When the body resists or has difficulty using GH the body makes naturally, or if the body is not making enough GH, a loss of lean body mass may occur
Hiv/aids Reduces The Absorption Of Food
Food, once eaten, is broken down by digestion into nutrients. These nutrients pass through the gut walls into the bloodstream and are transported to the organs and tissues in the body where they are needed. One of the consequences of HIV and other infections is that since the gut wall is damaged, food does not pass through properly and is consequently not absorbed.
Diarrhoea is a common occurrence in people with HIV/AIDS. When a person has diarrhoea the food passes through the gut so quickly that it is not properly digested and fewer nutrients are absorbed.
Reduced food intake and absorption lead to weight loss and malnutrition.
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Weight Gain And Pregnancy
It is normal to gain weight during pregnancy. Most women begin to lose some of this weight within a few months of having their baby. It is unclear if women who start HIV treatment during pregnancy gain more weight than other women. We dont know if women already on HIV treatment when they become pregnant gain more weight than other women.
If you have a high body weight and you plan to have a baby, you will be encouraged to lose weight before becoming pregnant. Losing weight before becoming pregnant will benefit you and your baby, reducing the risk of complications during pregnancy and at the time of birth. Women who are obese are at higher risk of developing diabetes or high blood pressure during pregnancy.
Dieting during pregnancy or while you are breastfeeding is not recommended.
Why Do Some Newer Hiv Drugs Cause Weight Gain
Future research should examine how particular combinations of antiretrovirals contribute to weight gain, according to one expert.
Some of the newer antiretrovirals , in particular integrase inhibitors, have been associated with weight gain, aidsmap reports. Given this concerning finding, researchers should set their sights on understanding which particular combinations of ARVs are the biggest drivers of weight gain among people with HIV.
That is according to an address given by Andrew Hill, PhD, of the University of Liverpool at the 17th European AIDS Conference in Basel, Switzerland, this month.
To some degree, the weight gain seen after individuals start ARVs is a result of the return to health effect among individuals who started with a compromised immune system. However, it is clear that this is not the only factor, given how weight gain can differ based on which ARVs individuals take.
The integrase inhibitors dolutegravir and bictegravir are associated with the greatest weight gains. Dolutegravir is sold as a stand-alone pill under the brand name Tivicay and is included in Juluca, Dovato and Triumeq. Bictegravir is included in Biktarvy and is not approved as a stand-alone tablet.
Research has consistently indicated that TDF-containing regimens are associated with less weight gain compared with regimens containing Ziagen or the newer version of TDF, tenofovir alafenamide . Abacavir is included in Triumeq, Epzicom and Trizivir.
To read the aidsmap article, .
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Obesity Among People Living With Hiv
AIDS.gov| November 19, 2009
In the U.S., as we move into the holiday season there is often increased reporting on obesity. HIV.gov asked Dr. Nancy F. Crum-Cianflone, a Research Physician with the Naval Medical Center San Diego, to provide us information on her new study of obesity in HIV-infected persons. Research has shown, HIV-infected persons are now are increasingly overweight or obese. Below is what she told us.
Obesity among HIV-infected persons: Impact of Weight on CD4 Cell Count
Since the availability of highly potent HIV medications in the mid-1990s, HIV-infected persons are less often suffering from wasting, but rather they now are increasingly overweight or obese. Prior studies have shown that obesity leads to negative health consequences in the general population including heart disease, diabetes, and certain cancers. We performed our study to evaluate if obesity could have additional health consequences among HIV-positive persons, specifically if obesity could affect their immune systems, as measured by their CD4 cell counts.
We evaluated over 1,000 HIV-infected persons as part of the US Military Natural History Study conducted at 7 HIV Clinics across the U.S. Participants of our study had known dates of HIV infection and had data on both weight measurements and immune cells over time. Statistical methods to evaluate the relationship of weights over time with changes in the CD4 counts included linear mixed effects models.
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. By taking HIV medicine daily as prescribed, you can make the amount of HIV in your blood very lowso low that a test cant detect it . Getting and keeping an undetectable viral load is the best thing you can do to stay healthy. If your viral load stays undetectable, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex.
- If you test negative, there are more HIV prevention tools available today than ever before.
- If you are pregnant, you should be tested for HIV so that you can begin treatment if you’re HIV-positive. If an HIV-positive woman is treated for HIV early in her pregnancy, the risk of transmitting HIV to her baby can be very low.
Use the HIV Services Locator to find an HIV testing site near you.
HIV self-testing is also an option. Self-testing allows people to take an HIV test and find out their result in their own home or other private location. You can buy a self-test kit at a pharmacy or online, or your health care provider may be able to order one for you. Some health departments or community-based organizations also provide self-test kits for free.
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Newer Type Of Hiv Drug Linked To Weight Gain
People on integrase inhibitors and protease inhibitors found to gain more weight on average than those on other treatment regimens
A study from the United States and Canada finds that people starting integrase inhibtor and protease inhibitor -based antiretroviral treatment are more likely to experience weight gain than those on nonnucleoside reversetranscriptase inhibitor -based treatment.
Gaining weight after starting ART is common, particularly among people with lower CD4 cell counts and/or a lower body mass index . Weight gain as a result of HIV treatment used to be seen as a return to health. Yet in recent years, the average BMI of people starting ART has increased considerably, in line with increased BMI in the general population. This surfaces concerns around the negative effect such weight gain could have on peoples health.
The study set out to analyse changes in weight over time among people living with HIV, and examine whether different types of antiretroviral drugs are associated with greater weight gain. Due to having fewer side effects and drug resistance, newer INSTI-based drugs such as raltegravir, elvitegravir and dolutegravir are now the recommended treatment for most people living with HIV.
Around 22,900 adults, 87% of whom were men, who began ART through the North American AIDS Cohort Collaboration on Research and Design programme on or after January 2007 were followed until the end of 2016.
Why Is Weight Gain A Problem
If you were underweight when you started treatment, putting on a few pounds isnt a bad thing. Getting to a healthy weight gives your body strength to fight HIV and other infections. Doctors used to call this weight gain a return to health.
But now the scales have tipped in the other direction. People with HIV in the United States are more likely to be overweight than those who dont have the virus. Putting on too many pounds can lead to health problems like diabetes and heart disease. If you have HIV, youre already at higher risk for these conditions.
Weight gain is an important thing to consider when you and your doctor choose an HIV drug, especially if you were overweight to start. You may be able to switch to a medicine thats less likely to cause weight gain. Diet and exercise can help you stay at a healthy weight and avoid complications that are linked to being overweight.
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Is Weight Gain Reversible If People Change Treatment
As the causes of weight gain are unclear, it is uncertain if changing to different antiretrovirals might slow down or reverse weight gain. It is also important to bear in mind that integrase inhibitors are preferred for first-line treatment because they are more reliable in suppressing viral load, are less likely to cause drug resistance and have fewer side effects than other antiretrovirals.
More evidence is needed on whether lifestyle changes such as diet and exercise have benefits for people who have gained weight on antiretroviral treatment.
Is There Any Treatment Of A Cure For Hiv/aids
Currently, there is no cure for HIV/AIDS. People living with HIV will need lifelong treatment. The best treatments right now are combinations of prescription drugs. These medications include antiviral treatment, protease inhibitors and other drugs that help people who are living with HIV stay healthy. People living with HIV also can stay healthy by doing things like eating properly, exercising and getting enough sleep.
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Anabolic Steroids Exercise And Growth Hormone Stimulators
The use of anabolic steroids combined with exercise can help boost lean tissue, including muscle size, but this combination does not significantly improve fat loss or accumulation. In studies of people using the steroids oxymetholone or nandrolone, muscle size increased but there were no reductions in accumulated fat, and there were worrisome decreases in HDL cholesterol . In those using oxymetholone, there were also increases in liver enzymes, indicating possible toxicity to the liver. Neither oxymetholone nor nandrolone is available by prescription in Canada.
Exercise alone has generally been shown to have either a small benefit or no benefit in terms of losing the fat associated with lipodystrophy. But exercise does have many other benefits, including boosting cardiovascular fitness, mental well-being and self-esteem.
The synthetic growth hormone-releasing medication called tesamorelin is available in Canada. It is approved for the treatment of HIV-associated fat accumulation. Clinical trials showed that Egrifta reduced visceral gut fat, but also that it would have to be used long-term when the drug was stopped, gut fat returned. The drug is expensive and used only by people with private drug insurance coverage. The cost of this drug is not subsidized by provincial/territorial drug formularies.
Evaluation And Treatment Of Weight Loss In Adults With Hiv Disease
BRUCE WILLIAMS, M.D., M.P.H., DEBRA WATERS, PH.D., and KATHERINE PARKER, M.S., R.D., University of New Mexico School of Medicine, Albuquerque, New Mexico
Am Fam Physician. 1999 Sep 1 60:843-854.
Weight loss late in the course of human immunodeficiency virus disease is common and often multifactorial. Increased energy expenditure in response to opportunistic disease, as well as to HIV infection itself, can lead to proteincalorie malnutrition similar to that observed in starvation. Weight loss of as little as 5 percent in patients with HIV infection is associated with an increased risk of disease progression. Loss of body cell mass carries a particularly poor prognosis, and aggressive measures should be taken to stop such depletion. Patients exhibiting unexpected weight loss should be carefully examined to exclude decreased food intake, malabsorption, occult infection or neoplasm as the etiology of the weight loss. Early aggressive treatment of HIV disease and underlying opportunistic pathology, along with adequate pharmacologic, hormonal, nutritional and physical therapy, can often restore normal weight and body composition.
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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.
Eating When You Are Ill
When you become ill you often lose your appetite. However, your energy requirements are often greater when you are sick. What you eat is likely to be very important to how you fight illness and the speed at which you recover.
- To help prepare for times when you are ill, make sure you always have food available in your home. Canned foods, long-life products and frozen meals can be helpful when you are feeling unwell.
- If you are unable to afford food then seek help and advice from your local council, HIV treatment centre or an HIV support agency.
- Snacking through the day, or having small frequent meals, may be easier than eating three main meals it can also be less tiring to prepare and eat food in this way.
- It is a good idea to have snacks full of energy at hand for when you are unwell such as nuts, dried fruits and cheese and biscuits.
- Easy-to-swallow full-fat drinks and yoghurt may also provide a useful source of energy and calories.
- Your clinic will be able to provide food supplements that contain a balance of the nutrients you need, which may help you boost your energy intake if you are very unwell.
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A Timeline Of Hiv Symptoms
What is HIV?
HIV is a virus that compromises the immune system. Theres currently no cure for it, but there are treatments available to reduce its effects on peoples lives.
In the majority of cases, once HIV infection takes hold, the virus stays in the body for life. However, unlike what may occur with infections by other types of viruses, HIV symptoms dont suddenly appear and peak overnight.
If left untreated, the disease progresses over time through three stages, each with its own set of possible symptoms and complications some severe.
Regular antiretroviral treatment can reduce HIV to undetectable levels in the blood. At undetectable levels, the virus wont progress to the later stages of HIV infection. In addition, the virus cant be transmitted to a partner during sex.
Early Symptoms In Primary Hiv
The first noticeable stage is primary HIV infection. This stage is also called acute retroviral syndrome , or acute HIV infection. Because HIV infection at this stage usually causes flu-like symptoms, its possible for someone in this stage to think their symptoms are due to a severe flu rather than HIV. Fever is the most common symptom.
Other symptoms include:
Centers for Disease Control and Prevention , primary HIV symptoms may show up two to four weeks after initial exposure. Symptoms can continue for up to several weeks. However, some people may exhibit the symptoms only for a few days.
People with early HIV sometimes dont show any symptoms, yet they can still transmit the virus to others. This is attributed to the fast, unrestrained viral replication that occurs in the early weeks after contracting the virus.
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