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HIV

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Human immunodeficiency viruses
Scanning electron micrograph of HIV-1 (in green) budding from cultured lymphocyte. Multiple round bumps on cell surface represent sites of assembly and budding of virions.
Scanning electron micrographof HIV-1 (in green) budding from culturedlymphocyte.Multiple round bumps on cell surface represent sites of assembly and budding of virions.
Scientific classificationEdit this classification
(unranked): Virus
Realm: Riboviria
Kingdom: Pararnavirae
Phylum: Artverviricota
Class: Revtraviricetes
Order: Ortervirales
Family: Retroviridae
Subfamily: Orthoretrovirinae
Genus: Lentivirus
Groups included
Other lentiviruses
HIV and AIDS explained in a simple way
Percentage of adults that are infected with HIV per country at the end of 2005
15–50% (15-50 people out of 100)
5–15% (5-15 people out of 100)
1–5% (1-5 people out of 100)
0.5–1.0% (1-2 people out of 200)
0.1–0.5% (1-5 people out of 1000)
<0.1% (less than 1 person out of 1000)
Greenlandno data
Diagram of the immature and mature forms of HIV

Human immunodeficiency virus(HIV) is a type ofviruscalled aLentivirus.This is a kind ofretrovirus.It infects the humanimmune system,which is the system in the body which fights offinfections.

HIV may causeAIDS.This kills thewhite blood cellswhich a healthy body uses to fight diseases.

African Americans,gay and bisexual men, black women, transgender women and drug users are most affected by the disease.[1]

South Africa,Lesotho,Swaziland,Botswana,Namibia,ZambiaandZimbabwehave the highest rate of HIV in the world.[2]

How people get infected

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A person can get infected with HIV if any body liquid with the virus gets into their body. The body liquids that carry HIV areblood,semen,liquid from thevagina,andbreast milk.

The virus may get into the body throughinjuredskin. More usually it gets in through themouth,eyes,nose,vagina,anus,orpenis.

However, when people get HIV by having sex, the virus may enter the body through thevaginaoranus.

There are some common ways to get HIV:

  • A person with HIV can give a sexual partner the virus if they have unprotected sex. That means havingsexual intercoursewithout acondom.
  • A person can get HIV if he or she uses the sameneedleas a person with HIV toinjectdrugsor get atattoo.
  • A person may get HIV if he or she is stuck by a needle that was used on a patient with HIV.
  • Babies can get the virusfrom their mothers when they are bornor when they arebreastfeeding.A baby may be protected from getting HIV this way if their mother takes certain medications while she is pregnant.
  • Blood transfusionsusing infected blood products was a common cause of HIV. The blood had been taken from people with HIV infections. Now, in thedeveloped worldscreening of blood products for HIV has mostly stopped this happening. However, people may still get HIV from blood transfusions in less-developed countries if the blood is not screened.

A person cannot get infected with HIV from non-sexual touching, like ahugorhandshake,or touching someone else'ssaliva.A person cannot get HIV from an insectbite,acough,or asneeze.[3]People also cannot get HIV from touching light switches, using toilets, or drinking from the same glass as a person with HIV.

Data

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Comparison of HIVspecies
Species Virulence Infectivity Prevalence Inferred origin
HIV-1 High High Global Common Chimpanzee
HIV-2 Lower Low West Africa Sooty Mangabey


Estimated per-act risk for acquisition of HIV by exposure route[4][5][6]
Exposure Route[7] Estimated infections per 10,000 exposures to an infected source[8]
Blood transfusion
[Being given blood in a transfusion] 		9,000 (90%)[9]
Mother-to-child,includingpregnancy,childbirthandbreastfeeding(without treatment)
[Mother giving her child or unborn child HIV, if she does not take medications to prevent giving the child HIV] 		2,500 (25%)[10]
Mother-to-child, including pregnancy, childbirth and breastfeeding (with optimal treatment)
[Mother giving her child or unborn child HIV, if she takes the best possible medications to prevent giving the child HIV] 		100–200 (1%–2%)[10]
Needle-sharing injection drug use
[People sharing the same needle to injectillegal drugs] 		67 (0.67%)[11]
Percutaneous needle stick
[Getting stuck by a needle used on a person with HIV - for example, in healthcare] 		30 (0.30%)[12]
Receptiveanal intercourse(2009 and 2010 studies)
[Receiving anal sex] 		170 (1.7%)‡[30–890][13]/ 143 [48–285][6]
Receptive anal intercourse (based on data of a 1992 study)
[Receiving anal sex] 		50 (0.5%)[14][15]
Insertive anal intercourse foruncircumcisedmen (2010 study)
[An uncircumsized man giving anal sex] 		62 (0.62%)a[7–168][6]
Insertive anal intercourse for circumcised men (2010 study)
[A circumsized man giving anal sex] 		11 (0.11%)a[2–24][6]
Insertive anal intercourse (based on data of a 1992 study)
[Giving anal sex] 		6.5 (0.065%)[14][15]
Low-income country female-to-male
[A woman giving a man HIV through sexual activity; rate is for low-income countries] 		38 (0.38%)‡[13–110][13]
Low-income country male-to-female
[A man giving a woman HIV through sexual activity; rate is for low-income countries] 		30 (0.3%)‡[14–63][13]
Receptive (female) penile-vaginal intercourse
[A woman receiving sexual intercourse from a man] 		10 (0.1%)[14][15][16]
Insertive (male) penile-vaginal intercourse
[A man giving sexual intercourse to a woman] 		5 (0.05%)[14][15]
Fellatinga man
[Performing oral sex on a man] 		1 (0.01%)†b[15]
Man being fellated
[A man receiving oral sex] 		0.5 (0.005%)†b[15]
aOther studies found insufficient evidence that male circumcision protects against HIV infection among men who have sex with men[17][18]
bOral trauma, sores, inflammation, concomitantsexually transmitted infections,ejaculationin the mouth, and systemic immune suppression may increase HIV transmission rate.[19]
†"best-guessestimate"
‡Pooled transmission probability estimate.
Bracketed values represent 95% confidence interval.

Treatment

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Drug treatment

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HIV causes a person to become more prone to illness, so infected people need treatment options. However, there is no cure for HIV. To help ease negativesymptoms,drugscalled anti-retroviral therapy (ART) are available. This treatment is also called high active anti-retroviral therapy (HAART). HAART treatment begins with one non-nucleoside reverse transcriptase inhibitor (NNRTI) and two nucleoside analogue reverse transcriptase inhibitors (NRTIs).[20]The NRTI drug could be named zidovudine (AZT), tenofovir (TDF), andlamivudine (3TC), or emtricitabine (FTC).[21]

These drugs slow the progression of the HIV virus in the body.[21]Usually, these treatments consist of a combination of three or more drugs, and each drug performs a different job in fighting the virus. In general, HAART prevents the HIV from multiplying and destroying CD4 cells. CD4 cells are necessary to help protect the body from infections andcancer.[22]Since the HIV virus destroys CD4 cells, it causes people with HIV to be more prone to illness.

It is recommended to start HAART if a person has HIV and has a CD4 cell count of less than or equal to 350 cells/mm3. This number can be determined by a doctor.[21]A person’s age, sex, and other infections determine which treatment he or she should take.[21]These medication regimens can help HIV-infected people live longer, healthier lives, and can also help prevent the HIV from advancing to AIDS.[23]

Symptoms of acute HIV infection

General treatment

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There has beencontroversysurrounding when the correct time to start therapy should be after a person discovers that he or she has HIV. Recently, the answer has been that earlier treatment is recommended.[24]This is because, first, effective therapy can prevent non-AIDS-related deaths. Second, therapy can prevent harm to a person’simmune system.Third, therapy can help prevent transmission of HIV to others, and can therefore reduce HIVprevalenceoverall.[24]Although there are some negativeside effectsof antiretroviral medications, the benefits of therapy usually outweigh the negative effects.

Effects of therapy

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Patients on HAART have reported significant improvements in physical health, emotional health,mental health,and daily function compared to HIV-positive patients not yet on treatment.[25]Most research has occurred indeveloping countries,and little research has been done on the impacts of ART on household wellbeing.[25]

Although HAART can be an effective means to treating HIV, there can be many negative side effects. Negative side effects can vary by drug, byethnicity,and by drug interactions in the body. The following list contains the most common and serious negative side effects associated with HAART medications to treat HIV.[26]

Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)

ProteaseInhibitors (PIs)

Fusion Inhibitors

Chemokine Coreceptor Antagonists

Integrase Inhibitors

  • Nausea, diarrhea, headache, rash

Pharmacokinetic Enhancers

Alternative therapy

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Many people living with HIV have tried using alternative treatment methods, known as complementary andalternative medicine(CAM). Some types of CAM includestressmanagement, natural health products,massage/therapeutic touch,acupuncture,andhomeopathy.[27]Stress management can increase quality of life for a person with HIV.[27]Even with little evidence of its effectiveness, many people chose to try CAM because of the many negative side effects associated with HAART and the few negative side effects associated with CAM. Some HIV-infected people also tryherbalmedicines to treat HIV, but there has been no evidence showing any positive outcomes with the use of herbal remedies.[28]

Another type of alternative therapy for treating HIV is micronutrient supplementation. Micronutrients arevitaminsandminerals,so these supplements would be in the form of a general dailymultivitamin.These supplements have been proven to help treat HIV because HIV can cause micronutrient deficiencies, so the supplements can help replenish these needed vitamins and minerals. Although the supplements may not help ease all negative symptoms, they offer some benefits and are safe for HIV-infected patients.[28]Supplements are also safe for HIV-infected pregnant women and their children. Specifically,vitamin Aandzinchave shown positive health effects.[28]There are no major negative side effects of vitamin and mineral supplements.[29]

Alternative therapies can help to reduce symptoms of diseases like HIV, but do not cure the disease, or stop the disease from spreading to other people.

PREP

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"PREP" or "PrEP" ispre-exposureprophylaxis.This means a person takes a drug before having risky sex. The drug 'Truvada' is a combination of two different anti-viral treatments:tenofovirandemtricitabine.[30]Truvada is very expensive, and was not available on the UK'sNational Health Servicebefore 2016. A study, published inThe Lancetin 2023 found that PrEP reduced the chances of getting HIV by almost 87% and recommended that it should be more easily available.[31]

References

  1. ↑"Who Is at Risk for HIV?".hiv.gov.
  2. ↑"The Status of the HIV/AIDS Epidemic in Sub-Saharan Africa".
  3. ↑"Can I get AIDS from...?".Retrieved2010-06-26.
  4. ↑Means the risk of getting HIV for asingle sexual act.
  5. ↑Smith DK, Grohskopf LA, Black RJ; et al. (January 2005)."Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services".MMWR Recomm Rep.54(RR–2): 1–20.PMID15660015.Retrieved2009-03-31.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  6. ↑6.06.16.26.3Jin F; et al. (March 2010)."Per-contact probability of HIV transmission in homosexual men in Sydney in the era of HAART".AIDS.24(6): 907–913.doi:10.1097/QAD.0b013e3283372d90.PMC2852627.PMID20139750.
  7. ↑Which sexual act was caused the infection
  8. ↑This means, in effect, the chance of getting the virus from one sex act of each kind. Data from various samples are adjusted to 10,000 cases so they can be compared.
  9. ↑Donegan E, Stuart M, Niland JC; et al. (1990). "Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody-positive blood donations".Ann. Intern. Med.113(10): 733–739.doi:10.7326/0003-4819-113-10-733.PMID2240875.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  10. ↑10.010.1Coovadia H (2004). "Antiretroviral agents—how best to protect infants from HIV and save their mothers from AIDS".N. Engl. J. Med.351(3): 289–292.doi:10.1056/NEJMe048128.PMID15247337.
  11. ↑Kaplan EH, Heimer R (1995). "HIV incidence among New Haven needle exchange participants: updated estimates from syringe tracking and testing data".J. Acquir. Immune Defic. Syndr. Hum. Retrovirol.10(2): 175–176.doi:10.1097/00042560-199510020-00010.PMID7552482.
  12. ↑Bell DM (1997). "Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview".Am. J. Med.102(5B): 9–15.doi:10.1016/S0002-9343(97)89441-7.PMID9845490.
  13. ↑13.013.113.2Boily MC, Baggaley RF, Wang L, Masse B, White RG, Hayes RJ, Alary M (February 2009)."Heterosexual risk of HIV-1 infection per sexual act: systematic review and meta-analysis of observational studies".The Lancet Infectious Diseases.9(2): 118–129.doi:10.1016/S1473-3099(09)70021-0.PMC4467783.PMID19179227.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  14. ↑14.014.114.214.3European Study Group on Heterosexual Transmission of HIV (1992)."Comparison of female to male and male to female transmission of HIV in 563 stable couples. European Study Group on Heterosexual Transmission of HIV".BMJ.304(6830): 809–813.doi:10.1136/bmj.304.6830.809.PMC1881672.PMID1392708.
  15. ↑15.015.115.215.315.415.5Varghese B, Maher JE, Peterman TA, Branson BM,Steketee RW (2002)."Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use".Sex. Transm. Dis.29(1): 38–43.doi:10.1097/00007435-200201000-00007.PMID11773877.S2CID45262002.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  16. ↑Leynaert B, Downs AM, de Vincenzi I (1998). "Heterosexual transmission of human immunodeficiency virus: variability of infectivity throughout the course of infection. European Study Group on Heterosexual Transmission of HIV".Am. J. Epidemiol.148(1): 88–96.doi:10.1093/oxfordjournals.aje.a009564.PMID9663408.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  17. ↑Millett GA, Flores SA, Marks G, Reed JB, Herbst JH (October 2009)."Circumcision status and risk of HIV and sexually transmitted infections among men who have sex with men: a meta-analysis".The Journal of American Medical Association.300(14): 1674–1684.doi:10.1001/jama.300.14.1674.PMID18840841.Retrieved2010-04-11.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  18. ↑Correction about the values although "the pattern of nonsignificant findings remains consistent with the originally published article"[1]Archived2007-05-15 at theWayback Machine
  19. ↑"Public Health Agency of Canada".Phac-aspc.gc.ca. 2004-12-01. Archived fromthe originalon 2012-06-23.Retrieved2010-07-28.
  20. ↑"Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach"(PDF).World Health Organization:1–145. 2010.
  21. ↑21.021.121.221.3"Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach"(PDF).World Health Organization:1–145. 2010.
  22. ↑"HIV and Its Treatment"(PDF).U.S. Department of Health and Human Services.2012. Archived fromthe original(PDF)on 2011-10-21.Retrieved2013-04-02.
  23. ↑"HIV and its treatment"(PDF).U.S. Department of Health and Human Services.2012. Archived fromthe original(PDF)on 2011-10-21.Retrieved2013-04-02.
  24. ↑24.024.1Jain V, Deeks SG. (2010)."When to start antiretroviral therapy".Curr HIV/AIDS Rep.7(2): 60–68.doi:10.1007/s11904-010-0044-6.PMC2856854.PMID20425559.
  25. ↑25.025.1Beard J, Feeley F, and Rosen S (2009). "Economic and quality of life outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review".AIDS Care.21(11): 1343–1356.doi:10.1080/09540120902889926.PMID20024710.S2CID21883819.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  26. ↑26.026.1McNicholl I. (2012)."Adverse Events of Antiretroviral Drugs".University of California San Francisco.Archived fromthe originalon 2020-10-31.Retrieved2013-04-02.
  27. ↑27.027.1Mills P, Wu P, Ernst E. (2005). "Complementary therapies for the treatment of HIV: in search of the evidence".Int. J of STD and AIDS.16(6): 395–403.doi:10.1258/0956462054093962.PMID15969772.S2CID7411052.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  28. ↑28.028.128.2Liu JP, Manheimer E, Yang M. (2005)."Herbal medicines for treating HIV infection and AIDS".Cochrane Database Syst. Rev.3(3): CD003937.doi:10.1002/14651858.CD003937.pub2.PMC8759069.PMID16034917.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  29. ↑Irlam JH, Visser MM, Rollins NN, Siegfried N. (2010). Irlam, James H (ed.). "Micronutrient supplementation in children and adults with HIV infection".Cochrane Database Syst. Rev.12(12): CD003650.doi:10.1002/14651858.CD003650.pub3.PMID21154354.{{cite journal}}:CS1 maint: multiple names: authors list (link)
  30. ↑PrEP: PK modeling of daily TDF/FTC (Truvada) provides close to 100% protection against HIV nfection. TheBodyPRO.com.PrEP: PK Modeling of Daily TDF/FTC (Truvada) Provides Close to 100% Protection Against HIV Infection - TheBodyPRO.comArchived2015-01-15 at theWayback Machine
  31. ↑Clews, Graham (2023-11-30)."PrEP highly effective in cutting HIV transmission but better access needed, study finds".The Pharmaceutical Journal.Retrieved2023-11-30.

Other websites

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