As
soon as someone contracts HIV, it starts to reproduce in their body.
The person’s immune system reacts to the antigens (parts of the virus)
by producing antibodies (cells that take countermeasures against the
virus).
The time between exposure to HIV and when it becomes
detectable in the blood is called the HIV window period. Most people
develop detectable HIV antibodies within 23 to 90 days after
transmission.
If a person takes an HIV test during the window
period, it’s likely they’ll receive a negative result. However, they can
still transmit the virus to others during this time.
If someone
thinks they may have been exposed to HIV but tested negative during this
time, they should repeat the test in a few months to confirm (the
timing depends on the test used). And during that time, they need to use
condoms or other barrier methods to prevent possibly spreading HIV.
PEP
needs to be taken as soon as possible after the exposure; it should be
taken no later than 72 hours after exposure but ideally before then.
Timing is important when testing for HIV.
During
this time, the virus reproduces rapidly. The person’s immune system
responds by producing HIV antibodies, which are proteins that take
measures to respond against infection.
During this stage, some
people have no symptoms at first. However, many people experience
symptoms in the first month or so after contracting the virus, but they
often don’t realize HIV causes those symptoms.
This is because symptoms of the acute stage can be very similar to those of the flu or other seasonal viruses, such as:
Because
these symptoms are similar to common illnesses like the flu, the person
who has them might not think they need to see a healthcare provider.
A high viral load means that HIV can be easily transmitted to someone else during this time.
Initial
HIV symptoms usually resolve within a few months as the person enters
the chronic, or clinical latency, stage of HIV. This stage can last many
years or even decades with treatment.
HIV symptoms can vary from person to person.
After the first month or so, HIV enters the clinical latency stage. This stage can last from a few years to a few decades.
Some
people don’t have any symptoms during this time, while others may have
minimal or nonspecific symptoms. A nonspecific symptom is a symptom that
doesn’t pertain to one specific disease or condition.
These nonspecific symptoms may include:
- headaches and other aches and pains
- swollen lymph nodes
- recurrent fevers
- night sweats
- fatigue
- nausea
- vomiting
- diarrhea
- weight loss
- skin rashes
- recurrent oral or vaginal yeast infections
- pneumonia
- shingles
As
with the early stage, HIV is still transferable during this time even
without symptoms and can be transmitted to another person.
However,
a person won’t know they have HIV unless they get tested. If someone
has these symptoms and thinks they may have been exposed to HIV, it’s
important that they get tested.
HIV symptoms at this stage may
come and go, or they may progress rapidly. This progression can be
slowed substantially with treatment.
With the consistent use of
this antiretroviral therapy, chronic HIV can last for decades and will
likely not develop into AIDS, if treatment was started early enough.
Learn more about how HIV symptoms can progress over time.
Many
people with HIV experience changes to their skin. Rash is often one of
the first symptoms of an HIV infection. Generally, an HIV rash appears
as multiple small red lesions that are flat and raised.
Rash related to HIV
HIV
makes someone more susceptible to skin problems because the virus
destroys immune system cells that take measures against infection.
Co-infections that can cause rash include:
The cause of the rash determines:
- how it looks
- how long it lasts
- how it can be treated depends on the cause
Rash related to medication
While
rash can be caused by HIV co-infections, it can also be caused by
medication. Some drugs used to treat HIV or other conditions can cause a
rash.
This type of rash usually appears within a week or 2 weeks
of starting a new medication. Sometimes the rash will clear up on its
own. If it doesn’t, a change in medications may be needed.
Rash due to an allergic reaction to medication can be serious.
Other symptoms of an allergic reaction include:
- trouble breathing or swallowing
- dizziness
- fever
Stevens-Johnson
syndrome (SJS) is a rare allergic reaction to HIV medication. Symptoms
include fever and swelling of the face and tongue. A blistering rash,
which can involve the skin and mucous membranes, appears and spreads
quickly.
When 30 percentTrusted Source
of the skin is affected, it’s called toxic epidermal necrolysis, which
is a life threatening condition. If this develops, emergency medical
care is needed.
While rash can be linked with HIV or HIV
medications, it’s important to keep in mind that rashes are common and
can have many other causes.
Learn more about HIV rash.
For
the most part, symptoms of HIV are similar in men and women. However,
symptoms they experience overall may differ based on the different risks
men and women face if they have HIV.
Both men and women with HIV
are at increased risk for STIs. However, women, and those with a vagina,
may be less likely than men to notice small spots or other changes to
their genitals.
In addition, women with HIV are at increased risk for:
While not related to HIV symptoms, another risk
for women with HIV is that the virus can be transmitted to a baby during
pregnancy. However, antiretroviral therapy is considered safe during
pregnancy.
Women who are treated with antiretroviral therapy are
at very low risk for transmitting HIV to their baby during pregnancy and
delivery. Breastfeeding is also affected in women with HIV. The virus
can be transferred to a baby through breast milk.
In the United States and other settings where formula is accessible and safe, it’s recommended that women with HIV not breastfeed their babies. For these women, use of formula is encouraged.
Options besides formula include pasteurized banked human milk.
For women who may have been exposed to HIV, it’s important to know what symptoms to look for.
Learn more about HIV symptoms in women.
AIDS
refers to acquired immunodeficiency syndrome. With this condition, the
immune system is weakened due to HIV that’s typically gone untreated for
many years.
If HIV is found and treated early with antiretroviral therapy, a person will usually not develop AIDS.
People
with HIV may develop AIDS if their HIV is not diagnosed until late or
if they know they have HIV but don’t consistently take their
antiretroviral therapy.
They may also develop AIDS if they have a type of HIV that’s resistant to (doesn’t respond to) the antiretroviral treatment.
Without
proper and consistent treatment, people living with HIV can develop
AIDS sooner. By that time, the immune system is quite damaged and has a
harder time generating a response to infection and disease.
With the use of antiretroviral therapy, a person can maintain a chronic HIV diagnosis without developing AIDS for decades.
Symptoms of AIDS can include:
- recurrent fever
- chronic swollen lymph glands, especially of the armpits, neck, and groin
- chronic fatigue
- night sweats
- dark splotches under the skin or inside the mouth, nose, or eyelids
- sores, spots, or lesions of the mouth and tongue, genitals, or anus
- bumps, lesions, or rashes of the skin
- recurrent or chronic diarrhea
- rapid weight loss
- neurologic problems such as trouble concentrating, memory loss, and confusion
- anxiety and depression
Antiretroviral
therapy controls the virus and usually prevents progression to AIDS.
Other infections and complications of AIDS can also be treated. That
treatment must be tailored to the individual needs of the person.
Treatment should begin as soon as possible after a diagnosis of HIV, regardless of viral load.
The
main treatment for HIV is antiretroviral therapy, a combination of
daily medications that stop the virus from reproducing. This helps
protect CD4 cells, keeping the immune system strong enough to take
measures against disease.
Antiretroviral therapy helps keep HIV from progressing to AIDS. It also helps reduce the risk of transmitting HIV to others.
When
treatment is effective, the viral load will be “undetectable.” The
person still has HIV, but the virus is not visible in test results.
However,
the virus is still in the body. And if that person stops taking
antiretroviral therapy, the viral load will increase again, and the HIV
can again start attacking CD4 cells.
Learn more about how HIV treatments work.
Many antiretroviral therapy medications are approved to treat HIV.
They work to prevent HIV from reproducing and destroying CD4 cells,
which help the immune system generate a response to infection.
This helps reduce the risk of developing complications related to HIV, as well as transmitting the virus to others.
These antiretroviral medications are grouped into six classes:
Treatment regimens
The U.S. Department of Health and Human Services (HHS) generally recommends a starting regimen of three HIV medications from at least two of these drug classes.
This
combination helps prevent HIV from forming resistance to medications.
(Resistance means the drug no longer works to treat the virus.)
Many
of the antiretroviral medications are combined with others so that a
person with HIV typically takes only one or two pills a day.
A healthcare provider will help a person with HIV choose a regimen based on their overall health and personal circumstances.
These
medications must be taken every day, exactly as prescribed. If they’re
not taken appropriately, viral resistance can develop, and a new regimen
may be needed.
Blood testing will help determine if the regimen
is working to keep the viral load down and the CD4 count up. If an
antiretroviral therapy regimen isn’t working, the person’s healthcare
provider will switch them to a different regimen that’s more effective.
Side effects and costs
Side
effects of antiretroviral therapy vary and may include nausea,
headache, and dizziness. These symptoms are often temporary and
disappear with time.
Serious side effects can include swelling of
the mouth and tongue and liver or kidney damage. If side effects are
severe, the medications can be adjusted.
Costs for antiretroviral
therapy vary according to geographic location and type of insurance
coverage. Some pharmaceutical companies have assistance programs to help
lower the cost.
Learn more about the drugs used to treat HIV.
Although
many researchers are working to develop one, there’s currently no
vaccine available to prevent the transmission of HIV. However, taking
certain steps can help prevent the transmission of HIV.
Safer sex
The
most common way for HIV to be transferred is through anal or vaginal
sex without a condom or other barrier method. This risk can’t be
completely eliminated unless sex is avoided entirely, but the risk can
be lowered considerably by taking a few precautions.
A person concerned about their risk for HIV should:
- Get tested for HIV. It’s important they learn their status and that of their partner.
- Get tested for other sexually transmitted infections (STIs). If they test positive for one, they should get it treated, because having an STI increases the risk of contracting HIV.
- Use condoms.
They should learn the correct way to use condoms and use them every
time they have sex, whether it’s through vaginal or anal intercourse.
It’s important to keep in mind that pre-seminal fluids (which come out
before male ejaculation) can contain HIV.
- Take their medications as directed if they have HIV. This lowers the risk of transmitting the virus to their sexual partner.
Shop for condoms online.
Other prevention methods
Other steps to help prevent the spread of HIV include:
- Avoid sharing needles or other paraphernalia.
HIV is transmitted through blood and can be contracted by using
materials that have come in contact with the blood of someone who has
HIV.
- Consider PEP. A person who has been
exposed to HIV should contact their healthcare provider about obtaining
post-exposure prophylaxis (PEP). PEP can reduce the risk of contracting
HIV. It consists of three antiretroviral medications given for 28 days.
PEP should be started as soon as possible after exposure but before 36
to 72 hours have passed.
- Consider PrEP. A person has a higher chance of contracting HIV should talk to their healthcare provider about pre-exposure prophylaxis (PrEP). If taken consistently, it can lower the risk of acquiring HIV. PrEP is a combination of two drugs available in pill form.
Healthcare providers can offer more information on these and other ways to prevent the spread of HIV.
Check here for more information on STI prevention.
More than 1.2 million people
in the United States are living with HIV. It’s different for everybody,
but with treatment, many can expect to live a long, productive life.
The
most important thing is to start antiretroviral treatment as soon as
possible. By taking medications exactly as prescribed, people living
with HIV can keep their viral load low and their immune system strong.
It’s also important to follow up with a healthcare provider regularly.
Other ways people living with HIV can improve their health include:
- Make their health their top priority. Steps to help people living with HIV feel their best include:
- fueling their body with a well-balanced diet
- exercising regularly
- getting plenty of rest
- avoiding tobacco and other drugs
- reporting any new symptoms to their healthcare provider right away
- Focus on their mental health. They could consider seeing a licensed therapist who is experienced in treating people with HIV.
- Use safer sex practices.
Talk to their sexual partner(s). Get tested for other STIs. And use
condoms and other barrier methods every time they have vaginal or anal
sex.
- Talk to their healthcare provider about PrEP and PEP. When
used consistently by a person without HIV, pre-exposure prophylaxis
(PrEP) and post-exposure prophylaxis (PEP) can lower the chances of
transmission. PrEP is most often recommended for people without HIV in
relationships with people with HIV, but it can be used in other
situations as well. Online sources for finding a PrEP provider include PrEP Locator and PleasePrEPMe.
- Surround themselves with loved ones. When
first telling people about their diagnosis, they can start slow by
telling someone who can maintain their confidence. They may want to
choose someone who won’t judge them and who will support them in caring
for their health.
- Get support. They can join an
HIV support group, either in person or online, so they can meet with
others who face the same concerns they have. Their healthcare provider
can also steer them toward a variety of resources in their area.
There are many ways to get the most out of life when living with HIV.
Hear some real stories of people living with HIV.
In the 1990s, a 20-year-old person with HIV had a 19-year life expectancyTrusted Source. By 2011, a 20-year-old person with HIV could expect to live another 53 years.
It’s
a dramatic improvement, due in large part to antiretroviral therapy.
With proper treatment, many people with HIV can expect a normal or near-
normal lifespan.
Of course, many things affect life expectancy for a person with HIV. Among them are:
- CD4 cell count
- viral load
- serious HIV-related illnesses, including hepatitis
- misusing drugs
- smoking
- access, adherence, and response to treatment
- other health conditions
- age
Where
a person lives also matters. People in the United States and other
developed countries may be more likely to have access to antiretroviral
therapy.
Consistent use of these drugs helps prevent HIV from
progressing to AIDS. When HIV advances to AIDS, life expectancy without
treatment is about 3 yearsTrusted Source.
In 2017, about 20.9 million peopleTrusted Source living with HIV were using antiretroviral therapy.
Life
expectancy statistics are just general guidelines. People living with
HIV should talk to their healthcare provider to learn more about what
they can expect.
Learn more about life expectancy and long-term outlook with HIV.
Currently,
there are no vaccines to prevent or treat HIV. Research and testing on
experimental vaccines are ongoing, but none are close to being approved
for general use.
HIV is a complicated virus. It mutates (changes)
rapidly and is often able to fend off immune system responses. Only a
small number of people who have HIV develop broadly neutralizing
antibodies, the kind of antibodies that can respond to a range of HIV
strains.
The first HIV vaccine efficacy study
in 7 years was underway in South Africa in 2016. The experimental
vaccine is an updated version of one used in a 2009 trial that took
place in Thailand.
A 3.5-year follow-up after vaccination showed the vaccine was 31.2 percent effective in preventing HIV transmission.
The study involves 5,400 men and women from South Africa. In 2016 in South Africa, about 270,000 peopleTrusted Source contracted HIV. The results of the study are expected in 2021.
Other late-stage, multinational vaccine clinical trials are also currently underway.
Other research into an HIV vaccine is also ongoing.
While
there’s still no vaccine to prevent HIV, people with HIV can benefit
from other vaccines to prevent HIV-related illnesses. Here are the CDC
recommendations:
- pneumonia: recommendedTrusted Source for all children younger than 2 and all adults 65 and older
- influenza: recommendedTrusted Source for all people over 6 months old annually with rare exceptions
- hepatitis A and B: ask your doctor if you should get vaccinated for hepatitis A and B, especially if you are in a higher risk groupTrusted Source
- meningitis: the meningococcal conjugate vaccination is recommendedTrusted Source
for all preteens and teens at 11 to 12 years old with a booster dose at
16, or anyone at risk. The serogroup B meningococcal vaccination is
recommended for anyone 10 years or older with increased risk.
- shingles: recommendedTrusted Source for those ages 50 or older
Learn why an HIV vaccine is so difficult to develop.
Here are today’s HIV numbers:
- In 2019, about 38 million people worldwide were living with HIV. Of those, 1.8 million were children below the age 15 years.
- At the end of 2019, 25.4 million people living with HIV were using antiretroviral therapy.
- Since the pandemic began, 75.7 million people have contracted HIV, and AIDS-related complications have claimed 32.7 million lives.
- In 2019, 690,000 people died from AIDS-related diseases. This is a decline from 1.9 million in 2005.
- Eastern and Southern Africa are the hardest hit. In 2019, 20.7 million
people in these areas were living with HIV, and 730,000 more contracted
the virus. The region has more than half of all people living with HIV
worldwide.
- Adult and adolescent women accounted for 19 percent of new HIV diagnoses in the United States in 2018. Almost half of all new cases occur in African Americans.
- Left untreated, a woman with HIV has a 15–45 percentTrusted Source
chance of passing HIV to her baby during pregnancy or breastfeeding.
With antiretroviral therapy throughout pregnancy and avoidance of
breastfeeding, the risk is less than 5 percentTrusted Source.
- In the 1990s, a 20-year-old person with HIV had a life expectancyTrusted Source of 19 years. By 2011, it had improved to 53 years. Today, life expectancy is near normalTrusted Source if antiretroviral therapy is started soon after contracting HIV.
As access to antiretroviral therapy continues to improve around the world, these statistics will hopefully keep changing.
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