HIV infection is triggered by the human immunodeficiency virus. Symptoms of infection may be similar to those of a flu infection, making it difficult to diagnose immunodeficiency. Not everyone infected with the HI virus will automatically have AIDS, but HIV infection can spread to the disease – sometimes only after several years.
HIV-infected people are called HIV-positive. Sufferers often feel healthy and have no physical or mental symptoms. This promotes the spread of HIV, because HIV-positive people often do not know about their infection for a long time and thus, for example, continue to have unprotected intercourse.
What exactly is AIDS?
Aids stands for Acquired Immunodeficiency Syndrome, which translates as “Acquired Immunodeficiency Syndrome”. The HI virus attacks the helper T cells, which are responsible for the defense against pathogens and remains initially for a long time hidden in the cells. Over time, more and more cells are destroyed and the disease AIDS breaks out. The number of T cells in the blood has then dropped from 8,000 to 10,000 cells per milliliter of blood to about 200 per milliliter.
AIDS numbers and facts: How many people in Germany have AIDS?
Germany is one of the countries with the lowest prevalence of HIV and AIDS. According to estimates by the Robert Koch Institute (RKI), around 2,700 people were infected with the HI virus nationwide in 2017. At the end of 2017, a total of approximately 86,100 people were living with the HIV virus in Germany. The RKI estimates that about 11,000 of them do not know about their infection. In the same year, about 450 HIV-infected citizens of the Federal Republic died.
Which countries are most affected by HIV?
Lack of education and cultural barriers facilitate the spread of AIDS. Worldwide, more than 36.9 million people were infected with HIV in 2017, including 1.8 million new infections. Most of them live in sub-Saharan Africa. The further south one goes, the more dramatic the HIV rate becomes, according to the world map of the United Nations AIDS Organization (Unaids). Most HIV-infected people are therefore living in South Africa, where the virus is a major problem, especially in the slums. In the neighboring kingdom of Swaziland about one in four is HIV-positive.
First Aids cases occurred in the 80s
The first cases of AIDS became known in the early 1980s: in 1983, the virologist Luc Montagnier from the Institut Pasteur in Paris succeeded in isolating the HI virus for the first time. The question of where the virus came from has been much researched and even more speculated. It is certain that the HI virus is a descendant of the Simian Immunodeficiency Virus (SI) virus that attacks apes.
Over the past 25 years, AIDS has become a global epidemic (pandemic) with huge societal consequences. Since the discovery of the HIV virus, more than 35 million people have died. Each year, about three million people become infected with the virus and more than two million succumb to diseases caused by their weakened by the HIV infection immune system. Thanks to the new therapies, however, the development of HIV in the body – and thus the outbreak of AIDS – can be slowed down.
HIV transmission and AIDS: causes of immunodeficiency
The HI virus, which can cause HIV infection and consequently the infectious disease AIDS, is difficult to transfer. Only blood and sexual contacts allow transmission.
The HIV infection is primarily transmitted through:
- unprotected sex
- infected blood products
- exchanged, contaminated drug cutlery
With unprotected intercourse, the risk of contracting the HIV virus remains greatest. The use of condoms is therefore the best protection against HIV infection. Transmission is possible through vaginal, anal and oral intercourse. The virus is detectable in the semen and vaginal fluid of those infected with HIV. It can be transmitted through the smallest injuries of the mucous membranes. Since the concentration of virus in the blood and other body fluids of the infected varies, so does the risk of infection by sexual contacts. Also, the multiple use of syringes carries a very high risk of infection.
Children of HIV-positive women may become infected while nursing , during pregnancy or at birth . Preventative measures can reduce the transfer risk from around 30 percent to less than five percent.
What is the virus doing in the body?
The HI virus belongs to the group of retroviruses. The genome of these viruses consists of RNA (ribonucleic acid, responsible for the transport of genetic information). Only in the affected host cell, the RNA is converted into DNA (deoxyribonucleic acid, carrier of genetic information) and integrated into the host genome – the genetic material of the human cell. Entry into the cells is possible only through certain specific receptor molecules on the surface of the cells. CD4 lymphocytes belonging to the white blood cells are the main target of the viruses. They are also called helper cells and play a key role in the defense against pathogens.
Symptoms of HIV infection
A few days to six weeks after the HIV infection occurs in about 70 percent of infected people to acute HIV phase (stage A), during which the virus in the body rapidly multiply and thus cause an immune response. The symptomatic section after infection usually lasts one week, exceptionally two weeks.
Swollen lymph nodes to rash: HIV symptoms at a glance
If you experience one or more of the following symptoms over a long period of time, you should consult a doctor to rule out or treat a new HIV infection. It is also important to address the treating physician after a risk contact specifically to an Aidstest.
These symptoms can trigger HIV infection after a few days to weeks:
- Lymph node swelling, for example, around the neck, neck and armpits
- Night sweats (more than a month)
- Diarrhea (more than a month)
- Fever with sometimes very high temperature (more than a month)
- body aches
- dry cough and shortness of breath
- Appetite and weight loss
- Tiredness and exhaustion
- Inflammation and pain in the throat
- open spots in the mouth
- Spotty, pronounced rash (HIV rash ) with severe itching lasting one to a few days
The most common and obvious symptoms of recently acquired HIV infection are fever (in around eight out of ten people) and the characteristic rash that affects about one out of every two people in the acute phase. About 45 percent of newly HIV-infected people have a combination of these two main symptoms.
Also general fatigue, loss of appetite and body aches are very common, followed by muscle pain , inflammation in the oropharynx and a significant weight loss. There are no differences between the sexes.
Drugs prolong symptom-free phases
After the acute HIV infection follows the disease-free interval, which can usually last a few months, but also several years. During this phase, the immune system manages to keep the HIV pathogen at bay. With antiretroviral drugs today it is possible to prolong this phase.
Extremely vulnerable to AIDS
If the immune system is so weakened that it can no longer defend itself against pathogens that are no problem for healthy people, AIDS is spoken of after the often (years) long symptom-free phase. The symptoms are also unspecific, so they also occur in other, usually more harmless, diseases such as the flu (influenza) . At this stage, certain forms of pneumonia (Pneumocystis pneumonia), tuberculosis or infections of the mouth and esophagus with the yeast Candida albicans are typical . These associated diseases are also referred to as opportunistic infections.
In addition, HIV infection also causes certain cancers that are caused by infection with viruses, such as Kaposi’s sarcoma, cervical cancer or lymphoma .
Diagnosis: How do I know if I have AIDS?
The HIV infection can be detected relatively easily and safely by a free blood test (HIV test). Most commonly, a test procedure is used to detect antibodies to the virus. However, antibodies against HIV can only be reliably detected four to twelve weeks after HIV infection.
HIV test: Free at public health offices
If HIV infection is suspected, any doctor can initiate an HIV test . The costs will be borne by the responsible health insurance company. In addition, many health departments have the ability to perform anonymous HIV testing for free and seek advice. The test results – negative as well as positive – may only be communicated personally. Anyone who has actually infected, would receive the test result “positive”.
How can you treat AIDS?
HIV infection can not be cured with today’s medicine. The extreme adaptability of the HI virus makes the search for medicines very difficult. Nevertheless, by combining several antiviral drugs, the concentration of the virus in the body for a long time can be kept so low that it does not come to the full onset of the disease.
For HIV-infected people, this means that they consistently have to take several medications every day for years. Although this HIV therapy is very expensive, in Germany it can be used by any HIV-infected person. In many other countries, patients do not have this chance.
Combination therapy in HIV
For HIV therapy, a combination of at least three different antiviral drugs is usually used. The experts also call this aggressive combination therapy “highly active antiretroviral therapy” (HAART). Since the active ingredients come from three different classes of drugs with different principles of action, the risk of developing resistant virus strains is significantly reduced. Today’s drugs have significantly less serious side effects and are much less likely to cause complications and long-term damage than they did in the 1990s.
Course and prognosis
The AIDS pathogen is still not curable. But there are isolated cases that give reason for hope: About 20 cases of a so-called functional healing are known in the infected after an HIV therapy, which was discontinued after years, the virus can control well, says the medical officer of the German Aids-Hilfe , Armin Schafberger.
How old can a patient become with HIV?
Today, however, a series of modern medicines are able to delay the onset of the disease and improve the quality of life of people with AIDS. With consistent therapy, HIV-infected people in countries like Germany can reach a normal age. “Those who start in good time and are treated well, probably have a normal life expectancy,” says Schafberger of the German AIDS Aid. These are only extrapolations.
Will AIDS be completely defeated someday?
That is questionable. The available medicines can control the multiplication of the virus but can not remove it from the body. According to experts, a vaccine will not be available in the coming years because the HIV virus is too diverse and the Aids trigger also mutates very quickly.
Preventing AIDS with simple measures
Protecting yourself from HIV infection is relatively easy. Caution is needed wherever contact with body fluids from potentially infected persons can not be avoided. For your own safety: Be sure to avoid unprotected sex if you change partners more often. The focus of all prevention measures is the education of the population – especially the risk groups: drug addicts and homosexuals.
Prevention is today recognized by many governments as an important socio-political task. In addition to government, there are a variety of non-governmental organizations that are involved in this area.