Prevention of Infection in HIV-infected Patients

Understanding HIV Infection

Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging the immune system, HIV interferes with the body's ability to fight infection and disease. HIV is a sexually transmitted infection and can also be spread by contact with infected blood and from illicit injection drug use or sharing needles, and spread from mother to child during pregnancy, childbirth, or breastfeeding. Without medication, it may take years before HIV weakens the immune system to the point that AIDS develops.

Symptoms of HIV Infection

The symptoms of HIV and AIDS vary, depending on the phase of infection. The majority of people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This primary phase of HIV infection may last for a few weeks. Initial symptoms may include fever, headache, muscle aches and joint pain, rash, sore throat and painful mouth sores, swollen lymph glands (mainly on the neck), diarrhea, weight loss, cough, and night sweats. These symptoms can be mild and unnoticeable. However, the amount of virus in the blood (viral load) is quite high at this time and infection spreads more easily during primary infection than during the next stage.

Clinical latent infection (chronic HIV) is the next stage of infection. HIV is still present in the body and in white blood cells, but many people may not have any symptoms or infections during this time. This stage can last for many years if treated with antiretroviral therapy. Some people develop more severe disease much sooner.

As the virus continues to multiply and destroy immune cells (those that help fight infection), mild infections or chronic signs and symptoms may develop such as fever, fatigue, swollen lymph nodes, diarrhea, weight loss, oral yeast infection, shingles, and pneumonia.

Access to better antiviral treatments has slowed the progression to AIDS and dramatically decreased deaths from AIDS. Because of these treatments, most people with HIV in the U.S. today do not develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years. When AIDS occurs, the immune system has been severely damaged. In those with AIDS, it will be more likely to develop diseases that would not usually cause illness in a person with a healthy immune system (opportunistic infections or opportunistic cancers).

Diagnosis of HIV Infection

HIV can be diagnosed through blood or saliva testing. It takes time for the body to develop a response and for tests to detect HIV. Antigen/antibody combination tests can take 2 – 6 weeks after exposure to become positive. Antibody tests can take 3 – 12 weeks after exposure to become positive. Nucleic acid tests will be the first test to become positive, about 10 – 33 days after exposure.

Treatment of HIV/AIDS Infection

There is no cure for HIV/AIDS, but medications can control the infection and prevent progression of the disease. Antiviral treatments for HIV have reduced AIDS deaths.

Role of Immune Globulin Therapy

Immune globulins are found naturally in the body and help fight infection. Some patients with recurrent infections may benefit from replacement immune globulins. Immune globulin is extracted from a large pool of human plasma and contains all the important antibodies present in the normal population. Immune globulin therapy can be administered into the blood stream intravenously (IVIG) or under the skin subcutaneously (SCIG).

References:

• HIV/AIDS - Symptoms and causes - Mayo Clinic
• Types of HIV Tests | Testing | HIV Basics | HIV/AIDS | CDC