You Can’t Contract an STD or STI from Masturbation — but There’s a Catch
Chronic HIV Infection: What To Know
HIV is the virus that causes AIDS. The illness known as HIV/AIDS happens in three stages: acute HIV infection, chronic HIV infection, and AIDS.
But the phrase "chronic HIV infection" isn't simply the second stage of HIV/AIDS. It also describes the illness as a whole: There's no cure for HIV infection. So in a sense, it's a chronic infection no matter what stage you're in.
However, the right diagnosis and treatment in the early stages of HIV/AIDS are likely to keep you from getting to the third and final stage, where it causes the most damage. It also helps stop transmission of the virus to others.
The first possible symptoms of HIV infection may develop within 2-4 weeks after you're exposed to the virus. You might notice flu-like symptoms such as fever, headache, and rashes. Or you could have no symptoms at all.
In this first stage of HIV/AIDS (acute HIV infection) the virus reproduces itself very quickly and spreads all over your body. This makes the virus especially easy to transmit to others through sexual contact or by sharing needles with other injecting drug users. The virus starts to destroy infection-fighting cells in your immune system called CD4 T cells, or sometimes just "T cells."
Once you reach the second stage of HIV/AIDS -- chronic HIV infection -- the virus has started to reproduce at a far slower pace. Even without treatment, many people in this stage don't notice any HIV-related symptoms for 10 years or more. That's why some doctors also call it "asymptomatic HIV infection" or "clinical latency."
Still, in some cases, you might get infections or symptoms like:
Whether you have symptoms or not, without treatment, HIV continues to take a relentless toll on your immune system. Your HIV levels go slowly up and your CD4 levels go slowly down until the illness progresses to the most serious stage: AIDS.
Treatment during these early stages of the illness is likely to have huge health benefits, especially with antiretroviral therapy, or ART.
If you don't treat chronic HIV infection, your illness is likely to progress to the third and final stage, AIDS. This usually happens after 10 or more years of chronic HIV infection, though it sometimes happens sooner.
At this point, serious damage to your immune system makes it harder for your body to fight off certain infections and cancers. These "opportunistic" infections and cancers often happen in people with a weakened immune response.
This is very serious. People with AIDS who don't get treatment typically survive about 3 years. And with AIDS, you're also more likely to have a high viral load that spreads more easily to sexual partners.
It's important to keep in mind that there is no cure for HIV/AIDS. Once you have the virus, you'll need treatment to keep its worst effects at bay. That said, treatment of chronic HIV infection works very well, especially if you start it early.
Treatment involves antiretroviral therapy, or ART. This is a combination of medicines that helps stop HIV from making copies of itself. That gives your body a chance to raise the levels of CD4 cells that help fight off opportunistic infections.
Properly followed, the right prescription of antiretroviral therapy can bring your HIV viral load down so low that it can't be detected by current blood tests. This not only makes you healthier, it also makes you less likely to pass the virus on to a sexual partner. Someone with an undetectable viral load has almost no chance of passing the virus to a partner.
This undetectable viral load is the goal of ART. Maintain it, and you and your doctors may be able to keep AIDS at bay for decades. This effectively keeps you in this second stage of HIV/AIDS, chronic HIV infection, almost indefinitely.
In fact, most people in the U.S. With HIV who get ART treatment will never develop AIDS.
Your doctor can tell by doing a blood test of your CD4 immune cells. A count of less than 200 cells/mm3 means you have AIDS. Certain opportunistic infections may also be enough to diagnose this third stage of the illness.
But only your doctor can tell you your stage for certain. That's why it's important to check in regularly with your medical team about your general health and treatment if you have HIV/AIDS.
Regular checkups can ensure that you get the right treatment at the right time and that you don't put your sexual partners at risk.
As more and more people with HIV live into old age, doctors have found that chronic HIV infection might raise your risk for other illnesses like heart disease and cancer. Chronic inflammation, which accompanies HIV infection, plays a role in the development of these and other diseases.
HIV: Make The Diagnosis And Take The Next Step
The CDC estimates that with more than 40,000 new infections annually, more than 1.2 million people in the United States are living with HIV—and 24% to 27% may not be aware of their infection status.1 Studies have shown that HIV is often diagnosed late in the disease process, when the individual has already developed AIDS, which typically occurs 8 to 11 years after HIV infection.2 Research also points to missed opportunities to offer HIV testing and diagnose the infection before AIDS develops, which would enable the newly diagnosed individuals to employ precautions to protect their partners from becoming infected.3,4 Almost half of HIV transmissions studied by Brenner et al were attributed to transmission by newly infected persons.5
In response to these issues, the CDC put forth revised recommendations for HIV testing that encourage screening for patients in all health-care settings after the person is notified that testing will be performed, unless he or she declines (opt-out screening).4 Primary-care providers need a better understanding of trends in HIV infection and what to do when an HIV test is positive. In a recent survey of 1,165 primary-care providers, 54% of the respondents reported treating HIV-positive individuals, with 43% indicating an "increased" or a "dramatically increased" caseload over the past year.6
HIV viral dynamicsHIV is classified as a retrovirus that is completely dependent on CD4 T cells for copying and surviving. The virus enters the CD4 T cell by binding onto receptors and fusing with the lipid outer layer. The virus then converts its ribonucleic acid (RNA) to deoxyribonucleic acid (DNA) through the enzyme reverse transcriptase. The enzyme integrase helps the virus to become part of the human DNA in the cell's nucleus. During transcription and translation, enzymes assist the HIV genes by converting them into messenger RNA, which then leaves the nucleus with the HIV codes within. The enzyme protease makes smaller pieces of the long strands of protein; these pieces become mature viral cores. The new virions bud from the CD4 T cell and go on to infect other cells and repeat the process. HIV can replicate itself billions of times each day.
Signs and symptoms of HIV infectionAcute retroviral syndrome (ARS) occurs early in the new infection. Approximately 50%-70 % of HIV-positive persons will experience an influenzalike illness that may consist of one symptom or a constellation of symptoms including fever, rash, pharyngitis, lymphadenopathy, and myalgias. Because these symptoms are nonspecific and frequently resolve on their own, without a high index of suspicion clinicians may not consider HIV infection in the differential diagnosis. An exposed individual usually becomes symptomatic two to four weeks after transmission and will have a markedly high HIV viral load (amount of virus in the serum).
The asymptomatic period of HIV infection can last from a few months to up to 15 years. This varies from person to person and is usually associated with the level of HIV viral load—typically, those with higher viral loads deteriorate faster than those with lower loads. During this time, the CD4 T cells usually decline at an average rate of approximately 50 cells/µL/year. The CDC defines AIDS as persons with both documented HIV infection and CD4 T cells <200/mm3 whether other AIDS-defining conditions are present or not, or the presence of an AIDS-defining condition (Table 1).
Many patients will be asymptomatic during the clinical latency period, but various nonspecific findings on physical examination and in lab tests are associated with HIV. Generalized nontender lymphadenopathy involving the cervical, occipital, and/or axillary nodal chains is very common and can persist beyond primary infection. The presence of unexplained fevers, weight loss, night sweats, dementia, and neuropathy help rule in HIV infection. Skin lesions may be suggestive of HIV infection. Seborreahic dermatitis, psoriasis, molluscum contagiousum, and extensive condyloma are all diagnoses associated with HIV infection. Oral candidiasis (thrush) and oral hairy leukoplakia may be seen when CD4 T cells fall to less than 500/mm3. Recurrent or severe herpetic lesions and chronic vaginal candidiasis should prompt consideration of HIV testing. Unexplained anemia, neutropenia, leukopenia, and an elevated protein level are all commonly seen laboratory abnormalities caused by HIV infection.
School Of Dentistry Names Deborah Greenspan Orofacial Sciences Chair
Deborah Greenspan
Deborah Greenspan, BDS, DSc, UCSF School of Dentistry professor of clinical oral medicine, interim chair of the Department of Orofacial Sciences and clinical director of the UCSF Oral AIDS Center, has been appointed chair of Orofacial Sciences. "She is an international leader in oral science and has spoken extensively on oral cancer, oral candidiasis, AIDS, the oral manifestations of HIV infection and infection control," said John D.B. Featherstone, MSc, PhD, interim dean of the UCSF School of Dentistry.Originally from England, Greenspan has been at UCSF since 1976. She has served as a consultant to the Centers for Disease Control and Prevention and on many University of California Academic Senate committees, including Academic Planning and Budget as well as Equal Opportunity. Greenspan is a leading investigator and clinician specializing in oral infectious diseases, and has long worked with colleagues throughout the world to improve oral and general health. Her international work includes training a generation of clinicians in clinical care and in developing research programs. Greenspan has made a number of discoveries concerning oral health: delineating new lesions associated with HIV infection, devising new ways of treating mouth problems in HIV-positive people and charting changes in the AIDS epidemic since its beginning in San Francisco. Greenspan's discovery of hairy leukoplakia - a white patch with a corrugated or hairy appearance on the side of the tongue - which is found in those with severe defects of immunity, opened up new aspects of AIDS research worldwide. Her research in Epstein-Barr virus, a member of the herpesvirus family, led to pioneering, effective oral care. High Honors Honored multiple times this past year, Greenspan was named an ambassador by Research!America's Paul G. Rogers Society for Global Health Research and, most recently, was the recipient of an honorary doctor of science degree from King's College London. Greenspan is president of the International Association for Dental Research and is immediate past chair of the San Francisco Division of the University of California Academic Senate. She is a fellow of the American Association for the Advancement of Science and a member of the Institute of Medicine of the National Academy of Sciences, and in 2000, received the Silver Medal of the Ville de Paris. In 1989, she was named Seymour J. Kreshover Lecturer by the National Institute of Dental and Craniofacial Research and also received the Samuel Charles Miller Award from the American Academy of Oral Medicine. That same year, she was awarded a Certificate of Commendation by the US Assistant Secretary for Health for her work with AIDS.
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