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Getting to know HIV


In light of Russell T Davies' new drama ‘It’s A Sin’, set in 1980s Britain during the HIV/AIDS crisis, and the extremely moving insight to some of the lived experiences during this time - we wanted to spread some awareness on HIV/AIDS. We will do this with a series of posts discussing the science of the disease and more.


Many of us have heard of, or read about HIV, but what exactly is HIV and what does it do?


HIV stands for ‘Human Immunodeficiency Virus’ and it is a virus that attacks the immune system by infecting and destroying our immune system cells.


If HIV is not treated, the disease can become Acquired Immunodeficiency Syndrome (AIDS), where the immune system is extremely weak and cannot fight off infections.


HIV originates from chimpanzees in Central Africa. The chimpanzee form of the virus (SIV; Simian Immunodeficiency Virus) is likely to have jumped to humans when humans came into contact with infected chimpanzee blood when hunting them for meat. [1]


Burden


Approximately 33 million people have lost their lives to HIV over the years. The highest burden owes to parts of Africa, where 61% of new cases globally occur [1] . At the end of 2019 an estimated 38 million people were living with HIV around the world. [2]


In the UK it is estimated that around 105,200 people were living with HIV by the end of 2019, 94% of which have been diagnosed, but this still leaves 6% (around 600 people) unaware of their positive status. Of those diagnosed, a large proportion (97%) are receiving treatment and are unable to transmit the virus. [3]


Transmission & Stages


HIV is transmitted in blood and certain body fluids during...

  • Unprotected anal and vaginal sex

  • Mother to child during pregnancy, birth and breastfeeding

  • Sharing needles and other drug equipment

  • Infected blood transfusions or organ donations


HIV cannot be transmitted via these means: hugging, kissing, insect bites, sharing food or cutlery, sneezing and coughing. These are common myths that were spread around the globe as HIV emerged.



There are three distinct stages of HIV infection:


The virus invades your immune system cells and destroys them (specifically a type of T cell called CD4+ cells), weakening the immune system.


1. Initial infection


  • After becoming infected with HIV, you are highly contagious initially (for about a month), as your viral load is high.

  • Some people experience a flu-like illness a few weeks after becoming infected as your body is reacting to the infection, though others may not experience any symptoms.


2. Chronic infection


  • During this stage HIV remains dormant in the body, still replicating, but at low levels.

  • People may not experience any symptoms and are unaware of being infected, yet can infect others.

  • This stage can last for many years (up to around 10 years).

  • During the latter phase of this stage the immune system weakens to a very low level, progressing to the final stage…


3. AIDS


  • This is the final and life-threatening stage of HIV infection.

  • The immune system is very weak and cannot fight off infections. Cancers can also develop.

  • This stage can persist for several years.


If somebody is taking antiretroviral drugs they will never develop AIDS.


[1]


The diagram above depicts the changes in the amounts of HIV virus and CD4+ cells over time during the three main stages of HIV infection.



Treatment


Over the years as our understanding of HIV has increased, medical advancements have allowed people who are HIV-positive to live a healthy, long and happy life by taking antiretroviral drugs that suppress the replication of the virus.


  • Post-exposure prophylaxis (PEP) are drugs you can take during 72 hours of suspecting being exposed to the virus, to prevent you developing HIV.

  • If you test positive it can be treated with antiretroviral drugs (ART) that stop the virus replicating. Though you will never be cured of HIV these drugs suppress the viral load so that you cannot transmit the virus to others or develop AIDS.


Prevention

  • Know your status and get tested!

  • Use condoms during sexual anal or vaginal sex

  • If HIV-positive, do not breastfeed if safe to do so (however breastfeeding in low-income countries is still recommended as there is no safe alternative)

  • If HIV-positive, take antiretroviral therapy (ART) during pregnancy

  • Screen blood and organs before a transplant

  • Pre-exposure prophylaxis (PrEP) - drugs to prevent infection, that can be taken by somebody who is HIV-negative but is at a high risk of contracting HIV (e.g. the partner of somebody HIV-positive)


Future


The wondrous advancements in medicine mean that those who test HIV-positive can now take antiretroviral drugs that suppress the viral load. This means you can live a healthy life with HIV without ever passing it on to others, or progressing onto AIDS. However HIV does still present its challenges in that there is no cure as it stands as there is a lot we do not understand about the virus.


Though interestingly two people have been cured of HIV by having a stem cell transplant to treat cancer they had developed due to HIV. The transplant prevented immune system cells being able to be infected with HIV [2]. This treatment however is not likely to become an option that is widely available due to extensive costs and side effects.


There is hope to develop a vaccine against HIV. Producing a vaccine that works against HIV is posing a challenge as when HIV infects the body the immune system does not respond to it. HIV also mutates very quickly, meaning it can change its genome. This means that a vaccine would need to be reproduced often to be effective against every variant.


Looking forward to the future it is paramount that everybody across the globe has access to HIV-testing and the necessary treatment to live a healthy life.



- A

 

Click on these charities for further information about HIV/AIDS:



A global organisation leading the worldwide mission to end AIDS as a public health crisis by the year 2030.


The UK’s leading HIV charity. Terrence Higgins was one of the first British people to die of an AIDS related illness in 1982. The charity supports those living with HIV and educates about sexual health.


A UK charity that provides peer-led support to those living or affected by HIV. The charity offers a range of services from help when planning parenthood, support when recently diagnosed and helps people form lifelong friendships.


A UK based charity that works with people living with, and affected by HIV, providing a range of services from counselling to financial support and mentoring.


A UK charity focusing on educating and spreading awareness surrounding HIV and sexual health.


A UK human rights HIV charity working to break down stigmas and discrimination surrounding HIV transmission.


 

Some great TV documentaries and dramas we recommend if you have not watched already:

  • It’s A Sin: A Channel 4 five-part drama series set in the 1980s, following the lives of a group of gay men in the UK during the rise and spread of HIV/AIDS.

  • Gareth Thomas: HIV and me


 

References


[1] Centers for Disease Control and Prevention, (2020). About HIV https://www.cdc.gov/hiv/basics/whatishiv.html


[2] World Health Organisation, (2020). HIV/AIDS https://www.who.int/news-room/fact-sheets/detail/hiv-aids


[3] National AIDS Trust, (2020). HIV in the UK statistics https://www.nat.org.uk/about-hiv/hiv-statistics


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