The role of your immune system is to protect your body against viruses and bacteria by targeting invaders and protecting healthy cells. Once a threat is detected, your white blood cells mobilize to protect you.
White blood cells destroy viruses and bacteria which threaten your body. White blood cells which destroy bacteria are called neutrophils. White blood cells which fight and destroy viruses are called CD4+ T lymphocytes. T lymphocytes have been called “killer” T cells because they destroy invading infections, and signal other white blood cells to do their job. Your B lymphocytes produce antibodies which help your body identify and recognize that particular virus or bacteria in the future and mobilize the immune system to fight it again.
While a healthy immune system can clear common viruses, once a person becomes infected with HIV, the virus attacks the immune system (especially the CD4+ T lymphocyte cells). Left untreated, HIV can develop into AIDS.
Many people mistakenly believe that HIV and AIDS are one and the same. There are also a significant number of people who believe that a diagnosis of HIV means AIDS is inevitable. It’s important to know that AIDS and HIV are not the same. More importantly, a person can have HIV and never develop AIDS.
HIV is the Virus That Causes AIDS
The human immunodeficiency virus, HIV, is an infection that attacks the immune system of those who contract the virus. HIV attacks and destroys CD4+ T lymphocyte cells, the white blood cells that protect you against infections and illness. As a result, the immune system does not work as efficiently or as effectively as it should. Left untreated, HIV can progress to AIDS, leaving the body vulnerable to infection and some types of cancer.
AIDS is a Medical Condition Caused by HIV Damage
AIDS, acquired immunodeficiency syndrome, develops as a result of the untreated HIV virus infection. The complications or even the shortened life expectancy of a person who has developed AIDS is not from the syndrome itself but from the way the syndrome affects the immune system. Due to the damage HIV causes to the immune system, a person living with AIDS can have difficulty fighting infections like pneumonia, tuberculosis or other opportunistic infections.
The Stages of HIV and AIDS
While HIV causes AIDS, not everyone who contracts the virus will develop acquired immunodeficiency syndrome. The rate at which HIV progresses varies significantly from person to person. Without treatment, HIV can linger without progressing to AIDS for up to a decade. With treatment, HIV activity can be controlled, and the immune system can be protected. For a person diagnosed with HIV, it may be helpful to know that there are three stages:
- Stage 1: Acute HIV
An acute HIV infection can develop two to four weeks after contracting the virus. This stage is also known as primary HIV infection. The acute stage of HIV lasts until the immune system creates antibodies to fight the virus. The symptoms of acute HIV can easily be mistaken for flu-like symptoms. Symptoms can include fever, rash, fatigue and muscle aches. However, a significant number of people never experience symptoms in the acute stage. In fact, HIV.gov estimates that one in seven Americans have HIV but do not know it.
- Stage 2: Chronic HIV
HIV is a lifelong condition. During the second stage of HIV, the virus continues to multiply and destroy CD4+ T lymphocyte cells. While there is currently no cure for the virus, there are medications that can help control HIV and reduce the severity of immune system damage. Those living with chronic HIV may not have symptoms. Medications can halt the progression of chronic HIV and prevent the development of AIDS.
- Stage 3: AIDS
AIDS is the most severe stage of HIV infection because the immune system has been significantly compromised and is unable to fight infection. A diagnosis of AIDS is determined by the CD4+ count, the T lymphocyte cell count affected by the virus. While the CD4 count in a healthy individual can range anywhere between 500 and 1600 cells/mm, the diagnosis of AIDS is made when an individual with HIV has a CD4 count of 200 cells/mm or less.
Current Treatments Can Slow Disease Progression
Currently in the US, most people with HIV do not develop AIDS. That’s because there are a number of medications, taken in a combination that halt disease progression. The use of medications to halt the progression of the virus called antiretroviral therapy (ART).
For those diagnosed with AIDS, these medications can still dramatically improve disease prognosis. ART therapy helps keep those living with the virus healthy while greatly reducing the risk of infecting others. Before the introduction of these treatments in the mid-90s, HIV could progress to AIDS within a few years.
Testing Options for HIV
HIV is diagnosed with a simple blood test or saliva test that detects antibodies related to the virus. While no HIV test can detect HIV immediately after infection, some can detect the virus sooner than others. Consider the following examples:
- Nucleic Acid Test (NAT) – can detect HIV 7 to 28 days after exposure
- Antigen/Antibody Test – accurate within13 to 42 days when performed by a lab
- Antibody test – accurate within 21 to 84 days. Most rapid testing methods and home test kits are antibody tests.
Before testing, It’s important to talk to your healthcare provider about the window period for the type of test being used. For negative test results after suspected exposure, consider a second test after the designated window has expired. If you suspect you have been infected within the past 72 hours, consult your doctor as soon as possible. Your doctor may want to prescribe post-exposure prophylaxis (PEP) to lower your risk of a permanent infection.
Everyone Should Be Tested for HIV
HIV does not discriminate by gender, age, race or sexual orientation. The only way to know your HIV status is to be tested. The Center for Disease Control (CDC) commonly recommends that everyone between the ages of 13 and 64 be tested at least once during their lifetime.
As many as one in five of those infected are unaware of their positive HIV status. Those at a higher risk of exposure to HIV may be advised to test for the virus several times each year. Just a few of the many reasons to consider more frequent testing include:
- Having more than one partner since your last test
- Sharing a needle, or drug supplies such as water or cotton, with another drug user
- Receiving a diagnosis of a sexually transmitted disease (other than HIV)
- Engaging in sexual contact without using a condom
- Having sexual contact with anyone you suspect may fit one of the preceding recommendations
Early Detection Saves Lives
“Since 1996, with the advent of highly active, antiretroviral therapy, a person with HIV with good access to antiretroviral therapy (ART) can expect to live a normal life span, so long as they take their prescribed medications,”
— Dr. Amesh Adalja, John Hopkins, Center for Health Security
With early detection and treatment, those who have contracted HIV are living long, productive lives. Current treatments can keep the virus at low levels and prevent AIDS. If treatments successfully reduce the level of viruses detected in the bloodstream to zero, there is little risk of transmitting the virus.