HIV (Human Immunodeficiency Virus)

Human Immunodeficiency Virus (HIV) is a Deadly Virus. It is a bad news that most of the patient get the disease through sexual contact, and worse still, there are also other ways to get infected. The effects of the infection are lifelong. Despite long research and medical advances, there is still no effective medicine to definitely prevent or cure the disease, but medication have helped the HIV patient to live longer and reduce the disease severity.

How HIV spread?
The virus are spread only through body fluid contact (like blood, semen (cum), vaginal fluid, or breast milk). This occur via :-

1. Sex
As there are rough body contact, involving soft organs, combined with bleeding and secretions produced in sexual act, this virus can get transferred from a person to another through sex. Unprotected sex causes mixing of body fluid between partners and virus in the fluid gets transferred as well. While all unprotected sex are high risk, it is even riskier in anal sex, due to natural fragility of the anus membrane covering.

2. Needles
Intravenous drug users, use syringes to ‘shove in’ the drugs. While doing so, blood gets into contact with the needles. If the previous user is HIV infected, the next user of the syringe will introduce the virus into his/her blood by sharing the needle. 15 – 20% of HIV patients are intravenous drug users. Unsterilized needles or sharps like tattoo needles or razors (eg: barber, hijama) can also deliver the virus to shared users.

3. Blood and Organ (Donor) Transfer
Although this is rare, it can happen if the blood and organ are not tested properly for presence of infections.

4. Pregnant Mother to Baby
Although mother’s blood and baby’s blood are not mixed together in the womb, still there is possibility of transmission of the virus, most likely to happen during a normal (via vagina) birth. Which is why doctor will offer HIV infected pregnant lady to give birth via surgery (c-section), to prevent transmission of HIV to the baby.

5. Breast milk
Babies can get infected by consuming breast milk from infected mothers.

How HIV Causes Problem?

HIV stands for Human immunodeficiency Virus. It specifically infect human cells that comes in contact with infected body fluids (like blood, semen (cum), vaginal fluid or breastmilk).
Immunodeficiency means deficiency in immunity for fighting diseases ( think as immuno = immunity ).
As general rule, virus is parasite-like organism (which means they depend and destroy their host to live). Virus need to be inside cells to produce nutrient supplies and breed. When they are outside cells, they are lifeless (or dormant). Inside cells, they became active, like going to a rock concert, replicating itself like mad.
Contra to that, in a normal person, immunity, powered by white blood cells, will fight the virus.

But, unlike common viruses around us, HIV is a ‘Clever’ Virus. Instead of get killed by our immune system, it makes the immune system work for them. Like virus that infect computers, HIV virus send death code to turn our cells ‘crazy’. It makes the white blood cells feed and breed the virus until the cells itself succumb to death. This virus, together with it’s new ‘babies’ will infect another cells, and then again this vicious cycle continues until there is no more immune system cell for them to infect.

At late stage, HIV infection leads to AIDS (Acquired Immunodeficiency Syndrome). At this point, immunity is very low and patient is very vulnerable to any kind of infections. White blood cells in their blood becomes critically depleted. They can even die from common flu, due to extreme disability to fight against diseases. AIDS patients’ life expectancy is around 3 years without treatment, and in case of getting other kind of infections, this will reduce to just 1 year.

SYMPTOMS OF HIV

HIV infection is Long-term and Deadly at final stage. It’s effect is not dramatic and the symptoms
mainly mimic common illness. HIV symptoms include :-

1. Fever: which last for few months, relentlessly
2. Chills and night sweat
3. Muscle pain
4. Tiredness
5. Swollen lymph nodes
6. Mouth ulcers

At Later Stage of illness, when it progressing to AIDS, symptoms can include :-

1. Rapid, weight loss
2. Relentless fever
3. Profuse, unexplained night sweat
4. Diarrhea lasting for more than a month
5. Sores of mouth, anus or genitalia
6. Red, brown, pink or purplish blue blotches on or under skin around eyes, mouth and cheek
7. White spots in oral cavity (oral candidiasis)

HIV TEST

It may take months to years before any symptoms are apparent. While waiting for the symptoms to become clear-cut, chances are, it already progressed or it already transferred to someone else. Testing is the only way to discover it in early stage. Even that, the disease can hide itself in latent stage where it is not detectable through testing for a range of 2 weeks to 6 months. During this period the virus is reproducing at low level, but it is still infective, because once HIV infect a person, it never leave.

In Malaysia, it is MANDATORY for Pre-Marital HIV Screening.

HIV screening test is anonymous and fast. Future spouse need to be tested as well. Either get tested together or separately (different time/day of testing).

In case of positive or doubtful results, doctors will suggest more elaborate tests.
This will include :-

1. Blood Test : for white blood cell (and CD4 cell) count, virus DNA in blood, whole blood count, kidney and liver function tests
2. Vaginal/ Urethral Fluid Test : in case of sexually transmitted disease probability
3. Related Test of Opportunistic Infection : if necessary, this set of tests is important to confirm the disease status, as it is a serious disease, and to direct the treatment.

** note the difference between a screening test and a blood test, both for HIV. Screening HIV Test will only prick at your fingertip (one drop of blood), meanwhile HIV Blood Test will need at least 5ml of your blood.
So technically, a blood test is MORE ACCURATE & MORE SENSITIVE to detect HIV.

TREATMENT.

This virus is lethal and anti-retroviral therapy is important to reduce HIV spread and production. It is not meant to completely cure the illness but it helps to delay the progress to AIDS. It will also help to reduce chances of spreading the virus to others.

It may vary depending on the HIV test results, current medical conditions and cost of treatment. There are 25 kinds of HIV medication available nowadays to help patients with different needs and severity.
Treatment and 4-6 monthly follow-up visit will be continued LIFELONG, to assess the disease state. During this period it is important to be prudent with other illness as well, because of weakened immunity status of the patient.

PREVENTION

HIV is a tough disease to deal with and there is No Cure. Hence, PREVENTION IS KEY !

1. Avoid Promiscous Sex : Reduce the number of sexual partner, monogamous relationship or abstinence is better
2. Practice Safe Sex : use condoms consistently and correctly
3. Avoid Drug Abuse
4. Use Sterilized Needles/Sharps for Drug or Invasive Procedures
5. Screening for HIV (as well as other STD) yearly

HIV is seriously the last thing you want to have. It is a very sad disease to bear with. Think Twice before running wild for impulsive tatoos, sex or drugs. It might be a matter of life or death !