HIV 1 – What is HIV?

WHERE ARE WE WITH HIV?

HIV continues to be a major global public health issue.^1a
There were an estimated 39 million people living with HIV at the end of 2022.^1b
Africa remains most severely affected, accounting for more than two-thirds of all people living with HIV worldwide.^1c

There is still a great need to further increase awareness and enable better access to affordable medications, thereby improving the quality of life for all people living with HIV.^1m

WHAT IS HIV / AIDS?

HIV | human immunodeficiency virus
HIV destroys the ability of the body’s immune cells to function and so over time, people gradually become immunodeficient (unable to fight off infection).^1d
AIDS | acquired immunodeficiency syndrome (AIDS)
When HIV is left untreated, it leads to the disease AIDS – this is the most advanced stage of HIV infection. A person with AIDS is more susceptible to developing a wide range of infections, certain cancers and other severe long-term clinical complications.

HOW DOES HIV CAUSE DISEASE?

HIV attacks and destroys the CD4 cells of the immune system. CD4 cells are a type of white blood cell that play a major role in protecting the body from infection. The loss of CD4 cells makes it difficult for the body to fight off infections and certain cancers.^3a,b
HIV uses the CD4 cells to multiple and spread throughout the body. HIV can also ‘hide out’ inside these cells for years forming a ‘latent’ HIV reservoir. At any time, cells in the latent reservoir can become active again and start making more HIV.^3b,c

The virus at work:

HOW DO YOU GET HIV?

HIV is spread through the exchange of body fluids from infected people, such as blood, breast milk, semen and vaginal secretions. HIV can also be transmitted from a mother to her child during pregnancy and birth.¹ⁱ

HIV is not transmitted through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water, sharing a toilet, or contact with urine.¹ⁱ

DID YOU KNOW?

People living with HIV who are consistently on HIV treatment and who have viral loads suppressed to undetectable levels on blood tests do not transmit HIV to their sexual partners.^1j

Early access to HIV treatment and support to remain on treatment is critical not only to improve the health of people living with HIV but also to prevent the spread of HIV.^1j

SIGNS AND SYMPTOMS

The progression of HIV infection is generally understood in terms of three main phases:

Acute HIV Infection: This is the initial stage, occurring shortly after infection, where the virus replicates rapidly and there may be flu-like symptoms.
Chronic HIV Infection (Clinical Latency): This stage can last for many years if HIV is well controlled with antiretroviral therapy (ART). During this phase, the virus is still active but reproduces at low levels. People may not have symptoms or may experience mild symptoms.
Acquired Immunodeficiency Syndrome (AIDS): This is the most advanced stage of HIV infection. AIDS is diagnosed based on specific criteria such as a very low CD4 cell count (below 200 cells/mm³) or the presence of opportunistic infections or cancers that indicate severe immune suppression.

WHO IS AT RISK OF CONTRACTING HIV?

Certain behaviours can increase people’s risk of getting HIV. These include:^1k

Having unprotected anal or vaginal sex
Having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhoea or changes of the vaginal environment resulting in vaginal candidiasis (thrush) or bacterial vaginosis
Sharing contaminated needles, syringes when injecting drugs
Receiving unsafe injections, blood transfusions and medical procedures that involve unsterile cutting or piercing
Accidental needle stick injuries, which can involve health workers
Don’t share razors, toothbrushes and other personal items that may come in contact with another person’s blood
Ensure that all tattoo and body piercing instruments are sterile before use.

HOW DO YOU FIND OUT IF YOU HAVE HIV?

There are normally two tests that can be done to diagnose and confirm HIV infection.^5a HIV testing services is the main entry point to continued HIV care.^5b HIV testing can usually be accessed from outpatient clinics, medical, surgical and paediatric wards, emergency units, and maternal/child health clinic services.^5cCounselling can be provided before and after you are tested for HIV.^5d
You can also buy an HIV testing kit at your nearest pharmacy and self-test at home.³ⁱ If you’re positive, it is important to get to your doctor or local clinic as soon as possible.^5e
It is important to know your own HIV status so that necessary prevention and/or treatment can be started.^5f,gFor more information on prevention of HIV infection (pre-exposure prophylaxis and post-exposure prophylaxis): read here.

For any questions and support, The National AIDS Helpline contact details are 0800 012 322.^5h

WHAT IS THE ‘WINDOW PERIOD’?

When a person is infected with HIV, the body may take up to 28 days to produce antibodies in high enough levels to be detected by a test. This is called the window period. It is during this time that a person can unknowingly transmit HIV to other individuals who are for example their sexual or drug-sharing partner.^1l

BLOOD TESTS

All people with HIV should have regular blood tests. The two most important blood tests are for CD4 count and viral load.^6a

VIRAL LOAD AND VIRAL SUPPRESSION

Antiretroviral medicines suppress the amount of virus in the blood, called viral load:^7a
What is viral suppression? When antiretroviral therapy reduces a person’s viral load to an undetectable level. Viral suppression does not mean a person is cured, HIV still remains in the body. If treatment is stopped, the person’s viral load will start to increase again.^7b,c

MEDICATIONS

HIV treatment involves taking medicine that reduces the amount of HIV in your body. HIV medicine is called antiretroviral therapy (ART).^10a
It is important to know that:

There is no effective cure for HIV. But with proper medical care, you can manage HIV.^10b
Taking HIV medicine does not prevent transmission of other sexually transmitted diseases.^10b

HIV medicine is recommended for all people with HIV – children, adolescents, adults, pregnant and breastfeeding women – regardless of how long they’ve had the virus or how healthy they are.^5i,10c

WHAT IS THE GOAL OF TREATMENT?

The main goal of ART is to reduce a persons viral load to an undetectable level and restore or preserve immune function which will lead to a reduction in risk of illness and death.^8a,b,9a
Patients should be prepared for lifelong ART with good adherence to medications – this is a critical component of achieving effective viral suppression.^8c,d

HOW DO THEY WORK?

People on ART take a combination of HIV medicines from at least two different HIV drug classes every day. Different classes of HIV medicines are designed to target specific steps in the HIV life cycle – ART is therefore very effective at preventing HIV from multiplying.^3j
For more on how these medicines work and specific treatment regimens for people with HIV, you can read further here – HIV treatment for Adults.

Speak to your doctor or pharmacist for further advice on your condition and the best treatment options for you.

Medical References