Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) are severe chronic infectious diseases that threaten life. Since their initial discovery in the 1980s, these diseases have become major public health concerns worldwide. HIV is a virus that destroys T cells in the immune system, which can ultimately lead to severe immune deficiency and progress to AIDS. This disease not only affects physical health but can also have profound impacts on patients' mental health, social relationships, and economic status.
According to data from the World Health Organization, approximately 38 million people worldwide are infected with HIV. Although advances in medical treatment have transformed this disease into a manageable chronic condition, misconceptions and discrimination still persist in society. Understanding the mechanisms of HIV infection, symptoms, diagnostic methods, and treatment options is key to prevention, reducing transmission, and improving patients' quality of life.
HIV is an RNA virus that primarily infects human T lymphocytes and macrophages, gradually destroying the core functions of the immune system. The virus is transmitted through specific body fluids such as blood, semen, vaginal secretions, and breast milk. The main transmission routes include:
After infection, the virus enters an acute phase, a latent asymptomatic period, and an AIDS stage. Risk factors include lack of treatment, multiple sexual partners, and poor hygiene knowledge. Studies indicate that injection drug users who share needles have an infection risk more than 30 times higher than the general population.
HIV has a high mutation rate, allowing it to evade immune responses. The virus enters cells via the CD4 receptor and uses host cell mechanisms to replicate its genetic material, leading to the release of numerous viral particles. Continuous immune system destruction causes CD4 cell counts to gradually decline. When the count drops below 200/μL, it meets the diagnostic criteria for AIDS. This process can take several years and is highly insidious.
Initial HIV infection may cause flu-like symptoms. Approximately 50-90% of infected individuals develop the following symptoms within 2-4 weeks after infection:
During the asymptomatic latent period, patients may have no obvious symptoms for years, but the virus continues to replicate. When progressing to AIDS, common symptoms include prolonged fever, unexplained weight loss, recurrent infections (such as Pneumocystis pneumonia, cryptococcal pneumonia), and opportunistic infections (such as oral candidiasis, chronic diarrhea). Some patients may also experience neurological symptoms like memory impairment or coordination difficulties.
AIDS-related symptoms are often associated with severe immune suppression. Common manifestations include recurrent severe infections, certain cancers (such as Kaposi's sarcoma), and persistent systemic symptoms (such as fever lasting over a month and unexplained weight loss exceeding 10%). These symptoms vary greatly and require laboratory data for diagnosis.
HIV infection is primarily diagnosed through blood tests, including:
Following a positive initial screening, confirmatory tests such as Western blot or PCR nucleic acid testing are necessary. The criteria for AIDS diagnosis according to CDC standards include a CD4 count below 200/μL or the presence of specific opportunistic infections or characteristic diseases (such as toxoplasmosis, cryptococcosis).
The diagnostic process includes:
Early diagnosis is crucial for effective treatment. It is recommended that high-risk individuals undergo screening every 6-12 months.
Current treatment centers on antiretroviral therapy (ART), which uses a combination of three or more drugs to effectively suppress viral replication. The goal is to reduce the viral load to undetectable levels and restore immune function. Modern treatment regimens have evolved into single-tablet formulations, improving patient adherence.
The effectiveness of treatment is closely linked to patient compliance. Interrupting therapy can lead to viral mutations and drug resistance. Studies show that continuous, regular treatment can extend life expectancy close to that of uninfected individuals. New therapies include immune modulation and gene therapy clinical trials, offering future treatment directions.
Management involves not only medication but also:
Managing medication side effects is key to successful treatment. Common side effects include lipid metabolism abnormalities and renal impairment, which require close monitoring by healthcare teams.
Preventive measures include:
Research in 2019 shows that PrEP can reduce the risk of sexual transmission by up to 99%. Public health policies promote anonymous testing services and medication subsidies to effectively increase prevention coverage.
Recent developments in prevention include:
Health education should target high-risk groups (men who have sex with men, injection drug users) and be combined with legal reforms to protect the rights of infected individuals, encouraging proactive medical consultation.
Seek medical attention immediately if:
If asymptomatic, individuals with high-risk behaviors should also undergo testing:
The World Health Organization recommends that all adults aged 15-64 undergo at least one HIV screening test, and high-risk groups should be tested every 3-6 months.
Pregnant women, children, and immunocompromised patients require special attention:
Early medical intervention can significantly improve prognosis. Timely treatment can make patients' life expectancy close to that of the general population.
HIV is mainly transmitted through blood, semen, vaginal secretions, and breast milk. Daily interactions such as sharing utensils, handshakes, or contact with open wounds do not transmit HIV. The virus survives poorly outside the body and requires direct entry into the bloodstream to cause infection. Therefore, general social interactions pose no risk of transmission.
Can HIV be completely cured with antiretroviral treatment?Current antiretroviral therapy (ART) can effectively suppress viral replication, reducing the viral load to undetectable levels. However, it cannot eliminate latent viral reservoirs within the body. Patients need lifelong medication, and there is no cure yet. "Undetectable = untransmittable," but treatment must not be interrupted.
If accidentally pricked by a potentially contaminated needle, what should be done?Immediately wash the wound thoroughly with soap and water, and seek medical evaluation as soon as possible. Doctors may recommend post-exposure prophylaxis (PEP) within 72 hours and monitor viral indicators. Prompt handling in this situation can significantly reduce the risk of infection.
Can HIV-infected individuals safely give birth to healthy babies?With regular antiretroviral treatment, maternal viral load can be reduced to undetectable levels, lowering vertical transmission risk to below 1%. Under professional medical supervision, natural vaginal delivery and breastfeeding carry extremely low risks. Modern medicine provides comprehensive safe childbirth options.
Do early diagnosis and treatment of HIV-infected individuals result in a life expectancy similar to that of the general population?If diagnosed early and adherent to medication, immune function can be maintained long-term, and life expectancy can approach that of uninfected individuals. The key is strict adherence to treatment plans and regular follow-up to prevent complications and side effects that could impact quality of life.
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