"Today, HIV transmission has been greatly reduced in certain ways".
DR. JOSÉ LUIS DEL POZO LEÓN
DIRECTOR. INFECTIOUS DISEASES SERVICE
HIV is a virus that selectively destroys some of the cellular mechanisms with which the human body defends itself against infections and tumors, thus deteriorating certain basic elements of our immune system.
For that reason, it was coined the name of Human Immunodeficiency Virus (HIV), and for the disease that causes Acquired Immune Deficiency Syndrome (AIDS).
So far, two types have been identified: HIV-1 and HIV-2. The first is the most common.
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What are the symptoms of HIV?
The initial infection, which can occur in many cases without producing symptoms, can also cause in many others a clinical picture similar to infectious mononucleosis, consisting of fever, swollen neck nodes, malaise and skin rash.
In the chronic or latent phase, most patients do not present any symptoms. Some, especially drug addicts, may have low platelet counts. A small number of patients may present alterations of the central or peripheral nervous system.
The final phase is characterized by a progressive deterioration of the general state, whose most frequent manifestations are loss of appetite, weight loss, fever and diarrhea. Then opportunistic infections appear (Pneumocystis carinii pneumonia, tuberculosis, fungal and viral infections), malignant tumors (Kaposi's sarcoma, more frequent in homosexuals, Hodgkin's or non-Hodgkin's lymphomas, cancer of the cervix and the anorectal region); and neurological disorders.
The most common symptoms are:
- Swollen neck nodes.
- Skin rash.
- Loss of appetite.
Do you have any of these symptoms?
You may have an HIV infection
Which ones transmit HIV?
We know today that HIV infection can be acquired through the following mechanisms
a) Vertical transmission, from mother to child
From infected pregnant woman to fetus (maternal-fetal).
During delivery or breastfeeding (perinatal).
b) By blood transfusion (or administration of blood products) contaminated by HIV. Since 1985, this route has become less important.
c) By sexual transmission, by having sex with an HIV-infected person.
d) By inoculation of infected blood:
- By sharing syringes or needles used by subjects infected with HIV.
- By accidental puncture with a needle from an infected patient.
What is your prognosis?
In the evolution of HIV infection, three phases are usually distinguished:
1. An initial or acute phase, lasting several weeks.
2. A phase of clinical latency in which the infected patient may not present any symptoms. In it, the virus remains active inside the cells, although with very variable intensity from one patient to another. This phase can be of very variable duration, although in most patients it usually lasts from 8 to 10 years.
3. A final phase or crisis, which clinically corresponds to what is properly called AIDS. The new treatments have managed to significantly lengthen the life expectancy and quality of life of AIDS patients.
How is AIDS diagnosed?
The diagnosis of HIV is made through a blood test that identifies any of the components of the virus (mainly its RNA) or the antibodies formed against any of those components. These tests are simple to perform and allow us to establish with certainty whether or not there is an infection.
In the few cases where there might be any doubt, complementary tests are performed to confirm the diagnosis, such as the Western blot. No culture is required.
The quantitative determination of RNA, called "viral load" has been incorporated as a routine test. It is very useful from the prognostic point of view and to evaluate the efficacy of the treatment. It allows an earlier diagnosis of the infection than the detection of antibodies.
How is HIV infection treated?
There is no curative treatment for HIV disease. Preventive measures are, at the moment, the only means of effectively dealing with the infection. There are several procedures, meaning those that "prevent" the infection.
Since we are dealing with a disease that has a very high mortality rate, preventive measures should be required to be close to 100 % safe. There are no vaccines available that make us immune against the disease and it does not seem that they can be had in less than 10 years.
Preventive measures are applied in different circumstances:
- Infection by blood transfusion or administration of blood derivatives. In developed countries, this risk of infection is practically non-existent.
- Mother-to-child transmission. Anti-retroviral treatment of the mother during pregnancy. It reduces the risk of transmission of the disease to the child to less than 5%.
- Drug addiction. The most effective prevention is to stop using drugs intravenously. It is essential not to share syringes with infected people.
- Accidental. By punctures or cuts, in doctors or nurses when they care for infected patients. The measures to avoid the development of the infection (anti-retroviral treatment) are known by the health personnel.
- Organ transplants. The risk is zero, since the law requires that the donor be checked for infection.
- Sexual transmission. It is, along with drug addiction, the most important mechanism of HIV transmission.
Where do we treat it?
IN NAVARRA AND MADRID
The Infectious Diseases Service
of the Clínica Universidad de Navarra
This area works on the diagnosis and treatment of diseases produced by an infectious agent, which can be bacteria, virus, fungus and protozoa. Infections affect people by causing very different processes that can be located in any tissue of the human body, so it requires a specific approach.
This area carries out its activity on three fronts: care work, focused on the diagnosis and treatment of infectious diseases; teaching, with training of medical students, resident doctors and nurses; and research vocation, through the development of clinical and laboratory studies.
Organized in care units
- Infections associated with biomaterials.
- Nosocomial infections (multi-resistance).
- Infections in immunosuppressed patients.
- Community infection.
- Traveler's medicine.
- Prudent use and optimization program of anti-infective therapy.
- Control of infection by multi-resistant microorganisms.
Why at the Clinica?
- We perform the traveler's assessment and analytical tests in less than 24 hours.
- Second opinion consultation when the infection has not yet been resolved.
- We ensure the prudent use of antibiotics.