Acquired Immuno Deficiency Syndrome ( AIDS ) : Diagnosis and management

Acquired Immuno Deficiency Syndrome ( AIDS ) : Diagnosis and management

AIDS is caused by human immunodeficiency virus (HIV). HIV kills or damages the body’s immune system cells.

AIDS is generally caused by unprotected sex with an infected partner. It may also spread through the use of infected syringes of HIV infected people and blood transfusions.

The first sign of AIDS is influenza (flu) like symptoms or may be swollen glands, but at times, symptoms might not appear. Symptoms may appear after two or three months. Generally, blood test is done to confirm the diagnosis. There is no cure, but there are many medicines to fight/ control HIV infection.

Symptoms of AIDS

Acute symptoms: The majority of people infected by HIV develop Influenza (flu) like illness within a month or two, after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible symptoms include:

Sore throat
Muscle soreness
Mouth or genital ulcers
Swollen lymph glands, mainly on the neck
Joint pain
Night sweats

Clinical latency:

There is persistent swelling of lymph nodes during clinical latent HIV. Else, there are no specific signs and symptoms. However, body remains infected with the virus.

Causes  of AIDS

A person becomes infected with HIV/AIDS by several ways:

Blood transfusions: In some cases, the virus may be transmitted through blood transfusions.
Sharing infected needles: HIV can be transmitted through needles and syringes contaminated with infected blood.
Sexual Contact: The most frequent mode of transmission of HIV is through sexual contact with an infected person.
From mother to child: A pregnant woman infected with HIV virus can transmit the virus to her foetus through their shared blood circulation, or an infected nursing mother can transmit it to her baby through her breast milk.

Diagnosis of AIDS

HIV test is done to detect human immunodeficiency virus in saliva, serum or urine. The UNAIDS/WHO policy statement on HIV Testing states that conditions under which people undergo HIV testing must be anchored in a human rights approach that pays due respect to ethical principles . According to these principles, the conduct of HIV testing of individuals must address:

Confidentiality: The entire process of testing and results are kept confidential to give boost to individuals, couples, and families to learn about  their HIV status in the convenience and privacy of their home environment. Home-Based HIV Testing and Counseling (HBHTC) allows rapid HIV tests that are most often used, so that results are available for the client between 15 and 30 minutes. It is:

Accompanied by counselling (for those who test positive).
Conducted with informed consent of the person being tested.

In diagnosis of HIV/AIDS several tests can help physician to determine what stage of the disease. These tests include:

Window period: There is a period of time between HIV infection and the appearance of anti-HIV antibodies that can be measured which is called “window period”. Antibody tests may give false negative (no antibodies are detected despite the presence of HIV) results during the window period, an interval of three weeks to six months between the time of HIV infection and the production of measurable antibodies to HIV sero conversion.

CD4 count: CD4 cells are a type of white blood cell that’s specifically targeted and destroyed by HIV. A healthy person’s CD4 count can vary from 500 to more than 1,000. Even if a person has no symptoms, HIV infection progresses to AIDS when his or her CD4 count becomes less than 200.

Rapid or point-of-care tests: The rapid test is an immunoassay used for screening, and it produces quick results, in 20 minutes or less. Rapid tests use blood or oral fluid to look for antibodies to HIV. If an immunoassay (lab test or rapid test) is conducted during the window period  (i.e., the period after exposure but before the test can find antibodies), the test may not find antibodies and may give a false negative result. All immunoassays that are positive need a follow up test to confirm the result.

ELISA (enzyme-linked immunosorbent assay): ELISA is set of blood tests used to diagnose HIV infection.  ELISA test is performed by inserting a needle to draw blood. A positive result on the ELISA screening test does not necessarily mean that the person has HIV infection. Certain conditions may lead to a false positive result, such as Lyme disease, syphilis, and lupus.

RNA tests : It detects the virus directly (instead of the antibodies to HIV) and thus can detect HIV at about 10 days after infection, as soon as it appears in the bloodstream, before antibodies develop. These tests cost more than antibody tests and are generally not used as a screening test, although doctor may order one as a follow-up test, after a positive antibody test, or as part of a clinical workup.

Western Blot: A positive ELISA test is always followed by a Western blot test which confirm HIV infection.

Management of AIDS

Definitive cure for AIDS is yet to be discovered. However, some medicines, given at certain stage of the disease, depending upon CD4 count in the blood of the patient, can prolong life of HIV positive persons.

Reverse transcriptase (RT) inhibitors – It interferes with a critical step during the HIV life cycle and keep the virus from making copies of itself.

Protease inhibitors – It interferes with a protein that HIV uses to make infectious viral particles.

Fusion inhibitors – It blocks the virus from entering the body cells.

Integrase inhibitors – It blocks an enzyme HIV needs, to make copies of itself.

Multidrug combinations – It combines two or more different types of drugs into one. These medicines help people with HIV, but they are not perfect. They do not cure HIV/AIDS. People with HIV infection still have the virus in their bodies. They can still spread HIV to others through unprotected sex and needle sharing, even when they are taking their medicines.

Avoiding AIDS is as easy as ABC;
A= Abstain
B= Be faithful
C= Condomise

HIV prevention refers to practices done to prevent spread of HIV/AIDS. HIV prevention practices may be done by individuals to protect their own health:

Spreading awareness among masses: Protected sexual contact through the use of condoms, reduces the risk of HIV/AIDS.Providing awareness among population about their HIV status especially in high risks population. High risks population involves sex workers and their partners, Intravenous drug users, truck drivers, labuor migrants, refugees and prisoners.

Safe injections: Use of auto disposal syringes help to prevent HIV infections.

Male circumcision: It is the surgical removal of the foreskin (prepuce) from the human penis.
Safe blood transfusion procured only from authorized and accredited blood banks.
Counselling of HIV positive pregnant mother on the issue of how to prevent parent to child transmission (PPTCT).


* American International Medical University  provides this indicative information for better understanding of health. For any treatment and diagnosis purpose you should consult your physician.