Human immunodeficiency virus, known as HIV, is the cause of AIDS, which stands for acquired immune deficiency syndrome. Transmission of the virus occurs most commonly through the exchange of body fluids by sharing needles, sharing intravenous drugs or through unprotected sex. Early patient education is the key to lowering the rate of this virus.
It is important to note that HIV is NOT spread through casual contact, mosquitoes or by touching items that were touched by an infected patient.
There are two types of HIV: HIV-1 and HIV-2. HIV-2 is found mainly in Western Africa, while HIV-1 is found worldwide.
Both strands of the virus start with infection. Initial or acute HIV infection is followed by a period of no symptoms, called asymptomatic HIV infection, followed by early symptomatic HIV and then AIDS.
Symptoms of acute HIV may or may not manifest after an initial exposure. These symptoms usually dissipate spontaneously in a few weeks and may include:
After initial symptoms, the disease often goes into a period of remission. This window period, known as asymptomatic HIV, can last for months or up to ten years. It is important to note that a person with an asymptomatic HIV infection can still pass the disease to other people.
When the HIV infection manifests again, a person’s T4 cells and CD4 cells, which are the body’s main fighters of infection, have been compromised, weakening the individual.
AIDS is the final stage of HIV. By the time HIV develops into AIDS, severe damage has been caused to the immune system, making that person vulnerable to attacks from the germs that are encountered daily with progression to serious illness or cancer.
Patients with AIDS (HIV infection with less than 200 CD4 cells/ml of blood) manifest with:
Doctors Who Treat HIV / AIDS – Patient Education
Healthcare providers that care for an individual on an ongoing basis would most likely be the ones to initially diagnose AIDS. These include:
- General Practitioner (family practice) - deals with prevention, discovery and treatment of illnesses in all age categories
- Internist - focuses on diagnosis, treatment and prevention of adult illness
- Gynecologist - deals with female health
- Gerontologist - deals with senior or elder health
- Nurse Practitioner - focuses on prevention, wellness and education of patients about health and health choices
Once the diagnosis of AIDS is made, however, it is prudent to see a specialist for this disorder. Get referrals from your current physician or the local teaching hospital. Ask the physician that you will be obtaining treatment from if he/she is an HIV specialist and get the patient education you need.
According to the Centers for Disease Control, HIV specialists should treat AIDS patients. Because the disease is so complex and new therapies are being formulated constantly, a patient needs to see a physician who focuses on this problem and deals regularly with the special challenges that this disease presents. A specialist has more experience in recognizing both symptoms and complications, enabling a more comprehensive and current treatment care plan.
Criteria to Become an HIV Specialist
Before a physician can be called an HIV specialist, there are certain requirements that must be met.
The American Academy of HIV Medicine (AAHIVM) set up three criteria for HIV specialists:
- Education - The physician must have completed a fellowship in AIDS or an HIV-related internship. Other physicians who have completed a minimum of 30 credits in continuing medical education (CME) of HIV related subject matter are also eligible.
- Experience - In addition to having an active state license, the physician must document ongoing care for a minimum of 20 HIV patients in two years.
- Recognition/Validation - The M.D. must pass an HIV medicine credentialing examination given by AAHIVM.
In addition to the HIV specialist, there are other healthcare providers that make up a team. They include:
Psychologist - offers counseling and psychotherapy for depression and other mental health problems
Psychiatrist - an M.D. who deals with the health and disorders of both mood and mind including anxiety, emotions, mental conditions, adjustment, substance abuse and sexual orientation through prescribing medications, psychotherapy and medical procedures
Infectious Disease Physician - focuses on diagnosis, treatment and prevention of adult infectious diseases involving all organ systems, including AIDS and fevers of unknown origins
Infectious Disease Pediatrician - a physician that focuses on the diagnosis, treatment and prevention of infectious diseases in infants, children and adolescents; is better equipped to deal with rare diseases or complications in children, affecting better outcomes
Nutritionist - designs diet protocols to impact health in a positive manner Occupational Therapist – plans programs for daily activities taking into consideration any compromise in cognitive or emotional function; evaluates the environment, whether it is home, school or work, and recommends training and guidance with the focus on helping the individual to adapt
Holistic Practitioner - considers the body in its entirety, including mental, physical and spiritual aspects; recommends herbs and nutritional supplements in addition to meditation, cleansing, diet and exercise protocols
Nurses - provide nurturing care and ensure the proper use of medications and protocols
How to Prepare for Your HIV/AIDS Doctor Visit
While early diagnosis and treatment of AIDS is crucial for your prognosis and outcome, it also will affect your social, emotional, financial and professional spheres.
Therefore, prior to going for an HIV blood test at the laboratory or physician’s office, it is very important to have counseling and better patient education. An appointment should be made for counseling after the blood test is performed as well.
Inform the doctor or laboratory which professionals you feel comfortable receiving the results from, and how you can be contacted when the results are available. If you have not heard within two weeks, call the physician to check the results.
A diagnostic test for HIV cannot be performed without your consent and no person (regardless of healthcare facility or physician status) can acquire the results without your permission.
Questions to Ask Your Doctor About HIV/AIDS
From your initial diagnosis throughout your treatment and care, you will have questions about yourHIV/AIDS. Our patient education guide lists questions to discuss with your doctor so you can make informed decisions about your condition.
Question About My HIV/AIDS Diagnosis
- Is the diagnosis completely accurate? Is there a different medical condition it can be confused with?
- Is there a difference in type of tests for HIV vs. AIDS? What type of testing do you do and why?
- If the HIV test is negative, does it need to be repeated over time? If so, how long must I wait and how often should I be tested?
- What are the symptoms that I may experience?
- How severe is my condition and what is my prognosis? How long can I live with AIDS ?
- How will my immune system be monitored?
- What are the complications of AIDS? What organ systems are affected? How are they monitored?
Questions About My HIV/AIDS Treatment
- If I have been exposed to HIV, should I get preventative treatment to inhibit the infection? Is there one available?
- What treatment do you recommend for me? What are the side effects of the drugs?
- How long must I take the drugs before I see a result? Can the drugs cure me of AIDS?
- Will I have to take the drugs forever or just for symptomatic relief? What happens if I don’t take the drugs?
- How will the treatment be monitored? How often will it be done?
- What other tests do I need? How often do I need them?
Questions About My Lifestyle & Family
- Am I contagious to my family and friends? Should I avoid being in large crowds?
- What should I do to prevent passing the virus to my family?
- Is there exercise I can do to keep my immunity up?
- Are there specific vitamins that I should take? Are there supplements or herbs that can help me?
- Will I still be able to work? Are there activities that I should avoid?
- Will I ever be able to have children? Will my baby contract the disease? How would he/she be monitored?
- Can I still have sex if it is protected? Can I still have deep passionate kisses without transmission?
Common Tests Or Labs To Diagnose HIV / AIDS
There are four main reasons to run a test for HIV:
- Pregnancy - to treat positive pregnant women to prevent the infection transfer to the fetus
- When a baby is born to an infected mother to determine whether the baby has contracted the disease
- Blood/Organ Donation - Donors are screened to prevent spread of AIDS from donor to recipient
- To diagnose a person who has been in contact with HIV or who has symptoms suggestive of an HIV illness
The tests do not convert to positive results until 2 – 24 weeks after exposure to HIV. During this interval, a person can still be contagious.
For best results, patients who believe they have come in contact with HIV should perform a test at 6 weeks, 3 and 6 months.
Blood Tests That Detect HIV
There are three main tests that can be performed to detect HIV/AIDS:
- Polymerase Chain Reaction (PCR) Test – detects the genetic material – RNA or DNA – of the HIV virus in white blood cells; can be positive when antibodies are not present yet, so it is beneficial in recent infection, but is more technically challenging and expensive to perform; is used to screen blood supplies for HIV in most developed countries
- Enzyme-Linked Immunosorbent Assay or ELISA Test – searches for antibodies and is generally the first test done to find HIV infection; if found to be positive, the test is repeated
- Western Blot Test – also an antibody detection test; is more challenging to perform than ELISA and is typically performed to confirm two positive ELISA test results; is required before a positive HIV diagnosis is reported in the United States
Common Medications and Treatments for HIV/AIDS
There are no drugs that cure HIV or AIDS, nor can they inhibit the spread of this virus to other individuals through exchange of bodily fluids (e.g. unprotected sexual contact or blood contamination through infected blood transfusions or shared needles).
The purpose of these drugs is to keep the HIV infection in check so that the immunity is not further lowered and the infection does not progress to AIDS (link “AIDS” back to main overview page) or further complications.
| Drug Class |
How the Medication Works |
| Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs) |
Prevents cells from producing new virus |
| Immune Based Therapies |
Bolsters the immune system’s ability to fight HIV on its own |
| Pharmacokinetic Enhancers |
Drugs that increase the amount of another drug in the bloodstream |
| Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) |
Prevents RNA from converting to DNA, which is needed for cells infected with HIV to multiplyIn turn, HIV’s genetic material cannot be incorporated into the healthy genetic material of the cell, and prevents the cell from producing new virus |
Protease Inhibitors (PIs)
|
Block the protease enzyme and prevent a cell from producing new HIV virusesTypically used in combination with other HIV drugs |
| Entry Inhibitors |
Prevent HIV from entering healthy CD4 cells in the body Work differently than many of the approved anti-HIV drugs by working before HIV has a chance to infect healthy CD4 cells |
| Multi-Class Combination Drugs |
Comprised of components of other antiretroviral drugs into a single pill |
| Integrase Inhibitors |
Block the integration of HIV’s DNA into the CD4 cells’ DNA |
| Maturation Inhibitors |
Hinder the virus maturation process, so new virus cannot go on to infect other cells in the body |
Alternative Therapies
Herbs, vitamins and supplements all play a part in the treatment of HIV/AIDS. However, these therapies are NOT a substitute for the traditional or conventional medication combinations that are prescribed by the specialist.
Rather, these natural therapies are meant as an adjunct or a complementary addition in order to help the patient overcome a particular physical obstacle caused by either the medications being taken, or the viral disease itself.
|
Vitamin/Supplement
|
How It Works
|
| Ascorbic Acid (Vitamin C) |
Improves immunityImproves circulation |
| Beta Glucans |
Boost the immune systemMay prolong life (in IV dose) |
| Coenzyme Q-10 |
Improves immunityDecreases blood vessel weakness/damage |
| DHEA |
Hormone made in the bodyMay improve mental health in patients with AIDS (no effect on actual infection control) |
| Glutamine |
Amino acid found in the bodyMay improve weight loss
Possibly helps intestinal problems
Helps in food absorption |
| Marijuana (Cannibus) |
An herbStimulates appetite
Helps with weight gain
Decreases nausea
May decrease nerve pain
May help with breathing |
| Red Yeast |
Decreases cholesterol, which is higher in HIV/AIDS patientsImproves blood circulation
Helps with stomach and spleen functioning |
| Selenium |
MineralMay elevate mood and promote feeling of well-being |
| St. John’s Wort |
An herbMay help in fatigue, muscle pain, cancer, nerve pain and weight loss |
| Whey Protein |
Protein sourceMay improve immunity
May increase nutritional value of diet |
| Zinc |
Essential trace metalLessens diarrhea |
Treatments will make an individual more comfortable and possibly keep the patient symptom free, stemming the progression of HIV to AIDS.
However, the most important aspect of care is CARING. The importance of feeling the care of other individuals can not be stressed enough.
The patient should be made to feel comfortable and have a confidante that he/she can share feelings and problems with. Encouragement helps tremendously.
Knowing you have someone to share your severe problems and condition with makes it more tolerable and even helps to dissipate some symptoms…if even for a while.
