WHAT IS HIV?
The human immunodeficiency virus (HIV) breaks down the body’s immune system, exposing the infected person to a variety of life-threatening diseases that are collectively called opportunistic diseases. These diseases have the potential to be fatal due to the weakened immune system. AIDS (acquired immunodeficiency syndrome) is diagnosed when one or more of these diseases are present. Research suggests that the vast majority of HIV-positive people eventually develop AIDS, although it might take several years.
THE SPREADING OF HIV
The HIV virus is mainly spread through unprotected contact with infected body fluids like blood, semen, breast milk, and vaginal secretions. The virus can enter the bloodstream through the vagina, anus, mucus membranes, or any area where there is a cut in the skin. The most common ways in which the HIV virus is spreading, is through unprotected sex with an infected person, sharing of contaminated needles and by transmission from infected mothers to their newborns during pregnancy and birth.
Universal safety measures include treating all body fluids as potentially infected, especially if they are blood-stained and to wear protective gloves and washing hands under running water after handling these.
The presence of HIV antibodies in the blood, indicates that a person is HIV positive. Only a blood test can confirm a person’s HIV status. In most cases, 3 to 12 months after exposure to the virus is sufficient time for the antibodies to be picked up by blood tests.
WHAT IS CD4 COUNT?
The CD4 cells are cells which give an indication of the strength of your immune system. The CD4 count is used in HIV management, to see the efficacy of treatment. One value can not be used as guide, a trend in the values will be needed to make a judgement. Your CD4 count should be monitored every three to six months.
Normal value ranges from 500 to 1500. People with HIV should have a CD4 count of more than 500 are of good health. A value of 200 or below is harmful to the immune system. It puts a person at high risk of developing life-threatening diseases or being diagnosed with AIDS.
The CD4 count should go up if adherence to medication is good. If it still low regardless of taking the medication as specified, resistant could be the cause and the doctor will need to change the medication. [1;2]
WHAT IS VIRAL LOAD?
Viral load is a value that indicates the quantity of HIV in your blood stream. It is tested six months after diagnosis and then once a year after. An increase in your viral load does not necessarily mean that the quantity is higher, vaccinations are also capable of increasing this value.
A value from 0-10000 copies is considered to be low and a high value is that of 100000 copies or more. A high viral load could be due to untreated HIV from someone who has not been initiated on treatment or uncontrolled HIV. Depending on the reason the doctor will need to change your medication or initiate treatment.
With proper adherence and a healthy lifestyle, the viral load should go down. There is a point to which the viral load becomes lower than detectable. This value ranges from 40-50 copies or below. This does not mean that HIV has disappeared from the body, it is still there but it is too low to be measured. Having a lower than detectable limit gives a lower risk of HIV being transmitted during sexual intercourse with your partner when using condoms. [3;4]
SIGNS AND SYMPTOMS
The most common signs and symptoms of primary HIV infection are fever, sore throat, sore muscles and swollen glands (lymph nodes) in the neck. After the initial infection, most patients enter a period of years where they have no symptoms at all. During this time, T4 cells may gradually decline, and with this, also a decline in the immune system’s ability to fight off diseases.
Talk to your doctor about prescribing antiretroviral drugs that will slow down the progression of the infection. Following a healthy diet, exercising, avoiding, smoking and taking suitable supplements to boost your immune system, is a key part of treatment.
HOW TO IMPROVE QUALITY OF LIFE AFTER DIAGNOSIS [5;6]
Always take your medication as prescribed. Missing a dose can have adverse effects to your immune system and thus your health.
Having good support from family and friends can help to cope with stigmatization and can boost emotional and mental health.
Individual therapy and/or group therapy to help cope with mental health challenges, stress, anxiety and self-esteem.
Practice safe sex by having only one partner, being honest with you partner about your diagnosis and using condoms during sexual intercourse.
Healthy lifestyle which involves regular exercise, plenty of sleep and have a proper diet. This will help boost your immune system and to a certain extent self-esteem.
Educating oneself about HIV and AIDS. This helps with understanding your disease better, helps with adherence to medications, to recognise side effects and/or danger signs.
Never miss scheduled doctor appointments and blood tests. It will help the doctor to keep track of your health and make adjustments to medications if necessary.
WebMD [Internet]. How Cd4 Counts Help Treat HIV and AIDS. America: WebMD LLC; [updated 2019 Jun 23; cited 2019 Aug 22]. Available from: https://www.webmd.com/hiv-aids/cd4-count-what-does-it-mean#1.
Ford, N., Meintjes, G., Vitoria, M., Greene, G., Chiller, T. 2017. The evolving role of CD4 cell counts in HIV care. Current Opinion. 12 (2): 123-128.
Monciviaz, A., Alexander, D. [Internet]. CD4 vs. Viral Load: What’s in a Number?. America: Healthline; [updated 2018 Feb 16; cited 2019 Aug 22]. Available from: https://www.healthline.com/health/hiv-aids/cd4-viral-count.
WebMD [Internet]. What Does HIV Viral Load Tell You?. America: WebMD LLC; [updated 2019 May 28; cited 2019 Aug 22]. Available from: https://www.webmd.com/hiv-aids/hiv-viral-load-what-you-need-to-know#1.
Iliades, C. [Internet]. 8 ways to Improve Quality of Life With HIV. America: Everyday Health; [updated 2013 Jan 07; cited 2019 Aug 22]. Available from: https://www.everydayhealth.com/hs/hiv/improve-quality-of-life-with-hiv/.
CDC [Internet]. HIV. America: Centers for Disease Control and Prevention; [updated 2019 Aug 6; cited 2019 Aug 22]. Available from: https://www.cdc.gov/hiv/basics/livingwithhiv/index.html.
Griffiths, J. [Internet]. Health Check: What are the symptoms of Aids and HIV, is there currently a cure and how does the test work?. United Kingdom: The Sun; [updated 2019 Jul 03; cited 2019 Sep 11]. Available from: https://www.thesun.co.uk/fabulous/2296124/hiv-aids-symptoms-signs-test-cure/.
AIDSinfo [Internet]. Three Things to Know about HIV Treatment. America: U.S. Department of Health and Huma Services; [updated 2019 Mar 26; cited 2019 Sep 11]. Available from: https://aidsinfo.nih.gov/understanding-hiv-aids/infographics/11/three-things-to-know-about-hiv-treatment.