Human Immunodeficiency Virus (HIV)

Human Immunodeficiency Virus (HIV) is a retrovirus that causes Acquired Immunodeficiency Syndrome (AIDS) by infecting and damaging CD4 cells (also called T-helper cells) of the immune system leaving the body defenseless to numerous infections and health problems. Although AIDS, the final stage of this infection, is always the result of an HIV infection, not everyone with HIV has AIDS.

TRANSMISSION

HIV is transmitted through direct contact with the blood or body fluid of someone who is infected with the virus. HIV is transmitted through blood to blood (needle-sharing, needle sticks, blood exposure), sexual contact, and an infected pregnant women can pass the virus to her baby during pregnancy, birth, or breast-feeding.

HIV is not spread through casual contact (e.g., touching, hugging, shaking hands, sharing eating utensils, eating food prepared by a person with HIV, coughing, sneezing, using restrooms, touching animals or insects (such as mosquitoes or bedbugs), working or attending school with an HIV-infected person).

DIAGNOSES

A blood test is needed to diagnose HIV by testing for the presence of antibodies (disease-fighting proteins) to HIV. HIV antibodies generally do not reach noticeable levels in the blood for 1 to 3 months after infection. It may take the antibodies as long as 6 months to be produced in quantities large enough to show up in standard blood tests.

CLINICAL MANIFESTATION

HIV is one continuous disease process that ranges from asymptomatic to AIDS. Even during the asymptomatic period, the virus is actively multiplying, infecting, and killing cells of the immune system. Early vague symptoms include fatigue, headache, lymphadenopathy, and night sweats. As the immune system fails, symptoms increase and the illnesses that occur become more and more severe.

TREATMENT

While there is no cure for HIV or AIDS, the U.S. Food and Drug Administration (FDA) has approved a number of drugs that inhibit the virus's growth, prevent or delay the onset of AIDS and allow people living with HIV to remain free of symptoms longer. The most effective treatment strategy is a combination drug therapy which can attack viral replication in several different ways, attack different stages of the HIV life cycle, produce a more sustained antiviral effect in a person with HIV, and decrease the likelihood of drug resistance.

PREVENTION

Despite much research, there is no vaccine that will prevent HIV infection. Only the avoidance of high-risk behaviors can prevent HIV infection. Healthcare personnel should assume that the blood and other body fluids from all patients/residents are potentially infectious. They should therefore adhere to standard precautions and follow infection control precautions at all times.

HEALTHCARE PROVIDER EXPOSURE

Immediate drug therapy (within two hours of blood exposure) has reduced the transmission of the HIV virus. So, if a needle stick or sharps accident or any other body fluids exposure occurs, immediately:

  • Wash needlestick and cuts with soap and water.
  • Flush splashes to the nose, mouth, or skin with water.
  • Irrigate eyes with clean water, saline or sterile irrigates.
  • Report exposure to your instructor, preceptor or supervisor.
  • Follow exposure control protocol.

REFERENCES

ADDITIONAL RESOURCES