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On October 2, 1985, American actor Rock Hudson died of a virtually unknown condition called AIDS, diagnosed with HIV in 1984. The high-profile death presented a hitherto clueless world with two ominous acronyms – Human Immunodeficiency Virus (HIV) and acquired immunodeficiency syndrome (AIDS).
Once infected, the person may not notice any symptoms of AIDS initially. They will experience a brief influenza-like illness. Following this, no other symptoms show up for a long time. However, if the infection is left untreated, it will interfere with the body’s immune system.
It will the chances of picking up common infections, such as tuberculosis and other opportunistic infections and tumors, which would otherwise have not developed if the immune function was normal. These advanced symptoms are collectively referred to as AIDS and are usually accompanied by drastic weight loss and a few other visible indicators.
Why Is October the AIDS Awareness Month?
Following Rock Hudson’s death in 1985, it was found that he had left roughly a quarter-million dollars to set up the American Foundation for AIDS Research. His death in October marked the month as a signpost in the AIDS awareness campaign.
October was then named AIDS Awareness Month. Three years earlier, in September 1982, the USA’s Centers for Disease Control and Prevention had coined the term AIDS to describe the baffling cases of severe immunodeficiency that had begun to appear in New York and California.
Today, AIDS Awareness Month is a time to support educational campaigns that promote scientific, factually accurate, and comprehensive information about AIDS among the public. With more than 40 million people living with HIV globally, knowledge of HIV/AIDS prevention and AIDS treatment must be made widely available.
Five Most Common Symptoms of AIDS
About 50 percent of people infected with HIV will reach the AIDS stage in less than a decade without AIDS treatment. Though they vary from person to person, the commonest symptoms include
- Pneumocystis pneumonia (PCP) – PCP affects around 40 percent of AIDS patients and is a form of pneumonia caused by the fungus Pneumocystis jirovecii. Known as an opportunistic infection, it typically attacks the lungs of people with weak immune systems.
- Cachexia – It is a complicated condition in which an underlying illness causes continuous and largely irreversible muscle loss. A range of diseases can cause cachexia, and AIDS is one of them. This condition is also known as HIV Wasting Syndrome and affects about 20 percent of AIDS patients.
- Esophageal candidiasis – This is an opportunistic infection of the esophagus by a yeast known as Candida albicans and usually occurs in patients with compromised immune systems. The primary symptom of esophageal candidiasis is difficulty or pain while swallowing, and if the condition persists, weight loss is one of the outcomes.
- Respiratory tract infections (RTI) – These infections can usually be further classified as upper and lower respiratory tract infections. Lower respiratory tract infections include pneumonia and are usually far more severe than upper respiratory tract infections such as the common colds.
- Diarrhea – AIDS is currently the leading cause of chronic diarrhea in many parts of the world. According to some estimates, nearly 90 percent of people infected with HIV who also show symptoms of AIDS will develop clinical diarrhea.
The Three Stages of HIV/AIDS
In the interest of AIDS awareness, it is important to realize that not everyone with HIV will necessarily develop AIDS if AIDS treatment is provided in time. Not everyone will display the same symptoms. Those infected will usually progress to AIDS through three stages:
1. Acute infection
This is the early stage of HIV when flu-like symptoms are common. These symptoms of AIDS usually occur in 50 to 90 percent of cases and most commonly include unexplained fevers, tender lymph nodes, sore throat, rashes, headaches, intense fatigue, mouth ulcers, and occasional sore genitals.
2. Clinical latency
This is the stage when the symptoms lie dormant for an average of eight years (though it can be as little as three) if the infection is untreated. Toward the end of this stage, more than 50 percent of people will experience fever, significant weight loss, gastrointestinal ailments, and muscle pains. Up to 70 percent will also develop persistent but non-painful enlargement of the lymph nodes.
3. Acquired Immunodeficiency Syndrome (AIDS)
AIDS is associated with the appearance of specific diseases related to an HIV infection. If untreated, around 50 percent of those infected with HIV will develop AIDS within an average of ten years. Apart from the common symptoms of AIDS listed above, this is also when opportunistic infections, normally prevented by the immune system, may occur.
AIDS Treatment and Its Benefits
There is yet no vaccine against HIV, and no cure for HIV or AIDS, although AIDS awareness and treatment procedures have seen significant advancement. In 1987, researchers developed azidothymidine (or AZT), the first antiretroviral medication to treat HIV.
Today, several classes of drugs can control HIV and prevent further complications, as well as prevent and actively treat opportunistic infections. These medications are collectively termed highly active antiretroviral therapy (HAART), applicable to anyone diagnosed with HIV.
- Current HAART options are combinations of at least three drugs belonging to at least two classes of antiretroviral agents. Initial treatment typically comprises a non-nucleoside reverse transcriptase inhibitor (NNRTI) with two nucleoside analog reverse transcriptase inhibitors (NRTIs). Common NRTIs include: AZT or tenofovir (TDF) and lamivudine (3TC) or emtricitabine (FTC)
- Protease inhibitors (PI) inactivate HIV protease, another protein that HIV needs to replicate. This treatment option is typically used if HAART proves ineffective. Examples include the drug classes atazanavir, darunavir, and lopinavir/ritonavir
- Integrase inhibitors disable a protein called integrase, which HIV uses to insert its genetic material into human CD4 T cells. Among these are bictegravir sodium/emtricitabine/tenofovir alafenamide fumar, raltegravir, and dolutegravir
- Entry or fusion inhibitors such as enfuvirtide and maraviroc block HIV’s entry into CD4 T cells
AIDS treatment brings a decreased risk of death and a greatly reduced risk of catching tuberculosis. Besides, the chances of a sexual partner or unborn child contracting the infection also go down. However, the treatment can only be effective if rigorously adhered to, which sometimes becomes difficult due to the non-availability of medication, an inability to follow complex treatment regimens, or social problems, such as mental illness and substance abuse.
HIV/AIDS Prevention, Much Better Than Cure
AIDS treatment begins with HIV/AIDS prevention. It is all about practices that prevent the spread of HIV, which is one of the goals of AIDS Awareness Month. Among the most common prevention practices are:
- Safe sexual contact – Using condoms without fail reduces the risk of HIV transmission by approximately 80 percent, studies have shown. And among couples where one partner is infected, continuous condom use brings the transmission rate down to less than one percent per year. Yet another option is applying a vaginal gel containing the NRTI tenofovir immediately before sex.
- Circumcision – Research has found that in Sub-Saharan Africa, the practice of male circumcision reduces the risk of HIV infection among heterosexual men by 38 to 66 percent over two years. In 2007, the World Health Organization and UNAIDS recommended male circumcision to prevent female-to-male HIV transmission. However, whether it protects against male-to-female or male-to-male transmission is still debatable.
- Sex education – If comprehensible sex education is provided at schools, high-risk behavior may decrease among young adults, although this is dependent on the individual behavior of the young people concerned.
- Pre-exposure – HAART (see above) among people with HIV effectively prevents HIV infection of their partners. This strategy is known as treatment as prevention or TASP, which appears to reduce transmission 10 to 20 times, particularly among high-risk groups.
- HIV and pregnancy – Treatment options to prevent the transmission of HIV from mothers to children can reduce transmission rates by 92–99 percent. The two main components of this option are using a combination of antiviral drugs during pregnancy and after birth in the child and bottle feeding rather than breastfeeding.
- Vaccination – As already stated, there is no licensed vaccine for HIV or AIDS as of now. To date, the most effective vaccine trial known as RV 144 was published in 2009, and it reduced the risk of transmission by roughly 30 percent. Further trials of RV 144 are ongoing.
First detected in the Congo in the 1920s, HIV had affected more than 400,000 people globally by the 1980s. Even today, despite ongoing AIDS awareness campaigns, AIDS stigma is still evident worldwide, including social and professional discrimination, even violence against HIV-infected individuals. The resulting fear prevents many people from seeking HIV testing or trying to get AIDS treatment. This helps HIV spread even further.