Elke Maria Erne (Photo: Sabes)
Ten new HIV cases have been recorded in South Tyrol since January. The primaria of the department for infectious diseases, Elke Maria Erne, explains what might be the cause of the almost four times higher HIV infections.
by Stefanie Putzer
In January, the surprisingly high rate of increase in HIV infections in South Tyrol caused a stir – ten new cases were reported in the first trimester of 2023 alone, four times as many infections as in previous years. “The sudden increase in HIV cases can be largely attributed to the pandemic, which has seen hospital closures and non-hospital prevention efforts halted during this period. It therefore seems obvious that people with a long-held feeling of suspicion, due to the lack of opportunities during the pandemic, have only now been able to get tested,” says Elke Maria Erne, head of the department for infectious diseases at the Bolzano hospital. Another striking feature of the new HIV-infected was the fact that their average age is 40 years. According to Erne, this circumstance can be traced back to the course of the infection itself, since this is only detected in many people at an advanced stage. This is the group of “late presenters”, who were infected a long time ago but have never had an HIV test, which in turn would explain the average age of the newly infected.
A total of 600 HIV patients are cared for in South Tyrol, and there are usually ten to 15 new infections per year, which corresponds to the national average. But the issue of HIV continues to be overshadowed, leading to fatal misunderstandings and a dangerous lack of information. “I think HIV should be made more of a public issue. Young people in particular should be better informed regarding the disease, since education is the first step towards prevention,” explains Elke Maria Erne. According to the Primaria, an example of such a misunderstanding is the fact that in some cases, even today, there is still the misconception that only drug addicts or homosexual people are at risk of contracting HIV. As a result, some people are embarrassed to have an HIV test done, Erne knows, even though it has recently been proven that sexual orientation plays no role in the risk of infection.
Infection with HIV occurs through blood or other infectious bodily fluids. This occurs most frequently during unprotected sex and when exchanging syringes or needles when using drugs. However, HIV can also be transmitted from an infected mother to her child. This happens either during pregnancy or while breastfeeding. Another risk of infection is blood transfusions in countries that have a lower medical quality standard than industrialized countries.
After an infection, the virus spreads throughout the body, primarily affecting and destroying the immune cells. “Nevertheless, this process is very unobtrusive, as often only mild, flu-like symptoms occur, which usually disappear following a few weeks. As a result, many people do not associate the sudden symptoms with an HIV infection and dismiss them as flu, which means they lose valuable time,” explains Elke Maria Erne. At the same time, the risk of infection is particularly high during this period, which is why a non-existent diagnosis can also have serious consequences for the environment. The period that follows is characterized by a symptom-free phase, as the immune system reacts to the HI virus. In this phase, an HIV-positive person leads a normal life due to the lack of symptoms, which is why the person concerned does not think regarding being infected with the HI virus at this point either.
Meanwhile, the virus continues to spread insidiously and permanently strains the immune system. “As a rule, an immune deficiency occurs following 10 to 15 years, because the constant stress causes the immune system to become weaker and weaker and it can no longer adequately defend itself once morest pathogens. In most cases, a person can only be tested for HIV if they have an advanced immune deficiency,” explains Erne. The last stage of HIV infection, also known as AIDS, is accompanied by characteristic infections and opportunistic diseases such as pneumonia or tumors. As a result, one ultimately dies not from HIV, but from an infection or opportunistic disease that the weakened immune system might no longer withstand.
In the past, an infection with the HI virus was tantamount to a death sentence. Nowadays, however, due to the medical possibilities, there is a real chance that the immune deficiency will recede or not develop at all. “Here too, early detection is very important, as this way the virus is blocked at an early stage, which means that it can no longer infect other immune cells and can destroy the immune system itself. However, such a procedure does not allow for a full recovery, which means that an infected person still has to live with the virus for life,” emphasizes Erne.
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