HIV positive: what does it mean?

2023-10-14 14:35:00

Definition: What are HIV and AIDS?

The like (Acquired Immunodeficiency Syndrome) is a disease caused by Human Immunodeficiency Virus (HIV).
“The virus causes a chronic infection of the immune system, in particular of the CD4 T lymphocytes which are essential for its functioning. In the absence of treatment, the infection progresses in a few years towards the destruction of the immune system” describes Dr. Agut.

HIV therefore attacks the immune system, weakening the body’s ability to fight infections and other diseases. “At the end the stage of AIDS occurs, leading to death because the patient can no longer defend himself once morest infections and the occurrence of cancers” specifies the specialist.

What is an HIV-positive person?

If in common parlance, the term seropositivity has been directly linked to HIV since its appearance in the early 1980s, it is in reality an abuse of language.

A person’s HIV status generally means that they have antibodies once morest a given virus. This seropositivity indicates the fact that the person has been infected by this virus and that their body, in response to the infection, has produced specific antibodies present in the circulating blood. Dr Henri Agut, virologist.

The transition from the seronegative state, that is to say not infected, to the seropositive state, having had an infection, is called seroconversion.

It is crucial to note thatbeing HIV positive does not necessarily mean having symptoms or being sick. In fact, an HIV-positive person can live for many years without developing AIDS. This period, often asymptomatic, is called the chronic phase of the infection.

However, even if the person does not have symptoms, she can still transmit the virus to others, especially through sexual or blood contact. This is why regular screening and the use of protection during sexual relations are essential.

What is the life expectancy of someone with HIV?

“AIDS had become a major cause of death worldwide, particularly among young people, in the early 1990s,” recalls Dr. Agut. The life expectancy of an HIV-positive person has since increased considerably thanks to medical advances. “The discovery of drugs that specifically block the multiplication of HIV in the body and administered in the form of combinations has completely changed the situation. These drugs do not eliminate the infection and we cannot speak of a cure, but they make it possible to prevent the deterioration of the immune system and the occurrence of AIDS” summarizes the virologist.

However, several factors can significantly influence this life expectancy: age at diagnosis, gender, lifestyle, compliance with treatment, etc. Statistics also show that life expectancy can differ depending on social or geographic groups.

We can nevertheless consider today that the life expectancy of an HIV-positive person in France, properly cared for and treated upon seroconversion, is the same as that of an HIV-negative person. Dr Henri Agut.

Flu, lymph nodes: What are the symptoms and signs of AIDS?

The symptoms of HIV infection can be very varied and manifest in different ways. Initially, when the virus infection begins to invade the body and seroconversion occurs, we often observe signs similar to those of a flu-like symptoms. The feverfor example, is very common and can be persistent.
It can be accompanied by significant fatigue, headaches, muscle aches and sometimes vomiting.
Some patients may experience a rash, usually as red patches on the body and face. Ulcerations can also form in the mouth or genitals.
Another characteristic is the appearance of swollen lymph nodes, located in the neck, armpits or groin. These nodes are generally not painful.
Be careful however, all of these symptoms are not specific to HIV and can also be linked to other diseases. Only screening tests can confirm HIV infection.
“In general, these symptoms disappear during the chronic phase of the infection which is most often asymptomatic. In the absence of antiretroviral treatment, AIDS occurs, the terminal phase of HIV infection, characterized by symptoms of serious infections affecting the lungs or the nervous system and by the occurrence of cancers of the skin, blood or genitals.” specifies Dr Agut.

HIV positive with undetectable viral load: what does it mean?

“When the diagnosis of HIV infection is made through the detection of seropositivity, it is important to measure two parameters: the decreased number of T lymphocytesCD4 which indicates the degree of damage to the immune system, the amount of HIV virus in the bloodcalled viral load, which reflects the intensity of virus replication in the body” explains the virologist.
An HIV-positive individual with an undetectable viral load is a person who, despite being infected with HIV, has such a low amount of virus in their blood that they cannot be detected by standard laboratory tests. This is generally the result of effective antiretroviral treatment. “Seropositivity with undetectable viral load has a positive impact on the health of the infected person and greatly reduces the risk of transmitting the virus to another person,” explains Dr. Agut.

Be careful, however, it is essential to specify that undetectable does not mean absent. The virus is still present in the body, but in quantities too small to be detected. Maintaining an undetectable viral load requires regular and correct taking of antiretroviral drugs.

What treatment when you are HIV positive and then suffer from AIDS?

Current recommendations are to treat everyone infected with HIV with a combination of drugs active once morest HIV (called antiretrovirals) as soon as their HIV status is known.

Very early treatment, at the time of seroconversion, is particularly useful and effective because it further reduces the long-term effects of the infection. Dr. Agut.

The treatment is essential if the infection has progressed for several years before being detected and if the patient already presents significant clinical signs, or has even reached the stage of AIDS.

“In all cases, the effectiveness of the treatment is monitored on the viral load which should ideally become undetectable and on the number of CD4 T lymphocytes in the blood which must remain at a normal value or re-increase if it has significantly increased. If the effectiveness of the treatment decreases, a problem with taking medication or the appearance of a virus resistance” explains the virologist.

“After analysis of this therapeutic failurethe composition of the associationantiretroviral drugs will be modified accordingly to regain effectiveness once morest the multiplication of the virus. In the current state of knowledge, this antiretroviral treatment is a definitive, lifelong treatmenteven if reductions or adaptations are possible in the long term” specifies Dr Agut.

To this treatment is added that of other infections and associated cancers when the patient is at an advanced stage of the disease.

What are the prevention tools?

Despite several decades of sustained research, we do not currently have an operational and effective vaccine which would be the ideal weapon of individual prevention. However, there are several tools to prevent the transmission of the virus.

The use of condoms remains an essential measure to prevent transmission during sexual intercourse. “Transmission through blood is prevented by the use of single-use syringes among intravenous drug users, by the selection of HIV-negative donors for blood and organ donation,” explains the virologist.

Furthermore, regular HIV testing makes it possible to know one’s serological status and to begin treatment as soon as possible in the event of seropositivity.

“No treatment of pregnant HIV-positive women during pregnancy has made it possible to reduce almost to 0% risk of transmitting HIV to their babieswhich was a considerable advance in the prevention of pediatric HIV infection,” adds Dr. Agut.

Another preventive tool lies in antiretroviral treatment of HIV-positive people, which, when effective, makes the viral load undetectable and thus prevents transmission of the virus (principle of TasP, for “Treatment as Prevention”).

There is also thePre-Exposure Prophylaxis (PrEP) : this preventive treatment is intended for people who are HIV negative but at high risk of infection to prevent transmission of the virus during subsequent sexual intercourse.

Finally, it is worth mentioning the communication campaigns aimed at combating the stigmatization of HIV-positive people, encouraging screening and promoting the use of prevention tools.

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