AIDS and the underlying HIV infection are no longer as public today as they were in the 1990s. But that only shows how sensitively our media work. Now that AIDS is much easier to treat than it was 30 years ago, it does not seem worthwhile to talk about it any more. It has not changed that those affected are still facing a very serious illness.
AIDS (Acquired immunodeficiency Syndrome) is a viral disease. It is triggered by the HI virus (Human immunodeficiency Virus), which proliferates in cells of the human immune system and thus massively weakens it in the long run. Without treatment, in most cases a collapse of the body's defense with fatal outcome.
Not curable, but better treatable
Three decades ago, the disease and the newly discovered virus terrified the world. Although AIDS is still not curable, today it can be kept in check for longer periods of time with the help of drug therapy. The infected thus open up the opportunity for a largely normal and symptom-free life. The life expectancy for HIV-infected people is approaching, at least in this country, the average value of the normal population more and more.
Acute symptoms of HIV infection are nonspecific
HIV infection is only noticeable in about half of those affected but is hardly recognized as such. Because the symptoms are nonspecific and are similar to a flu infection, such as fever, headache and sore throat, possibly swollen lymph nodes or rashes. The symptoms occur at the earliest one week, sometimes only six weeks after the infection and disappear soon.
The usual HIV test reacts only one to three months after the infection positive, because only at this time antibodies against the virus in the blood are detectable. When suspecting a possible infection, therefore, patience is required until a meaningful test result is obtained - and appropriate caution in dealing with sexual partners.
Transmission mainly through unprotected sexual intercourse
HIV is mainly transmitted during intercourse with an infected person. Using a condom significantly reduces the risk of transmission. Also via the direct blood contact, the virus can spread, such as when using infected syringes or needles of drug addicts. The risk of virus transmission from HIV-infected mothers to their child during pregnancy, childbirth or breastfeeding is significantly reduced if antiviral treatment is already used.
Different long latency phase
The more or less inconspicuous acute infection is followed by a so-called latency phase in which the virus multiplies in the body without causing discomfort. The duration of this phase is individually very different and can last from a few months to many years. There are even people who became infected in the 1980s but still had no symptoms.
Prognostic evidence of the possible course of disease provides the determination of the viral load - ie the amount of virus in the blood - and the number of T helper cells (CD4 lymphocytes) of the immune system. The fewer viruses and the more T helper cells, the better.
Combination therapy with different drugs
The main aim of HIV therapy is to reduce as much as possible the viral load and keep it in check. The aim is to delay the development of immunodeficiency and thus the onset of the actual AIDS disease as long as possible. For this purpose, various active ingredients have been and are being developed that begin at different points in the infection and multiplication cycle of the virus. Since the mid-90s, theHochactiveantiretroviraleTHAART), in which three to four drugs are combined simultaneously.
Individual and dynamic treatment scheme
The treatment scheme is always customized and changed from time to time. This is partly because of the special ability of HI virus to resistance formation needed, which is a major problem for the treatment. Especially if it is still favored by incorrect intake of the medication. On the other hand, the burden of side effects on the replacement of individual preparations can often be well mitigated without jeopardizing the success of the treatment.In the case of complete discontinuation of the antiviral drugs, on the other hand, massive proliferation of the virus usually occurs after a few weeks. The already attacked immune system is additionally damaged.
So far no vaccination possible - behavioral prevention is crucial!
The HI virus is today considered the best-researched virus in the world. Unfortunately, an HIV vaccine is still not possible due to the strong mutability of the pathogen. It is working feverishly, as illustrated by occasional, hopeful messages from the research laboratories. In this respect, in addition to the now much more effective and cheaper therapy, the prevention of HIV infection by proper behavior is so important. This has not changed in the face of more than 2 million new infections per year worldwide.
Authors: Dr. Hubertus Glaser & Dr. med. med. Jörg Zorn