Introduction
Human Immunodeficiency Virus, abbreviated as HIV, attacks the body’s immune system, and if left untreated, it can cause AIDS (Acquired Immune Deficiency Syndrome). HIV is a retroviral disease transmitted through unprotected sexual activity, from mother to child, blood transfusion, contact with infected body fluids, or hypodermic needles (Melhuish & Lewthwaite, 2018). The disease originated from a zoonotic animal, a chimpanzee in Central Africa. The virus version in chimpanzees, Simian Immunodeficiency Virus, is thought to have been passed to humans during their hunting activities way back in 1800. The disease has further been spread across Africa over the decades and eventually into other parts of the world. Its existence in the United States occurred between the mid to late 1970s.
Disease Manifestation
HIV weakens the immune system through infection and destruction of the CD4+ T cells, leading to immunodeficiency at the later stages of the disease. The virus adheres to the CD4+ protein on its surface and other cells to gain entry into the body (Melhuish & Lewthwaite, 2018). Other coreceptors such as CCR5 and CXCR4 are essential in enabling the virus to gain complete access and cause infection to the body cells. HIV infection undergoes three stages: acute illness, chronic infection, and acquired immunodeficiency syndrome (AIDS) (Velloza et al., 2020). The first stage usually develops between 2 to 4 weeks after initial exposure. The stage often goes unrecognized because of the occasionally mild and nonspecific symptoms. Some of the clinical manifestations observed in the first stage include typical rushes distributed on the face and trunk, although they may also appear in the palms and soles. Oral and genital mucocutaneous ulceration is also another clinical manifestation that can be experienced during the first stage. In this stage, gastrointestinal manifestation, facial nerve palsy, acute encephalopathy, and many other clinical symptoms may participate.
In the second stage of infection, the virus continues to multiply but at low levels. Infected individuals who are in this stage may not have any alarming symptoms. The stage can last for up to 10 to 15 years, although it may move so fast in some individuals c. AIDs infection occurs in the third stage. The infection may be manifested by symptoms such as rapid loss of weight, recurring fever, extreme tiredness, prolonged swelling of the lymph glands in the groin, armpits, or neck, sores in the mouth, diarrhea that lasts for more than a week, or memory loss and other neurologic disorder (Nasuuna et al., 2018). When infected individuals are not treated, they may develop severe diseases such as serious bacterial infections, cryptococcal meningitis, tuberculosis, and cancers like Kaposi’s sarcoma and lymphomas.
Diagnosis and Treatment
HIV diagnosis can be made by a rapid diagnostic test that provides results on the same day. Individuals may also test themselves using an HIV self-test kit, although a confirmatory test has to be done later on by a qualified health professional (Mayo Clinic, 2020). The diagnostic test works by detecting antibodies produced by a person as part of their immune response to fight the virus. When the results turn out positive, immediate treatment should be done to manage the virus (Mayo Clinic, 2020). A combination of three or more antiretroviral drugs (ARVs) or antiretroviral therapy (ART) may suppress the symptoms and viral replication within an individual hence allowing recovery of the immune system and regain the ability to protect the body from opportunistic infections.
Prevention
The public health measures of HIV prevention can be divided into three categories; primary, secondary, and tertiary prevention. Primary prevention measures protect an individual from acquiring HIV infection. It involves strategies such as abstaining from sex, not sharing needles and sharp objects and using condoms when engaging in sexual activities. Prevention medicines such as PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) may also be used to protect yourself from the infection (Mayo Clinic, 2020). Secondary HIV prevention involves measures that should be directed to infected individuals to prevent transmission to negative people (Mayo Clinic, 2020). Strategies used in secondary prevention entails giving health education to those who are infected, supporting ART adherence efforts, providing ongoing risk assessment regarding substance use and sexual behavior, encouraging infected individuals to disclose their HIV status to their sexual and drug use partners, prescribing condoms for positive individuals and providing counseling to them (Mayo Clinic, 2020). Tertiary prevention measures ensure the improved treatment to reduce the impact of HIV/AIDS disease and promote recovery. A tertiary prevention strategy aims at reducing complications that may be caused by HIV infection.
Surveillance measures
Local surveillance of HIV may be carried out using various reporting tools to fill HIV infection cases and later submitted to the local health departments for further analysis. The Centre for Disease Control and Prevention (CDC) plays a big role in collecting, analyzing, and disseminating data for national surveillance on HIV/AIDS. The CDC’s National surveillance system monitors HIV trends in the U.S (CDC, 2020). Moreover, the World Health organization can conduct international surveillance of HIV/AIDS, which surveys on HIV sentinel, STDs, and behavior.
Prevalence and Incidence
According to WHO (2020), the global prevalence of HIV is estimated to be over 37.7 million people, including 1.7 million children. The percentage prevalence in adults is 0.7%. Additionally, the incidence of HIV infection was 1.5 million (WHO, 2020). Most people living with HIV live in low and middle-income countries, with East and Southern Africa being the most affected region globally. In 2020, there were 670,000 new cases which amounted to 20.6 million infected individuals in East and Southern Africa.
Interesting facts
According to the WHO, some of the current interesting facts about HIV/AIDS is that it has claimed over 36.3 million people since its emergence; hence, it is still a major public health concern (WHO, 2021). Additionally, over 37.7 million were HIV positive in 2020, whereby 25.4 million were in the WHO African region. WHO also reports that over 680 thousand individuals succumbed to HIV-related infections, and over 1.5 million people acquired HIV/AIDS.
Reference
CDC. (2020, June 19). Tracking AIDS Trends. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/statistics/surveillance/index.html
Eisinger, R. W., & Fauci, A. S. (2018). Ending the HIV/AIDS pandemic. Emerging infectious diseases, 24(3), 413.
Mayo Clinic. (2020, February 13). HIV/AIDS – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524
Melhuish, A., & Lewthwaite, P. (2018). Natural history of HIV and AIDS. Medicine, 46(6), 356-361.
Nasuuna, E., Kigozi, J., Babirye, L., Muganzi, A., Sewankambo, N. K., & Nakanjako, D. (2018). Low HIV viral suppression rates following the intensive adherence counseling (IAC) program for children and adolescents with viral failure in public health facilities in Uganda. BMC Public Health, 18(1), 1-9.
Velloza, J., Kemp, C. G., Aunon, F. M., Ramaiya, M. K., Creegan, E., & Simoni, J. M. (2020). Alcohol use and antiretroviral therapy non-adherence among adults living with HIV/AIDS in Sub-Saharan Africa: a systematic review and meta-analysis. AIDS and Behavior, 24(6), 1727-1742.
WHO. (2021, June 9). HIV/AIDS. WHO | World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hiv-aids
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