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Knowledge: Getting Informed About HIV

Part One of Three in Project Inform's "After You've Tested Positive" Booklet

January 2013

What Is HIV Disease?

Simply put, HIV disease is a disease of the immune system caused by a virus. It can also affect other parts of the body such as the brain or kidneys. The Human Immunodeficiency Virus (HIV) gets into immune cells -- especially CD4 cells -- and uses them to reproduce. Since CD4 cells direct the immune response to most diseases, as HIV infects and kills more CD4s, your body loses its ability to fight off illnesses called opportunistic infections, or OIs.

Damage to your immune system doesn't happen the same way in everyone. In some people HIV weakens the immune system rapidly, in just a few years, while in a very small number of people this doesn't happen at all. In most people, without HIV treatment, it takes about 8-10 years before they face their most serious symptoms.

However, it's important to start treatment before symptoms appear, because HIV begins causing silent damage to the body years before symptoms develop. With early and effective treatment, many people can live a near-normal lifespan. Almost everyone will eventually need to start treatment.

The words HIV disease can make it seem like you should feel sick, when in fact you can feel quite well a lot of the time. For this reason, some people say they live with HIV or are HIV-positive. However, the term AIDS is different. It's the latter stage of HIV disease, when an HIV-positive person has lost a lot of CD4 cells or developed certain OIs or cancers. Today, AIDS is seen much less often than in the 80s and 90s.

Your Immune System

Your Immune System

The immune system is made of many parts: cells, tissues, organs, fluids and vessels. Some of these include the skin, appendix, tonsils, spleen, thymus and lymph glands.

The immune system is always on alert to find microorganisms like viruses or bacteria. When one is found, the immune system goes into action in many complex ways to get rid of it so it can't cause disease. Often you can feel various symptoms like headache, fever or aches and pains. This is why, during early HIV infection, many people feel like they have the flu.

Although the immune system can control HIV to some degree in most people over time, HIV can still push it out of balance, cause inflammation, harm the body and destroy immune cells that may not be easily replaced.

One way to help maintain a healthy immune system is to get into care as soon as possible to keep track of your health. Taking HIV medicines is the only way we know to control the virus over time.

Main Points to Remember

  • The immune system is complex and made of many parts.
  • HIV can push the immune system out of balance and destroy immune cells that are not easily replaced.
  • We know how to control HIV over time with treatment.

Do You Have to Start Meds Right Away?

Do You Have to Start Meds Right Away?

The answer to this depends on your situation. Some newly diagnosed people do not have to start right away. You will hopefully have time to get used to your diagnosis, learn about HIV and get your "ducks in a row." This includes understanding the benefits and risks of treatment and figuring out how and where to get your medications. However, some people should start HIV treatment right away.

If blood tests show that your immune system is not controlling HIV or you have other illnesses that make you less healthy, you may need to start right away. Pregnant HIV+ women are also advised to start, as are people with hepatitis B and hepatitis C and people who are over 50 years old.

Most experts believe that it's best for the average person to start HIV treatment when they are still fairly healthy and have at least 500 CD4 cells. Some experts believe that starting even earlier -- no matter the CD4 count -- could be even better.

It is also important to know that if your HIV levels are very low you are far less likely to transmit HIV to your sex partners. Since effective HIV treatment significantly lowers viral load, some people may decide to start treatment for this reason.

Helpful Resource

When to Start Treatment

HIV Treatment Guidelines

HIV Treatment Guidelines

The US Guidelines for treating HIV infection in adults were last updated March 2012. A panel of more than 30 HIV-experienced doctors, researchers and community representatives interpret the most current HIV research and make recommendations.

The US Guidelines state that HIV treatment should be offered to all people with HIV no matter what their current CD4 count happens to be. These Guidelines are recommendations -- not strict rules -- but they're an important source of information. You and your doctor should use the Guidelines to make treatment decisions, while also considering your unique health needs, lifestyle and ability to start and stay on a regimen.

Main Points to Remember

  • The Guidelines can help you and your doctor make treatment decisions.
  • The Guidelines help guide decisions while you consider other aspects of your health and ability to start HIV meds.
  • For more specific information on CD4 count ranges, read booklet 2: "Considering Treatment and Your Health Care."

Helpful Resource

US Guidelines for Treating HIV Infection in Adults

Two Blood Tests: CD4 Count and Viral Load

Two Blood Tests: CD4 Count and Viral Load

Two blood tests are used to track HIV infection, which can inform decisions about starting or changing HIV treatment. The first, the CD4 count, shows how many of these important immune cells are found in a sample of blood, which represents the total amount in your body. CD4s can be thought of as the "managers" of the immune system, by telling other cells what to do. The goal is to keep your CD4s as high as possible for as long as possible.

The other test, the viral load, shows the amount of HIV found in a sample of blood, which represents the total amount in your body. Another reason to use HIV treatment is to keep viral load as low as possible for as long as possible, ideally below 50 copies or what is called undetectable.

Main Points to Remember

  • The CD4 count reflects the health of your immune system. Keep it as high as possible for as long as possible.
  • Viral load tests show how active HIV is and how well treatment is controlling HIV. Keep HIV levels as low as possible for as long as possible.

Helpful Resource

Blood Work: Two Common Tests

Related Stories

"After You've Tested Positive": Table of Contents
Health: Getting Involved in Your Well-Being
Self-Advocacy: Learning to Support Yourself

This article was provided by Project Inform. Visit Project Inform's website to find out more about their activities, publications and services.


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