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

July 2015

What Is HIV Infection?

Simply put, HIV infection is a disease of the immune system. It can also affect other parts of the body such as the brain or kidneys. HIV (Human Immunodeficiency Virus) gets into immune cells -- especially CD4 cells -- and uses them to reproduce. Because HIV inserts itself into the cell's genes, it will stay there as long as the cell is alive. That's what makes it so hard to get rid of. Also, as the virus infects more immune cells they die and your body loses its ability to fight off other illnesses.

Damage to the immune system doesn't happen the same way in everyone. For some, HIV weakens their immune systems rapidly, in just a few years; while in a very small number of people this doesn't happen at all. In most people who aren't on HIV treatment, it takes about 8-10 years before they face the most serious symptoms.

However, it's important to start treatment well before symptoms appear, because HIV causes damage to the body that you don't feel years before those symptoms develop. Today's treatments are very effective, and many people can live near-normal lifespans. 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 name for the later stage of HIV disease, when a person has lost a lot of CD4 cells or developed certain infections or cancers. Today, AIDS is seen much less often.


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 it finds one, the immune system works in many complex ways to get rid of it so it can't cause disease. Some viruses or bacteria can make you feel symptoms like headache, fever or aches and pains. This is why many people feel like they have the flu within the first month of getting HIV.

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

One way to prevent these things from happening is to get into care as soon as possible. Taking medicines is the only way we know how to slow down damage and control HIV infection 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.


Should You Start Meds Right Away?

Do You Have to Start Meds Right Away?

Generally, it's wise to start as soon as you can, but it may depend on your situation. The U.S. Federal Guidelines for treating HIV state that everyone should start HIV treatment as soon as they're ready for it.

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. Many believe the evidence supports starting even sooner -- no matter the CD4 count.

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 women are also advised to start right away, as are people with hepatitis B and hepatitis C and people who are over 50 years old.

It is also important to know that if your HIV is at a very low level then you are far less likely to transmit HIV to your sex partners. HIV treatment can significantly lower viral load, so starting treatment helps to prevent transmission.


Helpful Resources

When to Start Treatment


Two Blood Tests: CD4 Count, Viral Load

Two blood tests are used to track HIV infection, which can help you decide to start or change HIV treatment. The first one, called the CD4 count, shows how many of these 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: 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, called the viral load, shows the amount of HIV also found in a sample of blood. HIV treatment helps 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 Resources

Blood Work: Two Common Tests


Next: Getting Involved in Your Well-Being
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