What Does HIV Do to You?
Part of A Practical Guide to HIV Drug Treatment for People Living With HIV
Life-Threatening Infections and AIDS
If the immune system becomes damaged enough, it leaves HIV-positive people vulnerable to infections that a healthy immune system could easily control. In general, these infections can be very serious or life-threatening. They are sometimes called opportunistic infections.
Some of these, like oral fungal infections, can be relatively minor and easy to treat (although even oral fungal infections can become very serious in people whose immune systems are weak). Other opportunistic infections that can also lead to serious complications and can be fatal if the immune system is weak include PCP (Pneumocystis pneumonia), MAC (Mycobacterium avium complex), toxo (Toxoplasmosis gondii), tuberculosis and CMV (cytomegalovirus). Certain types of cancer, such as lymphoma, are also more common in people with HIV.
The risk of life-threatening infections is usually closely tied to the CD4 count: a person's risk of developing many opportunistic infections increases when their CD4 count drops below 200 cells. For a person whose CD4 count is this low, medication to prevent and treat opportunistic infections is crucial.
The term AIDS describes the most serious stage of HIV infection, when the immune system is severely damaged and life-threatening infections have set in. AIDS stands for acquired immune deficiency syndrome:
In Canada, AIDS is diagnosed when a person with HIV develops one or more "AIDS-defining" opportunistic infections or cancers.
I was diagnosed in the hospital. I was really sick and didn't know what was going on. Then they did an HIV test and I tested positive. I was in really bad shape. My CD4 count was 33 and my viral load was half a million. I had pneumonia (PCP).
HIV Does Not Have to Lead to AIDS
Fortunately, HIV infection does not necessarily lead to AIDS. Antiretroviral drugs can slow down or halt the effects of the virus on the immune system. Even people who have had serious AIDS-defining illnesses can usually recover and stay healthy with proper care. This is good news because the word AIDS is scary. It harkens back to the time when the progression of HIV disease was all but inevitable: people got HIV, then developed AIDS, and then died. Things have changed a great deal since then. For people with HIV who get proper care, see their doctor several times a year, take their medicines as directed and stay healthy, AIDS is no longer a concern.
The words we use to describe HIV have changed to reflect this new reality. The medical problems resulting from HIV infection are now often referred to as HIV disease or chronic HIV infection. These terms can be used to describe anyone's condition, whether or not they are being treated and regardless of whether they have been diagnosed with AIDS.
Stopping the Slide
As we mentioned, there is no longer any reason that HIV infection should inevitably lead to severe illness or death. Proper treatment can prevent HIV from causing serious illnesses. Treatment can also help people to get better and stay healthy even if they have already become sick with HIV-related infections.
In addition to treatment, there are many other factors that also affect the speed at which HIV disease progresses. These include the following:
Some of these factors are not controllable, but others are. You may not be able to change your age (we wish!), but you can do something about how well you eat and whether you smoke or use street drugs. (See "There's More to Health Than ART: Holistic Health" for some health hints.)
Unfortunately, some people don't find out that they are HIVpositive until they have had the virus for many years. Their diagnosis may come as a result of a serious HIV-related illness that takes them by surprise. Even so, infections can usually be treated. Most people who develop a serious HIV-related illness and are not taking antiretroviral drugs should begin treatment as soon as possible, to strengthen the immune system so that it can fight off the illness as well as prevent future infections.
People who test positive while they are still physically healthy have one big advantage: they know what to look out for. By getting regular thorough health checkups and routine lab tests, you and your doctor can spot any changes or warning signs and deal with them before they become bigger problems.
This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.
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