The 1st of December has been observed as the World AIDS Day upon the 1988 Initiative of the World Health Organization. Its objectives are inter alia raising awareness about the disease, expressing solidarity towards people living with HIV, fighting prejudice and discrimination of the people with HIV and addressing risky sexual behaviors.
In the following text you can find information about HIV, AIDS, how it is transmitted, protection methods, virus detection, disease stages, etc.
What is AIDS?
Acquired immunodeficiency syndrome (HIV, AIDS) is a clinical manifestation of the disease caused by the human immunodeficiency virus (HIV). This virus affects human immune systems and makes people susceptible to infections and other diseases.
How is HIV transmitted?
The virus is present in the blood of infected people and is transmitted through blood, semen, vaginal secretion and breast milk. It may also be present in other body fluids, including tears, saliva, urine, but the concentration in these is much lower and insufficient to cause an infection.
- HIV is transmitted via unprotected sexual contact with an infected person (contact via vaginal mucosa, vulva, penis, rectum or mouth during an unprotected vaginal or anal sexual intercourse, i.e. without a condom. Even though oral transmission rate is low, the virus can be transmitted in this way as well.
- HIV is also transmitted via direct contact with infected blood (sharing injection needles, tattoo needles, menstruation blood)
- Mother to child (vertical transmission): an infected mother can pass the virus to a child during birth and breastfeeding, if prescribed prevention procedures are not obeyed, i.e. coordinated action between an infectious disease specialist, gynecologist and patient. These procedures, inter alia, include: antiretroviral prophylaxis during pregnancy, birth and first few weeks in the life of an infant, obstetric interventions including c-section before labors begin, avoiding breastfeeding (this depends on the virus amount in the mother’s blood)
How to protect yourself from the HIV infection?
It is important to remember that it is you who decide whether you will expose yourself to risks or not.
- Regular use of condoms reduces risks of the infection to minimum. You do not have to use condoms only if you are in a monogamous relationship.
- Do not use drugs. If you use it, do not share needles.
- By protecting yourself, you are protecting your partner.
Importance of prenatal screening for HIV infection
There are many advantages if a woman knows her HIV status during her pregnancy. Therefore, all pregnant women should be tested for HIV, together with other routine tests done during the pregnancy. If the test shows that a woman is HIV positive, her doctor will be able to timely undertake appropriate measures to prevent virus from spreading, and to prevent transmission of the virus to the baby (vertical transmission). In case the woman is not HIV positive, she can still learn about different preventive measures.
Gynecologic manifestations of HIV
Genital tract diseases (vaginitis, genital herpes, cervical dysplasia, Chlamydia, gonorrhea, syphilis, etc.) often occur in HIV infected women. These diseases are the first indicators of the immunosuppression caused by HIV. HIV infection is usually suspected if genital diseases occur too often without reacting to prescribed therapies. One must be aware of the fact that there is a direct relationship between HIV and other infections transmitted sexually. Therefore, early detection and treatment of STDs is an efficient strategy in preventing sexually transmitted HIV infections. Sexually transmitted diseases of reproductive organs are usually asymptomatic, and therefore it is important to perform regular tests on patients as to be able to detect such disease in its early stage. This includes both HIV positive and negative patients.
It is recommended that all sexually active women under 25 be tested for Chlamydia and gonorrhea at least once a year.
Serological tests for syphilis should be performed in high-risk patients (persons dating multiple partners).
HIV positive women with more than one partner should be tested at least once a year for syphilis, gonorrhea, Chlamydia, because these infections are very dangerous to persons with damaged immune systems.
Detection tests of the aforementioned can be performed in the Mehmedbašić institute by means of the PCR method, which is very efficient because it can detect even the smallest amount of the above mentioned indicators.
HIV and AIDS diagnosis
A period between six months and ten years can pass from the infection to clinical manifestations of the disease (AIDS). This depends on the infected person’s immune system.
Laboratory tests for HIV
Indirect tests (ELISA, Western blot, oral and capillary blood tests) can confirm the presence of the serum antigens for HIV. Antibodies can be detected in the blood after one to three months from infection. The antibodies are not present before this period in a sufficient amount, which is the reason why they cannot be detected by tests. Impossibility to detect the antibodies during this period is called “the window period”. If the ELISA test is positive, then Western blot test is performed.
Direct tests are used to confirm the presence of the virus’s genetic material in the plasma (PCR –polymerase chain reaction). This test is used to determine the number of viruses in the blood, which is important information when deciding on the therapy or type of therapy monitoring method. The Mehmedbašić Institute uses this method to detect the presence of the HIV virus in a simple and precise manner.
HIV stage assessment
Assessing the stage of the HIV infection is done based on the data obtained during interviews and examinations, additional tests and lab tests which are considered (by the infectious disease specialist) important.
Asymptomatic and symptomatic stage of the HIV infection
Primary HIV infection symptoms are similar to the flu symptoms: fever, headache and muscle and joint pain. Lymph nodes can be swollen and painless. These symptoms can last up to one month. At that point, a diagnosis is usually determined that the disease involved is of an unknown or viral origin (similar to the flu). The person who is infected is very contagious at that point. After this stage, the symptoms completely disappear, sometimes for several years, and then the AIDS symptoms appear.
Symptomatic HIV infection is characterized by the symptoms and signs which are usually unrecognized by either the patient or doctor. They slowly progress: high temperature for a longer period of time, sweating during the night, swollen and painless lymph nodes (on the neck, groin, underarms), fatigue, tiredness, difficulties in breathing, dry cough, chest pain, weight loss, diarrhea, white deposits in the mouth, tongue and throat. Very soon the virus will affect the cells of the central nervous system, and a person might experience muscle tiredness, weak coordination and slow movements, hand tremors, difficulties in remembering things and concentrating, apathy and depression.
Important things to know!!!
You can get tested for HIV and other STDs in the DPTS centers around entire BiH, free of charge, in confidence and anonymously. One of such DPTS centers in Sarajevo is located in the Clinic for infectious diseases of the KCUS, 25 Bolnička Street, phone number: +387 33 297 251.