What is it like to live with HIV today?

HIV is considered today as a ghost of the past, but it is still a serious health problem, especially in low-income regions where patients do not have access to antiretroviral therapy (TAR). According to the World Health Organization (WHO), today the human immunodeficiency virus has claimed 33 million lives and, in 2019, there were 38 million people with the disease active.

Due to the joint efforts of the WHO, the Pan American Health Organization (PAHO) and other entities governments, it is estimated that 68% of adults and 53% of children with HIV are in treatment. These results are positive up to a point, as they also imply that almost 1 in 3 people with HIV is not under observation or in the hands of medical professionals. An infected child lives an average of 2-3 years without ART.

Thus, HIV is a chronic but masquerade condition in high-income countries, while in disadvantaged regions it is still synonymous with death. With this idea in mind, Let's see what it's like to live with HIV today.

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HIV and AIDS are not the same

First, it is necessary to make it clear that HIV and AIDS are not the same, even though the two terms are used interchangeably in anecdotal conversations. HIV infection corresponds to the first two phases of the disease (acute and chronic), while that the most extreme face and the one with the worst prognosis is AIDS, the final and most complex stage of approach.

HIV is an RNA virus and, like all viruses, it is unable to replicate its genetic information on its own, since it does not have ribosomes, mitochondria or any metabolic structure at the cellular level. Therefore, it invades host cells (in this case almost exclusively CD4 + T lymphocytes), transforms their genetic information from RNA into DNA (by reverse transcription), integrates it into the nucleus of the cell and then the host machinery generates copies of the RNA viral. Eventually, the new viruses assemble and budge out of the cell, killing it in the process.

When a person is infected with the human immunodeficiency virus, an acute infectious picture occurs in up to 80% of cases, although there are asymptomatic people. During this phase, living with HIV is like having the flu, but a little worse. Symptoms such as fever, headache, itching, sweating, vomiting, and nausea appear. In the acute stage, the proportion of infected CD4 T lymphocytes is approximately 1 / 100,000, but the number of circulating viral agents in the blood is very high. For this reason, the host is highly contagious.

After this acute picture, the disease stabilizes. During the chronic period of the disease, HIV continues to reproduce and destroy CD4 cells, but at much lower rates. Whether receiving therapy or not, the patient may feel completely normal for a time, until the immune system is sufficiently damaged. Treatment at this point is critical: a person with chronic HIV without treatment will develop AIDS in about 10-15 years, while antiretroviral therapy allows the permanence in this phase for several decades.

A patient passes from HIV infection to AIDS when the CD4 lymphocyte count is less than 200 units per cubic millimeter of blood, indicating that the immune system has been severely damaged affected. At this point, many usually commensal microorganisms become pathogens, such as yeasts, complex fungi, and bacteria that are part of the human microbiota.

One of the first symptoms of AIDS is oral and epidermal infections, mainly caused by Candida albicans and other fungi. Other much more serious conditions can also appear over time, such as pulmonary aspergillosis, pneumonia, heart infections and many other things. Ultimately, the patient dies from opportunistic infections, not from the action of the virus itself.

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It is possible to live a full life with HIV

As catastrophic as the description may sound, today it is completely viable to lead a normal life, despite being infected with HIV. Antiretroviral therapy (ART) blocks the entry of the virus into CD4 cells, thus allowing the body to keep its immune system strong for many years.

In any case, the virus mutates and generates resistance to drugs within the body, hence it is They usually take three or more anti-HIV medicines in combination and some are added and others discarded with the weather.

A patient with HIV in the chronic phase, with the appropriate treatment, can lead a totally normal life. It is estimated that the life expectancy of an infected person (detected early) is about 77-80 years, while a healthy one is close to 86. The difference of 8 or 9 years in life expectancy is not negligible, but it is a much more encouraging picture than that observed 20 or 30 years ago.

In addition, if the patient takes the medications strictly and takes all the checkups up to date, he will be a carrier of HIV but will not be able to transmit it, due to the undetectable viral loads in the blood. For this reason, the social stigma that persecutes people with this condition (especially in certain communities) is completely unjustified. It is always better to use a condom than not to use it during sex (for any other disease, not just HIV), but an infected and treated person is not contagious, neither by kissing, nor by sharing food nor during sex.

Currently, a Spanish group belonging to the Higher Council for Scientific Research (CSIC) has presented a vaccine against HIV, the MVA-B. The results are extremely positive, since in the experimental phase I it has been shown that 90% of the Vaccinated volunteers have developed an immune response against the virus and 85% have maintained it (for at least less one year).

Little by little, human beings understand more and more the functioning of viruses and bacteria, which gives us the ability to fight as a society against some of the giants that have plagued populations during decades.

In any case, we cannot forget all the people who once made the problem of this condition visible, the exclusive dynamics to which it was associated and the lack of means and understanding that, unfortunately, still causes deaths. As long as there is only one untreated infected person in the world, the fight against HIV continues.

And of course, psychotherapy and psychological assistance is another useful resource to know how to adapt to life with HIV managing in the best way the emotions and personal relationships and with oneself. If you are looking for this kind of services, contact me.