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| for and by young people with HIV |
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explanation about HIV HIV, AIDS, T4 cells, viral load, STIs, … What do all these abbreviations and terms stand for? Sometimes it all seems like Latin and you get the idea that you don't really understand anything. And perhaps you don't even dare to ask your doctor any more questions, because he or she has already explained everything a number of times. In this section, you will find short and concise explanations about HIV, STIs, opportunistic infections, resistance, etc.  |
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what is HIV? HIV is a life-threatening virus because it destroys your natural immune system over the course of a number of years. It is still not possible to cure an HIV infection, but there is now medication that slows down its development. Whereas an HIV infection used to be strongly associated with disease and death, the reality today is different. The life expectancy of people with HIV has risen sharply thanks to the development of the medicines. Experts suspect that, in the best case, the virus can remain controllable for a very long time, so that AIDS might not develop. This makes it very possible to live with HIV. People with HIV are able to keep working or to start looking for a new job. Some people think about buying a house, starting new relationships and travelling. |
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anonymous I've been infected for almost nine years so far. I ended up in the hospital as a result of an infection, and that's when I heard that I was HIV positive. I was 19 years old then and had just had my first relationship. It was really hard to cope with my diagnosis. I knew very little about HIV and AIDS. Luckily I could turn to my doctor who tried to help me in every possible way. |
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what is AIDS? Being HIV positive doesn't mean that you have AIDS. You will only be diagnosed as having AIDS if HIV has weakened your immune system to such an extent that you get sick from an infection that otherwise wouldn't have been a problem if your immune system had been healthy (such an infection is also sometimes called an 'opportunistic infection'). AIDS stands for 'Acquired Immune Deficiency Syndrome'. Without treatment, the HIV virus will attack your immune system. After a while, your immune system will no longer be able to protect your body well enough against pathogens (microorganisms that can cause diseases). The 'long-term non-progressors' form the exception to this rule. Those are people who are capable of functioning for a long time without medication and who still do not show any symptoms of disease. Viruses or bacteria that would usually cause relatively harmless infections for someone with a healthy immune system can lead to severe and often life-threatening infections ('opportunistic infections') if your immune system is badly weakened. Certain forms of cancer can also appear. At that moment, you have AIDS. Without treatment, it takes a person with HIV an average of ten years before he or she develops AIDS. This period differs from person to person and depends on the strength of your immune system, among other things. With the current medicines, the life expectancy of people with HIV has risen sharply, and the infection is much less likely to progress to the stage of AIDS. Taking medicines will not guarantee that you won' t ever develop AIDS, however. Much depends on whether the HIV virus can be maximally suppressed.
Another favourable development is that, thanks to the treatments, some people who already had AIDS can once again live without too many medical problems, like someone who is 'merely' HIV positive. So an AIDS diagnosis doesn't necessarily mean your life is over. Most opportunistic infections can be treated, but they are often serious and can even be life threatening. The current anti(retro)viral medication can also suppress HIV in the AIDS stage, so that your immune system can restore itself (partially). The medication against HIV also has a positive effect on a number of virulent disorders.
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anonymous The medicines have made it so that I feel like I did in the days before my AIDS diagnosis. At a certain point, my health was really poor, but the current therapies have strongly improved my health. |
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symptoms? Whether or not someone will develop complaints, and when, varies from person to person. An infection with HIV doesn't have clearly recognisable symptoms at first. In the first days, you might have vague, flu-like symptoms, but otherwise you won't notice anything. In a later phase, when HIV is spreading further throughout your body, your lymph glands might swell up. Swollen lymph glands can occur with any infection, however. They are simply a sign that the immune system is fighting an infection. In other words, a different infection could also cause those symptoms. The only way to determine whether or not HIV is causing them is to for you to get tested.
When someone with HIV gets AIDS, opportunistic infections can definitely give you clear symptoms. Besides these infections, people with AIDS are also more apt to develop certain tumours and lymphomas.
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what is the role of the CD4 cell? Your body is constantly exposed to attacks from bacteria, viruses, parasites and moulds. Your immune system destroys these invaders and protects your body against any damaging effects. Your immune system consists of different types of white blood cells. The CD4 cell, also known as the T4 cell or T-helper cell, is a white blood cell that plays a central role within your immune system, since it has a coordinating function. When the HIV gets into your body, it uses precisely this central cell in order to make copies of itself. In effect, the CD4 cell becomes a sort of factory that makes new HIV viruses. After antibodies have been produced in reaction to the penetration of HIV in your body, there is a sort of balance in the beginning phase between the destruction of CD4 cells during the production of new viruses on the one hand and the production of new CD4 cells on the other hand. But as time goes on, the balance shifts more and more to the disadvantage of the CD4 cells. Your immune system is then no longer capable of producing enough new CD4 cells to compensate the loss of those cells. Your immune system becomes systematically weakened, and your body can't defend itself enough anymore.
A non-infected person has between 500 and 1500 CD4 cells per cubic millimetre of blood. In a person who has been infected with HIV, we see the number of CD4 cells drop. Once your CD4-cell count goes below 200, you run a real danger of getting opportunistic infections. Below 50 CD4 cells, the chance that you will get such serious infections is very great.
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anonymous When I was diagnosed as having HIV, my CD4-cell count turned out to be relatively low. My first therapies weren't able to change that very much. Despite the low count, I still haven't ever really been sick. Having a low level of resistance still means a greater risk for infections, though.
Read another personal story: anonymous |
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what is the viral load? The 'viral load' is a measure for the amount of HIV in the blood, expressed by the number of virus copies per millilitre of blood. Along with the number of CD4 cells, this is the most important parameter in monitoring a HIV infection.
In people who are HIV positive, the viral-load values can fluctuate from less than 50 to more than a million virus copies per ml. Very high values are seen mainly in the beginning phase of the infection, the acute seroconversion, or else at the very end of the infection. The greater the viral load, the more chance that the CD4 cells will be destroyed and, as a result, the more chance that AIDS will develop. With a high viral load, the risk of passing on HIV to someone else is also greater.
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how is HIV transmitted? In comparison with the viruses that cause an STI, HIV is less easy to pass on to someone else. HIV is transmitted through sperm and vaginal fluid during unprotected sexual contact and through blood, for example when using needles to take drugs. An HIV-positive mother can also give HIV to her (unborn or newborn) child during pregnancy, while giving birth, and through breastfeeding. With the right treatment and supervision during pregnancy and birth, it is possible to drastically reduce the risk of infecting the child.
Just to be clear about it: you cannot get HIV from a dirty toilet seat or a plate… Apart from HIV, it is always a good idea to be hygienic in terms of contact with your blood, vomit, excrement and urine anyway. Prevent others from coming into contact with your blood. It is best to put a used sanitary napkin or a bloody tampon in a little bag and to throw it away immediately.
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HIV in combination with other STIs A sexually transmitted infection (STI) increases a person's chance of contracting HIV. After all, many STIs enter your body through the penis, vagina, anus or mouth. STIs damage the tissue in those places: you get little sores, infections or haemorrhages. HIV also enters your body through the same places. If the mucous membranes are damaged by an STI, it will be easier for HIV to enter your bloodstream.
If you are HIV positive yourself and you also have an STI, there is a greater chance that you will pass on your HIV to someone else. Things like sores that are caused by an STI contain a lot of HIV. An infection in your penis can mean that your sperm contains much more HIV than otherwise, for example. The viral load - the amount of the virus in the blood - can also increase as a result of the STI and can cause your resistance to drop substantially. Moreover, if you are HIV positive, contracting an STI often means extra troubles. Due to your disrupted immune system, the complaints can be much more severe or more difficult to fight. In other words, having HIV is an extra reason for trying even harder to avoid getting STIs.
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the risk of transmission The amount of risk depends on a number of different things: the sexual technique being practiced, the presence of an STI and the viral load of the person with HIV. Having unprotected sex, in which the active male partner comes, forms the highest risk. You run a low risk if someone comes in your mouth, for example, but that risk increases considerably if you have infections, an STI or sores in your mouth.
By using a condom with lube or by choosing to practice sexual techniques where you don't run any risk, you can minimise the chance of transmission to basically nil. Choosing for a condom is still the safest method.
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