Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight infection and disease.
HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS.
There's no cure for HIV/AIDS, but medications can dramatically slow the progression of the disease. These drugs have reduced AIDS deaths in many developed nations.
The symptoms of HIV and AIDS vary, depending on the phase of infection.
Some people infected by HIV develop a flu-like illness within two to four weeks after the virus enters the body. This illness, known as primary (acute) HIV infection, may last for a few weeks. Possible signs and symptoms include:
These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.
In this stage of infection, HIV is still present in the body and in white blood cells. However, many people may not have any symptoms or infections during this time.
This stage can last for many years if you're not receiving antiretroviral therapy (ART). Some people develop more severe disease much sooner.
As the virus continues to multiply and destroy your immune cells — the cells in your body that help fight off germs — you may develop mild infections or chronic signs and symptoms such as:
Thanks to better antiviral treatments, most people with HIV in the U.S. today don't develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.
When AIDS occurs, your immune system has been severely damaged. You'll be more likely to develop opportunistic infections or opportunistic cancers — diseases that wouldn't usually cause illness in a person with a healthy immune system.
The signs and symptoms of some of these infections may include:
If you think you may have been infected with HIV or are at risk of contracting the virus, see a doctor as soon as possible.
HIV is caused by a virus. It can spread through sexual contact or blood, or from mother to child during pregnancy, childbirth or breast-feeding.
HIV destroys CD4 T cells — white blood cells that play a large role in helping your body fight disease. The fewer CD4 T cells you have, the weaker your immune system becomes.
You can have an HIV infection, with few or no symptoms, for years before it turns into AIDS. AIDS is diagnosed when the CD4 T cell count falls below 200 or you have an AIDS-defining complication, such as a serious infection or cancer.
To become infected with HIV, infected blood, semen or vaginal secretions must enter your body. This can happen in several ways:
You can't become infected with HIV through ordinary contact. That means you can't catch HIV or AIDS by hugging, kissing, dancing or shaking hands with someone who has the infection.
HIV isn't spread through the air, water or insect bites.
Anyone of any age, race, sex or sexual orientation can be infected with HIV/AIDS. However, you're at greatest risk of HIV/AIDS if you:
HIV infection weakens your immune system, making you much more likely to develop many infections and certain types of cancers.
There's no vaccine to prevent HIV infection and no cure for AIDS. But you can protect yourself and others from infection.
To help prevent the spread of HIV:
Your doctor will prescribe these drugs for HIV prevention only if you don't already have HIV infection. You will need an HIV test before you start taking PrEP and then every three months as long as you're taking it. Your doctor will also test your kidney function before prescribing Truvada and continue to test it every six months.
You need to take the drugs every day. They don't prevent other STIs, so you'll still need to practice safe sex. If you have hepatitis B, you should be evaluated by an infectious disease or liver specialist before beginning therapy.
HIV can be diagnosed through blood or saliva testing. Available tests include:
Antigen/antibody tests. These tests usually involve drawing blood from a vein. Antigens are substances on the HIV virus itself and are usually detectable — a positive test — in the blood within a few weeks after exposure to HIV.
Antibodies are produced by your immune system when it's exposed to HIV. It can take weeks to months for antibodies to become detectable. The combination antigen/antibody tests can take two to six weeks after exposure to become positive.
Talk to your doctor about which HIV test is right for you. If any of these tests are negative, you may still need a follow-up test weeks to months later to confirm the results.
If you've been diagnosed with HIV, it's important to find a specialist trained in diagnosing and treating HIV to help you:
If you receive a diagnosis of HIV/AIDS, several tests can help your doctor determine the stage of your disease and the best treatment, including:
Your doctor might also order lab tests to check for other infections or complications, including:
Currently, there's no cure for HIV/AIDS. Once you have the infection, your body can't get rid of it. However, there are many medications that can control HIV and prevent complications. These medications are called antiretroviral therapy (ART). Everyone diagnosed with HIV should be started on ART, regardless of their stage of infection or complications.
ART is usually a combination of three or more medications from several different drug classes. This approach has the best chance of lowering the amount of HIV in the blood. There are many ART options that combine three HIV medications into one pill, taken once daily.
Each class of drugs blocks the virus in different ways. Treatment involves combinations of drugs from different classes to:
Two drugs from one class, plus a third drug from a second class, are typically used.
The classes of anti-HIV drugs include:
Everyone with HIV infection, regardless of the CD4 T cell count or symptoms, should be offered antiviral medication.
Remaining on effective ART with an undetectable HIV viral load in the blood is the best way for you to stay healthy.
For ART to be effective, it's important that you take the medications as prescribed, without missing or skipping any doses. Staying on ART with an undetectable viral load helps:
Staying on HIV therapy can be challenging. It's important to talk to your doctor about possible side effects, difficulty taking medications, and any mental health or substance use issues that may make it difficult for you to maintain ART.
Having regular follow-up appointments with your doctor to monitor your health and response to treatment is also important. Let your doctor know right away if you're having problems with HIV therapy so that you can work together to find ways to address those challenges.
Treatment side effects can include:
Some health issues that are a natural part of aging may be more difficult to manage if you have HIV. Some medications that are common for age-related heart, bone or metabolic conditions, for example, may not interact well with anti-HIV medications. It's important to talk to your doctor about your other health conditions and the medications you're taking.
If you are started on medications by another doctor, it's important to let him or her know about your HIV therapy. This will allow the doctor to make sure there are no interactions between the medications.
Your doctor will monitor your viral load and CD4 T cell counts to determine your response to HIV treatment. These will be initially checked at two and four weeks, and then every three to six months.
Treatment should lower your viral load so that it's undetectable in the blood. That doesn't mean your HIV is gone. Even if it can't be found in the blood, HIV is still present in other places in your body, such as in lymph nodes and internal organs.
Along with receiving medical treatment, it's essential to take an active role in your own care. The following suggestions may help you stay healthy longer:
People who are infected with HIV sometimes try dietary supplements that claim to boost the immune system or counteract side effects of anti-HIV drugs. However, there is no scientific evidence that any nutritional supplement improves immunity, and many may interfere with other medications you're taking. Always check with your doctor before taking any supplements or alternative therapies to ensure there are no medication interactions.
Practices such as yoga, meditation and tai chi have been shown to reduce stress, as well as improve blood pressure and quality of life. While they need more study, these practices may be helpful if you're living with HIV/AIDS.
Receiving a diagnosis of any life-threatening illness is devastating. The emotional, social and financial consequences of HIV/AIDS can make coping with this illness especially difficult — not only for you but also for those closest to you.
But today, there are many services and resources available to people with HIV. Most HIV/AIDS clinics have social workers, counselors or nurses who can help you directly or put you in touch with people who can.
Services they may provide:
It's important to have a support system. Many people with HIV/AIDS find that talking to someone who understands their disease provides comfort.
If you think you might have HIV infection, you're likely to start by seeing your family doctor. You may be referred to an infectious disease specialist — who additionally specializes in treating HIV/AIDS.
Before your appointment, consider answering these questions and take them to your doctor's visit:
Your doctor will ask you questions about your health and lifestyle. Your doctor will perform a complete physical exam, checking you for:
If you think you might have HIV infection, take steps to protect yourself and others before your appointment. Don't have unprotected sex. If you use injectable drugs, always use a fresh, clean needle. Don't share needles with others.