05/02/2024
This week, 5th – 11th February 2024, marks 10 years since the first, National HIV Testing Week. A week dedicated to improving testing of, and education around the infamous HIV virus. The only way to diagnose an HIV infection is through testing. This is why it is essential that those at risk, and those who think they may have contracted the virus are tested regularly and promptly. Theres often confusion between HIV and AIDS, which we will clear up in this article, along with looking at the signs and symptoms of the infection, how common HIV infection really is in the UK, and the treatments that are available.
The same, but different
Some people find the terminology confusing. HIV and AIDS are related, but not necessarily the same thing. HIV stands for Human immunodeficiency virus, a virus which infects and attacks the white blood cells of the immune system. On the other hand, AIDS is the acronym for Acquired immunodeficiency syndrome. This is the most advanced stage of HIV infection when the body’s immune system is extremely compromised and vulnerable to infections and other illness, including cancer.
Signs & Symptoms
One of the problems with HIV is many cases don’t display any symptoms, especially over the first few weeks of infection. During this period however, most people experience flu-like symptoms such as a fever, headache, sore throat, muscle pain, mouth ulcers and perhaps a rash. This means many people don’t think much of it, and the infection is easily missed1.
After the initial 2-6 weeks, there is often a period of dormancy when no symptoms are present, which may last several years, in some cases over a decade. However, as HIV continues to work on the immune system, it weakens, and symptoms eventually begin to present. These symptoms may include swollen lymph nodes, weight loss, fever, diarrhoea, fatigue and coughing or breathing difficulties1.
Finally, if left untreated, the chronic HIV infection will progress to AIDS. Now the immune system is severely compromised, and the individual is at a much higher risk of severe infections and other illnesses like cancer, commonly lymphomas2.
Transmission
HIV infection is spread through contact with bodily fluids of an infected person. This is often blood, from sharing needles or other injection equipment during drugtaking and accidental needle sticks experienced by healthcare workers; breast milk from a mother who is unaware of her infection; or through semen or vaginal fluids during sex1. It can also be passed from a pregnant mother to her offspring. HIV cannot spread through saliva, urine or sweat, and cannot be contracted by hugging, kissing, or sharing food and water – HIV is a fragile virus and can’t survive outside the body for very long3.
Risk Factors
Some of the most common risk factors are related to the transmission methods discussed above. Unprotected sex, whether anal or vaginal, increases the risk of HIV infection. Similarly, using contaminated needles, syringes and drug solutions will increase the risk. A combination of sexual activity and harmful drug or alcohol abuse is also considered a risk factor for HIV infection.
Additionally, having another STI such as syphilis, herpes, chlamydia, gonorrhoea or bacterial vaginosis, is a risk factor for HIV infection1. This is why our Blood Borne Virus and Complete STI test packages include HIV testing, offering increased peace of mind regarding your sexual health.
The Stats.
In 2019, an estimated 105,200 people in the UK were living with HIV.4 However, only 94% of these people are diagnosed, meaning approximately 1 in 16 people in the UK are living with HIV and don’t know they are infected.
Of the people receiving care for HIV infection in 2022, 53.7% were white, 30.2% were black African and 4.6% were Asian4.
MSM (gay, bisexual or men who have sex with other men) make up 28.2% of newly diagnosed HIV cases4. This statistic may seem high, but this is actually a 63.8% decrease since 2014, illustrating the effectiveness of increased HIV testing and treatment.
8% of people living with HIV are in the 50-64 age group and 8.9% were 65+4
Over time, the number of people living with HIV to an older age has increased, and the 50-64 age groups has overtaken the 35-49 age group, reflecting the effectiveness of HIV treatment in helping people live longer with the infection (see figure 1).
National AIDS Trust. HIV in the UK statistics. Published 2022. Accessed January 31, 2024. https://www.nat.org.uk/about-hiv/hiv-statistics
Diagnosis & Treatment
The only way to diagnose HIV is through testing via a blood or saliva sample. Post-exposure prophylaxis (PEP) is an emergency anti-HIV medication that may stop the infection if started within 24-72 hours of exposure to the virus – the key here is the earlier this medication can be started, the more likely it is to be successful. Where PEP is unsuccessful at blocking the infection, early detection of the virus still allows for prompt treatment which can reduce the risk of severe illness and transmission3.
Antiretroviral therapy (ART) is used to treat those with HIV infection. ART works by inhibiting viral replication, allowing the immune system to repair itself and function normally. It is supplied as a daily tablet and is often a combination of medications as HIV infection can quickly develop resistance to individual medicines. The aim of ART is to reduce the viral load of an infected person. If viral load can be lowered to the point where it is undetectable, the individual will no longer be able to transmit the virus to others, providing another example of the importance of early detection and treatment3.
In Conclusion
- HIV is a viral infection which compromises the immune system which, if untreated, can progress to AIDS and severe illness or cancer.
- Asymptomatic HIV infections are common, and testing is essential to provide treatment to those infected, reduce transmission and prevent serious illness.
- Rates of HIV infection are on a downward trajectory, but this is no time for complacency! Only through increased testing, education and awareness can we hope to eliminate the threat of HIV and AIDS.
References
- World Health Organisation. HIV and AIDS. Fact Sheets. Published July 13, 2023. Accessed January 31, 2024. https://www.who.int/news-room/fact-sheets/detail/hiv-aids
- Lewden C. Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemiol. 2004;34(1):121-130. doi:10.1093/ije/dyh307
- National Health Service. HIV and AIDS. Health A to Z. Published April 22, 2021. Accessed January 31, 2024. https://www.nhs.uk/conditions/hiv-and-aids/
- National AIDS Trust. HIV in the UK statistics. Published 2022. Accessed January 31, 2024. https://www.nat.org.uk/about-hiv/hiv-statistics