HIV is a virus that attacks the human immune system, making the body susceptible to various diseases, malignant tumors, and a high mortality rate. The incubation period of HIV in human body is 8 to 9 years on average, and people can live and work without any symptoms for many years before getting AIDS.
Epidemic transmission
HIV can be transmitted through unprotected sexual intercourse (vaginal or anal) and oral sex with an infected person; the importation of HIV-contaminated blood; and the sharing of HIV-contaminated needles, syringes, or other sharp instruments. It can also be transmitted from an HIV-infected mother to her baby during pregnancy, delivery, and breastfeeding.
Clinical presentation
The onset of the disease is more common in young adults, with 80% of the cases occurring between the ages of 18 and 45, the more sexually active age group. HIV infection is often followed by rare diseases such as Pneumocystis carinii pneumonia, toxoplasmosis, and atypical mycobacterial and fungal infections.
After HIV infection, the first few years to more than 10 years can be without any clinical manifestations. Once the disease progresses to AIDS, the patient can develop various clinical manifestations. The initial symptoms may be like common cold or flu, such as general fatigue, loss of appetite and fever. Cough, shortness of breath, dyspnea, persistent diarrhea, blood in stool, enlarged liver and spleen, and complications of malignant tumors.
Clinical symptoms are complex and variable, but not all of the above symptoms are present in each patient. The invasion of lung often leads to dyspnea, chest pain, cough, etc.; the invasion of gastrointestinal can cause persistent diarrhea, abdominal pain, wasting and weakness, etc.; it can also invade the nervous system and cardiovascular system.
1.General symptoms
Persistent fever, weakness, night sweats, and persistent widespread generalized lymph node enlargement. Especially, the swelling of lymph nodes in the neck, axilla and groin is more obvious. The lymph nodes are more than 1 cm in diameter, firm in texture, movable and painless. Weight loss can be more than 10% within 3 months, up to 40%, and the patient’s wasting is especially obvious.
2.Respiratory symptoms
Long-term cough, chest pain, dyspnea, and blood in sputum in severe cases.
3.Gastrointestinal symptoms
Decreased appetite, anorexia, nausea, vomiting, diarrhea, and in severe cases, blood in the stool. Drugs usually used to treat digestive tract infections are not effective for this kind of diarrhea.
4.Nervous system symptoms
Dizziness, headache, unresponsiveness, mental retardation, mental abnormalities, convulsions, hemiplegia, dementia, etc.
5.Skin and mucous membrane damage
Herpes simplex, herpes zoster, inflammation and ulceration of the mucous membranes of the mouth and pharynx.
6.Tumor
A variety of malignant tumors may appear. Kapozi’s sarcoma located on the body surface can be seen as red or purplish macules, papules and infiltrative masses.
Diagnosis
1.Acute stage
Diagnostic criteria: patients with recent epidemiological history and clinical manifestations, combined with laboratory HIV antibodies from negative to positive can be diagnosed, or only laboratory tests from negative to positive HIV antibodies can be diagnosed. 80% of HIV-infected patients can detect antibodies in the initial screening test 6 weeks after infection, and almost 100% of infected patients can detect antibodies after 12 weeks, only a very small number of patients can detect antibodies within 3 months or 6 months after infection. Only a very small number of patients are detected within 3 months or 6 months after infection.
2.Asymptomatic period
Diagnostic criteria: Diagnosis can be made with epidemiological history combined with positive HIV antibodies, or only with positive laboratory tests for HIV antibodies.
3.AIDS period
(1) Persistent irregular fever of unknown cause of 38℃ or more for >1 month;
(2) Chronic diarrhea more than 3 times/day, >1 month;
(3) Weight loss of more than 10% within 6 months;
(4) Recurrent oral Candida albicans infections;
(5) Recurrent herpes simplex virus infection or herpes zoster virus infection;
(6) Pneumocystis carinii pneumonia (PCP);
(7) Recurrent bacterial pneumonia;
(8) Active tuberculosis or non-tuberculous mycobacteriosis;
(9) Deep fungal infections;
(10) Occupational lesions of the central nervous system;
(11) Dementia in young and middle-aged adults;
(12) Active cytomegalovirus infection;
(13) Toxoplasma gondii encephalopathy;
(14) Penicillium infection;
(15) Recurrent sepsis;
(16) Kaposi’s sarcoma and lymphoma of the skin, mucous membrane or internal organs.
Treatment
There is still a lack of effective drugs for the eradication of HIV infection worldwide. The goals of treatment at this stage are: maximum and durable reduction of viral load; acquisition of immune function reconstruction and maintenance of immune function; improvement of quality of life; and reduction of HIV-related morbidity and mortality. The treatment of this disease emphasizes comprehensive treatment, including: general treatment, antiviral treatment, treatment to restore or improve immune function and treatment of opportunistic infections and malignancies.
1.General treatment
No isolation treatment is required for HIV-infected patients or patients with acquired immunodeficiency syndrome. For asymptomatic HIV-infected patients, they can still maintain normal work and life. Anti-viral treatment should be given according to the specific condition, and the change of condition should be closely monitored. For patients with pre-AIDS or those who have developed AIDS, rest and a high-calorie, multivitamin diet should be given according to their condition. For those who cannot eat, intravenous fluids should be given to supplement nutrition. Strengthen supportive therapy, including blood transfusion and nutritional support therapy, to maintain water and electrolyte balance.
2.Anti-viral treatment
Anti-viral therapy is the key to AIDS treatment. With the use of highly effective antiretroviral combination therapy, the efficacy of anti-HIV has been greatly improved, and the quality of life and prognosis of patients have been significantly improved.
Preventive measures
There is no effective vaccine to prevent AIDS, so the most important thing is to take preventive measures. The methods are.
1.Adhere to cleanliness, do not prostitute, prostitute, avoid premarital and extra-marital sex.
2, strictly prohibit drug use, do not share syringes with others.
3, do not use blood transfusions and blood products without authorization, but under the guidance of a doctor.
4, do not borrow or share personal items such as toothbrushes, razors, shavers.
5.Use condom is one of the most effective measures to prevent STD and AIDS in sex life.
6.Avoid direct contact with blood, semen, breast milk and urine of AIDS patients to cut off their transmission route.