FAQs Answered By Dr. Pujari

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FAQs answered by Dr.Pujari

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How severe is the problem of AIDS?

AIDS has emerged into a global health problem of extraordinary scope and unprecedented emergency. It is estimated that 33.6 million people are living with HIV/AIDS in the world today. Everyday 16,000 new infections are occurring, 1500 in children alone. The majority of infections are concentrated in the age group of 15-40 years. Hence AIDS is a disease which predominantly affects the young population.

Highlights

IHO Project Saheli

Healing Properties of
sleep

The AIDS Clock: Everyday 16,000 new infections are occurring globally

What is the AIDS situation in India?

India is supposed to harbor the largest number of HIV infected individuals in the world. Currently it is estimated that 3-4 million people in India are carrying the AIDS virus. The spread of HIV infection in India has been extremely rapid.

When was AIDS first discovered?

In 1981, few homosexuals in the USA presented with unusual cancers and pneumonia’s that were indicative of a defect in their immune system.

Initially these symptoms were restricted only amongst the homosexual population. However, later these conditions were also seen amongst intravenous drug users (IVDUs) and people who needed repeated blood transfusions e.g. hemophiliacs.

This peculiar constellation of signs and symptoms associated with the defect in the immune system was defined as AIDS. Subsequently the causative organism of AIDS i.e. Human Immunodeficiency Virus (HIV) was discovered.

When and how was HIV discovered?

In 1983, French scientists isolated a virus from the lymph nodes of homosexual men. They called it Lymphadenopathy Associated Virus (LAV). Simultaneously scientists in the USA discovered a virus from the cells of individuals with AIDS. They called it HTLV III. Subsequently it was found that both these viruses were similar and a common name i.e. HIV was accepted internationally.

How is HIV transmitted?

There are four documented modes of transmission of HIV:

	Sexual transmission
	Transmission through contaminated blood
	Sharing of needles and syringes
	Mother to child transmission

What is the major mode of transmission of HIV in India?

Heterosexual transmission is the major mode of transmission in India. However, in the North-eastern states sharing needles and syringes while injecting drugs is the predominant mode of acquisition of HIV.

What is HIV?

HIV stands for Human Immunodeficiency Virus. The name is self-explanatory. The virus causes disease only in humans by producing deficiency in the immune system. A schematic picture of HIV is shown in Fig.1.

Fig 1: Schematic diagram of human immunodeficiency virus

What is immune system?

Immune system refers to the defence system present in our body to fight infections. We are surrounded by numerous micro-organisms around us. They are present in the food we eat, the water we drink and the air we breathe. Every time a micro-organism enters our body it doesn’t produce disease.

The defence system in our body (immunity) fights these micro-organisms and prevents development of disease. The immune system is important for maintaining normal health of human beings.

How does HIV destroy the immune system?

The basis of our immune system is the white blood cells (WBCs). HIV infects a type of WBC- the T-4 lymphocytes and kills them. T-4 lymphocytes are the most important cells, which control the entire immune system. By destroying the T-4 lymphocytes HIV cripples the immune system. This makes the body vulnerable to various infections.

What is the difference between HIV carrier and AIDS?

After entry of HIV into the body it takes about 8-10 years before symptoms start appearing. During this period an infected person looks and feels healthy. This is the carrier stage of HIV infection.

AIDS is said to occur when certain disease conditions are associated with HIV infection. More simply put AIDS is a term used to describe the terminal stage of HIV infection.

Do all people infected with HIV develop AIDS?

Around 50-70% of HIV infected persons will develop AIDS in about 10 years after infection. However, about 5% of infected people remain healthy and asymptomatic for even more than 12-15 years. These people have low levels of HIV in their body. In medical terminology this group is referred to as Long Term Non Progressors (LTNP).

What are opportunistic infections?

When the immune system in an HIV infected person gets weak, it leaves the body powerless to fight any micro-organisms entering the body. These micro-organisms have an easy passage in, and cause infections and disease.

Since these organisms have sought the opportunity of a destroyed immune system they are called opportunistic infections.

What is the difference between HIV-1 and HIV-2 infection?

There are two types of HIV: HIV-1 and HIV-2. In India the predominant virus is HIV-1. HIV-2 is more common in some parts of Africa. HIV-2 is a less pathogenic and less transmissible virus. Hence somebody with HIV-2 infection will stay healthy longer as compared to somebody with HIV-1 infection.

How does sexual transmission of HIV occur?

HIV is present in the sexual fluids viz. semen and vaginal fluids of infected persons. Whenever sexual intercourse occurs there is an exchange of these body fluids. The genital tract is rich in lymphocytes and macrophages and when exposed to HIV, through sexual fluids, these cells get infected.

Is it true that HIV is more easily transmitted from man to woman than vice versa?
Yes, the risk of transmission is more from man to woman than other way round. This is because the semen contains higher concentrations of HIV as compared to vaginal fluids.

In addition after sexual intercourse the semen remains deposited in the female genital tract thus giving more time for HIV to infect the cells lining the genital tract.

What is the probability of acquiring HIV infection from a single sexual exposure?
The risk of transmission of HIV from a single sexual exposure with an infected person is very low, around 0.5% i.e. 1 in 200 intercourses. However, it may be the first or the 200th intercourse, which may transmit HIV. Hence each unprotected sexual encounter with an infected person is risky and can transmit HIV.

Does having another Sexually Transmitted Disease (STD) increase the risk of transmission of HIV?

Yes, indulging in unprotected sex when having a STD amplifies the risk of transmission or acquisition of HIV. Genital ulcers may serve as a direct portal of entry for HIV into the body. Hence it is very important to seek proper treatment for STD’s and also practice safer sex to protect oneself from getting infected with HIV.

Which are the high-risk sexual behaviors, which increase the risk of acquiring HIV?
Unprotected sexual intercourse with an infected person leads to acquisition of HIV infection. It should be remembered that the question of HIV transmission doesn’t arise when sexual intercourse occurs between two uninfected partners.

However, it is difficult to make out HIV infection status of a person by his/her appearance. An HIV infected carrier can appear and feel healthy.

Can one acquire HIV infection by masturbation?

There is no question of acquiring HIV infection by self or mutual masturbation. Since there is no exchange of sexual fluids, it is a safe activity.

How is HIV transmitted through blood?

Transfusion of blood contaminated with HIV can lead to HIV infection. However, this possibility is low since many blood banks are screening all units of blood for anti-HIV and only HIV-negative blood is provided for transfusion. Only if the blood is in the window period (see below) can it transmit HIV in spite of routine screening.

Can donating blood increase the risk of acquiring HIV?

No, there is no risk of acquiring HIV during donating blood if all equipments used during blood collection are sterile and disposable. One should donate blood without fear of acquiring HIV.

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