HIV (Human immunodeficiency virus) is a retrovirus that attacks a person’s immune system. By compromising the very mechanism that protects the body from bacteria, viruses and infections, HIV can make a person susceptible to opportunistic diseases.
The virus is transmitted when the bodily fluids--such as blood, semen, pre-seminal fluids and breastmilk--from an infected person enters the bloodstream of an HIV-negative individual. HIV is commonly contracted through the sharing of needles with an infected individual.
HIV, however, cannot be contracted through saliva and tears—so kissing and spitting are not vectors for the virus. Hugging, hand-holding and other casual contacts are also considered safe.
HIV is believed to have originated from a chimpanzee virus known as Simian Immunodeficiency Virus (SIV). Around 1910-1930’s, people in West Africa, who hunted chimpanzees for meat, came in contact with infected blood and contracted SIV. This then mutated into the early form of HIV that is a progenitor of the strains that we deal with today.
HIV is difficult to cure because, as a retrovirus, it inserts its genetic information into the person’s DNA. This has the effect of “hiding” the virus from the standard antiviral therapies that the medical community uses to treat infections. Add to this HIV’s high mutation rate and you essentially not only have a hidden target - you also have a moving one.
An explosion of HIV awareness took place in the 1980s, with researchers gaining vital insights into the virus’ modus operandi: how it is transmitted, how it attacks the immune system. By the 1990s, scientists were able to develop the first set of drugs that helped manage the condition.
As of this writing, there is generally no recognized cure for HIV. There are, however, anti-retroviral therapies that have been shown to dramatically retard the progress of the disease.
HIV in the Philippines
The first reported case of HIV in the Philippines was in 1984.
There have been 66,303 cases since then, with ninety-four percent (94%) of those diagnosed being males, with a median age of 28. In April (2019) alone, there were 840 newly confirmed HIV cases.
Two disturbing trends beset the country with regards to the disease. First, the number of confirmed infections among women is steadily increasing. For instance, from January to April (2019), the number of confirmed diagnosed females have tripled—compared to the same period in 2014, just five years ago.
Second, the patients contracting the virus are getting younger. In 2000, the bulk of HIV infected persons belonged to the 35-49 age bracket. But beginning in 2006, that has shifted to 25-34-year-olds. Furthermore, those that belong to the 15-24 age group has almost doubled from 17% to 29% in only 10 years (2009-2019).
According to UNAIDS, the Philippines has become the fastest-growing HIV hotspot in Asia and the Pacific—with a 140% increase in cases annually (2010-2016).
The Department of Health (DOH) has sounded the alarm and has pointed to HIV testing as part of the national strategy to prevent the spread of the disease. To stem the tide of the disease, awareness campaigns have been spearheaded by the department as well as the country’s local government officials.
Stages & Symptoms
The signs and symptoms of HIV depends on the stage of the disease a patient is in. There are generally 3 stages: Primary Infection, Chronic Infection and finally, AIDS.
Stage 1: Primary Infection
This is when a person initially comes in contact with the virus. Two to four weeks after the initial infection, the individual usually suffers from a set of flu-like symptoms that include:
Fever
Fatigue
Headache
Chills
Sore Throat
Dry Cough
Skin Rash
Swollen Lymph Nodes
Diarrhea
Nausea
Vomiting
Night Sweats
Muscle Pain
Joint Pain
These are all signs that your body is fighting an infection, sometimes called “Acute Retroviral Syndrome.”
However, the presence of one or a combination of these signs does not immediately point to HIV. You’ll note that these symptoms are the very same ones expressed in the common flu, and the only way to be certain of HIV infection is to undergo a simple HIV test.
Two or three weeks after, the symptoms usually disappear and the person feels relatively healthy again. (An untested person becomes an HIV carrier without even knowing it and can inadvertently pass the virus to others.)
Stage 2: Chronic Infection
The Chronic Infection stage is often considered a clinically latent period because the patients in this stage do not feel sick. They are often asymptomatic and look reasonably healthy. But the virus is still in the body. The immune system failed to eliminate it during the Primary Infection stage. (The virus goes latent by hiding in the DNA of T-helper cells.)
The chronic stage lasts about 10-15 years and involves the virus very slowly replicating and gradually damaging the immune system. Unchecked, the virus slowly kills CD4 T-cells. These are vital components of the immune system which help it fight diseases and infections. A CD4 level below 200 cells/mm3 is an indicator of advanced HIV disease.
Stage 3: AIDS
This is the third and final stage of HIV.
White spots in the mouth of an AIDS patient
Symptoms at this progression of the disease include:
Significant weight loss
Persistent cough
Chronic diarrhea
Persistent high fevers
Severe fatigue
Genital or anal sores
White spots in the mouth area
AIDS (Acquired Immune Deficiency Syndrome) is a condition where the immune system has become so weakened and so damaged that infections that normally do not pose a problem become life-threatening. These diseases are referred to as “opportunistic infections.” Persons with AIDS have them with more frequency and in greater severity than those with a healthy immune system.
The most common opportunistic infections include gastroenteritis, retinitis, pneumonia, tuberculosis, lymphoma, encephalitis, etc. A great number of AIDS patients have died through complications from these infections.
Treatment
As mentioned, as of this writing, there exists no cure and no vaccine for HIV and AIDS.
However, HIV is no longer a death sentence. There are Antiretroviral Therapies (ART) that significantly slow down the progress of the disease, which means that HIV doesn’t necessarily need to lead to AIDS. The therapy can come in the form of several tablets that need to be taken at specific times during the day. Because of the advancements in medicine and the effectivity of these antiretroviral “cocktails,” HIV patients can expect to lead longer, healthier and normal lives.
Antiretroviral Therapy works by suppressing HIV’s attack on the immune system. Depending on the specific combination of prescribed drugs, the treatment can either “turn off” a protein HIV uses to replicate, prevent the production of the building blocks HIV uses to make copies of itself, block HIV’s entry to CD4 cells, or prevent the virus from inserting its genetic material to host cells.
ART is designed to lower the amount of HIV in the bloodstream (viral load). Antiretroviral therapy can suppress the virus so much that it becomes virtually undetectable through standard laboratory tests. Keeping the viral load at these extremely low levels ensures that the immune system now has a chance to ward off opportunistic infections that might otherwise seriously threaten the individual. Also, by keeping the viral load at these levels, the patient has practically no risk of transmitting the virus to his or her sexual partner.
The key to successfully managing the virus and living a healthy productive life is in the consistency of taking daily medication. Skipping doses allows the virus to change (mutate) and become resistant to the medication.
HIV Testing
The earlier HIV is managed, the brighter the prognosis is for the patient. This means early testing is very important.
That said, there is yet no test that can detect HIV immediately after contact. The standard blood tests look for specific signs that the body has been attacked by the virus. These telltale signs are in the form of antibodies that are the body’s response to HIV. To be detected in tests, these antibodies have to be produced in sufficient amounts (seroconversion). This process takes time, and for HIV, it takes around three months for the antibodies to definitively register in standard tests.
Taking the test too early, or at a time when not enough detectable antibodies have been produced, could result in a “false negative.”
Yes, the most advanced testing techniques can detect the antibodies 28 days after suspected exposure, but these only have 95% accuracy. A follow-up test is usually recommended three months after exposure.
If you suspect that you have been exposed to the virus, consider getting yourself tested. The test is quick and completely confidential. There are no requirements or preparations that need to be done.
BloodWorks Lab, your one-stop-shop for all your blood test needs, can provide you with accurate and reliable HIV test.
We are also proud to be the first laboratory in the Philippines to offer the Anti-NMDA Receptor Antibody Test and the Anti Acetylcholine Receptor (lgG) Antibody Test.
BloodWorks Lab is your one-stop-shop for all your blood test needs. Our branches are in Alabang, Katipunan and Cebu.