What is it like to live with HIV today?

Here's what you need to know about how complicated it is to live with HIV.

HIV is now considered a ghost of the past, but it remains a serious health problem, especially in low-income regions where patients do not have access to antiretroviral therapy (ART). According to the World Health Organization (WHO), as of today, the human immunodeficiency virus has claimed 33 million lives and, as of 2019, there were 38 million people with active disease.

Due to the joint efforts of WHO, the Pan American Health Organization (PAHO) and other government entities, an estimated 68% of adults and 53% of children with HIV are on treatment. These results are positive to a certain extent, as they also imply that almost 1 in 3 people with HIV is not under observation or in the hands of medical professionals. An infected child lives an average of 2-3 years without ART.

Thus, HIV is a chronic but maskable condition in high-income countries, while in disadvantaged regions it remains a synonym for death. With this in mind, let's take a look at what it's like to live with HIV today.

HIV and AIDS are not the same

First of all, it needs to be made clear that HIV and AIDS are not the same thing, even though the two terms are used interchangeably in anecdotal conversations. HIV infection corresponds to the first two phases of the disease (acute and chronic), while the most extreme and worst prognosis is AIDS, the final and most complex stage to deal with.

HIV is an RNA virus and, like all viruses, it is incapable of replicating its genetic information on its own, as it has no ribosomes, ribosomes, ribosomes and ribonucleic acid.It does not possess ribosomes, mitochondria or any metabolic structure at the cellular level. Therefore, it invades the host cells (in this case almost exclusively CD4+ T lymphocytes), transforms its genetic information from RNA into DNA (by reverse transcription), integrates it into the cell nucleus and then the host machinery generates copies of the viral RNA. Finally, the new viruses are assembled and by budding out of the cell, killing it in the process.

When a person is infected with the human immunodeficiency virus, an acute infectious condition occurs in up to 80% of cases, although some people are asymptomatic. During this phase, living with HIV is like having the flu, but a little worse. Symptoms such as fever, headache, itching, sweating, vomiting and nausea appear.. In the acute stage, the proportion of infected CD4 T lymphocytes is about 1/100,000, but the number of circulating viral agents in the Blood is very high. For this reason, the host is highly contagious.

After this acute stage, the disease stabilizes. During the chronic period of the disease, HIV continues to reproduce and destroy CD4 lymphocytes, but in much lower proportions. Whether on therapy or not, the patient may feel completely normal for a while, until the immune system is sufficiently damaged. Treatment at this point is critical: a person with untreated chronic HIV will develop AIDS in about 10-15 years, while antiretroviral therapy allows permanence in this phase for several decades..

A patient progresses from HIV infection to AIDS when the CD4 lymphocyte count is less than 200 units per cubic millimeter of blood, indicating that the immune system has been severely compromised. At this point, many usually commensal microorganisms become pathogenic, such as yeasts, complex fungi and bacteria that are part of the human microbiota.

One of the first symptoms of AIDS are oral and epidermal infections, mainly caused by Candida albicans and other fungi. Other much more serious conditions can also appear over time, such as pulmonary aspergillosis, pneumonias, cardiac infections and much more. In the end, the patient dies from opportunistic infections, not from the action of the virus itself.

It is possible to lead a full life with HIV

As catastrophic as this may sound, today it is completely feasible to live a full life with HIV, today it is completely feasible to lead a normal life, despite being infected with HIV.. Antiretroviral therapy (ART) blocks the entry of the virus into CD4 lymphocytes, thus allowing the body to keep its immune system strong for many years.

However, the virus mutates and generates drug resistance within the body, hence three or more anti-HIV drugs are usually taken in combination and some are added and others are discarded over time.

A patient with HIV in the chronic phase, with the appropriate treatment, can lead a completely normal life. It is estimated that the life expectancy of an infected person (detected early) is about 77-80 years, while a healthy person is about 86 years.. The difference of 8 or 9 years in life expectancy is not negligible, but it is a much more encouraging outlook than that observed 20 or 30 years ago.

Moreover, if the patient takes his medications strictly and has all his check-ups up to date, he will be a carrier of HIV but will not be able to transmit it, due to the undetectable viral loads in his blood. For this reason, the social stigma that haunts people with this condition (especially in certain communities) is completely unjustified. It is always better to use a condom than not to do so during sex (for any other disease, not just HIV), but an infected and treated person does not spread, neither by kissing, nor by sharing food, nor during sex.

At present, a Spanish group belonging to the Consejo Superior de Investigaciones Científicas (CSIC) has presented a vaccine against HIV, the MVA-B.. The results are extremely positive, since in the experimental phase I it has been shown that 90% of the vaccinated volunteers have developed an immune response against the virus and 85% have maintained it (for at least one year).

Little by little, human beings are understanding more and more how viruses and bacteria work, which gives us the capacity to fight as a society against some of the giants that have plagued populations for decades.

However, we cannot forget all the people who once made visible the problems of this condition, the exclusionary dynamics to which it was associated and the lack of means and understanding that, unfortunately, still continues to cause deaths. As long as there is a single untreated infected person in the world, the fight against HIV remains active.

And of course, psychotherapy and counseling is another useful resource for adapting to life with HIV by better managing emotions and personal and self relationships. and managing emotions and personal and self-relationships in the best way possible. If you are looking for these kinds of services, contact me.