HIV/AIDS

HIV/AIDS
Other namesHIV disease, HIV infection[1][2]
A red ribbon in the shape of a bow
The red ribbon is a symbol for solidarity with HIV-positive people and those living with AIDS.[3]
SpecialtyInfectious disease, immunology
SymptomsEarly: Flu-like illness[4]
Later: Large lymph nodes, fever, weight loss[4]
ComplicationsOpportunistic infections, tumors[4]
DurationLifelong[4]
CausesHuman immunodeficiency virus (HIV)[4]
Risk factorsUnprotected anal or vaginal sex, having another sexually transmitted infection, needle sharing, medical procedures involving unsterile cutting or piercing, and experiencing needlestick injury[4]
Diagnostic methodBlood tests[4]
PreventionSafe sex, needle exchange, male circumcision, pre-exposure prophylaxis, post-exposure prophylaxis[4]
TreatmentAntiretroviral therapy[4]
PrognosisNear normal life expectancy with treatment[5][6]
11 years life expectancy without treatment[7]
Frequency64.8 million – 113 million total cases[8]
1.3 million new cases (2022)[8]
39 million living with HIV (2022)[8]
Deaths40.4 million total deaths[8]
630,000 (2022)[8]

HIV (human immunodeficiency virus)[9][10][11] is a retrovirus[12] that attacks the immune system. It can be managed with treatment. Without treatment it can lead to a spectrum of conditions including AIDS (acquired immunodeficiency syndrome).[5]

Effective treatment for HIV-positive people (people living with HIV) involves a life-long regimen of medicine to suppress the virus, making the viral load undetectable. There is no vaccine or cure for HIV. An HIV-positive person on treatment can expect to live a normal life, and die with the virus, not of it.[5][6]

Treatment is recommended as soon as the diagnosis is made.[13]

An HIV-positive person who has an undetectable viral load as a result of long-term treatment has effectively no risk of transmitting HIV sexually.[14][15] Campaigns by UNAIDS and organizations around the world have communicated this as Undetectable = Untransmittable.[16]

Without treatment the infection can interfere with the immune system, and eventually progress to AIDS, sometimes taking many years. Following initial infection an individual may not notice any symptoms, or may experience a brief period of influenza-like illness.[4] During this period the person may not know that they are HIV-positive, yet they will be able to pass on the virus. Typically, this period is followed by a prolonged incubation period with no symptoms.[5] Eventually the HIV infection increases the risk of developing other infections such as tuberculosis, as well as other opportunistic infections, and tumors which are rare in people who have normal immune function.[4] The late stage is often also associated with unintended weight loss.[5] Without treatment a person living with HIV can expect to live for 11 years.[7] Early testing can show if treatment is needed to stop this progression and to prevent infecting others.

HIV is spread primarily by unprotected sex (including anal and vaginal sex), contaminated hypodermic needles or blood transfusions, and from mother to child during pregnancy, delivery, or breastfeeding.[17] Some bodily fluids, such as saliva, sweat, and tears, do not transmit the virus.[18] Oral sex has little risk of transmitting the virus.[19]

Ways to avoid catching HIV and preventing the spread include safe sex, treatment to prevent infection ("PrEP"), treatment to stop infection in someone who has been recently exposed ("PEP"),[4] treating those who are infected, and needle exchange programs. Disease in a baby can often be prevented by giving both the mother and child antiretroviral medication.[4]

Recognized worldwide in the early 1980s,[20] HIV/AIDS has had a large impact on society, both as an illness and as a source of discrimination.[21] The disease also has large economic impacts.[21] There are many misconceptions about HIV/AIDS, such as the belief that it can be transmitted by casual non-sexual contact.[22] The disease has become subject to many controversies involving religion, including the Catholic Church's position not to support condom use as prevention.[23] It has attracted international medical and political attention as well as large-scale funding since it was identified in the 1980s.[24]

HIV made the jump from other primates to humans in west-central Africa in the early-to-mid-20th century.[25] AIDS was first recognized by the U.S. Centers for Disease Control and Prevention (CDC) in 1981 and its cause—HIV infection—was identified in the early part of the decade.[20] Between the first time AIDS was readily identified through 2021, the disease is estimated to have caused at least 40 million deaths worldwide.[26] In 2021, there were 650,000 deaths and about 38 million people worldwide living with HIV.[8] An estimated 20.6 million of these people live in eastern and southern Africa.[27] HIV/AIDS is considered a pandemic—a disease outbreak which is present over a large area and is actively spreading.[28]

The United States' National Institutes of Health (NIH) and the Gates Foundation have pledged $200 million focused on developing a global cure for AIDS.[29] While there is no cure or vaccine, antiretroviral treatment can slow the course of the disease and may lead to a near-normal life expectancy.[5][6]

  1. ^ Cite error: The named reference AIDS2010GOV was invoked but never defined (see the help page).
  2. ^ "HIV Classification: CDC and WHO Staging Systems". AIDS Education & Training Center Program. Archived from the original on October 18, 2017. Retrieved September 10, 2017.
  3. ^ "Wear your red ribbon this World AIDS Day". UNAIDS. Archived from the original on September 10, 2017. Retrieved September 10, 2017.
  4. ^ a b c d e f g h i j k l m "HIV/AIDS Fact sheet N°360". World Health Organization. November 2015. Archived from the original on February 17, 2016. Retrieved February 11, 2016.
  5. ^ a b c d e f "About HIV/AIDS". U.S. Centers for Disease Control and Prevention (CDC). December 6, 2015. Archived from the original on February 24, 2016. Retrieved February 11, 2016.
  6. ^ a b c UNAIDS (May 18, 2012). "The quest for an HIV vaccine". Archived from the original on May 24, 2012.
  7. ^ a b UNAIDS, World Health Organization (December 2007). "2007 AIDS epidemic update" (PDF). Archived from the original (PDF) on May 27, 2008. Retrieved March 12, 2008.
  8. ^ a b c d e f "Global HIV & AIDS statistics — 2022 fact sheet". UNAIDS. Archived from the original on December 4, 2019. Retrieved July 20, 2023.
  9. ^ Sepkowitz KA (June 2001). "AIDS – the first 20 years". The New England Journal of Medicine. 344 (23): 1764–72. doi:10.1056/NEJM200106073442306. PMID 11396444.
  10. ^ Krämer A, Kretzschmar M, Krickeberg K (2010). Modern infectious disease epidemiology concepts, methods, mathematical models, and public health (Online-Ausg. ed.). New York: Springer. p. 88. ISBN 978-0-387-93835-6. Archived from the original on September 24, 2015. Retrieved June 27, 2015.
  11. ^ Kirch W (2008). Encyclopedia of Public Health. New York: Springer. pp. 676–77. ISBN 978-1-4020-5613-0. Archived from the original on September 11, 2015. Retrieved June 27, 2015.
  12. ^ "Retrovirus Definition". AIDSinfo. Archived from the original on December 28, 2019. Retrieved December 28, 2019.
  13. ^ Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV (PDF). World Health Organization. 2015. p. 13. ISBN 978-92-4-150956-5. Archived (PDF) from the original on October 14, 2015.
  14. ^ McCray E, Mermin J (September 27, 2017). "Dear Colleague: September 27, 2017". U.S. Centers for Disease Control and Prevention (CDC). Archived from the original on January 30, 2018. Retrieved February 1, 2018.
  15. ^ LeMessurier J, Traversy G, Varsaneux O, Weekes M, Avey MT, Niragira O, et al. (November 19, 2018). "Risk of sexual transmission of human immunodeficiency virus with antiretroviral therapy, suppressed viral load and condom use: a systematic review". Canadian Medical Association Journal. 190 (46): E1350–E1360. doi:10.1503/cmaj.180311. PMC 6239917. PMID 30455270.
  16. ^ "Undetectable = untransmittable". UNAIDS. Archived from the original on December 11, 2023. Retrieved August 26, 2022.
  17. ^ Rom WN, Markowitz SB, eds. (2007). Environmental and occupational medicine (4th ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. p. 745. ISBN 978-0-7817-6299-1. Archived from the original on September 11, 2015. Retrieved June 27, 2015.
  18. ^ "HIV and Its Transmission". U.S. Centers for Disease Control and Prevention (CDC). 2003. Archived from the original on February 4, 2005. Retrieved May 23, 2006.
  19. ^ "Preventing Sexual Transmission of HIV". HIV.gov. April 9, 2021. Archived from the original on February 1, 2022. Retrieved February 1, 2022.
  20. ^ a b Gallo RC (October 2006). "A reflection on HIV/AIDS research after 25 years". Retrovirology. 3 (1): 72. doi:10.1186/1742-4690-3-72. PMC 1629027. PMID 17054781.
  21. ^ a b "The impact of AIDS on people and societies" (PDF). 2006 Report on the global AIDS epidemic. UNAIDS. 2006. ISBN 978-92-9173-479-5. Archived (PDF) from the original on October 4, 2006. Retrieved June 16, 2006.
  22. ^ Endersby J (2016). "Myth Busters". Science. 351 (6268): 35. Bibcode:2016Sci...351...35E. doi:10.1126/science.aad2891. S2CID 51608938. Archived from the original on February 22, 2016. Retrieved February 14, 2016.
  23. ^ McCullom R (February 26, 2013). "An African Pope Won't Change the Vatican's Views on Condoms and AIDS". The Atlantic. Archived from the original on March 8, 2016. Retrieved February 14, 2016.
  24. ^ Harden VA (2012). AIDS at 30: A History. Potomac Books Inc. p. 324. ISBN 978-1-59797-294-9.
  25. ^ Sharp PM, Hahn BH (September 2011). "Origins of HIV and the AIDS pandemic". Cold Spring Harbor Perspectives in Medicine. 1 (1): a006841. doi:10.1101/cshperspect.a006841. PMC 3234451. PMID 22229120.
  26. ^ "HIV Statistics Overview (International Statistics)". U.S. Centers for Disease Control and Prevention (CDC). 2018. Archived from the original on December 7, 2018. Retrieved May 9, 2021.
  27. ^ "Fact Sheet – World AIDS Day 2019" (PDF). UNAIDS. Archived (PDF) from the original on December 21, 2019. Retrieved December 21, 2019.
  28. ^ Kallings LO (March 2008). "The first postmodern pandemic: 25 years of HIV/AIDS". Journal of Internal Medicine. 263 (3): 218–43. doi:10.1111/j.1365-2796.2007.01910.x. PMID 18205765. S2CID 205339589.(subscription required)
  29. ^ "NIH launches new collaboration to develop gene-based cures for sickle cell disease and HIV on global scale". National Institutes of Health (NIH). October 23, 2019. Archived from the original on September 4, 2021. Retrieved September 24, 2021.