What do you know about HIV?

I doubt there's anyone left in the world who is yet to hear the acronyms HIV and AIDS. Most often, laymen do not know the differences between the two. Today, I'd like to address this particular subject matter.

• HIV is an acronym for Human Immunodeficiency Virus while AIDS is Acquired ImmunoDeficiency Syndrome.

Looking further at these terms;

• H stands for human, implying that this virus infects only humans.

• I stands for immunodeficiency, this is a state of decrease in the body's abilitity to fight off antigens (which cause infections/illnesses). It is a weakened state of the immune system.
• V is for virus, my post, meet our frenemies described what a virus is. In this case, a virus is a pathogenic organism with the ability to replicate only in living cells.
• A is for acquired and it is an English word that means to gain, to obtain, to come into possession of something you didn't have.
• ID remains as described above
• Syndrome is a word that group signs and symptoms that occur together in a particular disease/infection; it characterizes particular abnormalities.

There are particular set of words that are related to different fields of life, when dealing with management of HIV, you will definitely come across the following;

• HTS: this stands for HIV Testing Services, this includes; pre-test counselling, testing, post-test counselling, disclosure, linkage to ART and follow-up.
• PMTCT: this stands for Prevention of Mother To Child Transmission. A pregnant previously known positive or newly detected at Antenatal care (ANC), Labour and Delivery or Post natal ward (PNC) is taken care of at PMTCT sites. This is to prevent the transmission of the virus from mother to child either during the gestational period or during breastfeeding. After delivery, the baby is monitored for 18 months after which final outcome test is done.
• ART: this stands for AntiRetroviral Therapy. After testing, a positive (index) client is placed on these therapy, actually they are drugs.
• Viral load; used alongside the CD4 count test, this is used to determine the amount of the virus in a patient's system. The higher your CD4, the lower your viral load but the moment your CD4 gives up the fight, the viral load skyrocket and if there's no timely intervention, that is the beginning of the end.

As of 2016, the estimate of HIV in Nigeria is;
ART coverage = 30%
New infections = 220, 000
AIDS related death = 100, 000
Number of People Living with HIV (PLHIV) = 3.2 million
Children infected = 37, 000
Patients with suppressed viral load = 24%

This is alarming hence the need to go for regular tests (every three months to beat the window/latency period). The virus is deadlier in children, without intervention they die within two years.

The 90.90.90 goal is being worked on currently;

• 90% must know their HIV status
• 90% of positive must be linked to ART
• 90% of linked to ART must be virally suppressed

<center> Summary of the gist

Just like every other organism, the HIV has a a life cycle which I'm not going to bore you with, basically, this is what happens; the virus attaches itself to CD4 cell, transcription occurs with the help of the enzyme integrate, after this assembling occurs using the enzyme protease, the newly birthed viruses are released in a process called budding.

Once the antigen (HIV) enters the body, the body alarm system (lymphocytes) informs the body of the invasion, this leads to to the production of antibodies (by B-cells with the help of T-cells). It is important to know that the first three months of infection, there will be no immune response, this is called the window/latent period and any test conducted during this time will be negative, this is because the kits test for presence of antibodies not antigens.

Once the antibodies lose their strength, AIDS begin and this gives room to Opportunistic Infections (OI) except intervention starts immediately. These OI are even worse than the disease itself. A positive client who's yet to show symptoms of TB is placed on INH immediately alongside the other ARTs.

In some cases when the viral load is done and it comes out really high (above 1000 copies per ml), the patient is placed on HART (Highly active Antiretroviral
Therapy), this combines all the mode of actions of ART.

ART

Just like every other drugs, ART have different modes of action, which includes with examples;

• Nucleoside Reverse Transcriptase (NRTs) e.g Zidovudine (AZT), Abacavir (ABC), among others
• Non-Nucleoside Reverse Transcriptase (NNRTs) e.g Nevirapine
• Protease Inhibitors (PI) e.g Atazanavir, Lopinavir, etc
• Integrate Inhibitors (II) e.g Dolutegravir
• Entry Inhibitors (EI) e.g Enfurvitide

These drugs are given in regimen and there can be a substitution or switch based on side effects.

I have to go now before I start boring you, but, ensure you get tested today, know your status, there are support groups for positive clients and your identity will be protected if you are scared of stigmatization.

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