Just 10 days ago, April 7th, was World Health Day. In honor of that, I wanted to offer our readers a crash course in HIV/AIDS 101. Every day in my conversations, I realize that there are still many gaps in people’s knowledge about AIDS. But, don’t mistake me for an expert. Just a couple months ago, a friend of CARE for AIDS and HIV researcher at Emory, Evonne Woodson, came in to help our team brush up on our HIV/AIDS knowledge, and we learned a ton. If you are aware of these 5 aspects of HIV, you will know more than 99% of the world.
1. Life expectancy with HIV/AIDS
Although HIV (human immunodeficiency virus) cannot be cured, it can be managed extremely well. Even people in extreme poverty can live long lives with proper diet, hygiene, and adherence to medication. In most countries, the life expectancy of those with HIV is equal to or approaching that of the general population. One of our clients said this, “If someone asked me if I wanted cancer or HIV, I would choose HIV.” She understands that she will have a full life despite her HIV.
2. The state of the global crisis
Most people have lost all sense of urgency about HIV because they believe it is under control. While there has been a lot of progress, that couldn’t be further from the truth. In 2014, there were approximately 2 million new infections globally. In that same year, about 1.2 million people died of AIDS-related causes. This means that the number of people living with HIV is growing by nearly a million a year. These are people that, at some time, will need care: medical, emotional, and spiritual. The costs of caring for these people are increasing but the funds available are decreasing. In Kenya, there are 100,000 new infections annually and 58,000 deaths. We need to continue working hard to see both of these numbers decrease.
3. Difference between HIV and AIDS
HIV is a virus that causes a condition called AIDS (acquired immune deficiency syndrome). CD4 count is a common measure of how compromised your immune system is. The test measures the amount of T-cells in your blood, which are a type of white blood cells that help fight off infection. A healthy person without HIV may have a CD4 count anywhere from 500 to 1500 cells/mm3. If a person with HIV has a CD4 count lower than 200 cell/mm3, they are diagnosed with AIDS. HIV is typically in a latent state for about 6-10 years before the symptoms of AIDS begin. At that point, without treatment, someone will live for about 3 more years.
4. Types, strains, and subtypes
There are two types of HIV: HIV-1 and HIV-2. Within HIV-1, there are four different strains of the virus: Group M, N, O, and P. HIV-1 Group M is the strain that is responsible for the global epidemic. But it doesn’t stop there. There are at least 9 main subtypes under Group M (A, B, C, D, F, G, H, J, K). Then, on top of that, there are many more subtypes that are combinations of the ones above. They are called Circulating Recombinant Forms. This is one of the many factors that make this virus so difficult to stop. Although many of the HIV treatments have proven effective against multiple subtypes, it is important to note that about half the world has subtype C but most of the U.S. has subtype B. Therefore, a disproportionate amount of funding and research has gone into addressing subtype B.
5. Treatment as Prevention (TASP)
One of the newest schools of thought on how to address this global issue is something called treatment as prevention. This basically means that the best way to prevent the spread of HIV is to begin treatment as early as possible. In doing so, it will suppress the virus to such a low level that it will be very unlikely that someone would be able to transmit it to someone else. The World Health Organization has adopted this “test and treat” philosophy and recommended that anyone testing positive for HIV should be treated immediately. Opponents of this theory contend that this early treatment will be too costly and could create more drug-resistant strains of HIV. In Kenya, HIV-positive individuals qualify to receive treatment when their CD4 count drops below 350 cells/mm3. TASP has been used extremely effectively to prevent the transmission of HIV from mother to child. Some studies have found a less than 1% chance of transmission when the mother is treated with antiretroviral medication during pregnancy, delivery, and breastfeeding.
I hope you feel a little more educated about HIV. It is important to remember that the medical intervention is not the only aspect, and CARE for AIDS is working hard to provide a holistic response.
What did you learn about HIV that you didn’t already know?
Sources: avert.org and aids.gov