Human immunodeficiency virus (HIV) is an infection that targets the body’s immune system, specifically attacking the CD4 cells, a type of white blood cell.
As HIV destroys these cells, it weakens the immune system, leaving the individual vulnerable to opportunistic infections such as tuberculosis, fungal infections, severe bacterial infections, and some forms of cancer.
The World Health Organization (WHO) recommends that anyone at risk of HIV should have access to testing.
Those at higher risk of contracting the virus should seek comprehensive prevention, testing, and treatment services.
HIV can be diagnosed using simple, affordable rapid diagnostic tests or self-tests.
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It is crucial that HIV testing services follow the “5 Cs” principles: consent, confidentiality, counseling, correct results, and connection to treatment and other services.
People diagnosed with HIV should begin antiretroviral treatment (ART) as soon as possible and undergo regular monitoring through clinical and laboratory assessments, including viral load testing to measure the amount of the virus in their blood. Consistent use of ART not only helps to manage the infection but also prevents its transmission to others.
A CD4 cell count should be done at diagnosis or soon after starting ART to assess immune function.
This blood test helps determine the progression of HIV and the risk of developing opportunistic infections. A normal CD4 count ranges from 500 to 1500 cells per mm³ of blood, but it decreases in those not receiving or not responding to ART.
If a person’s CD4 count drops below 200, their immune system is severely weakened, putting them at risk of serious infections and death, and they are considered to have advanced HIV disease (AHD).
Viral load testing measures the amount of HIV in the blood, used to monitor how well ART is working.
The goal of treatment is to reduce the viral load to undetectable levels (below 50 copies/ml). A viral load exceeding 1,000 copies/ml in people on ART indicates the need to adjust their treatment regimen.
Symptoms
Many people may not experience any symptoms during the first few months after contracting HIV and may remain unaware of their infection.
Others may have flu-like symptoms, such as fever, headache, rash, and sore throat. However, this early stage is when the virus is most contagious.
As HIV progresses, more noticeable symptoms can develop, including swollen lymph nodes, weight loss, fever, diarrhea, and cough.
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The virus weakens the immune system, making the body more vulnerable to severe infections and diseases such as tuberculosis, cryptococcal meningitis, bacterial infections, and certain cancers like lymphomas and Kaposi’s sarcoma.
HIV can be diagnosed through rapid tests, which offer same-day results and can even be done at home.
However, a confirmatory laboratory test is required to validate the infection.
Early detection is critical as it enhances treatment options and reduces the risk of spreading the virus to others, including sexual or drug-sharing partners.
Treatment
HIV is entirely preventable. Effective antiretroviral treatment (ART) can prevent mother-to-child transmission during pregnancy, childbirth, and breastfeeding.
Additionally, individuals on ART with suppressed viral loads cannot transmit HIV to their sexual partners.
Condoms provide protection against HIV and other sexually transmitted infections, while pre-exposure prophylaxis (PrEP) uses antiretroviral medicines to prevent HIV infection.
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Male circumcision is recommended in high-prevalence areas of eastern and southern Africa. Harm reduction strategies, such as needle exchange programs and opioid substitution therapy, are also effective in preventing HIV and other blood-borne infections among people who inject drugs.
HIV is treated with antiretroviral therapy, which typically includes one or more medicines. While ART does not cure HIV, it significantly reduces the virus’s ability to replicate, lowering the viral load to undetectable levels.
ART enables people living with HIV to lead healthy, productive lives, and it also acts as a powerful preventive tool, reducing the risk of transmission by 96%.
Consistent, lifelong adherence to ART is essential for maintaining these benefits.
In cases where ART becomes ineffective—due to factors like missed doses or drug stockouts—HIV drug resistance may develop, requiring a switch to alternative treatments to safeguard the individual’s health.
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