Understanding HIV/AIDS - Part 1
"The human body is a conversation going on, both within cells and between cells." - Danny Hills
You live in a mosquito prone area
somewhere in Accra, you go to bed and wake up the next morning with tiny
itchy bumps on your skin. A few days later you begin to experience
fever, chills, sweating, headache, weakness and other symptoms. That is
right! You have been bitten by a mosquito who was probably harbouring
the plasmodium parasite and you most likely have malaria.
In as much as the tiny itchy bumps, swelling and all the other symptoms may feel uncomfortable and awful, they are signs that your immune system is in good shape and working.
There were an estimated 38.0 million people living with HIV at the end of 2019 and it has so far claimed about 33 million lives. – WHO
The immune system is a vast network of
cells, tissues and organs and it is the body’s safeguard against
infections, diseases and illnesses. The body also employ physical
barriers including the skin, the gastrointestinal tract lining and the
respiratory system’s defenses such as mucus and cilia to protect our
body from microorganisms and injuries.
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| The immune system employs white blood cells to defend the body against microorganisms and injuries. |
The human body is under constant attack by various microorganisms and without the immune system, the body will be freely open to billions of bacteria, viruses, fungi and parasites attack which can make something as minor as a small cut or common cold lethal. The immune system depends mainly on white blood cells to defend the body against attacks by microorganisms and injuries. There are different types of these white blood cells . They include lymphocytes ( T- cells and B-cells ), neutrophils ,basophils, to name a few. They are specialized to tackle different types of threats the body encounters.
In Ghana, there were 342,307 people living with HIV as at 2019, out of which 122,321 were males and 219,986 were females. – Ghana Aids Commosion
One of these is the CD4 cell, a type of T- cell. CD4 is a molecule found on the surface of these T-cells. CD4 cells play a vital role in the body’s natural defense system against microbes. Simply put, they alert the other immune cells to the presence of threats such as bacteria, viruses and injuries.
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| CD4 cells are the target of HIV. Your CD4 cell count can be used to determine the severity of the disease. |
Unfortunately, these CD4 cells are the target of the human immunodeficiency virus (HIV). Since HIV infects the CD4 cells, they are unable to alert other white blood cells about its presence . Hence they are unable to mount a response. The HIV virus changes its RNA into DNA and integrates it into the CD4 cells’ DNA and multiplies (in other words, the virus hides in the CD4 cell’s DNA so that the other immune cells can not find it and this actually makes it difficult to treat HIV infections without harming the host cells). That’s quite smart of HIV!
So, what at all is HIV/AIDS?
Human immunodeficiency syndrome (HIV)
is a virus that infects and destroys the body’s immune cells (CD4
cells). HIV is a retrovirus, which means that it has special enzymes
that it uses to translate its genetic information (RNA) into DNA which
is then integrated into the host cell’s genetic material. It then uses
the host’s genetic material to make more HIV, destroying the host cell
in the process. Acquired immunodeficiency syndrome (AIDS) on the other
hand is the last stage of HIV infection where most of the CD4 cells are
destroyed, weakening the immune system and making way for opportunistic
infections such as tuberculosis and pneumonia.
How does HIV infect CD4 cells?
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| The processes HIV goes through to infect a cell. |
HIV infects CD4 cells in the following stages;
Attachment:
HIV infection begins with the virus, with the help of its gp120 protein
binding to the receptors found on the surface of CD4 cells.
Entry: The virus enters the cell by fusing its envelope coating with the membrane of the CD4 cell.
Reverse Transcription:
After entering the cell, HIV uses its special enzyme, reverse
transcriptase to turn its genetic material, RNA into DNA. This makes it
compatible with the CD4 cell’s genetic material, DNA.
Genome Integration:
The newly made viral DNA travels to CD4 cell’s nucleus and with help of
the enzyme integrase, the viral DNA becomes integrated into the DNA of
the CD4 cell.
Replication: The DNA of the now infected CD4 cell produces RNA as well as proteins that are needed to produce new HIV virions.
The new virus is formed from the RNA and proteins produced by the DNA of the infected CD4 cells.
Release: The new
virus pushes through the CD4 cells’ membrane and buds out of the cells.
As the virus buds out, it acquires a lipid coat from the membrane of the
CD4 cell. The virus is forced out of the cell in an immature state. In
order for the new virus to mature and infect other cells, another HIV
enzyme called protease cuts the structural proteins and rearranges them
and then a new virus is formed. The infected CD4 cell dies off and the
new matured HIV moves on to infect other CD4 cells.
As more CD4 cells are destroyed, the immune system becomes progressively weak reducing its ability to defend the body against microorganisms. The body is hence exposed to opportunistic infections (infections that occur more often or are more severe in people with weaker immune system) such as tuberculosis and pneumonia.
How does HIV spread from person to person?
đź“ŚSexual contact (penovaginal, anal and oral sex). Having penovaginal, anal or oral sex with an HIV infected person puts you at a greater risk of getting HIV infection. Anal sex is by far the highest risk of HIV transmission. Having multiple sexual partners also increases your risk of HIV infection. You may also be exposed to other sexually transmitted infections such as gonorrhea and chlamydia which further increases your chance of getting HIV infection. This is because, most of these STIs manifest as sores or broken skin around the genital area, making it easy for HIV to cross from one person to the other. Deep kissing an HIV infected person may predispose you to HIV infection although the risk is quite low.
đź“ŚSharing needles and needle sticks. Sharing needles as occurs in the abuse of intravenous drugs such as heroine , poses a greater risk of HIV transmission from one person to the other .This is because the infected person’s blood stains the tip of the needle which goes into the other person’s body.
đź“ŚPregnancy, birth and breastfeeding poses a risk of HIV transmission from mother to baby.
đź“ŚBlood and blood components transfusion and contact with infected blood.
How can we prevent HIV infection?
đź“ŚAbstinence from sex is the surest way to prevent HIV infection but the most difficult to adhere to.
đź“ŚThe use of condoms during sexual intercourse. Condoms are physical barriers that are effective in preventing any virus or bacteria from moving across the condom from one person to another.
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| Proper use of condoms during sexual activities can significantly reduce your risk of HIV transmission. |
đź“ŚReduce the number of sexual partners you have or better still stick to one sexual partner. This reduces your risk of getting HIV and other STIs though you can still get them if your partner has other sexual partners other than you.
đź“ŚAvoid using and sharing needles but if you must use them, then ensure that they are sterile or brand new.
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đź“ŚTry as much as possible to avoid STIs and treat them if you have them.
đź“ŚGet tested for HIV and know your partner’s status.
đź“ŚPreventing/ reducing mother to child transmission. Newborns are given zidovudine, nevirapine and septrin if they are exposed to HIV. Zidovudine and nevirapine are started within 24hrs of delivery and given as prophylaxis for twelve weeks and septrin is started when the baby is six weeks old and is given for six weeks. Pregnant women are given antiretroviral drugs if they are not on it already to reduce the HIV viral load.
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| “Give your child love, laughter and peace, not AIDS. ” – Nelson Mandela |
đź“ŚPre- exposure and post exposure prophylaxis: Pre- exposure prophylaxis is given to people with high risk of HIV infection. For instance, an HIV negative person in a relationship with HIV positive person can be given pre-exposure prophylaxis in addition to condom use. Post exposure prophylaxis given as early as possible to people who have been exposed to HIV infection. An example is a health worker who gets a needle stick injury from a needle used on an HIV positive patient.
Although there is currently no vaccine or cure for HIV/AIDS, when
someone is infected with HIV, it is not the end. Treatment for HIV/AIDS
these days is effective in reducing viral load, symptoms and prolonging
the lives of infected persons.
Ms. Seiduđź’•
Read more: https://www.cdc.gov/hiv/basics/whatishiv.html, https://www.who.int/news-room/fact-sheets/detail/hiv-aids, https://www.ghanaids.gov.gh/, https://youtu.be/ng22Ucr33aw, https://youtu.be/PSRJfaAYkW4
Picture source: Google
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