Human immunodeficiency virus (HIV) is a virus that targets the body’s immune system. While there is currently no cure for HIV, proper medical care can effectively control the virus.
Understanding Chronic HIV
Chronic HIV infection, also known as clinical latency or asymptomatic HIV infection, represents the second stage of HIV disease, following the initial acute infection. During this phase, the virus remains active within the body but reproduces at very low levels. Individuals in this stage may not experience any noticeable symptoms or feel unwell.
Despite the absence of overt symptoms, the virus continues to damage the immune system by specifically targeting CD4 T cells, which are a type of white blood cell. These cells are fundamental for the immune system’s ability to fight off infections. Over time, the ongoing viral activity gradually depletes the number of these crucial cells.
Monitoring chronic HIV involves tracking two primary indicators: viral load and CD4 count. Viral load measures the amount of HIV present in the blood, while CD4 count indicates the number of CD4 cells in a cubic millimeter of blood. A high viral load suggests active viral replication, whereas a declining CD4 count signals a weakening immune system.
Treatment and Management
Antiretroviral therapy (ART) is the standard treatment for chronic HIV and involves a combination of medicines designed to stop the virus from replicating. This therapy works by interfering with different stages of the HIV life cycle, thereby reducing the amount of virus in the blood, often to undetectable levels.
When viral load becomes undetectable, it means the level of HIV in the blood is so low that standard laboratory tests cannot detect it. This allows the immune system to recover and the CD4 cell count to increase, improving the body’s ability to fight off other infections. Consistent adherence to ART ensures its effectiveness and helps maintain an undetectable viral load.
The primary goals of ART are to improve the health of individuals with HIV, prevent the progression of the disease, and prevent the transmission of the virus to others. Early initiation of ART after diagnosis is recommended to achieve these benefits.
Living with Chronic HIV
Advancements in treatment have significantly improved the long-term outlook for people with HIV. A significant concept in living with chronic HIV is “Undetectable = Untransmittable” (U=U).
This means that when a person’s viral load is consistently undetectable due to effective ART, they cannot sexually transmit HIV to others. This understanding has transformed lives, reducing stigma and promoting healthier relationships.
Maintaining a healthy lifestyle, including regular medical check-ups, is important for overall well-being. Addressing mental health concerns, which can sometimes accompany a chronic condition, is also a part of comprehensive care for individuals living with HIV.
Preventing Progression to AIDS
Acquired Immunodeficiency Syndrome (AIDS) represents the most advanced stage of HIV infection. This stage is characterized by a severely compromised immune system, making the body vulnerable to opportunistic infections and certain cancers.
A diagnosis of AIDS is typically made when the CD4 cell count drops below 200 cells per cubic millimeter of blood, or when specific opportunistic illnesses develop, regardless of the CD4 count. Without treatment, people diagnosed with AIDS typically survive for about three years. For those on treatment, AIDS is now a rare diagnosis, highlighting modern medicine’s impact on managing HIV.