Q&A
What is AIDS ?AIDS is an abbreviation for the Acquired Immunodeficiency Syndrome. It is a disease induce by HIV (the Human Immunodeficiency Virus). HIV infects the CD4+ lymphocytes and macrophages and induces a state of severe immune deficiency which leads to the development of opportunistic infections and certain cancers.
How is HIV transmitted ?
HIV is an enveloped virus that is transmitted by close intimate contact of blood and body fluids. This includes:
* Sexual intercourse (vaginal, anal, oral).
* Blood and blood products, including blood or body fluids contaminated needles and instruments.
* Materno-fetal transmission (from the pregnant mother to her fetus or new-born).
Does kissing transmit HIV ?
Caresses, kisses including mouth to mouth (French) kissing do not transmit HIV. However, if there are mouth lesions or bleeding, a theoretical minimal risk exists.
What about mosquitoes ?
Mosquitoes do not transmit HIV. First, because the amount ingested by the mosquito is minimal; second, because the ingested virus remains in the digestive tract of the mosquito and is not regurgitated in its mouth piece.
Can I get HIV by eating ?
Definitely not. Even if the cook is HIV positive.
Who is at risk for catching HIV ?
Basically, no one is protected from HIV. However, some behaviors represent higher risk to acquire the infection. These include:
* Multiple sexual partners.
* Casual sex with unknown partners.
* Unprotected sex.
* Sex with sex workers.
* Sharing needles through injected drug use.
* Use and reuse of unsterilized instruments.
When is HIV transmitted from the pregnant mother to her baby ?
The risk of materno-fetal transmission is primarily during delivery and through breast feeding. However, the last trimester of pregnancy is also considered a high risk period.
Can an HIV infected mother breast feed her baby ?
This is not recommended.
Is there a vaccine against HIV ?
Several trials are now on-going worldwide using several vaccine preparations. The efficacy of the vaccine in monkeys is acceptable. Results in humans are yet to come. Vaccines are primarily used to protect uninfected individuals from new infection. However, some vaccines may be used in infected persons to boost their immunity in a treatment protocol. These are so far experimental trials.
Is there a treatment for AIDS ?
Yes. Several medications are used, in combination (at least three drugs together), for the treatment of AIDS (tritherapy). This treatment stops the disease from progression but does not cure, meaning does not eliminate the virus. Therefore, treatment should be continuous and for life. Any interruption leads to a relapse and the development of resistant virus which becomes more difficult to control. Treatment is associated with some discomfort because of the number of pills that have to be taken every day for life and because of some side-effects from the medications. There are numerous studies worldwide evaluating new treatments and new protocols aiming at better efficacy, especially against resistant virus, and better tolerance.
When should therapy be started ?
There are several protocols and guidelines for initiating therapy. Each country is adopting specific guidelines according to availability of drugs and according to local and international experience. Ask your doctor about them.
What about serologic testing ? What does seropositive mean ?
There are several testing methods for HIV infection. The serology detects antibodies (these are proteins produced in blood against the virus). The most frequently used methods are: rapid testing, ELISA and Western Blot. The first two are available in most diagnostic laboratories. The latter is used only as a confirmatory test in some laboratories. A person is called HIV seropositive if the serology test is positive, meaning that the person is infected by HIV. A seronegative person is therefore not infected. However, this does not mean that this individual is protected and should continue practicing a safe behavior.
What is PCR ?
PCR is polymerase chain reaction. It is a highly sophisticated technique to detect the viral genome. In human medicine, it is used for detecting many viruses, bacteria and some human genes. In HIV infection, this test may be used for the early diagnosis of HIV infection, especially in the newborn (qualitative PCR), or to quantify HIV (viral load) in order to make a decision to treat or to monitor response to treatment.
When does the serologic test become positive after an infecting contact ?
The new ELISA techniques allow detection of antibodies (seropositivity) within three weeks of infection. This period of seronegativity, while the individual is indeed infected is called the window period. However, it is safe to wait for a period of three months to consider a test to be truly negative
How long after infection does an individual become ill ?
This is variable. In most cases, there is an acute phase (within two weeks of infection) during which an infected person experiences symptoms of an acute viral illness with fever, sweating, sore throat, swollen lymph glands, rash and an enlarged spleen. This lasts for about a week to ten days and resolves spontaneously. There is afterward a period of clinical latency, during which the individual is totally free of symptoms, although he/she is contagious. This period of clinical latency lasts for an average of 7 to 10 years. Some individuals might develop the clinical disease earlier. Others may remain totally free of symptoms for 15 or 20 years; they are called long term non progressors. It is currently not possible to predict from the start what will be the course of illness in a particular person.
Where may I have a test for HIV done ?
Most clinical laboratories perform the test. In case the result is positive, it is advisable to have the test repeated in a large hospital laboratory or in the Central Laboratory.
How much does the test costs ?
The cost of the test is variable from very low in the Central Laboratory up to 40,000 L.L. in private laboratories.
How to ask for a test ?
It is best to have the test ordered by a physician who will provide pre and post test counseling. However, you may go to the laboratory and ask for an HIV serology test to be performed.
Is blood transfusion safe is Lebanon ?
Blood testing for HIV prior to transfusion is mandatory by law, and it is usually done, along with tests for syphilis, hepatitis B and C. The risk of a false seronegative result (the donor being in the window period) is very minimal, since Lebanon remains a low prevalence country.
What about dentists ?
Dentists sterilize their instruments prior to use in their patients. There is no risk if such sterilizations techniques are appropriately and routinely implemented, as they should be in any dental clinic
Is my confidentiality protected if I have a serologic test for HIV done, or if I am found to be seropositive ?
Laboratories and physicians are subject to the code of ethics of the Order of Physicians which guarantees the professional secrecy and the confidentiality of the individual regardless of the test and of the result.