Infectious diseases specialists diagnose and treat infections from bacteria, viruses, fungi, and parasites, focusing on fevers, antibiotics, and vaccines.
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Human Immunodeficiency Virus, or HIV, is a complex retrovirus that affects people worldwide. In medical settings, HIV is seen not just as a contagious virus but as a chronic condition that changes how the immune system works. HIV belongs to the lentivirus group, which means it can take a long time from infection to serious symptoms. The virus mainly attacks CD4+ T lymphocytes, which are white blood cells that help organize the body’s defense against infections and cancer.
HIV infection can take many forms in the body. When HIV enters, it looks for cells with the CD4 receptor. The virus attaches to these cells using a protein called gp120, which connects to the CD4 receptor and other co-receptors (CCR5 or CXCR4). This lets the virus enter the cell. HIV carries its genetic material as RNA, not DNA. It uses an enzyme called reverse transcriptase to turn its RNA into DNA. This new viral DNA moves into the cell’s nucleus, where another enzyme, integrase, inserts it into the host’s DNA. Once this happens, the virus becomes a permanent part of the cell, creating a viral reservoir. Because of this, HIV is a lifelong condition that needs ongoing treatment, not a short-term infection that can be cured.
It is important to tell the difference between HIV and Acquired Immunodeficiency Syndrome (AIDS). HIV is the virus and the infection it causes. AIDS is the most advanced stage of HIV infection. Today, not everyone with HIV will develop AIDS. AIDS is diagnosed when the immune system is badly weakened, shown by a CD4 cell count below 200 cells per cubic millimeter of blood, or when certain infections or cancers appear that a healthy immune system would normally control.
The way doctors define HIV and AIDS has changed a lot. With modern antiretroviral therapy, the goal is now to keep the immune system healthy for the long term, not just to provide comfort care. People who are diagnosed early and follow their treatment can keep their CD4 counts normal and lower the amount of virus in their blood to undetectable levels. This stops HIV from progressing to AIDS, allowing them to live as long as people without HIV.
A central concept in the modern definition of HIV is the viral reservoir. While antiretroviral medications are highly effective at stopping the virus from replicating in the blood, they cannot eliminate the proviral DNA that is dormant within resting CD4 cells in lymph nodes, the gut, and other tissues. This state is known as clinical latency. The virus remains inactive within these cells, invisible to the immune system and unaffected by standard drugs. However, if treatment is interrupted, these reservoirs can reactivate, leading to a resurgence of viral replication. Understanding this biological persistence is crucial for patients, as it underscores the necessity of continuous therapy and is the primary target of ongoing global research into curative strategies.
From a global health perspective, HIV is considered a pandemic, yet the narrative has shifted from one of crisis to one of control and chronic management. The modern epidemiological definition focuses on the “cascade of care,” which tracks individuals from diagnosis to linkage to care, retention in care, and finally, viral suppression. The ultimate goal in the modern definition of HIV care is the concept of “Undetectable equals Untransmittable” (U=U). This scientifically validated principle states that individuals who achieve and maintain an undetectable viral load through medication cannot sexually transmit the virus to others. This redefinition has profound social and psychological implications, dismantling stigma and transforming the understanding of what it means to live with HIV.
HIV and the human body are always adapting to each other. The virus changes quickly, which helps it avoid the immune system unless medication keeps it under control. The immune system tries to fight HIV with special cells and antibodies. Without treatment, this ongoing fight causes inflammation, which can lead to other health problems like heart disease and faster aging. So, managing HIV means not only stopping the virus but also taking care of the body’s long-term health.
Send us all your questions or requests, and our expert team will assist you.
HIV is the virus that causes the infection, while AIDS is the most advanced stage of that infection. A person can live with HIV for many years without developing AIDS if they receive proper treatment. AIDS is diagnosed only when the immune system becomes severely damaged, indicated by a very low CD4 cell count or the presence of specific opportunistic illnesses.
HIV is a retrovirus, meaning it carries its genetic material as RNA. Once it enters a human immune cell, it uses an enzyme called reverse transcriptase to convert its RNA into DNA. This viral DNA then enters the human cell’s nucleus. It uses another enzyme, integrase, to insert itself directly into the human DNA, becoming a permanent part of that cell’s genetic code.
The viral reservoir refers to populations of immune cells in the body that harbor HIV genetic material but are in a resting or dormant state. Because the virus is not actively replicating in these cells, the immune system and antiviral drugs cannot detect or kill them. This reservoir explains why HIV cannot currently be cured and requires ongoing treatment to prevent reactivation.
In the context of modern medicine and access to treatment, HIV is no longer considered a fatal disease but rather a chronic, manageable health condition. With strict adherence to antiretroviral therapy, individuals with HIV can expect to live a near-normal life expectancy, similar to individuals managing conditions like type 2 diabetes or hypertension.
CD4 cells, also known as helper T cells, are the “generals” of the immune system. They coordinate the body’s response to infections. HIV targets, infects, and destroys these cells. The CD4 count serves as a critical barometer of immune health; a high count indicates a strong immune system, while a low count indicates susceptibility to serious infections.
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