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How to know if you have HIV

Dr. Akin-Onitolo A.

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Last year, a whopping 2.1 million people worldwide became infected with HIV.
The virus is transmitted through body fluids – semen (as well as pre-cum), blood, vaginal fluid, anal fluid and breastmilk. You can be infected during sex, child delivery (mother to child) and sharing used needles, for example to inject drugs like heroin, or other sharp object. The virus destroys the body’s immune system which normally protects from disease.

Stages of HIV infection
The virus does not leave a conspicuous mark on the face so most infected people don’t even look sick.

But then, some persons get flu-like symptoms in the period shortly after getting infected as the virus quickly multiplies while the body tries to figure how to control it. This is called seroconversion illness, possible symptoms are fever, sore throat, headache, rash, mouth sores which usually end after one to two weeks. HIV levels in the blood (viral load) are high in this period and the CD4 count (the number of a vital type of immune cell in the blood, the type that HIV attacks) drops drastically. Some HIV tests may show that you are not infected even though you actually are simply because they depend on the product of the body’s reaction to the presence of the virus – antibodies. But you are more likely to infect someone else in this period. There are more advanced testing methods though.

In the next stage, there are usually no symptoms so it is also known as asymptomatic infection. The body seems to have achieved some control and the viral load and CD4 count are stable. But the virus is multiplying quickly as the body tries to make new cells to replace the infected ones. It is the longest stage of infection and can last from 2 to 10 or more years. If untreated, it progresses with increased chances of developing infections and may cause swollen nodes, fever, loss of weight, diarrhoea. During this time, your status is easily picked with rapid test kits.

AIDS – this stands for acquired immunodeficiency syndrome. It results when anti-HIV drugs are not used and the virus has successfully weakened the immune system over time that the body is no longer able to suppress infections. Such persons tend to get severe infections like Tuberculosis, fungal infections which can be in the brain, and some cancers. Because these illnesses are unusual in normal healthy people, they are called AIDS-defining illnesses, they are like pointers/indicators. The CD4 count is also very low. With proper treatment with anti-HIV drugs, this stage can be avoided and quality of life increased.

Testing
HIV counselling and testing is available in many centres all over the country, the counselling part being very essential. It is necessary to understand that it is a chronic infection that can be managed with drugs. After the test, you will be informed that you are either positive or negative.

Being positive means that antibodies to the virus were detected in your blood and this indicates the presence of the virus. Important steps to take after this include seeing a healthcare provider, checking your viral load and CD4 count, taking steps to prevent infecting other people and also prevent getting more infection. Exposure to more of the virus can cause worsened symptoms and faster progression of the disease. If you have a regular sexual partner, you need to inform that person and/or encourage him/her to get tested.

Being negative means the test could not pick antibodies to the virus. It could mean that you are not infected, or that you are in the window period – this is the period between when you are exposed to the virus and when antibodies are produced. If the latter is true, you would require advanced testing or a retest after a few weeks. On the other hand, if you are not infected, you need to remember that risky behaviours can put you at risk.

If you have been exposed to the virus and seek help in the space of 72hrs, infection can be prevented using post-exposure prophylaxis (PEP). This is especially useful for healthcare workers exposed to the virus for example via accidental needle injuries. If you feel you need this, you should discuss with your healthcare provider.
36.7 million people globally were living with HIV last year. It is not to be taken for granted, neither should you procrastinate getting tested. The expected survival is long in patients with HIV infection who are receiving treatment, so the earlier treatment begins, the better for you and I.
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Cheers!

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Dr. Akin-onitolo A. is a graduate of the University of Lagos whose mission is to achieve the sustainable development goals (SDGs) using health promotion and improved health literacy. She is an MDCN (Medical and Dental Council of Nigeria) certified doctor who had her elective at King's College London. Hugely interested in travel, meeting people and generally being creative, reading and writing fiction are a few hobbies you could find her engaged in during her spare time. Catch up with her on Twitter @Akinonitolo and Instagram @t_onitolo