HIV and AIDS

AIDS stands for acquired immunodeficiency syndrome, a disease that makes it difficult for the body to fight off infectious diseases. The human immunodeficiency virus known as HIV causes AIDS by infecting and damaging part of the body's defenses against infection — lymphocytes, which are a type of white blood cell in the body's immune (infection-fighting) system that is supposed to fight off invading germs.

HIV can be transmitted through direct contact with the blood or body fluid of someone who is infected with the virus. That contact usually comes from sharing needles or by having unprotected sex with an infected person. An infant could get HIV from a mother who is infected.

Though there are treatments for HIV and AIDS, there are no vaccines or cures for them. But there are things you can do to prevent you and your child from getting the disease.

What Does HIV Do to the Body?

The virus attacks specific lymphocytes called T helper cells (also known as T-cells), takes them over, and multiplies. This destroys more T-cells, which damages the body's ability to fight off invading germs and disease.

When the number of T-cells falls to a very low level, people with HIV become more susceptible to other infections and they may get certain types of cancer that a healthy body would normally be able to fight off. This weakened immunity (or immune deficiency) is known as AIDS and can result in severe life-threatening infections, some forms of cancer, and the deterioration of the nervous system. Although AIDS is always the result of an HIV infection, not everyone with HIV has AIDS. In fact, adults who become infected with HIV may appear healthy for years before they get sick with AIDS.

How Common Are HIV and AIDS?

The first case of AIDS was reported in 1981, but the disease may have existed unrecognized for many years before that. HIV infection leading to AIDS has been a major cause of illness and death among children, teens, and young adults worldwide. AIDS has been the sixth leading cause of death in the United States among 15- to 24-year-olds since 1991.

In recent years, AIDS infection rates have been increasing rapidly among teens and young adults. Half of all new HIV infections in the United States occur in people who are under 25 years old; thousands of teens acquire new HIV infections each year. Most new HIV cases in younger people are transmitted through unprotected sex; one third of these cases are from injection drug usage via the sharing of dirty, blood-contaminated needles.

Among children, most cases of AIDS — and almost all new HIV infections — resulted from transmission of the HIV virus from the mother to her child during pregnancy, birth, or through breastfeeding.

Fortunately, medicines currently given to HIV-positive pregnant women have reduced mother-to-child HIV transmission tremendously in the United States. These drugs (discussed in detail in the Drug Treatments section of this article) are also used to slow or reduce some of the effects of the disease in people who are already infected. Unfortunately, these medicines have not been readily available worldwide, particularly in the poorer nations hardest hit by the epidemic. Providing access to these life-saving treatments has become an issue of global importance.

How Is HIV Transmitted?

HIV is transmitted through direct contact with the blood or body fluid of someone who is infected with the virus.

The three main ways HIV is passed to a very young child are:

1. while the baby develops in the mother's uterus (intrauterine)
2. at the time of birth
3. during breastfeeding

Among teens, the virus is most commonly spread through high-risk behaviors, including:

• unprotected sexual intercourse (oral, vaginal, or anal sex)
• sharing needles used to inject drugs or other substances (including contaminated needles used for injecting steroids and tattooing and body art)

In very rare cases, HIV has also been transmitted by direct contact with an open wound of an infected person (the virus may be introduced through a small cut or tear on the body of the healthy person) and through blood transfusions. Since 1985, the U.S. blood supply has been carefully screened for HIV.

Signs and Symptoms of HIV

Although there may be no immediate physical signs of HIV infection at birth, signs of the infection might appear within 2 to 3 months after a child is born. Kids who are born with HIV can develop opportunistic infections, which are illnesses that can develop in weakened immune systems, such as Pneumocystis carinii pneumonia (PCP). A child with HIV may also get more severe bouts of other common childhood infections, such as Epstein-Barr virus (EBV) infection, which generally causes mild illness in most kids. In developing countries, tuberculosis has been a particularly common problem and often the cause of death of children and adults.

A baby born with HIV infection most likely will appear healthy. But sometimes, within 2 to 3 months after birth, an infected baby may begin to appear sick, with poor weight gain, repeated fungal mouth infections (thrush), enlarged lymph nodes, enlarged liver or spleen, neurological problems, and multiple bacterial infections, including pneumonia.

Teens and young adults who contract HIV usually show no symptoms at the time of infection. In fact, it may take up to 10 years or more for symptoms to show. During this time, they can pass on the virus without even knowing they have it themselves. Once the symptoms of AIDS appear, they can include rapid weight loss, intense fatigue, swollen lymph nodes, persistent diarrhea, night sweats, or pneumonia. They, too, will be susceptible to life-threatening opportunistic infections.