Sexually transmitted diseases

TREATMENTS OF SEXUALLY TRANSMITTED DISEASES

HIV – AIDS

It is a chronic disease and difficult to treat that can seriously endanger the life of those who suffer from it because it weakens the person's immune system and therefore, their ability to respond to other infections.

VIH principal

HIV – AIDS

Table of Contents

VIH principal

definition

What is HIV and AIDS?

Acquired Immunodeficiency Syndrome (or AIDS) is undoubtedly the best-known and most widespread sexually transmitted infection in the world.

It’s a disease that is chronical and difficult to treat that can seriously endanger the life of the patient because it weakens the person’s immune system and thus their ability to respond to other infections.

It's a sexually transmitted infection, with direct contact with vaginal, seminal secretions or blood. It can also be spread by blood transfusions. During gestation or breastfeeding, an HIV-infected mother can transmit the virus to her child.

Es una infección transmitida por vía sexual, con contacto directo de secreciones vaginales, seminales o sangre. También, por transfusiones sanguíneas puede contagiarse. Durante el periodo de gestación o lactancia, una madre infectada con VIH puede transmitir el virus al niño.

It’s a sexually transmitted infection, with direct contact with vaginal, seminal secretions or blood. It can also be spread by blood transfusions. During gestation or breastfeeding, an HIV-infected mother can transmit the virus to her child.

This disease is due to a retrovirus-type virus that has the ability to destroy CD4+ lymphocytes, which are responsible for keeping at bay certain infections and carcinogenic processes that take place in the body.

Initially, the disease has no symptoms, but it can be spread. This is known as the incubation period. That is to say, the time that elapses from the contagion of the virus until it ceases to be asymptomatic.

When HIV becomes symptomatic (i.e., evolves into AIDS itself), the disease has signs similar to a common febrile but longer-lasting process. As the attack against CD4+ lymphocytes increases, opportunistic infections become more frequent and severe.

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According to the World Health Organization estimations for 2016, about 36.7 million people were living with HIV worldwide. More than half of this number are unaware that they have the disease, so the risk of infection is increasing more and more. Nearly 2 million of the more than 37 million total are children and teenagers under 15 years of age.

In the same year, one million people acquired the disease and 1.8 million died from it or from infections developed from it. Ninety-five per cent of new infections are from developing countries, especially Africa. However, global efforts to reduce the incidence of HIV-AIDS have yielded many positive results and new advances in scientific research have significantly improved the quality of life of those infected.

HIV and AIDS have had a major impact on human history with large social movements promoting sexual health and against discrimination.

HIV and AIDS are the same?

No, HIV (or Human Immunodeficiency Virus) is the causal agent of AIDS (or acquired immunodeficiency syndrome), the disease itself.

A person getting the virus becomes a carrier of it. They can transmit it to other individuals (by various means) and not know, because during this period (which varies greatly from person to person) there are no clinical manifestations of relevance.

The virus travels through the bloodstream and invades almost all tissues of the body without causing an immune response. There, it reproduces and proliferates constantly in a silent way. This process usually takes years or even decades.

AIDS occurs when the virus has been able to infect all the tissues of the body and weaken the immune system to such an extent that almost any mild, transient infection (such as a common cold) is potentially fatal.

During AIDS, the disease reaches a point of no return. This means that patient with HIV does not necessarily have AIDS (although he/she may develop it over time).

HIV - AIDS

Treatment Summary

This is short summary of the whole process: from the appointment request, to receiving the medical discharge after the treatment in some our Andromedi centers in Madrid, Seville or Canary islands (Tenerife)

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Previous Advice

Because it is a disease difficult to control, the patient should know who their sexual partners have been in the last months and years.

Diagnosis And Testing

The AIDS virus can only be diagnosed by complex genetic techniques such as PCR. Medical examination is also key.

Treatment

Complex, expensive and with many side effects. The most common are antiretrovirals. Sexual partners must also take them.

Recovery Time

HIV is a disease with no real cure but modern drugs can achieve remission at undetectable levels.

Further Assistance and Care

The patient must go to the doctor from time to time for check-ups and laboratory tests. This way the disease can be monitored.

Resuming Sex Life

Many patients with HIV can live normally, taking certain precautions such as always using condoms and avoiding blood donations.

Medical Evaluation

How is it transmitted?

Human immunodeficiency virus (HIV) can be transmitted from person to person in several ways:

  • Genital contact during unprotected sex.
  • Sexual practices with a high risk of transmissibility (anal and oral sex).
  • Mother-to-child transmission by transplacental (during gestation), perinatal (during childbirth) or breastfeeding (through breast milk).
  • Needlesticks, syringes or medical instruments previously used in a person with HIV.

HIV has been isolated from samples of blood, semen, vaginal secretions, breast milk and suppurative fluid from wounds or ulcers (such as those produced by other sexually transmitted infections), so direct contact between these substances or with blood will cause the transfer of potentially infectious viral particles.

There are also certain untrue beliefs about HIV infection. For example, body fluids such as sweat or saliva may contain viral particles. However, for infection to occur in a healthy person, it’s necessary for that person to present oral wounds (during a kiss) or on the skin (by skin-to-skin contact with sweat) through which the virus enters this person’s body. This type of situation is quite infrequent.

In normal situations, person-to-person contact by a kiss on the cheek, a handshake, a hug, or sharing clothing or cooking utensils does not transmit the virus.

Other infrequent forms of transmission include transmission by blood transfusions or organ transplants from HIV-infected donors. Procedures sufficiently regulated by health authorities in countries such as Spain and the rest of the European Union.

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symptomatology

What are its symptoms?

Symptoms of AIDS vary according to the stage of the infection. In the primary infection or acute HIV, the patient shows symptoms similar to a common cold (or flu, influenza…). This occurs about one or two months after the initial infection and corresponds to the first viraemia (i.e., the first big virus proliferation in the bloodstream).

Symptoms of this primary infection are as follows:

High fever

High fever

Headaches

Headaches

Muscle and joint discomfort

Muscle and joint discomfort

Skin rash

Skin rash

Tonsillitis and swallowing pain

Tonsillitis and swallowing pain

Swollen lymph nodes in the neck

Swollen lymph nodes in the neck

During latent clinical infection or chronic HIV, which usually lasts several years, there are no major symptoms. There may be sporadic swollen lymph nodes in the neck or groin area. During this stage, the virus is in proliferation and active – silent invasion.

When HIV becomes symptomatic, it is a case of AIDS itself, the infection has evolved to such an extent that it gives rise to signs and symptoms such as the following:

  • High fever.
  • Chronic tiredness.
  • Swollen lymph nodes.
  • Diarrhoea with no apparent cause.
  • Weight loss and decreased appetite.

Other symptoms that may occur in this period include:

  • Oral infections with candida albicans (oral candidiasis).
  • Herpes Zoster.
  • Persistent sweating.
  • Skin rashes or bluish spots (Kaposi's sarcoma, a type of skin cancer in patients with HIV-AIDS).

Can a contagion be asymptomatic?

Yes. In fact, in its early stages, HIV-AIDS does not produce symptoms that lead patients to seek help early.

Differences between men and women

The United Nations Development Fund for Women estimates that HIV-AIDS infection is distributed equally between men and women. In some regions of Africa, 60 per cent of women are infected.

Medical evaluation

Risk factors

Among the risk factors that make it easier to get the infection, are:

  • Having sex with multiple partners.
  • Unprotected sex without latex condoms.
  • Using latex condoms inappropriately.
  • Sexual practices such as anal sex.
  • Previous sexually transmitted infections (such as syphilis or genital herpes, for example).
  • Sharing syringes.
  • Intravenous drugs such as heroin.
  • Uncircumcised men have an increased risk of becoming infected.

How to prevent it?

  • Keep stable, pre-tested sexual partners.
  • Use of latex condoms.
  • Consider circumcision.
  • Make sure each syringe you are going to use is new.
  • Intravenous drug addicts counselling.
  • Carry out STI screening tests at least once a year.
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Evaluación medica

How is it diagnosed?

Through blood tests such as:

  • Measurement of antibodies against HIV (which will eventually be elevated in these patients).
  • Determination of blood HIV viral load.
  • CD4+ lymphocyte (the cells affected by HIV) count.

Other more complex but more sensitive tests to identify the virus in the body are the popular ELISA test and electroimmunotransference.

There are also rapid HIV tests that are available in pharmacies.

Techniques and treatments

What does the treatment consist of in our Andromedi centres in Madrid, Seville and the Canary Islands?

AIDS is a complicated disease with no cure. However, many scientific investigations are currently being carried out to find a definitive solution.

Clinical management corresponds to the administration of combined antiretroviral drugs to reduce the viral load (amount of virus in the body) and thus delay the development of the syndrome. In theory, these drugs prolong the state of latency and lower the level of transmissibility.

They act by inhibiting certain enzymes that the virus requires to replicate RNA (genetic material that plays an essential role in the synthesis of proteins in human body cells).

The best-known antiretrovirals are:

  • Transcriptase inhibitors.
  • Protease inhibitors.
  • Integrase inhibitors.
  • Inhibitors of the entry of the virus into the cell or of the union of its RNA with the ribosomes.

Are there any re-infections after treatment? Until when is it still transmissible?

Because it’s technically impossible to kill all viruses, the infection remains latent for life. So transmissibility will always be present. The patient must learn to cope with the disease while receiving pharmacological treatment to delay the onset of symptoms.

Frequently asked questions at the Andromedi centres in Madrid, Seville and Tenerife

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Can there be complications?

Many are the complications of HIV-AIDS because the immune system is weakened in such a way that almost any common infection can have fatal outcomes.

The most frequent complications include pneumonia, fungal lung infections, candidiasis in the mouth, esophagus and trachea, cervical cancer (in women), cytomegalovirus retinitis (resulting in total vision loss), Kaposi’s sarcoma (a variant of skin cancer), non-Hodgkin’s lymphoma (a type of leukemia), tuberculosis, salmonellosis, toxoplasmosis, among many other infectious diseases and psychological disorders.

What causes aids and how does the virus work?

AIDS (the sexual disease par excellence) is produced by a virus, the Human Immunodeficiency Virus or HIV.

This virus invades the body tissues, travelling through the bloodstream. However, it has a special predilection for CD4+ T lymphocytes, the cells in charge of identifying pathogenic microorganisms (such as bacteria, fungi or other viruses) and causing their death, keeping infections at bay.

When HIV invades these cells, the body’s level of defence against new infections falls and a systemic weakening occurs.

Any normally neutralised infection (such as influenza, for example) can evolve to potentially dangerous levels.

When does hiv become aids?

According to careful observations in HIV patients, AIDS (or its associated signs and symptoms) begins to take place when the cell load of CD4+ T lymphocytes falls below 200 per micro-litre of blood.

This is in most cases. However, this phenomenon can be different from person to person, especially if they have

MEDICAL REFERENCES AND BIBLIOGRAPHY
Este contenido médico ha sido actualizado y revisado por revisado por el comité científico de Andromedi en la siguiente fecha: 5 April 2024
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Author

Dr. Natalio Cruz


Natalio Cruz MD, with 25 years of medical experience, has been until 2016 Head of the Andrology Unit in the Urology Service of the Virgen del Rocío Hospital in Seville, National Coordinator of Andrology in the Spanish Association of Urology (AEU) and General Secretary in the ESSM, positions that he has narrowed to focus squarely on this exciting project of offering a high-level private medical consultation in Marbella, Seville, Madrid and Tenerife.

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