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This information is for people who are infected with the human immunodeficiency virus (HIV). HIV is the virus that causes the disease acquired immunodeficiency syndrome (AIDS). You might also want to share this chapter with your friends and family. It will help you, and them, understand more about HIV.
Although HIV is a serious infection, people with HIV and AIDS are living longer, healthier lives today, thanks to new and effective treatments. This chapter will help you understand how you can live with HIV and how you can keep yourself healthy.
You probably have many questions about HIV, such as:
This chapter will give you answers to many of your questions. You should feel free to ask your doctor any question about HIV. Other sources of information about HIV are listed at the back of this chapter.
The first cases of AIDS were identified in the United States in 1981, but it most likely existed here and in other parts of the world for many years before that. In 1984 scientists proved that HIV causes AIDS.
You might have caught HIV by having unprotected sex–sex without a condom–with someone who has HIV. Or you might have shared a needle to inject drugs or shared drug “works” with someone who has HIV. Babies born to women with HIV also can become infected. Although in the past you could get HIV from a blood transfusion, today it is unlikely you got infected that way because all blood in the United States has been tested for HIV since 1985. You could not have gotten HIV just from working with or being around someone who has HIV - and no one can get it from you that way. HIV also is not spread by insect bites or stings, on toilet seats, or through everyday things like sharing a meal.
When HIV enters your body, it infects your “CD4 cells” and kills them. CD4 cells sometimes called T-helper cells) help your body fight off infection and disease. Usually, CD4 cell counts in someone with a healthy immune system range from 500 to 1800.
When you lose CD4 cells, your immune system breaks down and you can’t fight infections and diseases as well. When your CD4 cell count goes under 200, doctors say you have AIDS. Doctors also say you have AIDS if you have HIV and certain diseases, such as Tuberculosis or Pneumocystis carinii [NEW-mo-SIS-tis CA-RIN-nee-eye] pneumonia (PCP), even if your CD4 cell count is over 200.
There are many things you can do for yourself to stay healthy. Here are a few:
There also are many things you can do to protect your health when you prepare food or eat, when you travel, and when you’re around pets and other animals. You can read more about these things in the brochures in the CDC Opportunistic infections Series. You can get these brochures and other information on HIV from the CDC National AIDS Hotline at (800)342-2437 or at the CDC Internet address listed at the end of this chapter.
At your first appointment your doctor will ask you questions, do a checkup, draw blood, and do a Tuberculosis skin test and other tests. Your doctor also may give you some immunizations (shots). Tell your doctor about any health problems you are having so that you can get treatment. You also should ask your doctor any questions you have about HIV or AIDS, such as what to do if your medicine makes you sick, where to get help in quitting smoking or drug use, or how to eat healthy foods.
When your doctor draws blood, it is used for many tests, including the CD4 cell count and “viral load testing.” Viral load testing measures the amount of HIV in your blood. Viral load tests help predict what will happen next with your HIV infection if you don’t get treatment. They are used with CD4 cell counts to decide when to start and when to change your drug therapies.
Keep your follow-up appointments with your doctor. At follow-up appointments you and your doctor will talk about your test results, and he or she may prescribe medicine for you.
HIV and HIV-related illnesses vary from person to person. People can live with HIV for many years. Your doctor will design a medical care plan for you.
Your doctor will tell you about the risks and benefits of the drugs for HIV and when you need to start taking them. Many drugs are used together to treat HIV. These drugs often include “antiretroviral” medicines. These medicines are powerful drugs, but they are not cures for HIV. If your doctor prescribes any of these drugs for you, take them exactly as prescribed.
If your HIV infection gets worse and your CD4 cell count falls below 200, you are more likely to get other infections. Your doctor will prescribe TMP-SMX (trimethoprim-sulfamethoxazole [try-METH-o-prim - sul-fa-meth-OX-uh-zole]) - also known as Bactrim®, Septra®, or Cotrim®* - or other drugs, to prevent PCP.
Your doctor also may prescribe other drugs for you, depending on your CD4 count. Most people have no problem with these medicines. But if you get a rash or have other problems, call your doctor right away to discuss other treatments. Don’t change the way you are taking any of your medicines without first talking with your doctor. If you don’t take your medicines the right way, you might give your HIV infection a better chance to fight back.
In addition to PCP, you also have a higher chance of getting other diseases, depending on your CD4 count. These are called “opportunistic infections” because a person with HIV can get the infection if his or her weakened immune system gives it the opportunity to develop. More than 100 germs can cause opportunistic infections. Some of these infections include:
| MAC | (mycobacterium avium [my-ko-bak-TEER-i-um a-VEE-i-um] complex) |
| CMV | (cytomegalovirus [si-to-MEG-eh-lo-vi-res]) |
| TB | (tuberculosis [too-burr-qu-LO-sis]) |
| toxo | (toxoplasmosis [tok-so-plaz-MO-sis]) |
| crypto | (cryptosporidiosis [krip-to-spo-rid-e-O-sis]) |
Watch out for certain symptoms:
Tell your doctor right away if you have any of these problems. Your doctor can treat most of your HIV-related problems, but sometimes he or she may need to send you to a specialist. Visit a dentist at least twice a year, or more often if you have mouth problems.
Yes. If you are a woman with HIV, your doctor should check you for sexually transmitted
diseases (STDs) and perform a Pap test at least once a year.
Women with HIV are more likely to have abnormal Pap tests. If your Pap test is abnormal, your doctor may need to repeat it or do other tests. If you have had an abnormal Pap test in the past, tell your doctor.
If you are thinking about either avoiding pregnancy or becoming pregnant, talk with your doctor about important issues such as:
If you become pregnant, talk to your doctor right away about medical care for you and your baby. You also need to plan for your child’s future in case you get sick.
Your HIV treatment will not change very much from what it was before you became pregnant. You should have a Pap test and tests for STDs during your pregnancy. Your doctor will order tests and suggest medicines for you to take. Talk with him or her about all the pros and cons of taking medicine while you are pregnant.
If you decide to have your baby, talk with your doctor about how you can prevent giving HIV to your baby. It is very important that you get good care early in your pregnancy. The chances of passing HIV to your baby before or during birth are about 1 in 4, or 25%, but treatment with zidovudine [zy-DAH-vue-deen], sometimes called ZDV, AZT, or Retrovir®*, has been shown togreatly lower this risk. Your doctor will want to have you on a drug treatment that includes ZDV.
Although you are pregnant, you should still use condoms each time you have sex, to avoid catching other diseases and to avoid spreading HIV. Even if your partner already has HIV, he should still use condoms.
After birth, your baby will need to be tested for HIV, even if you took ZDV and/or other drugs while you were pregnant. Your baby will need to take medicine to prevent HIV infection and PCP. Talk with your doctor about your baby’s special medical needs. Because HIV infection can be passed through breast milk, you should not breast-feed your baby.
If you are living with HIV or AIDS, you need many kinds of support–medical, emotional,psychological, and, yes, financial. Your doctor, your local health and social services departments, your local AIDS service organization, and your local library can aid you in finding all kinds of help:
You also can get information on these things from the CDC National AIDS Hotline at (800) 342-2437.
Many people living with HIV feel better if they can talk with other people who also have HIV. Here are some ways to find others with HIV:
Thousands of people are living with HIV, and AIDS, today. Many are leading full, happy, and productive lives. You can too if you work with your doctor and others and take the steps outlined in this booklet to stay healthy.