The burden of HIV, while nowhere close to what is was just a decade ago, is still humongous in terms of the impact on a patient’s life and we’ll being.
For the longest time, the morbidity of HIV was due to opportunistic infections, that is, those infections that occur if a patient’s immunity begins to fall. This is quantified by a blood test that measures a specific subset called T Cells, or CD4 cells. Once a patient is infected with the virus, he or she will have no symptoms since the immune system is still strong. This may last for several years, until the system becomes weaker and unable to fight infections. A large majority is diagnosed with the HIV virus at this stage.
Infections, a large group of complications, are not the only problem. There are metabolic derangements, from increased lipid profiles (triglycerides, cholesterol), abnormal bone thinning, fat maldistribution besides others. There are also other complications such as insulin resistance, endocrine disorders, and more grievous ones such as malignancies. It is important to keep in mind that the virus does not get eliminated from patients, but merely hibernates. It resurfaces at a time when patients have either interrupted their treat, or are on a regimen that may be suboptimal. That is why the goal of any treatment is to keep the viral load optimally suppressed for as long as is possible.
Most patients with HIV, if they respond to treatment and live within a specified boundary will do and have long, productive lives.
I often say that patients with HIV do not die of the disease, but of shame. It is therefore crucial to have frank discussions with family members and have a support system that allows patients to overcome the period of grief, resentment, conflict, lack of esteem besides a mydriad of other emotions that only the person who is going through can identify with. A substantial number require professional counselling for significant duration.
In today’s times, HIV remains a manageable disease with good outcomes. Awareness, acceptance, and responsible lifestyle and sexual behaviours are the key. They are also the difference between getting infected with the HIV virus and being non-infected.