FAQ LIVING POSITIVELY

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In our bodies, we carry many germs -- bacteria, protozoa, fungi, and viruses. When our immune system is working, it controls these germs. But when the immune system is weakened by HIV or by some medications, these germs can get out of control and cause health problems.
 
Infections that take advantage of weakness in the immune defenses are called "opportunistic."
The rates of Opportunistic infections have fallen dramatically since the introduction of antiretroviral therapies. However, these infections are still a problem, especially for people who have not been tested for HIV. 
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People who aren't HIV-infected can develop OIs if their immune systems are damaged. For example, many drugs used to treat cancer suppress the immune system. Some people who get cancer treatments can develop OIs.

HIV weakens the immune system so that opportunistic infections can develop. If you are HIV-infected and develop opportunistic infections, you might have AIDS.

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The most common infections are listed here, along with the disease they usually cause, and the CD4 cell count when the disease becomes active:

·         Candidiasis(Thrush) is a fungal infection of the mouth, throat, or vagina. CD4 cell range: can occur even with fairly high CD4 cells.

·         Cytomegalovirus(CMV) is a viral infection that causes eye disease that can lead to blindness. CD4 cell range: under 50.

·         Herpes simplex virusescan cause oral herpes (cold sores) or genital herpes. These are fairly common infections, but if you have HIV, the outbreaks can be much more frequent and more severe. They can occur at any CD4 cell count.

·         Malariais common in the developing world. It is more common and more severe in people with HIV infection.

·         Mycobacterium avium complex(MAC or MAI) is a bacterial infection that can cause recurring fevers, general sick feelings, problems with digestion, and serious weight loss. CD4 cell range: under 50.

·         Pneumocystis pneumonia(PCP) is a fungal infection that can cause a fatal pneumonia. CD4 cell range: under 200. Unfortunately, this is still a fairly common OI in people who have not been tested or treated for HIV.

·         Toxoplasmosis(Toxo) is a protozoal infection of the brain. CD4 cell range: under 100.

·         Tuberculosis(TB) is a bacterial infection that attacks the lungs, and can cause meningitis. CD4 cell range: Everyone with HIV who tests positive for exposure to TB should be treated. 

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Most of the germs that cause OIs are quite common, and you may already be carrying several of these infections. You can reduce the risk of new infections by keeping clean and avoiding known sources of the germs that cause OIs.

Even if you're infected with some OIs, you can take medications that will prevent the development of active disease. This is called prophylaxis. The best way to prevent OIs is to take ART. 

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For each OI, there are specific drugs, or combinations of drugs, that seem to work best.  Strong antiretroviral drugs (ARVs) can allow a damaged immune system to recover and do a better job of fighting OIs. Visit a health facility.

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1.    Viral load greater than 5,000-10,000 regardless of clinical status = Consider beginning treatment. Retest every three to six months.

2.    Symptomatic disease, or a CD4 cell count less than 500µ or especially if the CD4 cell count is less than 350µ = Consider beginning treatment.

HIV/AIDS Prevention 

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HIV destroys a certain kind of blood cell (CD4+ T cells), which is crucial to the normal function of the human immune system. Most people infected with HIV carry the virus for years before enough damage is done to the immune system for AIDS to develop.

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There is no cure for AIDS. There are only medications that can slow down the progress of the HIV virus and the damage to the immune system. HIV medications are more effective in some people, but may not work for all. If you are HIV positive, check with your health care provider to see if these medications are appropriate for you

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HIV transmission can occur when fluids (shown to contain high concentrations of HIV) from an infected person enter the body of an uninfected person.

  • Blood
  • Semen
  • Pre-seminal fluid
  • Vaginal fluid
  • Breast milk
  • Other body fluids containing blood

HIV has been found in saliva and tears of some persons living with HIV, but in very low quantities.

Finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid. HIV has not been recovered from the sweat of HIV-infected persons. Contact with saliva, tears, or sweat has never been shown to result in transmission of HIV.

HIV can enter the body through:

  • A vein (during injection drug use)
  • The lining of the anus or rectum
  • The lining of the vagina and/or cervix
  • The opening of the penis
  • The mouth
  • Other mucous membranes (i.e., eyes, nose)
  • Cuts and sores
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Intact, healthy skin is an excellent barrier against HIV and other viruses and bacteria.

The most common ways HIV is transmitted from one person to another are:

  • Exchanging blood, semen, and vaginal secretions through vaginal, oral or anal intercourse with someone who has HIV
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  • Sharing needles or syringes used for injecting drugs, medicines, tattooing or body piercing with someone who has HIV
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  • A pregnant woman who is HIV positive can pass HIV to her unborn baby through the umbilical cord during birth, contact with vaginal fluids and blood during birth or breast milk after the child is born 
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The tests commonly used to detect HIV infection are actually looking for antibodies produced by your immune system when you are exposed to HIV. Most people will develop detectable antibodies within two to eight weeks (the average is 25 days). Ninety-seven percent will develop antibodies in the first three months following the time of their infection. In very rare cases, it can take up to six months to develop antibodies to HIV.

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