How to get HIV from a woman. How is AIDS transmitted? Is HIV transmitted through kissing?

HIV is short for human immunodeficiency virus, which is a virus that attacks the immune system. By destroying the human immune system, this virus contributes to the development of other infectious diseases, as the immune system loses the ability to protect the body from pathogens. A person infected with HIV, over time, becomes more susceptible to even such microorganisms that do not pose any danger to healthy people.

A person infected with HIV is called HIV-infected, or HIV-positive, or HIV-seropositive.

How can you get HIV infection?

The human immunodeficiency virus, or HIV, is spread from person to person. In other words, you can only get HIV from another person.

A person infected with HIV has large amounts of the virus in their blood, semen, vaginal discharge, and breast milk. In this case, the external manifestations of the disease may initially be absent. Quite often, many do not even know that they are infected with HIV and are dangerous to other people.

Infection with HIV infection occurs when a healthy person enters the body of HIV-infected blood, semen, vaginal secretions or mother's milk. This can happen when these bodily fluids come into contact with a wound on the skin, on the genitals, or in the mouth.

At-risk groups

Until recently, people with homosexual contacts were considered the main risk group. However, Russian statistics for the last two or three years show that the risk of HIV infection is also high among intravenous drug users and prostitutes. The number of people infected through sexual contact with representatives of these groups is growing. Below we describe in detail the ways in which HIV is transmitted.

Upon contact with the patient's blood

HIV-infected blood enters the blood of another person in different ways.
ways. This can happen, for example:

• transfusion of HIV-infected blood. Currently, in Russia, all blood used for transfusion is tested for the presence of antibodies to HIV, that is, it is determined whether it is infected with HIV or not. But you need to remember that within 3-6 months after HIV infection, there are still no antibodies to the virus in the donor's blood, and even if the test result is negative, such blood may actually be infected;


• when sharing needles, syringes and other materials for intravenous drug administration;


• when HIV enters the blood of an HIV-infected mother to her child during pregnancy and childbirth.

Upon contact with semen, vaginal secretions of a sick person

• This can happen during intercourse without using a condom. A small sore in the vagina, rectum, oral mucosa, or penis is enough for HIV infection to occur if sexual intercourse occurs without a condom.

At breastfeeding child of an HIV-infected woman.

• The danger of infection arises only through contact with infected blood, semen, vaginal secretions and mother's milk. In urine, feces, vomit, saliva, tears and sweat, HIV is also present, but in such small quantities that there is no danger of infection. The only exception is if visible blood is found in the above human secretions. HIV infection cannot be contracted by touching, shaking hands, kissing, massage, staying in the same bed together, using the same bed linen, drinking from the same glass. You also can't get infected through a toilet seat, coughing, sneezing, or mosquito bite.

Donation is prohibited

Since HIV is transmitted through blood, an HIV-infected person cannot be a donor. The same restrictions exist for donors of sperm, bone marrow, and other organs for transplantation, since HIV infection can also occur during organ transplantation.

What happens with HIV infection

The fact that a person has contracted the virus, that is, has become infected with HIV, does not mean that he has AIDS. Before AIDS develops, it usually takes a long time (average 10-12 years). Below we describe in detail how HIV infection proceeds.

At first, the person may not feel anything.

When infected with HIV, most people do not experience any sensations. Sometimes a few weeks after infection, a flu-like condition develops (fever, skin rashes, swollen lymph nodes, diarrhea). For many years after infection, a person may feel healthy. This period is called the latent (latent) stage of the disease. However, it is wrong to think that nothing happens in the body at this time. When any pathogen, including HIV, enters the body, the immune system mounts an immune response. She is trying to neutralize the pathogen and destroy it. To do this, the immune system produces antibodies. The antibodies bind to the pathogen and help destroy it. In addition, special white blood cells (lymphocytes) also begin to fight the pathogen. Unfortunately, in the fight against HIV, all this is not enough - the immune system cannot neutralize HIV, and HIV, in turn, gradually destroys the immune system.

HIV test

A blood test to check for antibodies to HIV is called an HIV test. Antibodies that appear in the blood after infection with HIV can be detected with a special blood test. The detection of antibodies indicates that a person is infected with HIV, i.e. HIV-seropositive. However, antibodies can only be detected in the blood 3-6 months after being infected with HIV, so sometimes a person who has been infected with HIV for several months will have negative blood test results.

HIV seropositivity

Often there is sad confusion about the term "seropositivity".

"Seropositivity" means that a person's blood contains antibodies to HIV. Only in children born to HIV-infected mothers can there be a passing carriage of maternal antibodies to HIV, i.e., over time, the antibodies disappear. These children may temporarily be seropositive, although they are not infected with HIV. A patient with AIDS also has antibodies to HIV in the blood, so he is also seropositive. Thus, the term "HIV-seropositive" means that a person is infected with HIV, there are antibodies to this virus in his blood, but there are still no external manifestations of the disease.

AIDS

AIDS is spoken of when a person infected with HIV develops infectious diseases due to the inefficient functioning of the immune system destroyed by the virus.

AIDS is short for Acquired Immune Deficiency Syndrome.

A syndrome is a stable combination, a combination of several signs of a disease (symptoms).

Acquired - means that the disease is not congenital, but developed during life.

Immunodeficiency - insufficiency of the immune system. Thus, AIDS is a combination of diseases caused by insufficient work of the immune system due to the defeat of her HIV.

HIV treatment

When infected with HIV, a person is given treatment that can delay the development of AIDS and opportunistic diseases, and some of the latter can be cured. The following drugs are used to treat HIV infection:

1. drugs that directly affect the virus, on its life cycles that interfere with its reproduction (antiretroviral drugs);
2. drugs for the treatment of opportunistic diseases;
3. drugs intended to prevent the development of opportunistic infections (drugs for prophylaxis - preventive therapy).

Treatment of an HIV-infected patient begins much earlier than AIDS develops. The fact is that even in the absence of signs of the disease, visible to the sick person or the doctor, HIV actively affects the body. Therefore, timely treatment helps a person feel healthy longer, prevents the development of opportunistic infections and tumor diseases.

Antiretroviral drugs

There are a large number of drugs that inhibit the reproduction of HIV. However, if any of these medicines are used alone, they will no longer work on HIV over time. The virus becomes insensitive to it (doctors call this phenomenon drug resistance of the virus, or virus resistance). Using several drugs at the same time in combination, you can minimize the risk of developing resistance to the virus. This treatment is called combination antiretroviral therapy.

If the virus does become resistant to the combination of drugs used, a new active combination of drugs is prescribed. Combination therapy is described in detail in the Medications section.

Preventive therapy

Preventive therapy - treatment aimed at preventing the development of opportunistic infections.

Over time, HIV infection destroys the immune system so much that opportunistic infections can develop. To prevent this, prophylactic (preventive) treatment is prescribed, mainly with antimicrobial drugs.

Such drugs do not work on the immunodeficiency virus itself. They only serve to prevent the development of opportunistic infections.

Ways to prevent other infections

Persons infected with HIV become more susceptible not only to opportunistic infections, but also to other widespread infectious diseases.

To prevent the development of these diseases, preventive measures are also taken.

Vaccination (immunization)

Vaccines can protect the body from certain infectious diseases. Vaccination is effective if the person's immune system is still slightly destroyed. That is why HIV-infected people are advised to be vaccinated against certain diseases as early as possible.

Below we describe those diseases against which it is desirable to be vaccinated.

FLU

Every year, a huge number of people are vaccinated against the flu. However, for HIV-infected people, it is not entirely clear whether all of them should receive these vaccinations. Those who get the flu frequently should probably get immunized. It is best to consult your doctor on this matter.

Inflammation of the lungs (pneumonia)

Russia does not produce an anti-pneumococcal vaccine, but the Ministry of Health of the Russian Federation has approved some foreign vaccines for use.

Vaccinations against other diseases

There are certain features of immunization of children, in addition, a number of vaccinations are necessary when traveling to other countries.

Other infectious diseases

HIV-infected people are more susceptible to some infectious diseases than healthy people. In this case, we are talking about those patients whose immune system is still preserved. We describe such infections below.

salmonellosis

People with HIV infection are more likely to contract salmonellosis. Salmonella is a bacterium that causes a dangerous disease of the gastrointestinal tract, which is accompanied by fever and diarrhea. In Russia, bird eggs and poultry meat are infected with salmonella. Do not eat raw bird eggs, eat only well-done poultry meat and bird products.

Tuberculosis

People infected with HIV are more likely than others to develop tuberculosis. In Russia in last years the incidence of tuberculosis has risen sharply. When you visit some countries, you are also at risk of contracting tuberculosis. Please consult your doctor before traveling or on a business trip.

The course and prognosis of HIV infection

When a person finds out they have HIV infection or AIDS, the first questions they most often ask are: "How much longer do I have to live?" and "How will my illness proceed?". Since HIV infection and AIDS are different for everyone, these questions cannot be answered unambiguously. However, we can provide some general information.

People living with HIV and AIDS are now living much longer than they used to.

The treatment of HIV infection and AIDS is becoming increasingly successful. On the background of treatment, people with HIV infection feel healthy for a longer time, and AIDS patients live longer and, in comparison with previous years, not only have fewer manifestations of the disease, but it is much easier.

At the beginning of the epidemic (1981-1986), AIDS developed in patients on average 7 years after infection with the virus. After that, a person could live for about 8-12 months. Since the introduction of combination antiretroviral therapy in 1996, the lives of HIV-infected people and people with AIDS have become much longer. Some people who develop AIDS can live 10 years or more. First of all, such progress is provided by drugs that act on the virus itself - antiretroviral drugs. Life is also extended due to the fact that with the help of combination therapy it is possible to prevent the development of many opportunistic infections that are the direct cause of death in HIV infection.

The search for new treatments continues. No doubt there will be more coming soon medicines effective in fighting this infection.

Each HIV infection is different

For each period of illness, we give only average figures. This means that some people get sick faster, while others feel great for a long time. Some people living with HIV for more than 15 years. still not developed AIDS. There are cases when people with AIDS. live without treatment for 10 years or more.

As a rule, the diagnosis of HIV infection causes psychological shock. However, this does not mean that a person will constantly feel his illness. Thanks to modern methods treatment, combination therapy, if it is well tolerated, he will feel quite healthy.

More information about your illness

How can you know how damaged the immune system is? HIV gradually destroys the immune system. How much the immune system is affected and how quickly the disease develops can be found out by various methods.

Viral load

When examining blood, you can determine not only the presence of antibodies to HIV in it, but also the amount of the virus itself. This method is called "viral load determination". The higher the test scores, the more active the HIV infection.

immune status

With the help of laboratory research, you can find out about the state of the immune system. The so-called T-lymphocytes, or CD4 + lymphocytes, play an important role in its functioning. Usually, these cells are found in large numbers in the blood, but in those affected by HIV, they die and gradually decrease in number. By measuring the number of CD4 + lymphocytes in the blood, the doctor can find out how much the immune system has been affected (see the section "HIV and the immune system").

Additional information about vaccinations

Viral load levels can increase after being vaccinated against the flu or against other infectious diseases, just as after having had the flu or other infections. No need to be upset, as this is a temporary rise in the indicator. If you have not been vaccinated and have not had infectious diseases (for example, the flu), and the viral load has increased significantly, this means that your condition has worsened. If there are less than 100 cells per 1 mm3 in the blood of CD4 + lymphocytes, vaccination against influenza (or other infectious diseases) may be useless.

To protect yourself from possible HIV infection, you need to be aware of how it is transmitted. Unfortunately, there is no vaccine or cure for the immunodeficiency virus, so the only way to deal with it is prevention.

Factors that increase the likelihood of infection:

• the presence of injuries, microcracks and bleeding ulcers on the skin and mucous membranes of a person,
• anal intercourse increases the risk of infection with the immunodeficiency virus for the receiving partner,
• detection of sexually transmitted diseases (STDs) or secondary infections in the body,
• non-traditional sexual orientation (homosexuality) and refusal to use barrier contraceptives.

We propose to consider the main ways of HIV infection, the possibility of infection in everyday life and when communicating with an HIV-positive person.

Methods of HIV transmission (official statistics for Russia):

sexual contact with an HIV-positive partner without using a condom

From infected mother to child (during childbirth, lactation)

“blood through blood”, including injecting drugs with an unsterilized needle.

The maximum likelihood of infection is present during anal intercourse, including both homosexual and heterosexual couples. What is the reason? The rectum is injured during the act and the natural secret is not released. Sperm containing the viral load enters through the resulting cracks, leading to infection of the partner.

Infection through the blood is allowed during medical procedures in the dental, surgical, gynecological and other areas. The use of reusable and poorly sterilized instruments in a tattoo parlor, piercing parlor, manicure centers can lead to infection of a healthy person.

The use of a shared syringe by drug addicts is one of the most common routes of infection. Injecting drugs with one needle in a circle leads to the fact that every 7 drug addict becomes a victim of HIV.

Infection occurs through unprotected sexual contact - oral, vaginal and anal. With oral caresses, the probability of infection is observed only in the receiving partner, since sperm gets on his mucous membranes.

Lesbian sex is the safest in terms of HIV transmission. On the this moment the likelihood of infection in this way exists only theoretically when sharing vibrators, vaginal balls, etc.

Possible routes of infection

All modes of transmission of HIV infection are inextricably linked to human biological fluids that have a high viral load. Infection through water in a pool or bath is excluded, as well as seats and handrails in public transport.

Biological fluids containing human immunodeficiency virus:

• blood,
• breast milk,
• vaginal secret,
• sperm.

Attention! Sweat, tears and urine of an HIV-positive person are absolutely safe - they do not contain the virus and it is impossible to infect them.

The virus is not transmitted through kissing. Theoretically, infection is allowed if both partners have bleeding wounds or ulcers in the oral cavity. In practice, cases of infection by this method are unknown.

From an HIV-positive mother, the virus can be transmitted to the baby. Infection occurs during pregnancy (through the placenta), directly during delivery (through the blood) and during feeding (through breast milk).

Studies conducted among women show that the highest risk of infection during pregnancy occurs in the 1st trimester. At this time, the placenta is weakened and not fully formed, which does not create obstacles to the penetration of the virus.

The possibility of infection in the home

Infection due to insect bites is impossible. The virus lives and spreads only in the human body, so insects and pets are 100% safe. The virus cannot be transmitted through the air.

Infection through food or water does not occur - the virus is not able to live and multiply in such conditions, especially since it does not tolerate high temperatures. When smoking a common cigarette, HIV will also not be able to enter the body of a healthy person.

The virus is not transmitted in everyday life, so you can be calm by sharing dishes, furniture and even clothes with an infected person.

How is HIV transmitted?

Transmission of HIV in the home is minimized. However, an infected person must follow a number of rules to protect others - use a separate razor, have your own manicure accessories, etc.

How is HIV transmitted?

• HIV is not transmitted through a toothbrush, towels and linen. In practice, not a single case of infection through household items has been recorded;
• With handshakes and hugs, infection is absolutely excluded. The presence of cuts or abrasions on the hands also does not lead to infection;
• The virus is not transmitted through plates, cutlery and washcloths. Even contact with the listed items of blood or sperm excludes infection.

Despite this, be vigilant - the human immunodeficiency virus is not fully understood, it quickly and easily mutates. Remember that the best way to prevent infection is proper prevention!

AIDS virus(abbreviation HIV) was discovered in 1983 in the study of the causes of AIDS - syndrome immunodeficiency. The first official publications about AIDS appeared back in 81, the new disease was associated with sarcoma Kaposi and unusually occurring pneumonia in homosexuals. The designation AIDS (AIDS) was fixed as a term in 82, when similar symptoms found in drug addicts, homosexuals and patients with hemophilia were combined into a single acquired immune deficiency syndrome.

Modern definition of HIV infection: viral disease, which is based on immunodeficiency, which causes the development of concomitant (opportunistic) infections and oncological processes.

AIDS is the last stage of HIV infection, either congenital or acquired.

How can you get HIV?

The source of infection is an HIV-infected person, and at any stage of the disease and for life. Large amounts of the virus contain blood (including menstrual) and lymph, semen, saliva, vaginal discharge, breast milk, liquor- cerebrospinal fluid, tears. endemic(with reference to the locality) the focus of HIV was detected in West Africa, monkeys were infected with the type 2 virus. The natural focus of the type 1 virus has not been found. HIV is transmitted only from person to person.

With unprotected sex the possibility of contracting HIV increases if there is inflammation, microtrauma of the skin or mucous membranes of the genitals, anus. At the only Infection is rare during sexual intercourse, but with each subsequent intercourse the probability increases. During any kind of communication receiving a sexual partner is more likely to get HIV (1 to 50 per 10,000 episodes of unprotected sex) than a transmitting partner (0.5 to 6.5). Therefore, the risk group includes prostitutes with their clients and barebackers- Gays who deliberately do not use condoms.

ways of HIV transmission

A baby can become infected with HIV in utero from an infected mother if there are defects in the placenta and the virus enters the blood of the fetus. In childbirth, infection occurs through the injured birth canal, later - through breast milk. Between 25 and 35% of children born to HIV-infected mothers may become carriers of the virus or develop AIDS.

For medical reasons: transfusions of whole blood and cell mass (platelets, erythrocytes), fresh or frozen plasma to patients. Among the medical staff, accidental injections with a contaminated needle account for 0.3-0.5% of all cases of HIV infection, so doctors are at risk.

With intravenous injections with a “public” needle or syringe, the risks of contracting HIV are more than 95%, therefore, at the moment, the majority of carriers of the virus and an inexhaustible source of infection are drug addicts constituting the main risk group for HIV.

HIV CANNOT be contracted through the household route, as well as through water in pools and baths, insect bites, air.

Spread of HIV

Features - Variable incubation period, unequal speed of occurrence and severity of symptoms, directly dependent on the state of human health. People weakened(asocials, drug addicts, residents of poor countries) or with concomitant chronic or acute STDs(, etc.), get sick more often and more severely, HIV symptoms appear faster, and life expectancy is 10-11 years from the moment of infection.

In a prosperous social environment, in practically healthy people, the incubation period can stretch for 10-20 years, the symptoms are erased and progress very slowly. With adequate treatment, such patients live a long time, and death occurs due to natural causes - due to age.

Statistics:

• At the beginning of 2014 in the world - 35 million people diagnosed with HIV;
• The increase in 2013 infected people was 2.1 million, deaths from AIDS - 1.5 million;
• The number of registered HIV carriers among the entire population of the Earth is approaching 1%;
• In the Russian Federation in 2013, there were 800 thousand infected and sick, that is, about 0.6% of the population is affected by HIV;
• 90% of all AIDS cases in Europe are in Ukraine (70%) and Russia (20%).

HIV prevalence by country (percentage of virus carriers among the adult population)

Data:

1. HIV is more often detected in men than in women;
2. In the last 5 years, cases of HIV detection in pregnant women have become more frequent;
3. Inhabitants of the countries of the north of Europe become infected and suffer from AIDS much less frequently than the southerners;
4. Africans are most susceptible to the immunodeficiency virus, approximately 2/3 of all sick and infected people are in Africa;
5. Those infected with the virus over the age of 35 develop AIDS 2 times faster than young people.

Characterization of the virus

HIV belongs to the group retroviruses HTLV groups and gender lentiviruses("slow" viruses). It has the form of spherical particles, 60 times smaller than an erythrocyte in size. It dies quickly in an acidic environment, under the influence of 70% ethanol, 3% hydrogen peroxide or 0.5% formaldehyde. sensitive to heat treatment– becomes inactive after 10 minutes. Already at +560°C, at 1000°C within a minute. Resistant to UV, radiation, freezing and drying.

Blood with HIV that has fallen on various objects remains infectious for up to 1-2 weeks.

HIV is constantly changing the genome, each subsequent virus differs from the previous one by one step of the RNA chain - a nucleotide. The HIV genome is 104 nucleotides long, and the number of errors during reproduction is such that after about 5 years nothing remains of the original combinations: HIV mutates completely. Consequently, previously used drugs become ineffective, and new ones have to be invented.

Although in nature there are not even two absolutely identical HIV genomes, some groups of viruses have typical signs. On their basis, all HIV is classified into groups, numbered from 1 to 4.

• HIV-1: the most common, it was this group that was first discovered (1983).
• HIV-2: Less likely to be infected than HIV-1. Those infected with type 2 have no immunity to type 1 of the virus.
• HIV-3 and 4: rare variations, do not particularly affect the spread of HIV. In the formation of a pandemic (a general epidemic covering countries on different continents), HIV-1 and 2 are of primary importance, and HIV-2 is more common in West African countries.

Development of AIDS

Normally, the body is protected from the inside: the main role is assigned to cellular immunity, in particular lymphocytes. T-lymphocytes produces thymus (thymus gland), according to their functional duties, they are divided into T-helpers, T-killers and T-suppressors. Helpers"recognize" tumor and virus-damaged cells, and activate T-killers, which are engaged in the destruction of atypical formations. T-suppressors regulate the direction of the immune response, not allowing you to start a reaction against your own healthy tissues.

The T-lymphocyte affected by the virus becomes atypical, the immune system reacts to it as a foreign formation and “sends” T-killers to help. They destroy the former T-helper, the capsids are released and take with them a part of the lipid membrane of the lymphocyte, becoming unrecognizable to the immune system. Further, the capsids disintegrate, and new virions are introduced into other T-helpers.

Gradually, the number of helper cells decreases, and inside the human body, the “friend or foe” recognition system ceases to function. In addition to this, HIV activates the mechanism of mass apoptosis(programmed death) of all types of T-lymphocytes. The result is an active inflammatory reaction to the resident (normal, permanent) and conditionally pathogenic microflora, and at the same time, an inadequate response of the immune system to really dangerous fungi and tumor cells. Immunodeficiency syndrome develops, characteristic symptoms of AIDS appear.

Clinical manifestations

Symptoms of HIV depend on the period and stage of the disease, as well as on the form in which the effect of the virus is predominantly manifested. HIV periods divided into incubation, when there are no antibodies to the virus in the blood, and clinical - antibodies are determined, the first signs of the disease appear. IN clinical distinguish stages HIV:

1. Primary, including two forms- asymptomatic and acute infection without secondary manifestations, with concomitant diseases;
2. Latent;
3. AIDS with secondary diseases;
4. Terminal stage.

I. Incubation period, the time from the moment of HIV infection to the onset of symptoms, is called the serological window. Serum reactions to the immunodeficiency virus are negative: specific antibodies have not yet been determined. The average duration of incubation is 12 weeks; the terms can be reduced to 14 days with concomitant STDs, tuberculosis, general asthenia, or increase up to 10-20 years. During the entire period, the patient dangerous as a source of HIV infection.

II. Stage of primary manifestations of HIV characterized seroconversion- the appearance of specific antibodies, serological reactions become positive. The asymptomatic form is diagnosed only by a blood test. Acute HIV infection occurs 12 weeks after infection (50-90% of cases).

First signs manifested by fever various types rash, lymphadenitis, sore throat (pharyngitis). Possible intestinal upset - diarrhea and pain in the abdomen, enlargement of the liver and spleen. A typical laboratory finding: mononuclear lymphocytes, which are found in the blood at this stage of HIV.

Secondary diseases appear in 10-15% of cases against the background of a transient decrease in the number of T-helper lymphocytes. The severity of diseases is moderate, they are treatable. The duration of the stage is on average 2-3 weeks, in most patients it becomes latent.

Forms acute HIV infections:

III. Latent stage of HIV, lasts up to 2-20 years or more. Immunodeficiency progresses slowly, HIV symptoms are expressed lymphadenitis- Enlargement of lymph nodes. They are elastic and painless, mobile, the skin retains its normal color. When diagnosing latent HIV infection, the number of enlarged nodes is taken into account - at least two, and their localization - at least 2 groups that are not connected by a common lymph flow (the exception is the inguinal nodes). Lymph moves in the same direction as venous blood, from the periphery to the heart. If 2 lymph nodes are enlarged in the head and neck, then this is not considered a sign of the latent stage of HIV. The combined increase in groups of nodes located in the upper and lower parts of the body, plus a progressive decrease in the number of T-lymphocytes (helpers) are in favor of HIV.

IV. Secondary diseases, with periods of progression and remission, depending on the severity of manifestations, is divided into stages (4 A-B). Persistent immunodeficiency develops against the background of massive death of T-helpers and depletion of lymphocyte populations. Manifestations - various visceral (internal) and skin manifestations, Kaposi's sarcoma.

v. terminal stage irreversible changes are inherent, treatment is ineffective. The number of T-helper cells (CD4 cells) falls below 0.05x109/l, patients die weeks or months after the onset of the stage. In drug addicts who have been using psychoactive substances for several years, the level of CD4 can remain almost within the normal range, but severe infectious complications (abscesses, pneumonia, etc.) develop very quickly and lead to death.

Kaposi's sarcoma

Sarcoma ( angiosarcoma) Kaposi - a tumor emanating from connective tissue and affecting the skin, mucous membranes and internal organs. It is provoked by the herpes virus HHV-8; more common in men infected with HIV. The epidemic type is one of the reliable signs of AIDS. Kaposi's sarcoma develops in stages: begins with the appearance spots 1-5 mm in size, irregularly shaped, bright bluish-red or brown in color, with a smooth surface. With AIDS, they are bright, localized on the tip of the nose, hands, mucous membranes and on the hard palate.

Then tubercles- papules, round or semicircular, up to 10 mm in diameter, elastic to the touch, can merge into plaques with a surface similar to an orange peel. Tubercles and plaques transform into nodular tumors 1-5 cm in size, which merge with each other and are covered ulcers. At this stage, sarcoma can be confused with syphilitic gums. Syphilis is often combined with the immunodeficiency virus, like hepatitis C, shortening the incubation period and provoking the rapid development of acute symptoms of AIDS - lymphadenitis, lesions internal organs.

Kaposi's sarcoma is clinically divided into forms- acute, subacute and chronic. Each is characterized by the rate of tumor development, complications and prognosis regarding the duration of the disease. At acute form, the process spreads rapidly, the cause of death is intoxication and extreme exhaustion ( cachexia), a lifetime of 2 months to a maximum of 2 years. At subacute the course of symptoms increases more slowly, the prognosis of life expectancy is 2-3 years; for the chronic form of sarcoma - 10 years, possibly more.

HIV in children

Incubation period lasts about a year if HIV has been passed from mother to fetus. When infected through the blood (parenteral) - up to 3.5 years; after transfusion of infected blood, the incubation is short, 2-4 weeks, and the symptoms are severe. HIV infection in children occurs with a predominant lesion of the nervous system(up to 80% of cases); prolonged, up to 2-3 years, bacterial inflammation; with damage to the kidneys, liver and heart.

Develops very often pneumocystis or lymphocytic pneumonia, parotid inflammation salivary glands (mumps aka a pig). HIV is congenital dysmorphic syndrome- impaired development of organs and systems, in particular microcephaly - reduced size of the head and brain. A decrease in the level of gamma globulin fraction proteins in the blood is observed in half of those infected with HIV. Very rare Kaposi's sarcoma and hepatitis C, B.

Dysmorphic syndrome or HIV embryopathy determined in children infected with early terms of pregnancy. Manifestations: microcephaly, nose without membranes, the distance between the eyes is increased. forehead flat, upper lip split and protrude forward. Strabismus, eyeballs protruding outward ( exophthalmos), the cornea is bluish in color. Growth retardation is observed, development does not meet the standards. Forecast for life basically negative, mortality is high during 4-9 months of life.

Manifestations of neuro-AIDS: chronic meningitis, encephalopathy(damage to brain tissue) with the development of dementia, damage to peripheral nerves with symmetrical disorders of sensitivity and trophism in the arms and legs. Children significantly lag behind their peers in development, are prone to convulsions and muscle hypertonicity, paralysis of the limbs may develop. Diagnosis of HIV neuro-symptoms is based on clinical signs, blood test data, and computed tomography findings. Layered images reveal atrophy(reduction) of the cerebral cortex, expansion of the cerebral ventricles. With HIV infection, calcium deposits are characteristic in the basal ganglions (ganglia) of the brain. The progression of encephalopathy leads to death within 12-15 months.

Pneumocystis pneumonia: in children of the 1st year of life observed in 75% of cases, older than a year– in 38%. Often, pneumonia develops by the age of six months, manifestations - heat, shortness of breath, dry and persistent cough. Increased sweating, especially at night; a weakness that only gets worse with time. Pneumonia is diagnosed after auscultation (according to the stages of development, first weakened breathing is heard, then small dry rales, in the stage of resolution - crepitus, the sound is heard at the end of inspiration); x-ray (enhanced pattern, infiltration of lung fields) and microscopy of the biomaterial (pneumocysts are detected).

Lymphocytic interstitial pneumonia: a unique disease associated specifically with childhood AIDS, there are no concomitant infections. The partitions between the alveoli and the tissue around the bronchi are compacted, where lymphocytes and other immune cells are determined. Pneumonia begins imperceptibly, develops slowly, among the initial symptoms are typical prolonged dry cough and dry mucous membranes. Then shortness of breath appears and respiratory failure sharply increases. The x-ray image shows the compaction of the lung fields, enlarged lymph nodes in the mediastinum - the space between the lungs.

Laboratory tests for HIV

The most common method for diagnosing HIV is (ELISA or ELISA test), using it to detect the immunodeficiency virus. Antibodies to HIV are formed in the period from three weeks to 3 months after infection, they are found in 95% of cases. Six months later, HIV antibodies are found in 9% of patients, later - only in 0.5-1%.

As biomaterial using blood serum taken from a vein. You can get a false-positive ELISA result if HIV infection is accompanied by autoimmune (lupus, rheumatoid arthritis), oncological or chronic infectious diseases (tuberculosis, syphilis). A false-negative answer happens during the so-called. seronegative window, when antibodies in the blood have not yet appeared. In this case, to control the blood for HIV, you need to donate again, after a pause of 1 to 3 months.

If the ELISA is evaluated positively, the HIV test is duplicated using a polymerase chain reaction, determining the presence of virus RNA in the blood. The technique is highly sensitive and specific, does not depend on the presence of antibodies to the immunodeficiency virus. Immune blotting is also used, which makes it possible to find antibodies to HIV protein particles with an exact molecular weight (41, 120 and 160 thousand). Their identification gives the right to make a final diagnosis without confirmation by additional methods.

HIV test necessarily is done only during pregnancy, in other cases, a similar examination is voluntary. Doctors do not have the right to disclose the diagnosis, all information about patients and those infected with HIV is confidential. Patients have the same rights as healthy people. Criminal punishment is provided for the deliberate spread of HIV (Article 122 of the Criminal Code of the Russian Federation).

Principles of treatment

HIV treatment is prescribed after a clinical examination and laboratory confirmation of the diagnosis. The patient is constantly under observation, repeated blood tests are carried out during antiviral therapy and after treatment of manifestations of HIV.

The cure for HIV has not yet been invented, the vaccine does not exist. It is impossible to remove the virus from the body, and this is given time- fact. However, one should not lose hope: active antiretroviral therapy (HAART) can reliably slow down and even practically stop the development of HIV infection and its complications.

The life expectancy of patients receiving modern treatment is 38 years (for men) and 41 years (for women). An exception is the combination of HIV with hepatitis C, when less than half of patients reach the 5-year survival threshold.

HAART- a technique based on the use of several pharmaceuticals at once, which affect various mechanisms for the development of HIV symptoms. Therapy combines several goals at once.

1. Virological: block the reproduction of the virus in order to reduce the viral load (the number of copies of HIV in 1 ml3 of blood plasma) and fix it at a low level.
2. Immunological: stabilize the immune system to raise the level of T-lymphocytes and restore the body's defense against infections.
3. Clinical: to increase the period of full-fledged life of those infected with HIV, to prevent the development of AIDS and its manifestations.

Virological treatment

The human immunodeficiency virus is affected by drugs that do not allow it to attach to the T-lymphocyte and penetrate inside - this inhibitors(suppressors) penetration. A drug Celzentree.

The second group of drugs are viral protease inhibitors, which is responsible for the formation of full-fledged viruses. When it is inactivated, new viruses are formed, but they cannot infect new lymphocytes. Preparations Kaletra, Viracept, Reyataz and etc.

The third group is reverse transcriptase inhibitors, an enzyme that helps reproduce viral RNA in the nucleus of a lymphocyte. Preparations Zinovudine, Didanosine.Also use combined anti-HIV medicines that need to be taken only 1 time per day - Trizivir, Combivir, Lamivudine, Abacavir.

With simultaneous exposure to drugs, the virus cannot get inside the lymphocytes and "multiply". When appointed tritherapy the ability of HIV to mutate and develop drug insensitivity is taken into account: even if the virus becomes immune to one drug, the remaining two will work. Dosage calculated for each patient, taking into account the state of health and possible side effects. A separate scheme is used for pregnant women, and after the use of HAART, the frequency of HIV transmission from mother to child decreases from 20-35% to 1-1.2%.

It is important to take your medicines at the same time every day for the rest of your life.: if the schedule is violated or the course is interrupted, the treatment completely loses its meaning. Viruses quickly change the genome, becoming immune ( resistant) to therapy, and form numerous resistant strains. With such a development of the disease, it is very problematic to choose antiviral treatment, and sometimes it is simply impossible. Cases of resistance development are more often observed among HIV-infected drug addicts and alcoholics, for whom exact adherence to the therapy schedule is unrealistic.

The drugs are effective, but their prices are high. For example, the cost of a year's treatment with Fuzeon (a group of penetration inhibitors) reaches $25,000, and the cost per month when using Trizivir ranges from $1,000.

note that farm. funds almost always two names - according to the active substance and the commercial name of the drug, which was given to it by the manufacturer. The prescription must be written by active substance, indicating its amount in a tablet (capsule, ampoule, etc.). Substances with the same effect are often presented under different commercial names and can vary significantly in price. The job of the pharmacist is to offer the patient a choice of several options and to orient regarding the cost. Generics- analogues of original developments are always much cheaper than "branded" medicines.

Immunological and clinical treatment

The use of an immunostimulant drug Inosine pranobex, due to which the level of lymphocytes increases, the activity of certain fractions of leukocytes is stimulated. The antiviral action indicated in the annotation does not apply to HIV. Indications relevant for HIV-infected: viral hepatitis C, B; immunodeficiency states; cytomegalovirus; herpes simplex virus type 1; mumps. Dosages: adults and children 3-4 times / day. at the rate of 50-100 mg / kg. Well 5-15 days, can be repeated many times, but only under the control of an infectious disease specialist. Contraindications: increased uric acid in the blood ( hyperuricemia), kidney stones, systemic diseases, pregnancy and breastfeeding.

The drug of the interferon group Viferon has antiviral and immunomodulatory activity. In the case of HIV (or AIDS), it is used for Kaposi's sarcoma, fungal infections and hairy cell leukemia. The action of the drug is complex: interferon enhances the activity of T-helpers and increases the production of lymphocytes, blocks the reproduction of viruses in several ways. Additional components - vit.C, E - protect cells, and the effectiveness of interferon increases by 12-15 times (synergistic effect). Viferon can be taken for long courses, its activity does not decrease over time. In addition to HIV, indications are any viral infections, mycoses (including internal organs), hepatitis C, B or D. When administered rectally the drug is used twice a day for a course of 5-10 days, the ointment for HIV is not used. Pregnant women are prescribed from 14 weeks.

Treatment of pulmonary manifestations

The main early manifestation of HIV infection is inflammation of the lungs.to their caused by pneumocystis (Pneumocystis carina), single-celled organisms similar to fungi and protozoa at the same time. In patients with AIDS, untreated pneumocystis pneumonia in 40% ends in death, and correct and timely prescribed therapeutic regimens help reduce the mortality rate to 25%. With the development of relapse, the prognosis worsens, repeated pneumonia is less sensitive to treatment, and mortality reaches 60%.

Treatment: main drugs - Biseptol (Bactrim) or pentamidine. They act in different directions, but eventually lead to the death of pneumocysts. Biseptol is taken orally, pentamidine is injected into the muscles or into a vein. The course is from 14 to 30 days, with AIDS it is preferable to use pentamidine. Together, drugs are not prescribed, tk. their toxic effect is enhanced without a noticeable increase in the therapeutic effect.

Low toxicity drug DFMO (alpha-difluoromethylornithine) acts on pneumocysts and at the same time blocks the reproduction of retroviruses, which include HIV, and also has a beneficial effect on lymphocytes. The course is 2 months, the daily dosage is calculated based on 6 g per 1 sq. meter of body surface and break it into 3 doses.

With adequate treatment of pneumonia, improvement is noticeable already on the 4th-5th day from the start of therapy, after a month, pneumocysts are not detected at all in a quarter of patients.

Immunity to HIV

Statistics of confirmed HIV resistance: among Europeans, 1% are completely immune to the immunodeficiency virus, up to 15% are partially. In both cases, the mechanisms are not clear. Scientists associate this phenomenon with epidemics of bubonic plague in Europe in the 14th and 18th centuries (Scandinavia), when, perhaps, in some people, early genetic mutations were fixed in heredity. There is also a group of so-called. "Non-progressors", which make up about 10% of those infected with HIV, in whom AIDS symptoms do not appear for a long time. In general, immunity to HIV does not exist.

A person is immune to the HIV-1 serotype if his body produces the TRIM5a protein, which is able to “recognize” the viral capsid and block HIV reproduction. The CD317 protein can keep viruses on the surface of cells, preventing them from infecting healthy lymphocytes, and CAML makes it difficult for new viruses to be released into the blood. The beneficial activity of both proteins is disrupted by hepatitis C and simple viruses, therefore, with these concomitant diseases, the risks of HIV infection are higher.

Prevention

The fight against the AIDS epidemic and its consequences is declared by WHO:

HIV prevention among drug addicts is an explanation of the danger of infection through injections, the provision of disposable syringes and the exchange of used ones for sterile ones. The last measures seem strange and are associated with the spread of drug addiction, but in this case it is easier to at least partially stop the ways of HIV infection than to wean a huge number of drug addicts.

HIV kit is useful in everyday life for everyone, at the workplace - to doctors and rescuers, as well as people in contact with HIV-infected people. Medicines are available and elementary, but their use really reduces the risk of infection with the immunodeficiency virus:

• Alcohol solution of iodine 5%;
• Ethanol 70%;
• Bandaging products (package of sterile gauze swabs, bandage, plaster) and scissors;
• Sterile distilled water - 500 ml;
• Crystals of potassium permanganate (potassium permanganate) or hydrogen peroxide 3%;
• Eye pipettes (sterile, in a package or in a case);
• Specific preparations are provided only for physicians working at blood sampling stations and in the emergency departments of hospitals.

The blood that got on the skin from an HIV-infected person, you should immediately wash it off with soap and water, then treat it with a swab dipped in alcohol. When pricked or cut through gloves they need to be removed, squeezed out blood, on the wound - hydrogen peroxide; then blot the foam, and cauterize the edges of the wound with iodine and, if necessary, apply a bandage. hit in the eyes: washing first with water, then with a solution of potassium permanganate (light pink). Oral cavity: rinse with pale pink potassium permanganate, then with 70% ethanol. After unprotected intercourse: if possible - a shower, then treatment (douching, washing) of the genital organs with a rich pink solution of potassium permanganate.

Prevention of AIDS will be more effective if each person becomes conscious of their health. It is much easier to use a condom during sexual intercourse and avoid unwanted acquaintances (prostitutes, drug addicts) than to undergo long and expensive treatment later. To understand the picture of the danger of HIV, just compare the statistics: for a year from fever ebola about 8,000 people died, and more than 1.5 million from HIV! conclusions obvious and disappointing modern world The immunodeficiency virus has become a real threat to all mankind.

Video: educational film about HIV

Video: AIDS in the program “Live healthy!”

The well-known way of transmission of the human immunodeficiency virus is sexual contact with an infected partner without a condom. It occupies a leading position in the study of the causes and diagnosis of the disease, and accounts for 70% of clinical cases according to WHO. The modern generation is increasingly concerned about whether it is possible to become infected with HIV through saliva after a kiss.

The topic is raised for a reason and is significant in view of the prevailing standards of understanding. For a long time, the opinion was imposed on society that it is better to bypass sick people. This has led to the fact that one in two is inclined to believe in information about the likelihood of transmission of infection through saliva, handshakes, sharing towels and household items. In those days, there was not even a dilemma about whether HIV could be transmitted through saliva. Almost everyone was sure that this is how infection occurs.

Thanks to multiple studies and modern medical equipment, it was possible to establish that the virus is transmitted only through direct contact of the biological fluids of an infected and healthy person. Most often it is blood and semen. In order for HIV to be transmitted through saliva, it is necessary for an uninfected person to have a bleeding wound in the mouth, for example, a damaged gum or cheek. Such a statement has a reasonable medical explanation: contact of the virus and blood is necessary for infection.

In other situations, if there are no wounds in the mouth, then even if the patient is diagnosed with the last stage, infection will not occur. Answering the question whether it is possible to become infected with HIV through saliva, doctors state that it is necessary to exchange more than two liters of fluid for infection. This is due to the low concentration of the virus in saliva. Therefore, with a typical kiss, the transmission of the disease is impossible. Some people tend to confuse the concepts of HIV and AIDS. In the first case, a virus progresses in the patient's body, which gradually degenerates into a disease - acquired immunodeficiency.

Based on this, it follows that it is impossible to get infected with AIDS, infection is possible only with a virus, that is, HIV. The disease itself cannot be transmitted to a healthy person through sweat or urine. Only a virus has such abilities, which, penetrating into the body, suppresses the immune system. The frightening word AIDS and the more terrifying disease cannot be transmitted through saliva, so only infection comes to a healthy person. With a kiss, it can be transmitted, but on condition that the oral cavity of the uninfected has even the slightest bleeding damage.

Based on this information, it is necessary to dispel some myths regarding the ways of transmission of the disease:

1. You can get infected through saliva. Yes, this option is possible, but if the mucosa is not damaged, then you can be calm about your health.
2. You can get infected by airborne droplets. No, this transmission option is not possible, due to the inability of the virus to survive outside the human body.
3. You can become infected through contact with a drug addict. No, such a route of transmission does not take place, because infection requires contact of an infected biological fluid with the blood of a healthy person. Although, statistics show that the majority of patients are representatives of disadvantaged segments of the population (alcoholics, drug addicts, people who have promiscuous sex).

Society must be tolerant of people with HIV and AIDS. To do this, it is important to know the likely risks and routes of infection. Only in this way the question will not pop up in the minds of whether it is possible to become infected with HIV through saliva, and whether carriers of the virus should be avoided. If a person has sexual contact with an HIV-positive partner without using a condom, then the probability of infection is almost 100%.

Any biological fluid, getting on the mucous membrane of a healthy person, transmits the virus. This applies to oral, anal and vaginal sex. Unfortunately, cases of infection in medical institutions are not uncommon, for example, during transfusion or blood sampling. If before a healthy person they took blood from an HIV-infected person, and then did not sterilize the instrument, or did not use a new one, the probability of infection is the same as during sexual contact.

It is also possible that the blood of an infected person could be used in the transfusion. This includes infection during organ transplantation. Children in the womb of a sick mother are not protected. During childbirth, the child passes through the path and comes into direct contact with the mucous membrane, as a result of which infection occurs.

Knowing exactly whether it is possible to become infected with HIV through saliva, do not forget about the possible risks of getting the virus:

• healthcare workers who frequently come into contact with body fluids different people, can acquire immunodeficiency if the substance gets on the injured surface of the skin;
• people who have complex concomitant diseases are prone to infection: syphilis or hepatitis;
• upon contact with a sick person, while having microtrauma of the mucous membrane: ulcers, erosion, scratches.

In addition, doctors say that the probability of infection in women is three times higher than in men.

Is HIV transmitted through saliva - in what cases can and cannot be infected with HIV

Undoubtedly, it is important to understand in what cases it is possible to become infected with HIV through saliva. When analyzing this issue, one should not forget that the transmission of the virus is possible only through direct contact of an infected biological fluid with the blood or mucous membrane of a healthy person. Only when the partner has an open wound is there a chance of infection.

So there are several options:

1. The virus is transmitted to a man from a woman during cunnilingus if there is damage in his oral cavity.
2. The virus is transmitted to a woman from a man during a blowjob, if the sperm got into the mouth and the mucous membrane is injured.

To summarize, in which cases HIV can be infected through saliva, then this is oral sex, provided that the partner has bleeding wounds in his mouth.

To finally dispel all myths and doubts about communicating with or avoiding people with AIDS, one should know the situations in which the immunodeficiency virus is not transmitted.

First of all, this is everyday communication: hugs and any other contact with the skin (superficial) is not dangerous. There is no need to be afraid to live together with a person who has been diagnosed with HIV (you can use the same dishes, wear the patient’s clothes and even sleep on the same bed linen), because the virus does not survive outside the body. The same applies to fears of catching an infection in a bath, sauna or pool. Pathogenic cells die in water almost instantly.

Some are sure that the bite of a mosquito or other insect can transfer the virus from the patient's blood to a healthy body. But this is also not true, because bacteria can only live in the human body.

Thinking about the cases in which one can become infected with HIV through saliva, one involuntarily recalls the headlines that said that a person was infected with a syringe in a public place. To date, not a single case of such infection has been recorded, which, again, is due to the inability of the virus to survive outside the body.

Let be modern medicine still has not invented a cure for HIV and AIDS. But this should not make sick people outcasts in society. It is very important to be able to properly communicate with the infected, and not to neglect security measures.

HIV is not transmitted, it is taken. Do you want to know how?

In a concentration sufficient for infection, the virus is found in blood, semen, vaginal secretions, and breast milk.

Ways of contracting HIV infection are different, but for infection to occur, you must: . getting HIV into the blood of a healthy person; . the amount of HIV must be sufficient for infection.

Therefore, the immunodeficiency virus can enter the human body in only three ways:

1. Through unprotected sexual contact with an HIV-infected or AIDS patient. Most HIV transmission occurs through sexual contact. The more people a person has sex with, the more likely they are to end up with an HIV-positive partner. At the same time, only one sexual contact with a carrier of the virus may be enough to become infected with HIV. During sexual intercourse, HIV can be transmitted from man to woman, from woman to man, from man to man, and from woman to woman.

2. When the blood of an HIV-infected or AIDS patient enters the body of a healthy person. This can occur when transfusing blood or blood products from HIV-infected donors, or when using non-sterile, untreated medical equipment containing particles of the blood of infected people. But now the chances of getting infected in this way are very small. Blood products that are used to treat people are tested for the presence of the virus, disposable medical instruments are used. This route of HIV transmission is common among intravenous drug users, as often a group of drug addicts share a syringe and needle that are not handled in any way.

3. From an HIV-infected or AIDS-infected mother to a child. This can happen during pregnancy (when HIV passes through the placenta to the fetus), during childbirth (when during the passage of the child through the birth canal of the mother, HIV along with the blood can enter the body of the newborn through easily vulnerable skin) and during breastfeeding of the child (when HIV from mother's milk through microtrauma in the mouth enters the blood).

HIV infection is not transmitted in everyday life!

It is impossible to get infected by sharing utensils and toilets with HIV-infected people, swimming with them in the same pool, greeting and hugging. HIV is not carried by insects. No one is immune from HIV infection. Any person, male or female, at any age, regardless of place of residence and religious beliefs, can become infected. Only knowledge (about the ways of transmission and prevention of HIV infection) and the skills of a particular person can protect him from infection.

Consider several vital situations with different levels of risk of infection:

The risk is very big

The risk is very high when sharing syringes and medical needles. Our advice: Be sure to avoid it.

The risk is very high in anal intercourse (sexual intercourse through the anus) without protective measures, for both men and women. There is also a risk when there is no ejaculation. . Our advice: Think you need it? If so, be sure to use condoms and plenty of oil-free moisturizer.

During sexual intercourse with a carrier of the virus without protective measures, there is a great risk of infection. Our advice: use condoms.

There is a risk

If semen containing HIV enters the mouth, infection can occur. A woman's secretions can also contain HIV. Our advice: avoid getting semen or vaginal secretions into your mouth. Sexual intercourse through the mouth only with a condom. .

no risk

There is no risk during kissing. Theoretically, one cannot completely exclude the possibility of infection through a deep kiss with the help of the tongue, but so far no cases of infection by this route have been recorded worldwide. . During skin touching or contact, such as giving a hand, stroking, caressing, there is no risk. . Even if someone lives in the same apartment as a carrier of the virus, infection cannot occur. . Infection cannot occur even if the patient sneezes or coughs. . Sharing utensils does not involve any risk. There is also no need to separately wash the clothes or underwear of a sick person. . Sharing a swimming pool, bathhouse, toilet does not contain the risk of HIV infection. . During medical procedures, there is no risk if the usual hygiene rules are observed (i.e. use of single-use medical supplies and thoroughly sterilized devices). When transfusing blood and plasma, despite very effective precautionary measures, there is a minimal risk of infection. Therefore, before the planned operation, it is recommended to donate your own blood. Proper manufacture of inactivated blood products virtually guarantees their safety. . Subject to existing hygiene rules, a hairdresser, manicure, tattoo, ear piercing do not carry the risk of HIV infection. Our advice: get tattoos or ear piercings only from specialists. . There is no risk for insect bites.