Acquired immunodeficiency syndrome has been one of the key problems of modern society for over forty years. Therefore, HIV diagnosis is now attracting a lot of attention and resources. After all, the sooner a virus is detected that destroys the body’s immune system, the higher are the chances of avoiding a fatal outcome.
The essence of the problem
Under the acronym HIV hides the definition of human immunodeficiency virus - one of the most dangerous among the existing ones. Under its influence, there is a deep oppression of all the protective properties of the body. This, in turn, leads to the appearance of various malignant tumors and secondary infections.
HIV infection can occur in different ways. Sometimes a disease destroys a person in 3-4 years, in some cases it can last more than 20 years. It is worth knowing that this virus is unstable and quickly dies if it is outside the host organism.
HIV can be found in semen, blood, menstrual flow and the secretion of the vaginal glands. As the causes of infection, you need to recall such problems as periodontal disease, abrasions, injuries, etc.
HIV can be transmitted artificially by blood contact and through a biocontact mechanism.
If there was a single contact with the virus carrier, then the risk of infection will be low, but with constant interaction, it increases significantly. Diagnosis of HIV infection is something that should not be neglected, especially when changing a sexual partner
It is worth paying attention to the parenteral route of infection. It can occur during blood transfusions of infected blood, injections using needles that are contaminated with the blood of HIV-infected people, as well as during non-sterile medical procedures (tattoos, piercings, dental procedures using tools that are not properly processed).
At the same time, it is worth knowing that there is no need to be afraid of contact-house transmission of the virus. But the fact remains: a person has a high susceptibility to HIV infection. And if a person is infected over the age of 35, then the development of AIDS occurs significantly faster than those who have not yet overcome the thirty-year milestone.
Main symptoms
Of course, the best way to identify a problem or its absence is to diagnose HIV infection. But what reasons can a person leading a healthy lifestyle have to go and check for infection? Naturally, such an initiative should be justified by something. Therefore, it is important to know what symptoms may indicate destructive processes that depress the immune system.
It is unlikely to detect the stage of incubation of the virus without a blood test, since the body at this time still does not react to hostile elements.
The second stage (primary manifestations) without the help of a doctor can also occur unnoticed. But sometimes an active replication of the virus occurs, and the body begins to respond to this - there is a fever, various polymorphic rashes, lienal syndrome and pharyngitis. In the second stage, the accession of such secondary diseases as herpes, fungal infections, pneumonia, etc. is possible.
For the third, latent stage, a gradual increase in immunodeficiency is characteristic. Due to the fact that the cells of the protective system die, the dynamics of their production increases, and this allows you to compensate for tangible losses. At this stage, several lymph nodes belonging to different systems can become inflamed. But strong pain is not observed. On average, the latent period lasts from 6 to 7 years, but can be delayed by 20.
During the stage of secondary diseases, which is the fourth, concomitant infections of fungal, bacterial protozoal, viral origin appear, as well as malignant tumors. All this happens against the background of severe immunodeficiency.
Methods for diagnosing HIV infection
Speaking about the deep suppression of the body's defense mechanisms due to the influence of the virus, it is worth noting that the future of the patient in this case directly depends on timely and accurate diagnosis.
For this, in modern medicine, various test systems are used, which are based on an immunochemiluminescent, as well as an enzyme-linked immunosorbent assay. These methods allow you to determine the presence of antibodies belonging to different classes. This result helps to significantly increase the information content of analytical, clinical specificity and sensitivity methods when working with infectious diseases.
Also interesting is the fact that it was the polymerase chain reaction method that made it possible to bring HIV diagnostics to a fundamentally new level. A variety of biological materials are suitable as a material for research: blood plasma, biopsy, scraping, serum, cerebrospinal or pleural fluid.
If we talk about laboratory research methods, they are primarily focused on identifying several key diseases. We are talking about HIV infection, tuberculosis, all sexually transmitted infections, and viral hepatitis.
Molecular genetic and serological tests are also used to identify the immunodeficiency virus. In the first case, virus RNA and provirus DNA are determined, in the second case, an analysis of antibodies to HIV is carried out and the P24 antigen is detected.
In clinics that use, so to speak, classical diagnostic methods, they mainly use the standard protocol for serological testing.
Early diagnosis of HIV
This type of determination of the fact of infection is necessary in order to identify the threat of damage to the immune system as early as possible. This, firstly, allows to avoid the spread of infection, and secondly, to influence the disease in the initial stage.
If we consider the example of Russia, then the clinical classification of HIV infection was introduced in the army and navy of the Russian Federation. This yielded positive results: the process of early clinical diagnosis became much easier.
Common symptoms that indicate a possible damage to the immune system include headache, night sweats, and unmotivated fatigue. It is also possible the development of fever, accompanied by signs of tonsillitis. This means that the temperature rises to 38 degrees and above, and at the same time palatine tonsils increase, as well as pain during swallowing. All this is complemented by rapid weight loss. Moreover, these symptoms are often complex.
In some cases, HIV infection in the early stages can manifest itself in the form of various changes in the condition of the skin. We are talking about spots, roseola, pustules, furuncles, etc. Early HIV diagnosis also includes dealing with symptoms such as generalized or limited enlargement of the peripheral lymph nodes.
If there is a simultaneous growth of several lymph nodes, lasting for three months or more, and in different groups, with the exception of the inguinal region, then there is every reason to suspect a human immune system virus.
Speaking about the diagnosis in a later period, you need to pay attention to the manifestation of secondary immunodeficiency, which often occurs under the guise of various clinical symptoms. These are the following manifestations:
- unmotivated generalized peripheral lymphadenopathy;
- arthralgia of unknown etiology, which has a wave-like course;
- ARVI (ARI), inflammatory lesions of the lungs and respiratory tract, which make themselves felt quite often;
- fever of unknown origin and prolonged subfebrile condition;
- general intoxication, which manifests itself through unmotivated weakness, fatigue, lethargy, etc.
HIV diagnosis at a late stage includes examination for a disease such as Kaposi’s sarcoma, manifested by the appearance of multiple neoplasms often in the upper body of young people, followed by dynamic development and metastasis.
Polymerase chain reaction
Considering various methods of diagnosing HIV infection, this should be given special attention. It should immediately be noted that this blood test can be aimed at quantitative and qualitative characteristics.
The following tasks can be defined as the goal of such a method for detecting the virus:
- early diagnosis of HIV infection;
- clarification in case of doubtful results as a result of an immunoblotting study;
- identification of a specific stage of the disease;
- monitoring the effectiveness of treatment aimed at suppressing the virus.
If we talk about primary infection, it should be noted that a similar technique allows you to determine HIV RNA in the patient’s blood after 14 days from the moment of infection. This is a very good result. Moreover, the result of the study itself will have a qualitative expression: either positive (the virus is present) or negative.
Quantification of PCR
This type of polymerase chain reaction is used to determine the possible rate of AIDS development and to make a prognosis of the patient's lifespan.
Quantification of HIV RNA cells in the blood makes it possible to understand when the disease will enter the clinical stage.
It is worth paying attention to the fact that laboratory diagnostic methods for HIV give a more accurate result if the biomaterial needed for analysis is determined correctly and its collection is performed correctly.
In order to carry out high-quality monitoring of infected people, it is necessary (if this is possible) to use an integrated approach to the study of the patient’s immune status. This is a quantitative and functional determination of all parts of the protective system: cellular, humoral immunity and non-specific resistance as such.
Laboratory diagnostics
Increasingly, in modern laboratory conditions, a multi-stage method of assessing the state of the immune system is used. This technique often involves the determination of a subpopulation of immunoglobulins, lymphocytes in the blood. This means that the ratio of CD4 / CD8 cells is taken into account . If the result shows less than 1.0, then there is reason to suspect immunodeficiency.
Laboratory diagnosis of HIV infection should include this test without fail, since this virus is characterized by selective damage to CD4 lymphocytes, which leads to a noticeable violation of the above ratio (less than 1.0).
To assess the immunological status, doctors can test for the presence of "gross" or general defects in the humoral and cellular immunity system. We are talking about hypogammaglobulinemia or hypergammaglobulinemia in the terminal stage, as well as reducing the production of cytokines, increasing the concentration of circulating immune complexes, weakening the response from lymphocytes to mitogens and antigens.
It is worth paying attention to the fact that laboratory diagnosis of HIV has two key stages:
- Screening laboratory. If a positive result was obtained in ELISA (enzyme-linked immunosorbent assay), then it is repeated two more times in the same system and without changing serum. In the event that two of the three examinations lead to the detection of the influence of the virus, the serum is sent for further research to the reference laboratory.
- The second stage, which includes methods for laboratory diagnosis of HIV infection, - a definition of the state of the immune system. It is carried out in the reference laboratory mentioned above. Here, positive serum is again tested in ELISA, but using another test system that differs from the previous composition of antigens, antibodies or the format of the tests themselves. When determining a negative result, a second study is carried out in the third test system. If the effect of the virus was never found, then the absence of HIV infection is recorded. But with a positive result, the serum is examined in a linear or immune blot.
Ultimately, such an algorithm results in positive, neutral, or negative results.
Every citizen should know that he is available for HIV diagnosis. AIDS can be identified in private, municipal, or public health care facilities.
Treatment
Naturally, the identification of the virus would be of little use in the absence of various methods of influencing the infection. And although at the moment there is still no vaccine that could completely neutralize the virus, competent diagnosis, HIV treatment and subsequent prevention can significantly improve the patient's condition, thereby prolonging his life. This thesis is confirmed by the fact that the average life expectancy of men who have started timely treatment for HIV is 38 years. Women who started the fight against the immunodeficiency virus live an average of 41 years.
After the diagnosis has been carried out, HIV treatment is reduced to the use of several methods. Active antiretroviral therapy, also called HAART, can be identified as one of the most common. If in time and correctly apply this type of treatment, then you can significantly slow down the development of AIDS or even stop it.
The essence of HAART is that several pharmaceuticals are used simultaneously, the purpose of which is to influence various mechanisms of the development of the immunodeficiency virus.
After different methods of HIV diagnosis have determined the fact of infection, drugs that have the following effects can be used:
- Immunological The immune system is stabilized, the level of T-lymphocytes rises, and protection against various infections is also restored.
- Clinical. The development of AIDS and any of its manifestations is prevented, the life span of patients is prolonged with the preservation of all body functions.
- Virological. Virus reproduction is blocked, as a result of which the viral load is reduced and subsequently fixed at a low level.
It is difficult to overestimate the importance of such measures of influence on the disease as diagnosis, treatment, prevention of HIV infection. Therefore, the best thing that can be done after a positive outcome of a study for infection is to immediately begin to fight the disease. Another method that can help to do this is virologic treatment.
In this case, we are talking about the use of drugs that do not allow the virus to attach to the T-lymphocyte and enter the body. Such drugs are called penetration inhibitors. As a concrete example, “Celzentry” can be cited.
Viral protease inhibitors may be used to suppress HIV. The goal of this group of drugs is to prevent infection of new lymphocytes. These are such drugs as Virasept, Reataz, Kaletra, etc.
The third group of topical drugs is reverse transcriptase inhibitors. They are needed to block the enzyme that allows the virus to multiply RNA in the nucleus of the lymphocyte. Such methods can significantly affect a problem such as HIV infection. Diagnosis, treatment and prevention of AIDS is the work of qualified doctors, so the algorithm for using drugs should be made up of them.
If necessary, immunological and clinical effects can also be used.
Prevention
The World Health Organization offers the following HIV methods:
- Sexually transmitted infection prevention. These include protected sex, condom distribution, STD treatment, and educational programs.
- For pregnant women who have been diagnosed with HIV infection, diagnosis, prevention using appropriate chemicals, as well as professional counseling and treatment.
- Organization of prevention through blood products. In this case, we are talking about anti-virus processing and verification of donors.
- Social and medical care for patients and their families.
In order for the HIV diagnosis to not detect the presence of the virus, you need to follow simple safety rules:
- if the blood of an infected person comes into contact with the skin, immediately wash it off with soap and water, and then treat the contact area with alcohol;
- if damage was caused to an object with elements of the virus, then the wound should be squeezed, squeezed blood, treat this place with hydrogen peroxide, and burn the edges with iodine;
- never use syringes whose sterility has been impaired;
- use a condom during sexual intercourse, but it is better to initially check the partner for infection.
Summary
Thanks to the fact that HIV diagnosis does not stand still, thousands of people get the opportunity to start treatment on time and significantly increase their life expectancy. The main thing is not to ignore the obvious symptoms and not be afraid to go to the doctor.