Acquired immunodeficiency syndrome has been one of the key problems of modern society for more than forty years. Therefore, HIV diagnosis is now attracting a lot of attention and resources. After all, the sooner a virus that destroys the body's immune system is detected, the higher the chances of avoiding a lethal outcome will be.
The core of the problem
Under the abbreviation HIV lies the definition of the human immunodeficiency virus - one of the most dangerous among the existing ones. Under its influence, there is a deep inhibition of all the protective properties of the body. This, in turn, leads to various malignancies and secondary infections.
An HIV infection can proceed in different ways. Sometimes the 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's body.
HIV can be contained in semen, blood, menstrual flow and secretion of the vaginal glands. As the causes of infection, you need to remember such problems as periodontal disease, abrasions, injuries, etc.
HIV can be transmitted artificially, by blood contact andthrough a biocontact mechanism.
If there was a single contact with a carrier of the virus, 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 sexual partners
Pay attention to the parenteral route of infection. It can occur during blood transfusions of contaminated blood, injections using needles that are contaminated with the blood of HIV-infected people, and during non-sterile medical manipulations (tattoos, piercings, dental procedures using instruments that have not been properly processed).
At the same time, you should know that there is no need to be afraid of contact-household transmission of the virus. But the fact remains: a person has a high susceptibility to HIV infection. And if a subject over the age of 35 becomes infected, then the development of AIDS occurs significantly faster than in those who have not yet overcome the thirty-year milestone.
Main symptoms
Of course, the best way to identify a problem or lack thereof is to diagnose HIV infection. But what reasons can a person leading a he althy lifestyle have to go and check himself for the fact of 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.
The stage of incubation of the virus without a blood test is unlikely to be detected, since the body at this time is stilldoes not react in any way to hostile elements.
The second stage (primary manifestations) without the help of a doctor can also go unnoticed. But sometimes there is an active replication of the virus, and the body begins to react to this - fever, various polymorphic rashes, lienal syndrome and pharyngitis are noted. At the second stage, it is possible to attach such secondary diseases as herpes, fungal infections, pneumonia, etc.
For the third, latent stage, a gradual increase in immunodeficiency is characteristic. Due to the fact that the cells of the defense system die, the dynamics of their production increases, and this makes it possible to compensate for tangible losses. At this stage, several lymph nodes belonging to different systems may become inflamed. But strong painful sensations are 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 genesis appear, as well as malignant formations. All this happens against the background of severe immunodeficiency.
Methods for diagnosing HIV infection
Speaking of the deep inhibition of the body's defense mechanisms due to exposure to the virus, it is worth noting that the patient's future in this case directly depends on timely and accurate diagnosis.
To do this, in modern medicine, various test systems are used, which are based on immunochemiluminescent, as well asenzyme immunoassay. These techniques make it possible to determine the presence of antibodies belonging to different classes. This result helps to significantly increase the information content of methods of analytical, clinical specificity and sensitivity when working with infectious diseases.
It is also interesting 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 the methods of laboratory research, they are primarily focused on the detection of 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, the RNA of the virus and the DNA of the provirus are determined, in the second case, antibodies to HIV are analyzed and the P24 antigen is detected.
In clinics that use, so to speak, classical methods of diagnosis, the standard protocol for serological testing is predominantly used.
Early HIV detection
This type of detection 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 you to avoid the spread of infection, and secondly, to affect the disease ininitial 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 has yielded positive results: the process of early clinical diagnosis has become much easier.
Headache, night sweats and unmotivated fatigue can be identified as common symptoms indicating a possible damage to the immune system. 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 the palatine tonsils increase, and pain also appears during swallowing. All this is complemented by rapid weight loss. However, 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 skin condition. We are talking about spots, roseola, pustules, furunculosis, etc. Early HIV diagnosis also includes working with symptoms such as generalized or limited enlargement of 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 virus of the human immune system.
Speaking of 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. It is about the followingmanifestations:
- unmotivated generalized peripheral lymphadenopathy;
- arthralgia of unknown etiology, which has an undulating 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.
Late-stage HIV diagnosis includes screening for diseases such as Kaposi's sarcoma, which presents with multiple neoplasms often in the upper body in young people, followed by dynamic development and metastasis.
Polymerase chain reaction
Considering the 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 this method of detecting a virus:
- Early diagnosis of HIV infection;
- clearing up when there are doubtful results in the result of an immunoblot study;
- identifying a specific stage of the disease;
- monitoring the effectiveness of treatment to suppress the virus.
If we talk about primary infection, it should be noted that this technique allowsdetermine the HIV RNA in the patient's blood after 14 days from the moment of infection. This is a very good result. At the same time, the outcome of the study itself will have a qualitative expression: either positive (the virus is present) or negative.
PCR quantification
This type of polymerase chain reaction is used to determine the likely rate of progression of AIDS and predict how long a patient will live.
Quantification of HIV RNA cells in the blood makes it possible to understand when the disease goes into the clinical stage.
It is worth paying attention to the fact that the methods of laboratory diagnostics of HIV give a more accurate result if the biomaterial required for analysis is determined correctly, and its sampling is done correctly.
In order to carry out qualitative monitoring of the infected, it is necessary (if possible) to use an integrated approach to the study of the patient's immune status. We are talking about the quantitative and functional determination of all parts of the defense system: cellular, humoral immunity and non-specific resistance as such.
Laboratory diagnostics
Increasingly, in modern laboratory conditions, a multi-stage method for 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 suspectimmunodeficiency.
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 ratio mentioned above (less than 1.0).
To assess the immunological status, doctors can test for the presence of "gross" or general defects in the system of humoral and cellular immunity. We are talking about hypogammaglobulinemia or hypergammaglobulinemia in the terminal stage, as well as a decrease in the production of cytokines, an increase in the concentration of circulating immune complexes, a weakening of the response of lymphocytes to mitogens and antigens.
It is worth paying attention to the fact that the laboratory diagnosis of HIV has two key stages:
- Screening laboratory. If a positive result was obtained in ELISA (enzymatic immunoassay), then it is repeated two more times in the same system and without changing the 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 analysis to the reference laboratory.
- The second stage, which includes methods of laboratory diagnosis of HIV infection, is the determination of the state of the immune system. It is carried out in the reference laboratory mentioned above. Here, positive serum is again examined in ELISA, but using a different test system, which differs from the previous composition of antigens, antibodies, or the format of the tests themselves. When determininga negative result is re-examined in the third test system. If the impact of the virus was not detected in the end, then the absence of HIV infection is recorded. But with a positive result, the serum is examined in a linear or immune blot.
Ultimately, this algorithm leads to positive, neutral or negative results.
Every citizen should know that HIV diagnostics is available to him. AIDS can be identified in private, municipal or public he alth 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 extending his life. This thesis confirms the fact that the average life expectancy of men who started timely HIV treatment is 38 years. Women who start fighting HIV live an average of 41 years.
Once the diagnosis has been made, HIV treatment is reduced to the use of several techniques. Active antiretroviral therapy, also known as HAART, can be identified as one of the most common. If this type of treatment is applied in time and correctly, then it is possible to significantly slow down the development of AIDS or stop it altogether.
The essence of HAARTcomes down to the fact that several pharmaceutical preparations are used simultaneously, the purpose of which is to influence various mechanisms of the development of the immunodeficiency virus.
After various methods of HIV diagnosis have determined the fact of infection, drugs can be used that have the following effects:
- Immunological. The immune system stabilizes, the level of T-lymphocytes rises, and protection against various infections is restored.
- Clinical. The development of AIDS and any of its manifestations is prevented, the life of patients is extended while maintaining all body functions.
- Virological. There is a blockage of the reproduction of the virus, as a result of which the viral load decreases and subsequently is fixed at a low level.
It is difficult to overestimate the importance of such measures of influence on the disease as the diagnosis, treatment, and prevention of HIV infection. Therefore, the best thing that can be done after a positive result of the study for infection is to immediately begin to fight the disease. Virological treatment can be identified as another method that will help to do this.
In this case, we are talking about the use of drugs that do not allow the virus to attach to the T-lymphocyte and get inside the body. These drugs are called penetration inhibitors. A specific example is Celzentry.
Inhibitors can be used to suppress HIVviral protease. The purpose of this group of drugs is to prevent infection of new lymphocytes. These are drugs such as Viracept, Reyataz, Kaletra and others.
The third group of topical drugs are reverse transcriptase inhibitors. They are needed to block the enzyme that allows the RNA of the virus to multiply 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 business of qualified doctors, so they should make up the algorithm for using drugs.
Immunological and clinical effects can also be used if needed.
Prevention
The World He alth Organization offers the following methods to fight HIV infection:
- Prevention of sexually transmitted infection. These are safe sex, condom distribution, STD treatment and educational programs.
- For pregnant women who have been diagnosed with HIV, diagnosis, prophylaxis with appropriate chemicals, and 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 assistance to the sick and their families.
In order for HIV diagnostics not to reveal the presence of the virus, you need to follow simple safety rules:
- if the blood of an infected person gets on the skin, it needswash immediately with soap and water, then treat the contact area with alcohol;
- if damage was received by an object with elements of the virus, then the wound must be compressed, squeezed out the blood, treat this place with hydrogen peroxide, and burn the edges with iodine;
- never use compromised syringes;
- use a condom during sexual intercourse, but it is better to initially check the partner for infection.
Results
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 life expectancy. The main thing is not to ignore the obvious symptoms and not be afraid to go to the doctor.
