All you need to know about HIV

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What types of pain can HIV cause?
By Jamie Eske
https://www.medicalnewstoday.com/articles/323860.php

Experiencing pain is common among people living with HIV. Types of HIV-related pain can include headaches, joint pain, and abdominal cramping.
Pain can have a profound, negative impact on people's overall quality of life. One study revealed that people with HIV were more likely to experience pain than those without HIV. The researchers also found that HIV-related pain increased symptoms of depression and functional impairment.

In this article, we discuss the causes, types, and treatments for HIV-related pain, including some home remedies that may help.

Causes
There are different causes of HIV-related pain and the type, location, and severity of the pain can vary between different people. It is important to work with a doctor to determine the possible cause and devise a suitable treatment plan.

Some people living with HIV may experience short-term pain from secondary infections, injuries, or surgery. Short-term pain usually goes away once the body recovers.

Many people who are living with HIV experience chronic or long-term pain. In one study that followed 238 people living with HIV, 53 percent of participants reported having chronic pain within the last 6 months.

Chronic pain in people living with HIV can be the result of:

the direct effects of HIV on the body
nerve damage, also known as peripheral neuropathy
cancer
opportunistic infections
HIV treatments

Types of HIV-related pain

HIV-related pain manifests in a variety of ways. People living with HIV can experience pain as a result of the HIV itself or as a side effect of HIV treatment and other medications.

People with untreated HIV are at risk of developing secondary infections that can cause inflammation and painful symptoms.

Types of pain that people with HIV often have include:

Headache. Pain can range from mild to severe and may present as intense pressure, tightness, or throbbing sensation. Low CD4 cell counts, infections, or other HIV-related illnesses can cause headaches.
Joint, muscle, and bone pain. HIV can lead to arthritis and osteoporosis that can cause pain in the joints, muscles, and bones. This type of pain can also occur with aging.
Abdominal pain. If left untreated, HIV can weaken the immune system, leaving the body vulnerable to opportunistic infections. These infections sometimes occur in the gastrointestinal tract, causing painful symptoms, such as inflammation. Some HIV treatments can also cause painful abdominal cramps.


Peripheral neuropathy
HIV can cause damage to the peripheral nerves, which can lead to a neurologic disorder known as peripheral neuropathy. In people living HIV, doctors sometimes also refer to this condition as HIV neuropathy.

Peripheral neuropathy is the most common neurologic complication in adults with HIV. According to one study, older age and smoking increase the risk of developing peripheral neuropathy.

Some symptoms of peripheral neuropathy include:

numbness or pain in the hands and feet
muscle weakness in the hands and feet
numbness or tingling in the extremities
increased sensitivity to pain

Treatment
There are many ways to manage HIV-related pain. Doctors can prescribe medications to reduce painful symptoms.

People living with HIV can also purchase over-the-counter (OTC) pain medicines, but they should speak with their doctor before starting any new medications. Non-drug therapies and home remedies may also provide relief for some people.

We discuss the different types of treatment options below:

Medications
Some HIV medications can increase a person's pain sensitivity.

One of the first approaches doctors take when managing painful symptoms is either stopping or reducing the dosage of HIV treatments. If this approach does not work, the doctor may recommend prescription or over-the-counter pain relief medications.

Some of these options include:

Opioids: These are the strongest type of pain medication available and are only available on prescription. Opioids can cause side effects, such as drowsiness, nausea, and constipation. It is essential to follow the doctor's instructions when taking opioids to prevent complications and overdose.

Non-opioid medications: A wide variety of non-opioid pain relievers are available both OTC and on prescriptions. Common examples include acetaminophen, aspirin, and ibuprofen. Topical pain relievers, such as gels, creams, or patches, are also available.

Non-drug therapies
Some people may also find pain relief from:

acupuncture
massage
cognitive behavioral therapy, or CBT
joining a chronic pain support group

Home remedies
Some ways to manage HIV-related pain at home include:

practicing relaxation techniques, such as meditation and mindful breathing exercises
applying hot and cold compresses
taking warm baths when necessary
getting regular physical activity
identifying and reducing the causes of stress
limiting alcohol consumption
quitting smoking

Takeaway
Pain is a common symptom of HIV and is different for everyone. Pain can result from the effects of the virus itself as well as complications of HIV and side effects of HIV treatment.

Pain is treatable, but it requires an individualized approach. A doctor can help a person determine the cause of the pain and will recommend a treatment plan. This may involve adjusting current HIV treatments or prescribing pain-relieving medications.

Home remedies and alternative therapies, such as acupuncture and massage, may also help manage pain.

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Undetectable viral load: Everything you need to know By Rachel Nall, MSN, CRNA
https://www.medicalnewstoday.com/articles/323874.php

Advances in medicine have made it possible for a person living with HIV to have an undetectable viral load with traditional blood testing methods. If HIV is undetectable over an extended period, it is also untransmittable.
An undetectable viral load is when a person has so little of the virus in their blood that a test cannot identify it.

While an undetectable viral load does not mean that a person's HIV is cured, it does offer tremendous promise for a person's overall health and for reducing viral transmission.

In this article, learn more about what an undetectable viral load means, as well as how healthcare providers test for it.

What is an undetectable viral load?

A viral load test is a blood test that measures the number of viral copies of HIV in a person's blood.

Typically, the higher a person's viral load, the greater their chance of transmitting HIV if they have condomless sex or share needles.

However, taking antiretroviral therapy can reduce the amount of viral copies in a person's blood to levels that are so low that they do not register on a viral load blood test.

Healthcare providers call this an undetectable viral load. While the measurement for an undetectable viral load can vary by laboratory, it is usually fewer than 40 copies per milliliter (mL).

A healthcare provider may also use other terms related to an undetectable viral load, such as:

Durably undetectable: When a person's viral load has been at undetectable levels for 6 months or more, it is durably undetectable.

Viral load suppression: This term means that a person's viral load is fewer than 200 copies/mL. While the virus is not undetectable, people with a viral load this low will not transmit the virus.

An undetectable viral load is an important milestone for a person living with HIV because it signifies that the amount of the virus in the body is not likely to cause any health problems.

Undetectable equals untransmittable
Several long-term landmark studies into the effects of antiretroviral therapy on HIV have led researchers to conclude that undetectable levels of HIV mean that the virus is untransmittable.

In a 2016 study, researchers enrolled 1,166 couples who had vaginal or anal sex without a condom. In each couple, one partner had HIV, was virally suppressed, and was taking antiretroviral therapy.

The researchers studied them for an average of 1.3 years per couple.

In the follow-up period, there were no instances of HIV transmission within the couples. This means the member of the couple who had HIV did not transmit the virus to the person without HIV while they were virally suppressed.

A study presented at the 2017 International AIDS Society conference came to similar conclusions.

The study's authors recruited 358 same-sex male couples in Australia, Thailand, and Brazil.

In each couple, one partner was virally suppressed, taking antiretroviral therapy, and had HIV. At the study's conclusion, the authors found no evidence of HIV transmission between partners after sex without a condom.

Results from these and other studies have led many large organizations, including the Centers for Disease Control and Prevention (CDC) and the United Nations, to concur that undetectable viral levels mean that HIV is untransmittable.

They may refer to the conclusions as "undetectable = untransmittable," or "U=U."

Tests
Several types of test exist for HIV. There are tests to determine to what extent HIV is affecting the body, such as CD4 count, which assesses how HIV has affected a person's immune system.

Other tests, such as a saliva test, can test for the presence of HIV genetic material.

Healthcare providers use a viral load test to determine whether a person is virally suppressed or has undetectable HIV levels. This test measures the amount of HIV RNA in the blood.

Examples of viral load tests include:

qualitative transcription-mediated amplification
quantitative branched DNA
reverse transcriptase-polymerase chain reaction
A healthcare provider can discuss which test they will use and what the results mean based on the laboratory's standards.

A person taking antiretroviral medications with a stable viral load will usually undergo these tests between two and four times per year.

Treatment

According to UNAIDS, an estimated 47 percent of those who have HIV are virally suppressed.

The fact that antiretroviral therapy improves people's health and makes the virus untransmittable has the power to help millions of people around the world.

A variety of antiretroviral medications exist. A healthcare provider should discuss the options and possible combinations with a person.

They will take into account the stage of HIV, a person's overall health, potential treatment costs, and many other factors when recommending a treatment course.

Typically, a person who has recently received an HIV diagnosis will take at least three HIV medications from at least two drug classes to fight off the virus.

These medications keep HIV from replicating. Having less HIV in the body gives a person's immune system a chance to fight off the virus.

A person will not immediately become virally suppressed when they start taking antiretroviral medications. It may take 6 months or more before the viral load reduces, so it is vital to start treatment as soon as possible.

Continuing to take antiretroviral therapy is crucial to ensure that HIV remains untransmittable. Even with an undetectable viral load, the virus is still present in the body.

If a person stops taking antiretroviral therapy, it may begin to multiply again.

Outlook
If a person living with HIV has an undetectable viral load for 6 months or more, the virus is untransmittable. An undetectable viral load also drastically reduces the chances of HIV causing any additional health problems.

Consistently taking antiretroviral medications can bring a person's HIV levels down to an undetectable level.

If a person has recently received an HIV diagnosis, they should work with their healthcare provider to begin a treatment plan as soon as possible.

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HIV and AIDS: A timeline and history
By Rachel Nall, MSN, CRNA
https://www.medicalnewstoday.com/articles/323877.php

The history of AIDS and HIV was initially shrouded in misunderstanding and fear. Now, thanks to decades of research and medical advances, we know much more about the virus and how to treat it.
This article will cover the primary topics in the history of HIV, from its beginnings to the latest research today.

Origins

Doctors are not exactly sure when HIV originated, but they believe it developed from a type of chimpanzee virus in West Africa called the simian immunodeficiency virus (SIV). People who hunted the chimpanzees for meat came in contact with the infected blood and contracted the virus. Researchers believe the virus mutated at some point into the human form of HIV.

Researchers collected the earliest detected HIV in 1959 from a man in the Democratic Republic of the Congo. Later, genetic analysis determined the virus might have developed between 1910 and 1930.

Pre-1980
In the mid- and late 1970s, doctors noticed that people in New York and California were developing rarer forms of opportunistic infections, such as aggressive pneumonia and rare cancers.

Opportunistic infections tend to occur in people who have a weakened immune system. In healthy people, the immune response is enough to keep these infections at bay.

Doctors at this time did not know that a virus was the underlying cause of these infections.

Studies suggest that HIV was present in North America, South America, Europe, Africa, and Australia before 1980.

1980 to 1990
Misunderstandings about the virus and its transmission plagued the early years of HIV in the United States.

In 1981, doctors and researchers began to notice a set of symptoms in previously healthy young men who had sex with men. At first, healthcare providers called the disease gay-related immune deficiency (GRID).

However, doctors also began to observe that intravenous drug users also experienced the same symptoms.

In 1982, doctors realized that the symptoms and related conditions were due to a compromised immune system.

They began to call it acquired immunodeficiency syndrome (AIDS). Scientists thought those who had conditions such as Kaposi's sarcoma (a rare cancer) or a form of pneumonia called Pneumocystitis jirovecii had acquired them through AIDS.

In 1983, the scientific community identified the virus that causes AIDS. They first named the virus human T-cell lymphotropic virus type III, or lymphadenopathy-associated virus (HTLV-III/LAV).

Later, researchers changed the name to human immunodeficiency virus. They also identified the leading methods of HIV transmission and learned that a person could not contract HIV from casual contact, food, water, or air.

In 1985, the first International Conference on AIDS took place in the U.S. During the same year, the U.S. Food and Drug Administration (FDA) licensed the first commercial blood test to test for viral antibodies. This test was a simple way of diagnosing the condition.

Blood banks also began screening their blood supplies for the virus to prevent transmission through blood transfusions.

In March 1987, the FDA approved zidovudine (AZT), the first antiretroviral medication that could treat HIV.

In 1988, the first World AIDS Day took place on December 1. By 1989, an estimated 100,000 people in the United States reportedly had AIDS, which develops from untreated HIV.

1990 to 2000

According to the Canadian Foundation for AIDS Research, an estimated 8 to 10 million people across the world were living with HIV by 1990.

In 1991, the red ribbon became the symbol of AIDS awareness. The Visual AIDS Artists Caucus created the Red Ribbon Project to show compassion and support for people living with AIDS and their loved ones.

By 1995, doctors introduced the first triple combination therapy as an antiretroviral treatment. This drug combination prevented the virus from replicating, which allowed a person's immune system to fight off existing HIV in the body.

In June 1995, the FDA approved a type of medication called a protease inhibitor as part of the HIV treatment regimen. In areas where the treatment was available, the incidences of AIDS-related deaths and hospitalizations decreased by 60 to 80 percent, according to the charity Avert.

However, in 1996, around 23 million people around the world were living with HIV and AIDS, according to the Canadian Foundation for AIDS Research.

By 1999, AIDS-related illnesses were the fourth-leading cause of death worldwide and the number one killer in Africa.

At this time, researchers estimated that 14 million people had died from AIDS-related illnesses since the HIV epidemic began.

2000 to 2010
In July 2000, organizations belonging to UNAIDS, which is The Joint United Nations Program on HIV and AIDS, negotiated with pharmaceutical companies to make antiretroviral medication more affordable to developing countries.

In 2002, the FDA approved the first rapid HIV test. With this test, a person can receive a result within 20 minutes with 99.6 percent accuracy.

The 2000s also saw an increase in funding and support for AIDS research and treatment.

In 2008, the World Health Organization (WHO) announced that the U.S. domestic HIV infection rate had stabilized, meaning the number of people living with HIV on a yearly basis had not increased. As of this article's publication, the HIV infection rates have remained stable in the U.S.

In 2009, the FDA approved the 100th antiretroviral drug.

Current research and developments

In 2012, the FDA approved the pre-exposure prophylaxis (PrEP) preventive drug treatment plan for those who are at high risk for HIV infection.

Also in 2012, about 54 percent of people eligible for HIV treatment were receiving it. Fast-forward to today, and an estimated 19.5 million people are receiving antiretroviral medications.

In February 2015, the CDC announced that diagnosis and proper treatment could prevent an estimated 90 percent of new HIV infections in the U.S.

In 2017, several organizations, including the CDC, endorsed the Undetectable = Untransmittable (U=U) initiative, which bases its campaign on robust evidence that people who receive antiretroviral medications and have an undetectable viral load cannot pass on HIV.

This education and medical response have provided hope for those with HIV and their partners to live long, healthy lives without the risk of transmission.

Researchers are also currently working toward a preventive HIV vaccine. While the FDA has yet to approve any vaccines, clinical trials are ongoing.

Also, researchers are working on therapeutic vaccines to increase a person's immune response when they have HIV.

According to the National Institutes of Health, an estimated 30,000 people around the world have participated in studies for preventive HIV vaccines.

Summary
Advances in HIV medications have made the condition manageable with regular treatment. The hopes for a preventive HIV vaccine are bringing researchers closer to eradicating HIV worldwide.

However, the virus remains a threat. An estimated 1.1 million people in the U.S. have HIV, but one in seven people do not know it.

It is vital to get an HIV test as part of regular sexual health testing, or if a person thinks they may have come into contact with the virus.

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What causes HIV-related fatigue?
By Jenna Fletcher
https://www.medicalnewstoday.com/articles/323890.php

Many people who are living with HIV experience fatigue. It may be directly related to HIV or indirectly related through medications, psychological effects, or life stress.
In this article, we look at the causes of HIV-related fatigue, how to overcome fatigue, and the effects HIV has on a person's mental health. An unusual level of fatigue, along with other symptoms, can be an early symptom of HIV.

Fast facts
Fatigue can be an early symptom of HIV.
HIV-related fatigue is often related to psychological factors, such as life stress, anxiety, and depression.
Some HIV medications can cause fatigue. However, people usually experience an increase in energy after beginning antiretroviral therapy.
Looking after mental and physical health can help improve fatigue.

Why does HIV cause fatigue?
Sometimes, HIV causes fatigue because of its impact on a person's immune system. Other times, additional health conditions, treatment factors, or psychological factors are responsible.

Some sources claim that fatigue is the most problematic and frequent symptom in people with HIV. Although a 2010 research review states that 33 to 88 percent of people with HIV experience fatigue, estimates vary as fatigue is difficult to define and measure.

According to 2018 research, the following factors have links with HIV-associated fatigue:

Physiological
chronic inflammation
poor nutrition
medication side effects

Psychological
anxiety
depression
changes in the brain
social isolation

Behavioral
sleep hygeine
a lack of activity
substance use
smoking

Fatigue can have a significant effect on a person's wellbeing and quality of life. Because fatigue can make a person feel tired but unable to sleep, it can impact their motivation and decision-making abilities.

Fatigue can also weaken a person's immune system, which can make HIV progress more rapidly. It is essential to find out the cause of the fatigue and to treat both the cause of the fatigue and HIV.

Potential causes of fatigue for people with HIV include:

Active HIV
After a person contracts HIV, their immune system responds by trying to fight off the virus. The effort involved in trying to defend the body against HIV causes fatigue in people, especially in the early stages before treatment has begun.

HIV can also cause fatigue because it impairs immune system function. Most people report an increase in energy after beginning to take antiretroviral medication.

Fatigue is among the early symptoms of HIV that can appear within the first 2–4 weeks after a person has contracted the virus, along with other flu-like symptoms, such as:

fever
chills
muscle aches
swollen lymph nodes
mouth ulcers

Anemia
Anemia is one of the most common blood-related complications of HIV. Among other symptoms, anemia can cause fatigue, dizziness, and concentration problems.

Research suggests that HIV-associated anemia has similarities to the type of anemia that occurs as people age. Scientists think this is due to the expression of molecules called pro-inflammatory cytokines that cause anemia and inflammation in older people.

Stress
Stress can have a major impact on a person's quality of life. The American Institute of Stress (AIS) lists 50 common symptoms of stress, including constant tiredness, weakness, and fatigue.

The AIS also note that people with HIV may be more susceptible to stress. It is essential that people with HIV treat and combat their stress, which might help alleviate some of the symptoms of fatigue.

HIV has links to various psychological issues, such as depression and anxiety, which can also contribute to fatigue. Sometimes, the uncertainties surrounding an HIV diagnosis can cause anxiety. Other people experience depression, which may result in a low quality of life and poor adherence to HIV treatment.

Underlying conditions
A person with HIV may also experience fatigue that is caused by unrelated conditions. These conditions may have existed before a person received an HIV diagnosis or developed afterward.

Some underlying conditions that can contribute to fatigue include:

depression
insomnia
underactive thyroid (hypothyroidism)
not producing enough testosterone (hypogonadism)
anemia

Opportunistic infections
HIV compromises a person's immune system by attacking and weakening the cells that typically protect the body from other forms of infection. This means that people living with HIV are more likely to contract viral and bacterial infections that they might not get otherwise. These are known as secondary or opportunistic infections.

Opportunistic infections are more likely to occur when a person is not taking antiretroviral medications and has a very low CD4 count. CD4 cells play a vital role in keeping the immune system healthy. Taking HIV medication will prevent HIV from damaging the immune system, and allow the CD4 count to increase, which signals a boost in immune system function.

Possible HIV-related opportunistic infections include:

oral or vaginal thrush also called candidiasis
herpes simplex 1 (HSV-1), which causes cold sores around the mouth
salmonella, a bacterial infection that causes nausea and diarrhea
toxoplasmosis, an infection that can affect the brain

Other reasons
Additional causes of fatigue for people with HIV may include:

a side effect of HIV medications
hormonal imbalances
use of allergy medications, such as antihistamines
an unhealthful diet
overwork or too much physical activity in a day
alcohol or recreational drug use
fatigue with no known cause, which is called idiopathic fatigue

How to overcome fatigue

The most effective treatment for fatigue will depend on its cause.

The best treatment for HIV-related fatigue is usually taking antiretroviral medications. People typically experience a boost in energy levels when they begin to take antiretroviral drugs, which is a sign that their immune system is recovering.

People who do not know what is causing their fatigue should consider keeping a journal to note down the times when they feel the most fatigued. This may help the person identify the exact cause of the fatigue and give healthcare providers a better idea of how to combat it.

Some possible treatments for fatigue include:

treating the underlying condition, such as depression, stress, or insomnia
switching medications or ask about alternatives if medications seem to be the issue
eating a more healthful diet
reducing physical demands throughout the day if possible
avoiding alcohol and recreational drugs

Mental health effects of HIV
According to the U.S. Department of Health and Human Services, people with HIV experience "higher rates of mental health conditions than the general population." It is essential that people with HIV look after their mental health and a range of treatments is available.

Anyone experiencing the following symptoms may benefit from seeking help for their mental health:

high stress or anxiety levels
a feeling of emptiness or sadness
finding less enjoyment in things they used to enjoy
thoughts of suicide
The following treatments can help improve a person's mental health:

speaking to a psychologist, psychiatrist, social worker, or another therapist
developing a strong social support network
joining support groups of people with similar issues
trying meditation
maintaining or increasing healthful habits, such as eating well and moderate exercise
taking medications

Summary
Fatigue is a symptom commonly associated with HIV. The condition can cause fatigue because of its impact on the immune system, which can lead to anemia, stress, and other psychological conditions.

People can improve their energy levels and combat fatigue by taking antiretroviral therapy for HIV and treating the underlying causes of fatigue, which may include mental health support.

A person should work with their healthcare providers to determine the root cause of their fatigue so that they can better manage the underlying cause of their fatigue.

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Differences between HIV-1 and HIV-2
By Lana Burgess
https://www.medicalnewstoday.com/articles/323893.php

HIV is a virus that weakens the immune system. There are two main types of this virus: HIV-1 and HIV-2.
Both types of HIV are long-term but manageable health conditions. With effective treatment, people with HIV can live long, healthy lives.

Understanding the different types of HIV helps increase awareness of the condition. In this article, we explore the differences and similarities between HIV-1 and HIV-2.

Geography and genetics

HIV-1 is the most common type of HIV and occurs all over the world. According to the HIV awareness charity Avert, around 95 percent of people living with HIV have HIV-1.

HIV-2 is mainly present in West Africa, but it is slowly starting to appear in other regions, including the United States, Europe, and India.

Though HIV-1 and HIV-2 are both retroviruses that can have similar effects on the human body, they are genetically distinct. A 2008 study revealed that the genomes of the two viruses only had a 55 percent sequence identity.

This means that not all tests and treatments work for both types of HIV.

Transmission
HIV-2 is harder for people to transmit than HIV-1. According to one 2013 review, the most common mode of HIV-2 transmission is heterosexual sex. However, heterosexual transmission rates of HIV-2 are five to 10 times lower than those of HIV-1.

Between mothers and babies, transmission rates of HIV-2 are 20–30 times lower than those of HIV-1.

A person can contract either type of HIV through direct contact with bodily fluids that contain the virus, including:

blood
sexual fluids
breast milk
Risk factors for HIV-1 and HIV-2 transmission include sex without a condom and sharing needles or syringes.

However, there is little risk of transmitting HIV through sex if a person takes HIV medications correctly and is able to maintain an undetectable viral load. This can also significantly reduce the risk of mother-to-child transmission.

Diagnosis
The genetic differences between HIV-1 and HIV-2 mean that if a person takes a test for HIV-1, it may not detect HIV-2. For people at increased risk of HIV-2, a healthcare provider may also test for HIV-2 antibodies or antigens.

Treatment

To treat HIV, a healthcare provider usually prescribes a combination of several medications called antiretroviral therapy. Taking these medications daily as they instruct can slow progression of HIV, prevent transmission, and help protect the immune system.

Because of the genetic differences, a healthcare provider may prescribe different drug combinations for treating HIV-1 and HIV-2.

HIV-2 is less responsive to certain drugs that can treat HIV-1. These include:

non-nucleoside reverse transcriptase inhibitors
enfuvirtide
Though a healthcare provider may prescribe different drug combinations, they still monitor a person's progress in the same way. This includes checking their viral load and CD4 cell counts, as well as looking for other clinical improvements.

Viral load
People with HIV-2 tend to have a lower viral load, or how much of the virus is in their blood, than people with HIV-1. Together with CD4 cell count, which is a way of determining how healthy the immune system is, viral load tells a healthcare provider how well a person's treatment is working.

Outlook
If left untreated, HIV-1 and HIV-2 both weaken a person's immune system, leaving them more vulnerable to other infections and disease. However, HIV-2 tends to develop more slowly than HIV-1.

According to one 2011 review, people with HIV-2 may have a longer period without symptoms than people with HIV-1, and the rate of progression to stage 3 HIV is slower. HIV-2 also has a lower mortality rate than HIV-1.

Though there is currently no cure for either type of HIV, the development of effective treatments now means that people with HIV can live long, healthy lives.

Summary
HIV-1 and HIV-2 are the two main types of the HIV virus. Most people living with HIV have HIV-1.

Both types of HIV weaken the immune system, but HIV-2 tends develop more slowly and is less easy for people to transmit than HIV-1.

Genetic differences between the two viruses means that there are some differences in how healthcare providers diagnose and treat HIV-1 and HIV-2.

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What is a 4th generation HIV test?
By Lana Burgess
https://www.medicalnewstoday.com/articles/323901.php

Fourth-generation HIV tests can detect both HIV antibodies and p24 antigens, whereas older versions only check for antibodies. This means the newer tests can provide a quicker diagnosis than the previous ones.
Many clinics and healthcare providers offer free HIV testing. The process is straightforward, and it usually involves taking a small sample of blood, such as from a finger prick.

In this article, we look in detail at fourth-generation HIV tests, including how they differ from the earlier tests and what to expect from the procedure. We also discuss reliability and when to get tested.

Overview

Researchers estimate that, as of 2015, nearly 1.2 million people in the United States had HIV, but around 14 percent were unaware that they had the condition. Being tested regularly is the best way for a person to determine their HIV status.

Fourth-generation tests detect the virus as soon as possible, which allows for earlier treatment. Studies show that early treatment improves long-term outcomes for people with HIV.

Receiving effective treatment can slow the virus' progression, protect the immune system, and prevent transmission.

How does a 4th generation HIV test work?
Fourth-generation tests detect two factors in the blood: HIV antibodies and p24 antigens.

When a person contracts HIV, the immune system starts to produce HIV antibodies. This is the body's method of fighting the virus.

The immune system produces these antibodies in response to p24 antigens.

P24 antigens are a part of the virus, and research indicates that they tend to appear within 2 weeks of HIV entering the body.

A fourth-generation test can reliably detect HIV as soon as 1 month after a person contracts it.

What to expect

When a person has an HIV test, the healthcare provider will take a small sample of their blood. For a fourth-generation HIV test, the provider will usually send the sample off to a lab for testing.

A person can usually expect their result within a few weeks, though the result may come back in a few days.

If the result is positive, the healthcare provider may arrange for a follow-up test to confirm the findings. A positive result means that the person is living with HIV.

After receiving a positive result, it is essential to inform any current or former sexual partners so that they can also get tested.

A doctor will advise on the best course of treatment.

Difference from earlier tests
Fourth-generation HIV tests are different from third-generation tests, which can only detect HIV antibodies.

In contrast, fourth-generation tests detect both HIV antibodies and p24 antigens. This allows them to identify the virus sooner than the earlier tests.

Fourth-generation tests can detect the virus before the immune system starts producing HIV antibodies. This is because p24 antigens appear before HIV antibodies.

Other available HIV tests include rapid tests and self-testing kits. Both may provide results more quickly than fourth-generation tests, but they may be less accurate.

A person who has taken either a rapid test or one from a kit may need to see a healthcare provider for a follow-up test to confirm the findings.

Reliability
Fourth-generation HIV tests can reliably detect the virus as soon as 1 month after a person has contracted it.

It is important to note that, after contracting HIV, there is a window of time during which no test can dependably detect it.

Healthcare providers refer to this as the window period. It ends when the body starts producing detectable amounts of antibodies or antigens, in a process called seroconversion.

If a person takes an HIV test during their window period, they may receive a false-negative result.

In a 2014 study, researchers found the window period for fourth-generation HIV tests was around 18 days. This means that if a person takes a test within 18 days of contracting HIV, they are likely to receive a false-negative result.

For this reason, it is important that people who may have been exposed to HIV wait until the window period ends before taking a test. This would involve waiting for 1–3 months after the possible exposure.

Availability

Fourth-generation HIV tests are now common in the U.S. A person may be able to access them through:

healthcare providers
sexual health clinics
family planning clinics
some community centers
In the U.S., the Affordable Care Act requires that health insurance companies cover HIV testing without any copayments.

For people without health insurance, some clinics and community centers offer free testing.

Check with a healthcare provider or search online to find the nearest place that does HIV testing. In the U.S., a person can use the GetTested search tool.

When to get tested?
The Centers for Disease Control and Prevention (CDC) recommend that everyone ages 13–64 take an HIV test at least once, as part of their standard healthcare.

However, as with any sexually transmitted infection, it is a good idea to take a yearly HIV test.

People with higher risk of contracting HIV should consider taking a test every 3–6 months. Sharing needles or having sex without a condom, for example, can increase a person's risk.

Anyone concerned that they may have contracted HIV should consider taking a test.

Takeaway
Fourth-generation tests are an accurate way to diagnose HIV. They can reliably detect the virus 1 month after a person contracts it.

These tests only require a small blood sample, and they are available at most healthcare centers. They detect both HIV antibodies and p24 antigens.

Fourth-generation testing supports the early diagnosis and treatment of HIV, which can significantly improve a person's outlook.

With the right treatment, people with HIV can live long, healthy lives.

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What to know about HAART for HIV
By Jenna Fletcher
https://www.medicalnewstoday.com/articles/323897.php

HAART refers to any HIV treatment that uses a combination of two or more drugs. A healthcare provider may choose to prescribe a combination of three or more drugs to improve the treatment's chance of success.
Highly active antiretroviral therapy (HAART) is also sometimes called combination antiretroviral therapy, or antiretroviral therapy.

In this article, we take look at the effects of HAART, the official guidelines of its use, and a list of HAART drugs.

What is HAART?

Specialists introduced HAART in 1996 in response to the poor success rate among those taking only one HIV medication at a time.

The beginnings of three-drug antiretroviral treatment marked a turning point in the history of HIV treatment. The new treatment design transformed what used to be a diagnosis with a very poor outlook into a manageable condition.

HAART has a twofold effect on the body. It increases the number of immune cells while also decreasing the number of virus cells present in the body.

HAART has the following positive effects on HIV:

stops it from multiplying in the blood
reduces viral load, which is the number of HIV copies in the blood
increases the number of CD4 cells, which are immune cells that HIV targets, to improve immune system function
slows down and prevents the development of stage 3 HIV, or AIDS
prevents transmission
reduces the severity of complications and increases survival rates
keeps virus counts low in the blood
When prescribing antiretroviral therapy, healthcare providers typically use a regimen of three or more drugs for the best chances of lowering the amount of HIV in the body.

A person can, however, talk to their healthcare provider about a single pill that contains several medications.

According to the Centers for Disease Control and Prevention (CDC), HAART can reduce viral load to such an extent that it is undetectable. This means that a person can no longer transmit the virus to another person, even via condomless sex.

This concept is called undetectable = untransmittable, or U=U.

The CDC advise that people with HIV take antiretroviral medication regardless of their health status or how long they have had HIV.

When a person with HIV uses HAART as their healthcare provider instructs, it can help them live a full, healthy life.

HAART drugs and regimens

There are seven classes of HIV drug, including around 30 different medications:

non-nucleoside reverse transcriptase inhibitors (NNRTIs)
nucleoside reverse transcriptase inhibitors (NRTIs)
post-attachment inhibitors
protease inhibitors (PIs)
CCR5 antagonists
integrase strand transfer inhibitors (INSTIs)
fusion inhibitors
Initial treatment regimens usually include two NTRIs combined with a third active antiretroviral drug, which may be in the INSTI, NNRTI, or PI class. They may sometimes include a booster, which may be cobicistat (Tybost) or ritonavir (Norvir).

The HAART starting regimen for adults and adolescents with HIV is usually one of the following:

bictegravir/tenofovir alafenamide/emtricitabine (Biktarvy)
dolutegravir (Tivicay) plus tenofovir/emtricitabine (Truvada)
raltegravir (Isentress) plus tenofovir/emtricitabine (Truvada)
abacavir/dolutegravir/lamivudine (Triumeq), but not for those with a genetic sensitivity to abacavir

Once the healthcare provider finds an effective regimen, it takes around 3–6 months before the viral load reaches an undetectable level. This is not a cure, as the virus will remain in certain body tissues. However, the levels will be substantially lower.

For HAART to be effective, a person must take the medication exactly as a healthcare provider prescribes. Avoid missing doses or stopping medication for any period of time. Adhering to the regimen will prevent HIV from multiplying in the blood and affecting the immune system.

When discussing the most suitable treatment regimen, talk to the healthcare provider about any possible difficulties with taking the medication, such as a busy lifestyle or a lack of health insurance. They can help address and solve these issues.

Healthcare providers will take the following into consideration when choosing a person's HAART regimen:

other health conditions
whether the person is pregnant
possible side effects of the HIV medications
possible interactions between HIV medications and other medications a person is taking
the cost of HIV medications
a person's ability to adhere to their medication regimen

Summary
HAART, or combined antiretroviral therapy, refers to HIV treatment that uses a combination of two or more antiretroviral drugs. HAART revolutionized HIV treatment upon its introduction in 1996.

HAART is an effective treatment for HIV. It does not cure the condition, but it can reduce the viral load to undetectable levels. This means that the virus is not transmittable through sexual activity and a person's immune system can recover.

It usually takes around 3–6 months for the viral load to reach undetectable levels.

Strict adherence to the HAART regimen is important, as this will prevent HIV from multiplying in the blood and tissues and damaging the immune system.

[Big Sexy]

GSK wins U.S. nod for two-drug HIV combination
Ludwig Burger
https://www.reuters.com/article/us-g...-idUSKCN1RK29O

(Reuters) - GlaxoSmithKline Plc’s two-drug treatment for HIV infections won U.S. market approval on Monday, boosting the British drugmaker’s growth prospects against competitor Gilead Sciences Inc.

The U.S. Food and Drug Administration cleared the combination of dolutegravir and lamivudine, to be branded as Dovato, for use in newly diagnosed adults.

GSK showed in drug trials last year that the once-a-day Dovato pill was as good as a standard three-drug cocktail in suppressing the virus that causes AIDS and also in terms of tolerability.

GSK’s HIV drugs division ViiV, in which Pfizer Inc and Shionogi & Co Ltd have small stakes, will use the lower drug burden as its main selling point to patients and physicians, while hoping that longer-term studies will yield hard evidence of fewer side effects over time.

As HIV positive patients grow older thanks to highly effective treatment, the focus shifts to long-term side effects as nearly half of all HIV patients in the profitable markets of North America and Europe are now over 50.

“We are trying to establish a new normal for people with HIV. We absolutely believe that people living with HIV should not take more medicines than they need,” said Deborah Waterhouse, who heads the British drugmaker’s HIV unit.

ViiV accounted for about 39 percent of GSK’s group operating profit last year, according to UBS analysts. With a 23 percent share in the $26 billion-a-year HIV market, it is seeking to catch up with Gilead’s 53 percent.

Gilead will keep up the pressure with new anti-retroviral drug Biktarvy, a combination of three HIV medicines in a daily tablet, which was approved early last year. Market researcher Evaluate pharma expects sales from the product to reach $6.1 billion in 2024.

Hopes for growth - despite harsh competition from Gilead - rest on Dovato as well as on another two-drug combination that will be given as a monthly injection but regulatory approval of the latter is not expected before next year.

The company’s growth prospects are clouded by the recent U.S. launch of cheap generic copies of blockbuster asthma treatment Advair, generated 2.4 billion pounds in revenues for GSK last year.

GSK already has two-drug regimen Juluca on the market, but only for the smaller market of HIV patients that have received prior treatment. Dovato is the first such product for new cases.

[Big Sexy]

What is the link between HPV and HIV?
By Jenna Fletcher
https://www.medicalnewstoday.com/articles/323946.php

HPV and HIV are both viruses that cause sexually transmitted infections. The viruses cause different conditions, though people with HIV are more susceptible to HPV than others.
People with untreated HIV are more likely to have active HPV infections and may experience worse symptoms of HPV. HPV prevention is especially important for people with HIV.

These infections have different symptoms, outlook, and treatment. Continue reading to find out more about the differences and links between HPV and HIV.

What is HPV?
The human papillomavirus (HPV) is the most common sexually transmitted infection (STI). The CDC estimate that almost every sexually active person will get HPV in their lifetime unless they have had the HPV vaccine.

There are many different types of HPV. The virus may not always cause symptoms, but some types can cause genital warts and certain cancers. Most people will not know they have HPV until a doctor detects it during routine screening, such as in a Pap smear, or they develop symptoms of an infection.

What is HIV?
HIV is a virus that targets a person's immune system. It specifically targets white blood cells called CD4 cells. HIV is most frequently transmitted through sexual intercourse or using the same needles as a person with HIV.

There are many effective treatments for HIV that can halt its progression and prevent its transmission to others. If left untreated, HIV will advance to stage 3 HIV, also known as AIDS, which can be fatal.

What is the link between HPV and HIV?
HPV and HIV are different viruses. They are not related and have few similarities.

People can contract both HPV and HIV from sexual activity, so they are both considered STIs. Both viruses can lay dormant in the body for years without causing symptoms.

A person can have both HPV and HIV. Both viruses can make a person more susceptible to other diseases or complications

HPV can cause genital warts on the penis, vagina, and rectum. People living with HIV can have more severe sores in the rectum and area around the cervix. People with HIV are also more likely to have abnormal cells in the anus or vagina, which can develop into certain cancers.

Symptoms of HIV and HPV

Many people with HPV will not develop symptoms because their body fights off the infection. However, the virus often remains dormant in a person's body.

For some, HPV's symptoms will present as genital warts. While genital warts typically appear on or around the genital area, they may also appear on the hands, feet, face, and legs.

Some people who contract HPV may develop cancer as a result. The most common cancer is cervical cancer. However, a person may develop cancers of the vagina, penis, anus, vulva, mouth, or throat as a result of HPV.

Many people who have HIV are not aware that they have it until they get a routine STI test.

An estimated 40 to 90 percent of people with HIV will experience flu-like symptoms around 2 to 4 weeks after contracting the virus. Early symptoms include:

swollen lymph nodes
fever
fatigue
muscle aches
rash
chills
a sore throat
mouth ulcers
night sweats
These symptoms of HIV can last a few days or a few weeks. During this time, the risk of sexually transmitting HIV is high, and HIV tests may not yet be able to detect the virus.

Risk factors
Sexually active teens and adults having oral, vaginal, or anal sex are at risk of contracting either HPV or HIV. HPV is very easy to contract because the virus lives on the surface of a person's skin. This means that someone can contract the virus through skin-to-skin contact with a person's feet, hands, penis, mouth, vagina, or another mucus cavity.

People who share needles with others are at higher risk of contracting or transmitting HIV. In the 1980s, blood transfusions were also a risk factor for contracting HIV. Today, however, thanks to improved screening methods, blood transfusions pose virtually no risk.

Prevention
People can reduce the risk of contracting both HPV and HIV by taking preventive measures.

People can reduce their risk of contracting STIs, including HPV and HIV, through using barrier contraceptive methods during sexual activity.

Condoms are very effective in reducing the risk of HIV transmission. However, people can contract HPV from the skin around a person's genitals, so condoms do not offer complete protection from HPV.

Typically, healthcare professionals give the HPV vaccination in two injections to people up to 15 years old. However, adults up to 45 years old who did not get vaccinated as teenagers can now get a slightly different version. The U.S. Food and Drugs Administration (FDA) have recently extended the use of an existing vaccination to include people in this age group.

To reduce the risk of contracting HIV, a person can take a daily dose of pre-exposure prophylactic (PrEP). Doctors recommend this measure for people at high risk of contracting HIV.

According to HIV.gov, which is a U.S. Department of Health & Human Services website, taking PrEP can significantly reduce a person's risk of developing HIV. It can reduce the risk of contracting HIV through sexual activity by 90 percent, and by 70 percent for people who use injected drugs.

Diagnosis
Doctors can detect both HPV and HIV using certain screening tests. Diagnosis can be difficult as these viruses do not always express physical symptoms.

To help diagnose an STI, a doctor will ask a person about their symptoms, sexual history, and risk factors.

A doctor may not be able to diagnose HPV until symptoms develop. Doctors can diagnose genital warts with a visual exam, and may detect HPV cervical infection through a Pap smear, also called a cervical smear. Doctors can check cervical cells for HPV.

Doctors recommend that women aged 21 to 65 have a cervical smear every 3 years. However, women aged 30 to 65 who require an HPV and a Pap smear should get tested every 5 years.

A person with HIV may not test positive for several weeks after contracting the virus. This is because it takes time for the body to generate antibodies against the virus in high enough numbers to be detectable on most tests. A doctor usually orders a blood test to diagnose HIV.

Early diagnosis of HIV is imperative for a good outlook. Even if initial tests come back negative, a person who suspects they may have contracted HIV should get retested.

Treatments
There is no treatment for HPV. Many people will find that their immune system will fight off the virus successfully. For those that do not, a doctor will treat genital warts or cancer based on individual circumstances.

Healthcare providers can treat HIV with a regimen of medications called antiretrovirals. A person living with HIV will take a combination of drugs to:

reduce the total number of HIV cells, known as the viral load
increase the number of CD4 immune system cells
stop HIV from progressing
prevent HIV from transmitting to others
A person who receives successful treatment will see their HIV cell counts drop to undetectable levels. This means the person's HIV is not progressing and they are no longer able to transmit HIV sexually.

Antiretrovirals do not cure HIV, and some HIV remains in the tissues. For this reason, a person needs to continue taking HIV medication for life to prevent transmission and HIV progression.

Outlook
A person's immune system can often fight off HPV with no negative symptoms. Others may experience outbreaks of genital warts, which a doctor can treat when they arise. The outlook for a person with HPV-related cancer varies depending on a person's risk factors and the stage of the cancer.

There is no cure for HIV. However, due to modern treatment, people with HIV can have a normal quality of life. A person will need to take medicine each day and get regular check-ups to make sure the medication is still working, however.

Summary
HPV and HIV are two viruses that people can contract through sexual contact. The symptoms, causes, and treatments for the two viruses are different. Both can lead to other health complications

A person with HIV may experience worse symptoms and complications from HPV than a person without HIV. This is due to the effect that HIV has on the immune system.

A vaccination is available to prevent HPV, and it is possible to reduce the risk of contracting HIV with PrEP medication. HPV may present no symptoms, and a person's immune system may fight off the infection. However, HIV has no cure, and anyone who has the virus will require regular check-ups and treatment.

[youngboy99]

recently had a rapid test(20mins) and the results were negative
however, i experienced a fever on 8th April, and having a fever now

the fever on 8th april only lasted half a day
the fever right now i'm having started from afternoon

the test i took is effective 28 days after exposure

should i be taking another test in 1-2 months?

[Big Sexy]

4gen test is pretty accurate on/after 28 days..
chances are you probably caught the flu bug, no need to worry about the fever..

if you are still worry, then go for another test in 2 months time.

Originally Posted by youngboy99

recently had a rapid test(20mins) and the results were negative
however, i experienced a fever on 8th April, and having a fever now

the fever on 8th april only lasted half a day
the fever right now i'm having started from afternoon

the test i took is effective 28 days after exposure

should i be taking another test in 1-2 months?

[boomshaka]

so it is better to have a HIV test taken after 28 days?

[Big Sexy]

yes.. if u need to take the 4gen HIV test..take it 28 days after exposure

Originally Posted by boomshaka

so it is better to have a HIV test taken after 28 days?

[jontan9001]

Thanks so much guys. Newbie here frantically seeking answers. Found them all in this thread.

[Hotdickson6699]

Thanks for sharing. Worth reading it