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Thursday, November 27, 2014
HIV and AIDS
Can AIDS Easily Be Contracted?
How easy is it to get AIDS and is there a possibility that it will go away?
The correspondent asks two questions. Question#1: HIV, the causative agent of AIDS has two major routes of transmission. Sexual and Parenteral.
Sexual Route: HIV is certainly not the most contagious of the sexually transmitted diseases (STDs). It is the most serious, because of its long term consequences. Other STDs are either curable like Syphilis or Gonorrhea, while others are incurable but not lethal, like Herpes and Condiloma. HIV is incurable and, in most cases, lethal. Most HIV infected people have history of multiple sexual partners and promiscuity, but there are plenty of well documented cases of HIV transmission from a single sexual contact.
There are some factors that increase the risk of transmission: Having sex with an infected male has a higher risk of transmission than having sex with a female. The presence of other STDs appear to increase the risk of transmission. In the parenteral route, ie, via blood, blood products, injection drug use, tattoos etc, it is more or less well established that Hepatitis B is the most contagious (30% of people aquire the infection afer an accidental needle stick with a contaminated needle), then Hepatitis C (3% after needle stick) and then HIV (0.3%). Again, the type of exposure and the frequency of exposure are important factors. A blood transfusion before the screening of the blood bank supply became available had an incredibly high risk of transmission. The blood product used to treat hemophilia before HIV screening became available resulted in more than 50% of Hemophiliacs becoming HIV infected. People that use dirty needles for IV drug use are at high risk to aquire HIV.
Question 2: So far there are no documented cases of spontaneous or medicine mediated cures of HIV infection. A few people appear to be resistant to infection: A minority of Sex workers in Nairobi, Kenya, despite having several high risk contacts a week for years, have not become infected. Also a small percentage of HIV infected people are what is call long term non-progressors: They harbor the virus, and perhaps might be able to infect other people, but they themselves do not develop the disease AIDS. For most individuals, once someone is infected with HIV he or she will die from HIV or at least with HIV.
Francisco Gomez, MD
College of Medicine
University of Cincinnati