What is HIV and AIDS?

Since it was first discovered in 1983, HIV has sadly resulted in approximately 40.4 million deaths worldwide, as of 2022. This alarming number highlights the potential for HIV to become a significant global health crisis if not kept under control. Thankfully, the creation and widespread use of highly active antiretroviral therapies (ARTs), which are medicines used to treat HIV, have helped control the HIV situation worldwide. Also, improvements in treating HIV and related infections mean that it is now considered a manageable chronic illness, meaning people with HIV can live long, healthy lives.

However, people with HIV should still prioritize the prevention of chronic diseases due to their weakened immune systems. The United Nations has set ambitious goals for addressing HIV worldwide: by 2025, they hope to have diagnosed 95% of HIV cases, have 95% of those diagnosed receiving ART, and have 95% of those on ART achieve suppression of the virus in their bodies. Thankfully, we are on the right track, with global HIV rates and death rates from HIV steadily decreasing.

Notably, the number of people living with HIV is increasing, partially due to improvements in treatment. In 2020, about 37.7 million people were diagnosed with HIV, rising to 39 million in 2022, with two thirds of these individuals living in Africa.

However, HIV imposes heavy costs on both the individuals affected and the healthcare system. It increases the likelihood of chronic diseases, particularly heart and brain-related illnesses. While ART can help slow the progress of HIV, it does not cure it and can cause side effects. It also requires patients to stay closely connected to the healthcare system. Challenges to treating everyone who needs it include health stigma, adequate access to healthcare, the quality of care, and the cost. Using local guidelines for managing HIV can improve patient outcomes and stop the spread of the virus.

Community involvement in HIV testing and treatment, as well as integration of related health services, can expand the reach of necessary services, improve connections to care, and boost overall health. Supportive social and policy environments regarding services access, testing, conveying test results, and discrimination can protect patients and the community.

The mention of HIV-1 is about a specific type, and the information provided aims to equip doctors with the latest knowledge for managing HIV. Good social and policy environments are fundamental in supporting a response to HIV, as recommended by the World Health Organization (WHO), the Joint United Nations Programme for HIV/AIDS (UNAIDS), the United States Centers for Disease Control (CDC), and certain state governments. A companion resource, “HIV-2 Infection,” offers more information.

What Causes HIV and AIDS?

HIV, or Human Immunodeficiency Virus, belongs to a family of viruses known as Retroviridae, specifically in the Lentivirus category. This virus primarily attacks a type of immune cell known as CD4+ T-lymphocyte helper cells. The virus defense cells in our body are weakened as more and more of these helper cells are damaged, leading to various health issues. If HIV is left untreated, it can progress to AIDS, where the immune system has weakened to the point where it can’t fight off infections – these infections can be serious enough to cause death.

There are two main types of HIV – called HIV-1 and HIV-2. They are similar in structure but differ significantly at the genetic level. These viruses come from different transmissions of a virus found in monkeys, hence each has different levels of severity, how easily it can spread, and prognosis – or the likely outcome of the disease. It’s important to note that HIV-1 and HIV-2 are only 60% identical in terms of their protein structure, and only 48% identical in terms of their genetic structure.

The way HIV-1 and HIV-2 are structured is that they have a lipid membrane – or fatty layer – that surrounds a protein shell, called a capsid. Inside the capsid, there’s a complex made up of two identical copies of RNA – a molecule similar to DNA – and various proteins. The capsid has a specific conical shape due to the arrangement of the protein shell.

HIV can be transmitted through body fluids, like blood, fluid in the womb, breast milk, semen, pre-ejaculate, rectal and vaginal fluids. It can be passed on through sexual contact, during pregnancy and childbirth, and by using contaminated items like reusable medical equipment or syringes. To learn more about preventing HIV, check out our companion resource, “HIV Prevention [https://www.statpearls.com/point-of-care/22919]”.

Risk Factors and Frequency for HIV and AIDS

HIV is a global health problem. Most people with HIV have a type called HIV-1, but there’s also a less common type, HIV-2, which is mostly found in West Africa. As of the end of 2022, there were 39 million people living with HIV globally, and the majority of them live in Sub-Saharan Africa. In 2022, there were 1.3 million new cases and 630,000 deaths related to HIV.

Even though some countries have seen a rise in new cases, overall, the number of new HIV infections worldwide is declining. The most significant progress in preventing and treating HIV has been made in eastern and southern Africa, where the virus is most widespread. In fact, from 2010 to 2022, the number of new infections and AIDS-related deaths in this region decreased by 57% and 58% respectively. Progress has been slower in other areas, especially those where there’s less focus on HIV and greater inequalities. Even though the number of new cases among teenagers and young adults has decreased globally, in Asia and the Pacific, one in four new infections affect people aged 15-24 and their partners.

Some regions have seen an increase in new HIV cases. For example, there was a 61% jump in the Middle East and North African region between 2010 and 2022. Still, the number of people infected there (about 16,000 in 2022) is small compared to the estimated 160,000 in Eastern Europe and Central Asia in 2022. In these regions, HIV cases increased by 49% between 2010 and 2022. Difficult legal situations, human rights abuses, and war have made it harder to tackle HIV.

How well HIV is diagnosed, treated, and controlled varies from place to place. In 2019, global figures show more women (65.8%) being diagnosed than men. Yet, men tend to have lower rates of diagnosis, treatment, and viral suppression. For instance, one study in Uganda found that men were 1.5 times less likely than women to have their virus under control. Steps that help more men control their virus could shrink the gap between men and women’s rates of new HIV cases.

  • The World Health Organization (WHO) and the United Nations Programme on HIV/AIDS (UNAIDS) identify five key groups that are particularly affected by HIV and need special care and support:
  • Men who have sex with men
  • Sex workers
  • People in prisons and other closed environments
  • People who inject drugs
  • Transgender and gender-diverse people

Most new HIV cases worldwide happen through sexual contact. While the most common mode of transmission in many parts of the world is between men who have sex with men, in Africa, infection through heterosexual contact is dominant. In the US in 2021, 70% of all new infections were in men who have sex with men, while only 22% happened through heterosexual contact. Drug use is another significant risk factor for HIV. Around 2008, roughly 3 million people who inject drugs were living with HIV worldwide. In the US, one in ten new HIV cases are linked to drug use. Needle and syringe exchange programs can help reduce HIV transmission among people who inject drugs by limiting the sharing and reuse of needles and syringes.

Signs and Symptoms of HIV and AIDS

When a person is suspected or confirmed to have HIV, a comprehensive medical history and physical check-up are undertaken. This process helps rule out other health conditions that might explain their symptoms. It also checks for infections or health complications that might arise due to HIV. The doctor will also understand the patient’s risk factors for HIV, such as their sexual behavior, drug use, and history of blood transfusions. The doctor will need information about the patient’s sexual health, including their practices and history of sexually transmitted infections (STIs).

The patient’s drug use history is important too, detailing substances used, frequency, method of use, and whether equipment was shared. Also, a mental health assessment can reveal any issues such as depression, mental illness, or substance use that might affect their overall care or contribute to chronic diseases. The doctor must also acquire the patient’s immunization history to determine which vaccines might protect against illnesses they may be susceptible to due to HIV.

Social history provides essential insights that aid in providing comprehensive care. This includes understanding the patient’s ability to adhere to treatment, obstacles in accessing healthcare services, and their support systems. Their living situation, income, insurance, social support, experiences of stigmatization, coping strategies, and exposure to violence all play a role in their care.

The United States National Institutes of Health states that HIV progresses in three stages: acute HIV, chronic or asymptomatic HIV, and AIDS. Each presents with different symptoms and complications.

In the acute HIV stage, 90% of patients experience at least one symptom within the first four weeks after infection. These symptoms include:

  • Fever
  • Fatigue
  • Muscle pain
  • Skin rash
  • Headache
  • Sore throat
  • Swollen lymph nodes
  • Joint pain
  • Night sweats
  • Diarrhea

Chronic HIV is the next stage where patients often do not exhibit symptoms. When symptoms do occur, they often present as persistent fatigue and swollen lymph nodes in various places. Patients may develop several conditions including mouth sores, severe herpes outbreaks, and cervical precancerous changes.

AIDS is the last stage of HIV where the virus severely damages the immune system. Diagnosis occurs when the patient develops specific diseases defined by the CDC, such as candidiasis of the digestive or pulmonary tract, invasive cervical cancer, certain fungal infections, brain lymphoma or HIV-related cognitive disorders, tuberculosis, lung infection, and severe weight loss linked to HIV.

These conditions usually appear when the patient’s CD4+ count falls below 200 cells/mm3. This marker is indicative of advanced HIV that hasn’t been treated, during which the total count of disease-fighting white blood cells diminishes over time.

Testing for HIV and AIDS

Testing is a crucial step in diagnosing HIV. Doctors use a variety of tests including antibody tests, antigen-antibody tests, and nucleic acid amplification tests. However, there’s a period after the initial infection (called the “window” or “eclipse” period), when the virus can’t yet be detected by tests. This period can last up to 20 days.

The following tests can detect different stages of the virus in the body:

  • Nucleic acid amplification tests: These can detect HIV RNA, a part of the virus, in the blood about 6 to 8 days after the infection, up to 33 days.
  • Antigen tests: These can detect viral proteins such as p24 antigen as early as 13 to 20 days after the infection.
  • Antigen-antibody tests: These can detect viral proteins as well as anti-HIV antibodies around 20 and 30 days after infection.

In clinical settings, a combination of antigen and antibody tests, also known as Ag/Ab tests, are recommended to diagnose HIV. These tests can detect both HIV-1 and HIV-2 and are increasingly available around the world. If the initial test proves positive but can’t distinguish between HIV-1 and HIV-2, a follow-up test is required.

If the combined test result is negative, no more testing is usually required, unless the exposure to HIV is too recent for detectable p24 antigen levels to have developed. If HIV is still suspected despite a negative initial test, an HIV-1 nucleic acid amplification test should be done. In some cases, positive results should be followed by a second test to confirm diagnosis.

An acute HIV case is diagnosed with a positive nucleic acid test under several conditions such as a recent negative test result, a positive antigen-antibody test result with a negative antibody-only test, or a case where the HIV-1 and HIV-2 antibodies are nonreactive following a positive screening. If the test results do not affirm these situations, the HIV-1 test may be a false positive. In case of high suspicion, even with negative results, repeat testing in 1 to 3 weeks is advised. Home-based or rapid tests can be helpful in this regard, but positive results need confirmation by standard lab tests.

Once HIV is diagnosed, a series of laboratory tests help identify the progression of HIV, allow the selection of appropriate treatment, and help identify any other conditions that a person has. These tests measure things like the number of specific white blood cells (CD4+ T-lymphocyte cell count), the number of viral particles in the blood (viral load), and complete blood count, among others. Some medication considerations may require additional specific tests.

Viral load and CD4+ count are crucial for monitoring health and making treatment decisions. The viral load indicates the effectiveness of the treatment and the CD4+ count reflects the immune function and helps determine when to start treatment for infections. CD4+ testing is required before starting treatment, but treatment should not be delayed while waiting for results. Routine testing for herpes simplex, cytomegalovirus, and toxoplasma is generally not recommended as these tests can’t distinguish between active disease and previous exposure. However, testing for cryptococcal antigen might be considered in patients with a low CD4+ count.

Treatment Options for HIV and AIDS

The main objective of HIV-1 treatment with antiretroviral medications is to suppress the virus in the body. This is done according to guidelines set by health organizations like WHO and CDC, which suggest starting antiretroviral therapy (ART) as soon as HIV is diagnosed, regardless of the patient’s immune status or disease stage. Exception to this is when a severe opportunistic infection is present that needs to be treated first.

The key aspect of HIV treatment is helping the patient continue the prescribed medication routine, which is especially important for patients who may face social or healthcare barriers.

The choice of treatment is primarily made based on the patient’s preferences and their ability to follow the medication regimen. Antiretroviral drugs work in different ways to inhibit HIV. For example, one type of drugs (NRTIs) prevent the virus from copying itself, while another type (NNRTIs) block the enzyme that the virus needs to multiply. A third type, known as INSTIs, prevent the virus from integrating into our body’s cells, and a fourth type, called protease inhibitors, stop the virus from maturing and becoming infectious.

In addition to these, other classes of drugs are used in case HIV becomes resistant to the main set of drugs.

Current guidelines suggest starting therapy with an INSTI and two NRTIs initially before doing further lab tests for most patients with HIV. The choice among these drugs depends on their effectiveness, adverse effects, how quickly they suppress the virus, and how likely they are to develop resistance.

It’s important to consider other health conditions a patient may have when selecting an HIV treatment regimens. For example, if a patient has hepatitis B, a regimen that includes tenofovir is preferred. If the patient has kidney dysfunction, some drugs are avoided and others are preferred. Pregnancy also needs to be taken into consideration because certain medications have not been proven safe for use during pregnancy.

When the results of lab tests are available, the treatment regimen may be adjusted. For those who cannot take an INSTI-based regimen, a combination of two NRTIs and another antiviral drug may be prescribed.

In patients who have previously undergone treatment, the treatment plan is more complex due to the risk of resistance to the drugs. The goals of maintaining long-term suppression of the virus and stopping the disease progression are still the focus. The regimen usually includes an NRTI and an NNRTI, along with an integrase or protease inhibitor.

Patients taking preventive medication who acquire HIV will require testing for drug resistance before starting therapy. Decisions about ongoing therapy will be based on these test results.

For patients with HIV-2, the treatment strategy is slightly different as more NRTIs are required along with a second-generation INSTI or a boosted protease inhibitor.

Once treatment is initiated, the patient’s HIV viral load must be monitored regularly to ensure that the levels are decreasing. It can up to six months of continuous therapy to effectively suppress the virus. If the virus level does not significantly decrease within three months of starting therapy, drug resistance tests may be recommended. Following their viral load helps gauge the effectiveness of treatment and helps the doctor make adjustments as needed.

Resistance development and viral suppression failure are significant issues in HIV treatment. When the virus doesn’t respond to medication, it can mutate and develop resistance. This can lead to clinical failure, where the patient’s HIV stage worsens while on the treatment.

Recovery does occur in some cases but it is usually a slow process. It’s important to keep track of CD4 count, a type of white blood cell that HIV attacks, to monitor a person’s immunological response to treatment. If a patient doesn’t respond immunologically to therapy, they’re at an increased risk for serious non-AIDS related illnesses and death.

Doctors should think about HIV if a patient constantly gets serious infections. There are also other conditions that can affect the body’s defense system in similar ways:

  • Severe malnutrition
  • Severe combined immune deficiency syndrome
  • Immunosuppression due to chemotherapy

For patients who come in with sudden symptoms of HIV, doctors will also need to rule out the following illnesses that might cause the same symptoms:

  • Mononucleosis
  • Toxoplasmosis
  • Viral hepatitis
  • Systemic lupus erythematosus (an auto-immune disease)

What to expect with HIV and AIDS

Without treatment, HIV infections ultimately lead to death. However, effective antiretroviral therapy (ART), which is a treatment to stop the virus from replicating, can significantly improve the health outcomes for people living with HIV. According to a study from 2017, if a person starts taking ART at the age of 20 in high-income countries, their life expectancy increases to around 43.3 years; starting therapy at 35 increases life expectancy to 32.2 years. For those in lower income countries, life expectancy is approximately 28.3 years if treatment starts at 20 and about 25.6 years if it starts at 35. Overall, life expectancy after starting ART has improved in all areas, regardless of income level, thanks to improved therapy methods, starting treatment earlier, and better support for lifestyle and medication adherence.

How well the virus is controlled, or “viral suppression”, is key to predicting the effect of the infection on the person’s health. Those who achieve viral suppression for at least three years without full immune recovery (measured by CD4+ cell count less than 200 cells per cubic millimeter) are 2.6 times more likely to die from any cause compared to those whose immune system recovers (CD4+ count greater than 200 cells per cubic millimeter).

Starting treatment as soon as a person is diagnosed with HIV results in better health outcomes and a higher chance of rebuilding their immune system. Delaying treatment until the patient’s CD4+ count is too low means that it’s less likely their immune system will return to a normal level, even after being on antiretroviral therapy for many years. This delay increases a patient’s risk of HIV-related illnesses and death. Other factors related to poor immune recovery include older age, lower CD4+ count to begin with, and a longer time before starting antiretroviral therapy.

Having Hepatitis C, Hepatitis B, or actively injecting drugs are significant factors that contribute to higher rates of illness and death among people with HIV. For people who inject drugs, it’s especially crucial to provide support for lifestyle and medication adherence, primarily if treatment isn’t readily available.

Possible Complications When Diagnosed with HIV and AIDS

HIV complications can take various forms — taking medications to manage HIV (referred to as ART, or antiretroviral therapy) has certainly helped decrease the usual complications like opportunistic infections and cancers related to HIV. However, the progression to AIDS is a challenging problem. Regular check-ups and screenings are necessary to spot any AIDS-related illnesses, dependent on the patient’s health status.

It is also essential to screen and monitor for specific HIV- and medication-related problems. Some of these complications include:

  • HIV-related brain and mental disorders linked to use of specific ART medications like efavirenz, rilpivirine, and others
  • Damage to nerves causing pain, tingling, or numbness (HIV-related distal symmetric polyneuropathy)
  • Changes in body fat distribution (HIV-related lipodystrophy)
  • Toxicity to our cells’ energy producers due to HIV ART medications (mitochondrial toxicity of HIV NRTIs)
  • Cancers related to immune system function (lymphomas) and skin (Kaposi sarcoma)

For more detailed information on these subjects, check the related articles on the StatPearls website.

Another issue noted with ART medications is the increased risk of heart disease, which has resulted in more illnesses and deaths. People with HIV seem to be more prone to heart disease as they age. A significant part of the long-term care provided to HIV patients is directed towards minimizing heart disease risks. Several factors contribute to this increased risk, including:

  • Cholesterol problems are common among HIV patients, whether they’re on ART treatment or not.
  • ART treatment could lead to increased blood sugar levels and diabetes; it’s especially true with some older medications.
  • Weight gain is a common side effect with many ART treatment plans.

Most patients getting ART experience weight gain, which contributes towards heart disease risk in HIV patients. It’s not entirely clear why this happens. Some medications seem to cause more weight gain than others. Therefore, routine screening for blood sugar, diabetes, and cholesterol problems is recommended from the start of ART treatment to control weight gain and other risks.

Preventing HIV and AIDS

People living with HIV should be continuously educated, supported, and counseled by their healthcare team. It may also be helpful to connect with organizations like the CDC or NIH, which provide free and easily accessible information about HIV and AIDS.

Treatment for HIV involves regular lab work, check-ups, and open communication with your healthcare provider. This is necessary to effectively address any side effects, obstacles to treatment, or other health concerns. Continual education and counseling can help encourage taking medication as prescribed. This includes beginning Antiretroviral Therapy (ART) as soon as possible after diagnosis, and understanding the importance of medication adherence which means taking medication exactly as the doctor prescribed.

Taking HIV medications consistently is key to reducing the amount of the virus in your body, or achieving HIV viral load suppression. Without continuous medication, the viral load can increase within weeks, leading to health complications, resistance to HIV treatments, and increased risk of transmission. To overcome challenges in taking medication consistently, helpful strategies can include receiving counseling, joining support groups, keeping in contact with your healthcare team, receiving home nurse visits, using medication packaging that makes it easier to remember doses, and using automated reminders.

Understanding potential side effects of ART and knowing what to do next is an important part of managing HIV. Side effects like feeling sick can often be managed with medications you can get without a prescription. Symptoms indicating potential liver or kidney damage need immediate medical attention. It’s also important to be aware of potential drug interactions and work with your pharmacist to manage your medications effectively. Bringing any changes in your medication to the attention of your healthcare team helps to ensure the best treatment outcomes. A healthy lifestyle, including nutritious eating, regular exercise, and avoiding things like smoking, is also suggested as people with HIV are at an increased risk of heart problems and metabolic complications.

Preventing the transmission of HIV to others is especially relevant if you have a partner not infected with HIV. It’s been observed that as more people achieve viral suppression, the incidence of new HIV cases decreases. Being educated about the concept of “undetectable equals untransmittable” is crucial to HIV treatment as it benefits both your health and that of your partner or partners. People of childbearing age with HIV should be aware of options for treatment, the potential for transmission during pregnancy, and the benefits of planning.

People with a suppressed viral load can take further preventive steps like using condoms consistently and correctly; choosing lower risk sexual activities; encouraging their partners to take HIV prevention medication; and avoiding sharing needles or drug equipment. Disclosure of your HIV status may be required, for example, to doctors in some places, or if you are a healthcare provider yourself.

Receiving a diagnosis of a chronic illness like HIV can be distressing due to its impact on lifestyle and well-being, and can potentially worsen existing mental health conditions. Along with this, stigma and discrimination can add to the challenges people with HIV face, including self-stigma, which is when a person takes on negative views about HIV. Disclosing your HIV status can be challenging and lead to anxiety, especially where laws punish non-disclosure. The fear related to protecting others can limit social interactions and lead to isolation. Reaching out to a psychologist, social worker, or support groups can help in managing such issues. Discussing your HIV status with trusted friends and family can also provide practical and emotional support.

Frequently asked questions

HIV is a virus that has resulted in approximately 40.4 million deaths worldwide since its discovery in 1983. It can lead to AIDS, which is a chronic illness that weakens the immune system. However, with the use of antiretroviral therapies (ARTs), HIV can be managed, allowing people with HIV to live long, healthy lives.

As of the end of 2022, there were 39 million people living with HIV globally, and the majority of them live in Sub-Saharan Africa. In 2022, there were 1.3 million new cases and 630,000 deaths related to HIV.

The signs and symptoms of HIV and AIDS can vary depending on the stage of the infection. In the acute HIV stage, which occurs within the first four weeks after infection, common symptoms include fever, fatigue, muscle pain, skin rash, headache, sore throat, swollen lymph nodes, joint pain, night sweats, and diarrhea. During the chronic or asymptomatic HIV stage, patients often do not exhibit symptoms. However, when symptoms do occur, they may include persistent fatigue and swollen lymph nodes in various places. Patients may also develop conditions such as mouth sores, severe herpes outbreaks, and cervical precancerous changes. AIDS is the last stage of HIV, and it occurs when the virus severely damages the immune system. Diagnosis of AIDS is based on the development of specific diseases defined by the CDC, including candidiasis of the digestive or pulmonary tract, invasive cervical cancer, certain fungal infections, brain lymphoma or HIV-related cognitive disorders, tuberculosis, lung infection, and severe weight loss linked to HIV. These conditions typically appear when the patient's CD4+ count falls below 200 cells/mm3, indicating advanced HIV that hasn't been treated. As the CD4+ count decreases, the total count of disease-fighting white blood cells diminishes over time.

HIV can be transmitted through body fluids, like blood, fluid in the womb, breast milk, semen, pre-ejaculate, rectal and vaginal fluids. It can be passed on through sexual contact, during pregnancy and childbirth, and by using contaminated items like reusable medical equipment or syringes.

Severe malnutrition, severe combined immune deficiency syndrome, immunosuppression due to chemotherapy, mononucleosis, toxoplasmosis, viral hepatitis, systemic lupus erythematosus (an auto-immune disease).

The types of tests that are needed for HIV and AIDS include: - Antibody tests - Antigen-antibody tests - Nucleic acid amplification tests (NATs) - CD4+ T-lymphocyte cell count - Viral load testing - Complete blood count (CBC) - HIV-1 nucleic acid amplification test (if HIV is still suspected despite a negative initial test) - Follow-up tests to confirm diagnosis in case of positive results - Home-based or rapid tests (for initial screening, but positive results need confirmation by standard lab tests) - Additional specific tests for medication considerations - Testing for cryptococcal antigen in patients with a low CD4+ count (considered) - Testing for drug resistance before starting therapy in patients taking preventive medication who acquire HIV

HIV and AIDS are treated primarily with antiretroviral medications. The main objective of treatment is to suppress the virus in the body. Treatment is typically started as soon as HIV is diagnosed, regardless of the patient's immune status or disease stage, according to guidelines from health organizations like WHO and CDC. The choice of treatment depends on the patient's preferences and ability to follow the medication regimen. Different types of antiretroviral drugs work in different ways to inhibit HIV. The treatment regimen may be adjusted based on lab test results and the presence of other health conditions. Regular monitoring of the patient's HIV viral load is important to gauge the effectiveness of treatment. Resistance development and viral suppression failure are significant issues in HIV treatment, and recovery can be a slow process. Monitoring CD4 count is also important to assess the patient's immunological response to treatment.

When treating HIV and AIDS, there can be several side effects. Some of the side effects include: - HIV-related brain and mental disorders linked to the use of specific ART medications like efavirenz and rilpivirine. - Damage to nerves causing pain, tingling, or numbness (HIV-related distal symmetric polyneuropathy). - Changes in body fat distribution (HIV-related lipodystrophy). - Toxicity to our cells' energy producers due to HIV ART medications (mitochondrial toxicity of HIV NRTIs). - Cancers related to immune system function (lymphomas) and skin (Kaposi sarcoma). - Increased risk of heart disease, which can be caused by factors such as cholesterol problems, increased blood sugar levels and diabetes, and weight gain associated with ART treatment.

The prognosis for HIV and AIDS has significantly improved over the years due to advancements in treatment and care. With the use of highly active antiretroviral therapies (ARTs), HIV is now considered a manageable chronic illness, allowing people with HIV to live long and healthy lives. However, it is important for individuals with HIV to prioritize the prevention of chronic diseases due to their weakened immune systems.

You should see an infectious disease specialist or an HIV specialist for HIV and AIDS.

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