WHAT IS HIV?

To understand what HIV is, lets break it down:

H Human virus I Immunodeficiency

This particular

can only infect human beings.

HIV weakens your

immune system

by

destroying important cells that fight disease and infection. A "deficient" immune system can't protect you.

V Virus Human Immunodeficiency Virus flu system

that cause the " can't seem to get rid of it. Scientists are still trying to figure out why. immune system your

A virus can only reproduce itself by taking over a cell in the body of its host. is a lot like other viruses, including those

" or the common cold. But there is an important difference over time, your

immune

can clear most viruses out of your body. That isn't the case with HIV the human immune system

We know that HIV can hide for long periods of time in the cells of your body and that it attacks a key part of your

T-cells CD4 cells

or

. Your body has to have these cells to fight

infections and disease, but HIV invades them, uses them to make more copies of itself, and then destroys them. Over time, HIV can destroy so many of your CD4 cells that your body can't fight infections and diseases anymore. When that happens, HIV infection can lead to AIDS.

WHAT IS AIDS?

To understand what AIDS is, lets break it down:

A Acquired
after birth.

AIDS is not something you inherit from your parents. You

acquire

AIDS

I Immuno
or disease. should.

Your body's immune system includes all the organs and cells that work to fight off infection

D Deficiency S Syndrome

You get AIDS when your immune system is "deficient," or isn't working the way it

A syndrome is a collection of symptoms and signs of disease. AIDS is a syndrome,

wide range of complications and symptoms

rather than a single disease, because it is a complex illness with a .

Acquired Immunodeficiency Syndrome

for .

is the final stage of HIV

infection. People at this stage of HIV disease have badly damaged immune systems, which put them at risk

opportunistic infections (OIs) one or more specific OIs certain cancers CD4 cells medical intervention and treatment Basic Information About HIV And AIDS
You will be diagnosed with AIDS if you have , , or a very low number of will need to prevent death. For more information, see CDCs .

. If you have AIDS, you

WHERE DID HIV COME FROM?

Scientists believe HIV came from a particular kind of chimpanzee in Western Africa. Humans probably came in contact with HIV when they hunted and ate infected animals. Recent studies indicate that HIV may have jumped from monkeys to humans as far back as the late 1800s.

HOW DO YOU GET HIV?

HIV is found in specific human body fluids. If any of those fluids enter your body, you can become infected with HIV.

WHICH BODY FLUIDS CONTAIN HIV?

HIV lives and reproduces in following fluids can contain high levels of HIV:

blood and other body fluids

. We know that the

Blood Semen (cum) Pre-seminal fluid (pre-cum)

Breast milk Vaginal fluids Rectal (anal) mucous feces nasal fluid saliva urine vomit unless significant direct HIV Transmission: Which Body Fluids Transmit HIV? Healthcare workers

Other body fluids and waste productslike tears, , or , , , sweat, dont contain enough HIV to infect you, and them and you have contact with them. For more information, see CDCs of HIV, including:

they have blood mixed in

may be exposed to some other body fluids with high concentrations

HOW IS HIV TRANSMITTED THROUGH BODY FLUIDS?

HIV is transmitted through body fluids in very specific ways:

Amniotic fluid Cerebrospinal fluid Synovial fluid

During sexual contact: When you have anal, oral, or vaginal sex with a partner, you will usually have contact with your partners body fluids. If your partner has HIV, those body fluids can deliver the virus into your bloodstream through microscopic breaks or rips in the delicate linings of your vagina, vulva, penis, rectum, or mouth. Rips in these

areas are very common and mostly unnoticeable. HIV can also enter through open sores, like those caused by herpes or syphilis, if infected body fluids get in them. You need to know that its much easier to get HIV (or to give it to someone else), if you have a sexually transmitted disease (STD). For more information, see CDC's The Role Of STD Detection And Treatment In HIV Prevention.

During pregnancy, childbirth, or breastfeeding: Babies have constant contact with their mothers body fluidsincluding amniotic fluid and bloodthroughout pregnancy and childbirth. After birth, infants can get HIV from drinking infected breast milk. As a result of injection drug use: Injecting drugs puts you in contact with blood-your own and others, if you share needles and works. Needles or drugs that are

contaminated with HIV-infected blood can deliver the virus directly into your body.

As a result of occupational exposure: Healthcare workers have the greatest risk for this type of HIV transmission. If you work in a healthcare setting, you can come into contact with infected blood or other fluids through needle sticks or cuts. A few healthcare workers have been infected when body fluids splashed into their eyes, mouth, or into an open sore or cut. As a result of a blood transfusion with infected blood or an organ transplant from an infected donor: Screening requirements make both of these forms of HIV transmission very rare in the United States.

HOW DO YOU GET AIDS?

AIDS is the late stage of HIV infection, when a persons immune system is severely damaged and has difficulty fighting diseases and certain cancers. Before the development of certain medications, people with HIV could progress to AIDS in just a few years. Currently, people can live much longer - even decades - with HIV before they develop AIDS. This is because of highly active combinations of medications that were introduced in the mid 1990s. Read more abou

HIV-POSITIVE WITHOUT SYMPTOMS

symptoms Often people only begin to feel sick when they progress toward AIDS (Acquired Immunodeficiency Syndrome)
Many people who are HIV-positive do not have of HIV infection. periods of being sick and then feel fine. disease come from the

. Sometimes people living with HIV go through

While the virus itself can sometimes cause people to feel sick, most of the severe symptoms and illnesses of HIV

opportunistic infections

that attack a

damaged

immune system

. It is important to remember that some symptoms of HIV infection are

similar to symptoms of many other common illnesses, such as the flu, or respiratory or gastrointestinal infections.

EARLY STAGES OF HIV: SIGNS AND SYMPTOMS

As early as

3 months later acute retroviral syndrome (ARS) primary HIV infection

after exposure to HIV (but up to experience an acute illness, often described as the worst flu ever. This is called , or and its the bodys natural response to HIV infection. During primary HIV infection, there are higher levels of virus circulating in the blood, which means that people can more easily transmit the virus to others.

2-4 weeks

), people can

Symptoms can include Fever Chills Rash Night sweats Muscle aches Sore throat Fatigue Swollen lymph nodes Ulcers in the mouth not everyone gets ARS when they become infected with HIV Acute HIV Infection
: It is important to remember, however, that . For more information, see NIHs .

CHRONIC PHASE OR LATENCY: SIGNS AND SYMPTOMS

After the initial infection and it is still present.

seroconversion During this period, many people do not

, the virus becomes less active in the body, although

have any symptoms of HIV infection 10 years

chronic or latency phase. This period can last up to

. This period is called the

sometimes longer.

AIDS: SIGNS AND SYMPTOMS

chills, night sweats, and even

When HIV infection progresses to AIDS, many people begin to suffer from fatigue, diarrhea, nausea, vomiting, fever,

wasting syndrome
.

at late stages. Many of the signs and

symptoms of AIDS come from opportunistic infections which occur in patients with a damaged immune system. For more information, see NIHs

AIDS

RELATIONSHIP?

WHAT IS A MIXED-STATUS

A "mixed-status" relationship is a sexual relationship between partners with different HIV statuses: one partner is HIVpositive and one is HIV-negative. This can involve a couple in a long-term relationship or a single encounter between two partners. You may also hear these terms to describe such relationships:

IS IT SAFE FOR MIXED-STATUS COUPLES TO HAVE SEX?

Serodiscordant Discordant Serodivergent Magnetic HIV-positive/negative

For mixed-status couples, the possibility of HIV infection is a constant reality. There is always a risk, but you can minimize it. If you are in a mixed-status relationship and you have sex (anal, oral, or vaginal), you can protect against HIV and

dental dams Prevention: Safer Sex Tips for Using Condoms and Dental Dams
other sexually transmitted infections by using condoms and consistently and correctly. For more information on using condoms and dental dams, see AIDS.gov's or the Department of Veterans Affairs' great, plain-language . If you are part of a mixed-status couple, it is important that you and your partner communicate openly and often about safer sex practices and HIV prevention. Healthcare providers and local HIV/AIDS organizations can be important sources of information and support for you and your partner.

If you are the HIV-positive partner in a mixedstatus relationship antiretroviral therapy viral load
, you can lower the risk of transmitting HIV to your partner if you are . Taking all your medications, on time, will help to lower on the use a condom and practice safer sex. And, if you inject drugs, never share syringes, water, or drug preparation equipment with others since HIV-infected blood can be transmitted through them.

in your body fluids and decrease the chance that you will transmit HIV to your partner. But

remember, even if you have a low viral load, you can still transmit HIV to your sex partner. So it is important to always

If you are the HIV-negative partner

in a mixed-status

relationship, talk with your partner about condoms and safer sex practices. If you are in an ongoing relationship with your partner, support him/her in taking all of his/her HIV medications at the right times. This "medication adherence" will lower his/her viral load and reduce the risk that HIV can be transmitted. You may also want to stay up-to-date on developments about

pre-exposure prophylaxis

(PrEP). Though researchers are not

recommending PrEP be immediately used to prevent HIV infection, recent research findings suggest this may someday be another prevention method to be used with not instead of condoms, safer sex practices and other HIV prevention methods.

CAN I TRANSMIT HIV TO MY BABY?

Yes. HIV-positive mothers can transmit HIV to their babies. This is called mother-to-child transmission. (It is also called perinatal" or "vertical transmission.) An HIV-positive mother can transmit HIV to her baby in three ways:

During pregnancy During vaginal childbirth Through breastfeeding

But with proper treatment and coordination with healthcare providers, HIV-positive mothers can significantly reduce the risk of transmitting HIV to their babies.

TYPES OF HIV TESTS

Antibody Tests: The most common HIV tests look for HIV antibodies in your body, rather than looking for HIV itself: Enzyme immunoassay (EIA) tests use blood, oral fluid, or urine to detect HIV antibodies. Results for these tests can take up to two weeks. Rapid HIV antibody tests also use blood, oral fluid, or urine to detect HIV antibodies. Results for these tests can take 1020 minutes.
If you get a positive result from either of these tests, you will need to take another test, called a Western blot test, to confirm that result. It can take up to two weeks to confirm a positive result.

Antigen Tests
These tests are not as common as antibody tests, but they can be used to diagnose HIV infection earlier from 1-3 weeks after you are first infected with HIV. Antigen tests require a blood sample.

PCR Test (Polymerase chain reaction test)

This test detects the genetic material of HIV itself, and can identify HIV in the blood within 2-3 weeks of infection. Babies born to HIV-positive mothers are tested with a special PCR test, because their blood contains their mother's HIV antibodies for several months. This means they would test HIV-positive on a standard antibody testbut a PCR test can determine whether the babies have HIV themselve

WHAT DOES "HIV-POSITIVE" MEAN?

Being diagnosed as "HIV-positive" means that you have been exposed to the Human Immunodeficiency Virus (HIV)and that two HIV testsa preliminary enzyme immunoassay (EIA) test and a confirmatory Western blot test have both come back positive for antibodies to HIV. Being HIV-positive means that it is possible for you to pass the virus along to others, including your sexual partners. If you are female, you could also pass it along to your unborn child. Once you have been infected with HIV, you will always carry it in your body. There is no cure for HIV. It is a serious, infectious disease that can lead to death if it isn't treated. But many scientific and technological advances have made HIV a chronic manageable disease. Many people with HIV lead healthy, happy, and productive lives and learn how to cope with the disease. This is why it is so important to know your HIV status. Knowing that you are HIV-positive gives you the ability to protect your own health and the health of your partners and children. Being HIV-positive does NOT mean you have AIDS. AIDS is the most advanced stage of HIV disease. Proper treatment can keep you from developing AIDS.

NEWLY DIAGNOSED CHECKLIST

Being diagnosed with HIV can be a scary thing to face. You may have a lot of unanswered questions and concerns. This checklist will help you take the first steps toward managing a new HIV diagnosis.

Dont panicjust breathe. This is life-changing news but you have life-enhancing options. Make a list of all your questions. You will probably have some time between when you are diagnosed and when you have your first visit with an HIV specialist or healthcare provider. This might be a good time to sit down and write out a list of questions about your new diagnosis. Making a list is a good way to organize your thoughts. No question is too vague, too detailed, or unimportant. You may find the answers to some of these questions through your own research, and some may need to be answered by your healthcare provider. Understand your diagnosis. After you have listed your questions, take some time to understand what it means to be HIV-positive. You can visit government and private websites, read printed materials (from the testing center or local library), talk with healthcare providers, or take advantage of community resources.

Find a support system. This is one of the most important pieces of managing a new HIV diagnosis. You can find support among friends, family, or members of your community. If you are not ready to tell other people about your HIV diagnosis, thats ok. Look to community resources and professional organizations that offer support groups for newly diagnosed people, one-on-one counseling, peer counselors, or health educators. Find a care provider. Your care provider will be the person who partners with you to manage your HIV care. That person will be responsible for monitoring your laboratory results, working with you to develop a proper treatment plan, advising you on health-related matters, and caring for your general health and well-being. This clinician, usually a doctor or nurse practitioner, will be your partner in your healthcare. It is important to maintain an open and honest dialogue with your care provider. Sometimes a care provider will be recommended to you at the time of your diagnosis, or you will receive a referral from the place that conducted your HIV test. In some cases, you may need or want to find a provider on your own. Prepare for your first appointment. Your first appointment with your HIV specialist can cause anxiety. Remember to bring your list of questions and be open and honest with your clinician. Take some time to research the medical tests that your clinician may want to run during your first visit. Begin thinking about who you want to tell. Disclosing can be one of the hardest parts about managing a new diagnosis of HIV. Its important to remember that you do not need to tell everyone all at once, and that there are systems in place to help you. At this time it is important to disclose your HIV status to your healthcare providers, sexual partners, and anyone who may be at high risk for exposure. Please see the section entitled Talking to Others About Your HIV Status.

WHAT IS A CD4 CELL OR T-CELL?

CD4 cells or T-cells are the generals of the human immune system. These are the cells that send signals to activate your bodys immune response when they detect intruders, like viruses or bacteria. Because of the important role these cells play in how your body fights off infections, its important to keep their numbers up in the normal ranges. This helps to prevent HIV-related complications and opportunistic infections. For more information, see the National Cancer Institutes

The Human Immune System.

THE BASICS

A normal CD4 count ranges from 5001,000 cells/mm3. When your CD4 count is 350 cells/mm3 or less, its time to consider treatment. A CD4 count of fewer than 200 cells/mm3 is one of the qualifications for a diagnosis of AIDS. Your CD4 count can vary from day to day. It can also vary depending on the time of day your blood is drawn and on whether you have other infections or illnesses, like the flu or STDs. Typically, your healthcare provider will check your CD4 counts every 3-6 months.

hat is hepatitis? Hepatitis (he-puh-TEYE-tuhs) means inflammation (swelling) of the liver. Hepatitis can be caused by:

Toxins Certain drugs Some diseases Heavy alcohol use Bacterial and viral infections

Hepatitis is most often caused by one of several viruses, which is why it is often called viral hepatitis. The most common types of viral hepatitis in the United States are hepatitis A, hepatitis B, and hepatitis C. This fact sheet focuses on viral hepatitis. You can learn more about other kinds of hepatitis from the National Library of Medicine. Return to top What are the signs of viral hepatitis? Some people with viral hepatitis have no signs of the infection. Symptoms, if they do appear, can include:

Jaundice (JOHN-duhs), which is when the skin and whites of the eyes turn yellow Low-grade fever Headache

Muscle aches Tiredness Loss of appetite Nausea Vomiting Diarrhea Dark-colored urine and pale bowel movements Stomach pain

Return to top How do you get viral hepatitis? You can get hepatitis A by eating food or drinking water contaminated with feces (stool) from a person infected with the virus or by anal-oral contact. Some ways you can get this type of hepatitis include:

Eating food prepared by a person with the virus who didnt wash his or her hands after using the bathroom and then touched the food Contact with infected household members or sexual partners Touching diaper changing tables that arent cleaned properly Eating raw shellfish that came from sewage-contaminated water

You can get hepatitis B if you come into contact with an infected persons:

Blood Semen and other fluids from having sex Needles from drug use

The virus can also be passed from an infected mother to her baby during childbirth. Hepatitis C is also spread through contact with the blood of an infected person. This usually happens when people use contaminated needles to inject drugs. Return to top Do I need to be tested for hepatitis? This depends on your risk factors. Ask your doctor about testing if:

You have ever used injectable drugs, even once You have had a blood transfusion or organ transplant prior to 1992

You can live with hepatitis C for a long time without knowing it, so it is important to discuss your risk with your doctor. Return to top How is viral hepatitis diagnosed? If you think you might have viral hepatitis, see your doctor. To diagnose your illness, your doctor will:

Ask you questions about your health history Do a physical exam Order blood tests

Hepatitis infections are diagnosed with blood tests that look for parts of the virus or antibodies your body makes in response to the virus. Return to top What's the difference between acute viral hepatitis and chronic viral hepatitis? Acute viral hepatitis is a short-term, viral infection. It happens when you first get infected with the virus and can be mild or severe. In some cases, acute infection leads to chronic infection. Chronic viral hepatitis is a long-lasting infection that can last a lifetime. Hepatitis A only causes acute infection. Hepatitis viruses B and C can cause both acute and chronic infections. Chronic hepatitis B and C are serious health problems. They can lead to:

Cirrhosis (suh-ROH-suhs) Liver failure Liver cancer

Return to top How is viral hepatitis treated? Viral hepatitis will often get better on its own after several weeks to several months. However, when hepatitis becomes a chronic or long-term illness, the infection may need to be treated with specific medications called antivirals. If you think you have any type of viral hepatitis, talk to your doctor about what treatments may be right for you.

Return to top How common is viral hepatitis? In the United States in 2007, there were an estimated:

25,000 new hepatitis A infections 43,000 new hepatitis B infections 17,000 new hepatitis C infections

An estimated 800,000 to 1.4 million people have chronic hepatitis B and 3.2 million people have chronic hepatitis C in the United States. Between 75 and 85 percent of people who get infected with the hepatitis C virus develop a chronic infection. Return to top How can I prevent viral hepatitis infection? Below are the best methods for preventing the hepatitis viruses most commonly seen in the United States. Hepatitis A prevention

Get vaccinated. People with certain risk factors and health problems need this vaccine, so ask your doctor if the vaccine is right for you. Properly wash your hands following bathroom use and diaper changes, and before preparing or eating food.

Hepatitis B prevention

Get vaccinated. As with other sexually transmitted infections, limit sexual partners and use latex condoms to help lower your risk.

Hepatitis C prevention

Do not share needles or other equipment used to inject drugs, steroids, or cosmetic substances. Do not use personal items that may have come into contact with an infected persons blood, such as razors, nail clippers, toothbrushes, or glucose monitors. Do not get tattoos or body piercings from an unlicensed facility or in an informal setting.

If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharp objects.

If you are pregnant, your doctor will test your blood for hepatitis B. If you are an infected mother, your baby should be given hepatitis B immune globulin (H-BIG) and the hepatitis B vaccine within 12 hours after birth. If you have chronic hepatitis B, make sure your babies get all of their hepatitis B shots in the first six months of lif Return to top Who should get viral hepatitis vaccines? The hepatitis A vaccine is given in two doses, six to 18 months apart. The vaccine is recommended for:

Travelers to areas with high rates of hepatitis A Men who have sex with men Injection and non-injection drug users Persons with clotting factor disorders, like hemophilia (hee-muh-FIL-ee-uh) People with chronic liver disease All children at age 1

The hepatitis B vaccine is usually given in three doses over six months. The vaccine is recommended for:

All children at birth A person that lives with or has sex with someone who has chronic hepatitis B Men who have sex with men Someone who has been recently diagnosed with a sexually transmitted infection (STI) People with multiple sex partners Someone who uses needles to inject drugs People whose jobs expose them to human blood

Return to top How long do the hepatitis A and B vaccines protect you? Only one series of the hepatitis A vaccine (two shots) and hepatitis B vaccine (three shots) is needed during a person's lifetime. Most people dont need a booster dose of either vaccine. But, if you have had hemodialysis (hee-moh-dy-AL-uh-suhs) (medical procedure to purify blood) or have a weakened immune system, your doctor might recommend a booster dose of the hepatitis B vaccine. Return to top

Is it safe to visit someone with hepatitis? It is safe to visit someone with viral hepatitis. You cannot get hepatitis through casual contact. It is fine to shake hands with, hug, or kiss someone who is infected with any type of viral hepatitis. Return to top How does a pregnant woman pass hepatitis B virus to her baby? During birth, blood from the mother gets inside the babys body. If the mother has hepatitis B virus in her blood, her baby will likely become infected. But this can be prevented by having the baby receive all of the shots in the hepatitis B vaccine series. A very small number of babies get infected before birth. Return to top If I have hepatitis B, what does my baby need so that she doesn't get the virus? Make sure your baby gets the hepatitis B vaccine and hepatitis B immune globulin (H-BIG) within 12 hours of birth. Your baby will need two or three more shots of vaccine over the next one to 15 months to help prevent hepatitis B. The timing and total number of shots will depend on the type of vaccine and babys age and weight. The vaccine is very important. More than 90 percent of babies who are exposed to the virus, but dont get the vaccine, develop chronic hepatitis B. Your baby should be tested after the last vaccine shot to make sure he or she is protected from the disease. Return to top Can I breastfeed my baby if I have hepatitis B? Yes, you can breastfeed your baby if you have hepatitis B. Make sure your baby gets the hepatitis B vaccine and hepatitis B immune globulin (H-BIG). Take good care of your nipples to prevent cracking and bleeding. If your nipples are cracking or bleeding, avoid nursing your baby on that breast until the sores heal. Until they heal, you can pump your milk to keep up your milk supply. But, you should throw away this pumped milk. Do not feed it to your baby.