This information provided by Project HOPEFUL volunteers and vetted by several pediatric infectious disease physicians involved with Project HOPEFUL. Our thanks to each of them for their professional review and input.

HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome, or AIDS. HIV resides in the blood and weakens the immune system over time. HIV is spread through body fluids that affects specific cells of the immune system, called CD4 cells or “T” cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. When this happens, HIV infection leads to AIDS.

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HIV can be passed from person to person in a very limited number of ways; specifically it can only be passed through shared needles (IV drug use), unsafe intercourse, and mother-to-child-transmission during birth.

HIV affects people around the globe, but access to modern medicine has reduced HIV’s impact in many regions. An estimated 1.1 million people are living with HIV in the United States, but another 30+ million have HIV in other countries, according to the US Department of Health and Human Services. There is almost no mother-to-child transmission any longer in the US, and very few US-born children are HIV positive. Unfortunately, that is not the case in other parts of the world. Over 97% of HIV positive people live in low and middle-income countries (particularly African countries). HIV continues to spread and end lives early where people have inadequate access to education, prevention, care, and counseling.

Thanks to on-going research and investment, HIV medications continue to improve; people with HIV are now living longer—and with a better quality of life—than ever before. Meanwhile, with proper medical care, HIV can be controlled. Treatment for HIV is often called antiretroviral therapy or “ART.” It can dramatically prolong the lives of many people infected with HIV and lower the threat of transmission. Before the introduction of ART in the mid-1990s, people with HIV could succumb to AIDS in just a few years. Most research indicates that children with HIV who are receiving modern western medicine (antiretrovirals) can expect a normal life expectancy.

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Unlike some other viruses, the human body cannot get rid of HIV on its own or with any known clinical regimen at this point in time. That means that (today), once a person has HIV, s/he will have it for life. No effective cure exists, but scientists are working hard to find one and they remain hopeful. Recent research has focused on a possible therapy for babies born positive and a process called gene editing for adults. Physicians and researchers are hopeful there may be a cure for HIV and/or AIDS in the future.

The following short commentaries may be helpful:

AIDS (acquired immunodeficiency syndrome): This is the stage of infection that occurs when an immune system is badly damaged and becomes vulnerable to infections and infection-related cancers called opportunistic illnesses. Normally, CD4 counts range between 500 and 1,600 cells per cubic millimeter of blood (which can be written as “500/mm3”). When the number of CD4 cells falls below 200 cells per cubic millimeter of blood (“200 cells/mm3”), a person has progressed to AIDS. A person can also be diagnosed with AIDS if s/he develops one or more opportunistic illnesses, regardless of the CD4 count. Without treatment, people who are diagnosed with AIDS typically survive about 3 years. If the person also contracts a dangerous opportunistic illness, life expectancy without treatment falls to about 1 year.

Treatment: It’s very important for people who have HIV to take their medicines exactly as directed. Not taking medications correctly may lower the level of CD4 cells and cause the level of virus in their blood (the “viral load”) to go up. If this happens, the medicines become less effective. This can also lead to developing a “tolerance” for a drug regimen and the subsequent need to switch medications. Because there is a limited number of treatment regimens commercially available today, (and therefore HIV patients can’t just keep switching regimens) adherence is important.

Spread of the Virus: HIV is spread through body fluids such as blood, semen, vaginal fluids, and breast milk. In the United States, HIV is most commonly passed from one person to another through unprotected anal or vaginal sex or through sharing needles or other drug equipment. In addition, a mother can pass HIV to her baby during pregnancy, labor, breastfeeding, or by pre-chewing her baby’s food.

Blood tests: People who are infected with HIV monitor closely two particular blood counts: their viral load and their CD4 levels. Viral load can range from undetectable levels of 40 to 75 copies per milliliter of blood to tens of millions of copies. The higher the viral load, the greater the risk of spreading HIV to others. The goal of treatment is to suppress the viral load to undetectable levels.

Although having a low viral load (and high CD4) greatly decreases the chance of spreading HIV, some risk remains. To avoid transmission, it is critical to ensure that people do not come into contact with the bodily fluids of others.

  • Abstinence (not having sex) is the best way to prevent the spread of HIV infection and some other STDs. If abstinence is not possible, use condoms.
  • Do not share drug equipment. Blood can get into needles, syringes, and other equipment. If the blood has HIV in it, the infection can be spread to the next user.
  • Do not share items that may have blood on them, such as razors or toothbrushes.

More information on HIV and AIDs can be found at the US Department of Health and Human Services website AIDS.gov.