Welcome to informationhood health section, today we are going to talk about HIV/aids in Nigeria, we are going to look deeply into this deadly virus, such as the early and severe symptoms, treatment, and how HIV is been transmitted from one person to another in Nigeria.
HIV/AIDS in Nigeria: Symptoms, Treatment and Mode of Transmission
WHAT IS THE MEANING OF HIV AND AIDS?
HIV stands for Human Immunodeficiency Virus. HIV harm the immune system by destroying the white blood cells that help the body to fight infections. HIV put the body at risk of serious infections and certain cancers. AIDS stands for Acquired Immunodeficiency Syndrome.
AIDS is the final stage of HIV infection but not every HIV infections develop into AIDS. Early treatment of HIV infection help prevent its development into AIDS. Human Immunodeficiency Virus is the virus that cause the Acquired Immunodeficiency Syndrome. It suppresses and weakens the strength of the body immune system which give way for different infections, diseases, conditions and Cancers, into the body. Infected immune system find it difficult to fight the infections and diseases.
Immune system And HIV
The immune system is a host defense system which comprises of many biological structures and processes within an organism that protect the body system against diseases. An immune system functioning properly, should detect a wide variety of agents known as pathogens (from various viruses and parasitic worms) and distinguish them from the body healthy tissue and organisms).
In the body, the immune system can be classified into subsystems; the innate immune system (humoral immunity) and the adaptive immune system (cell-mediated immunity). In humans, the blood–brain barrier, blood–cerebrospinal fluid barrier, and similar fluid–brain barriers separate the peripheral immune system from the neuroimmune system, which protects the brain.
Disorder of the immune system result in autoimmune diseases, inflammatory diseases and cancer. Immunodeficiency occurs when the immune system is less active than normal, resulting in recurring and life-threatening infections.
In humans, immunodeficiency can either be the result of a genetic disease such as severe combined immunodeficiency, acquired conditions such as HIV/AIDS, or the use of immunosuppressive medication. Also, autoimmune diseases results from a hyperactive immune system attacking normal tissues as if they were foreign organisms.
Common autoimmune diseases include Hashimoto’s thyroiditis, rheumatoid arthritis, diabetes mellitus type 1, and systemic lupus erythematosus.
HIV infects the immune system by attaching itself to the T cell and merge with the host T cells. T cells, also known as CD4 cells is a type of white blood cell that form a crucial part of the immune system. HIV multiplies inside the T cells.
The HIV virus damages or destroys the T cells before moving on to infect other cells. CD4 count indicates how healthy an immune system is. A healthy CD4 count is between 500 and 1,500. The CD4 count of a person with HIV who does not receive HIV treatment reduces over time. Once the CD4 levels fall below 200, the immune system is probably damaged and the person is likely to experience definitive signs and symptoms of illness.
People with HIV that are not receiving treatment put themselves at greater risk of developing symptoms, a condition known as symptomatic HIV. They are also more likely to transmit the virus. Untreated HIV infection develop into AIDS because the immune system is no longer able to protect the body.
At this stage, even the most minor infection becomes life-threatening.
Difference Between HIV And AIDS
HIV (Human Immunodeficiency Virus) is the virus that cause AIDS while AIDS (Acquired Immunodeficiency Syndrome) is a condition or syndrome, cause by the virus. AIDS is the final stage of HIV infection.
Mode Of HIV Transmission
HIV is mostly contacted through unprotected sex with an infected person. It contacted by sharing needles, sharp objects or through contact with the blood of an infected person. Infected women can transmit it to their babies during pregnancy or childbirth.
HIV is spread through certain body fluids from an infected person. These fluids include blood, semen, pre-seminal fluids, rectal fluids, vaginal fluids, and breast milk. These fluids must come in contact with a mucous membrane or damaged tissue or directly injected into the bloodstream (from a needle or syringe) for transmission to occur. Mucous membranes are found inside the rectum, vagina, penis, and mouth.
HIV can be transmitted through any of the following ways;
- Anal or Vagina sex
- Oral sex- sucking penis (fellatio), vagina (cunnilingus), or anus (rimming).
- Sharing sharp objects like needles and blade, with an infected person.
- Eating food pre-chewed by an infected person.
- Blood transfusion and organ/tissue transplant.
- From mother to child during pregnancy, child birth and breast feeding.
- Deep bite from an infected until skin is broken.
- Deep kiss from an infected person.
- Contact of open wound or broken tissue with infected blood.
HIV/ AIDS TABOO AND WAYS BY WHICH THEY ARE NOT TRANSMITTED.
HIV are not transmitted by:
- Hugging and shaking infected person.
- Sharing spoon, plates and cups.
- Sharing public toilet.
- Contact with saliva, tears, or sweat that is not mixed with the blood of an HIV-positive person.
- Bite from Mosquitoes, ticks or other blood-sucking insects.
- Breathing in air.
EARLY SIGN AND SYMPTOMS OF HIV INFECTION
The first signs of HIV infection are swollen glands and flu-like symptoms. These come and go within two to four weeks. Severe symptoms may not appear until months or years later.
The first signs of HIV usually appear after 2-6 weeks of infection in form of flu-like symptoms, a condition known as seroconversion illness. Seroconversion is the stage when human body produces antibodies to fight HIV, which means that the immune system is fighting the infection.
Flu-like symptoms that accompany seroconversion include:
- Skin rash.
- Sore throat.
- Swollen glands.
- Severe headache.
- Joint or muscle pain.
These symptoms usually last for 1-2 weeks. Once the seroconversion period is over, the person maynot experience any HIV symptoms for several years. Although people look healthy at this stage, it is important to have in mind that HIV is still active. As HIV continue to reproduce and infect new T cells, HIV damage the immune system, which disable it’s ability to protect the body from illnesses.
Less common symptoms of HIV/AIDS include:
- Swollen lymph nodes
- Ulcers in the mouth or on the genitals
- Muscle aches
- Joint pain
- Nausea and vomiting
- Night sweats
SEVERE SIGN AND SYMPTOMS OF HIV/AIDS.
- Persistent diarrhea.
- Chronic fatigue.
- Rapid weight loss.
- Cough and shortness of breath.
- Recurring fever, chills and night sweats.
- Rashes, sores or lesions in the mouth or nose, on the genitals or under the skin.
HOW TO AVOID HIV/AIDS
- Avoid unprotected sex.
- Avoid anal and oral sex.
- Limit the number of your sex partners.
- Use condom if you are not sure of your sex partners.
- Treat sexually transmitted diseases at early stage.
- Avoid sharing sharp objects like needles and blades.
- Blood should be thoroughly screened before blood transfusion.
- Organs and tissues should be well tested before transplant.
- People who are at high risk should be placed on HIV prevention medicines.
HOW LONG DOES IT TAKE TO START SHOWING SYMPTOMS AFTER INFECTION?
The earliest symptoms of an HIV infection typically occur between two to four weeks after the initial infection. This is because it takes time for the virus to infect enough cells to begin spreading throughout the body and affect immune system health.
SIGN AND SYMPTOMS OF AIDS
Thanks to better antiviral treatments, most people with HIV in the Nigeria today don’t develop AIDS. Untreated HIV typically turns into AIDS in about 10 years. When AIDS occurs, it means the immune system has been severely damaged.
The infected person is more likely to develop opportunistic infections, opportunistic cancers and diseases that wouldn’t trouble someone with a healthy immune system.
The signs and symptoms of some of these infections may include:
- Soaking night sweats.
- Recurring fever.
- Chronic diarrhea.
- Weight loss.
- Skin rashes and bumps.
- Persistent and unexplained fatigue.
- Persistent white spots or unusual lesions on the tongue or mouth.
COMPLICATIONS OF HIV/AIDS.
HIV infection weakens the immune system, giving way for numerous infections and certain types of cancers.
Infections common to HIV/AIDS;
Tuberculosis (TB): TB is the most common opportunistic infection associated with HIV. It’s a leading cause of death among people with AIDS.
Cytomegalovirus: This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus and it remains dormant in the body. Once the immune system is weakened, the virus is activated and it cause damage to the eyes, digestive tract, lungs or other organs in the body.
Candidiasis: Candidiasis is a common HIV-related infection. It causes inflammations, a thick, white coating on the mucous membranes of the mouth, tongue, esophagus or vagina.
Cryptococcal meningitis: Meningitis is an inflammation of the body membranes and fluid surrounding your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus found in soil.
Toxoplasmosis: This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasites in their stools, which may then spread to other animals and humans. Seizures occur when it spreads to the brain which can lead to death of the infected person.
Cryptosporidiosis: This infection is caused by an intestinal parasite that is commonly found in animals. Infection occur when someone eat or drink contaminated food or water. The parasite grows in the intestines and bile ducts, leading to severe and chronic diarrhea in people with AIDS.
Cancers common to HIV/AIDS;
Kaposi’s sarcoma: A tumor of the blood vessel walls, this cancer is rare in people not infected with HIV, but common in HIV-positive people. It usually appears as pink, red or purple lesions on the skin and mouth. In people with darker skin, the lesions may look dark brown or black. Kaposi’s sarcoma also affect the internal organs including the digestive tract and lungs.
Lymphoma: This cancer starts in the white blood cells. The most common early sign is painless swelling of the lymph nodes in your neck, armpit or groin. Lymphoma is common in people with AIDS.
Other complications include;
Wasting syndrome: Aggressive treatment approaches have reduced the number of cases of wasting syndrome, but it still affects many people with AIDS. It is defined by loss of at least 10 percent of body weight often accompanied by diarrhea, chronic weakness and fever.
Neurological complications: Although AIDS doesn’t appear to infect the nerve cells, it can cause neurological symptoms such as confusion, forgetfulness, depression, anxiety and difficulty walking. One of the most common neurological complications is AIDS dementia complex, which leads to behavioral changes and reduced mental functioning.
Kidney disease: HIV-associated nephropathy (HIVAN) is an inflammation of the tiny filters in the kidneys that remove excess fluid and wastes from the blood and pass them to urine. It most often affects blacks or Hispanics. Anyone with this complication should be placed on antiretroviral therapy.
HOW LONG DOES SOMEONE WITH UNTREATED HIV/AIDS HAS TO LIVE?
Without medication, there is a gradual loss of CD4+ cells in the body. Typically people start developing symptoms when CD4 counts drop below 100, there is no way to know how long this will take for each individual, but several years would be an average time-line. There is also no way to predict exactly how someone with untreated AIDS will die but in general, it involves suffering which is difficult to hide. Therefore it is not easy to predict the number of years someone with untreated HIV/AIDS will live.
HOW OFTEN SHOULD SOMEONE GO FOR HIM CHECKUP?
It is advisable to go for HIV check up every three month at least.
CAN HIV POSITIVE PERSON MARRY AN UNINFECTED PERSON?
This is very possible. Someone with HIV can marry someone without the infection once the infected person is placed on antiretroviral medications.
CAN AN INFECTED PERSON GIVE BIRTH TO AN UNINFECTED BABY?
The infected person is placed on medications that suppress the spread and reduce the reproduction of the virus in the immune system. The drugs also boost the CD4 count in the body. Regular intake of the drugs as prescribed by the doctor, make it possible to give birth to a free child.
HIV/ AIDS IN PREGNANCY.
HIV transmission from mother to child during pregnancy, labor, delivery or breastfeeding is called perinatal transmission. Perinatal HIV transmission is the most common way children are infected with HIV. If a woman is infected with HIV, her risk of transmitting the virus to her baby is reduced if she stays as healthy as possible.
Factors which increase the risk of transmission include:
- Vitamin A deficiency.
- Infections such as STD.
- Clinical stage of HIV, including viral load (quantity of HIV virus in the blood)
Factors related to labor and childbirth.
Factors that reduce the risk of transmission of HIV from mother to child include:
Cesarean section or rupture of the membrane before labour start. significantly reduce the risk of perinatal transmission of HIV.
Full medical care for the mother during pregnancy: Pregnant women with HIV should be placed on antiretroviral drugs. Women who have not received any drug treatment before labor should be treated during labor with one of several possible drug regimens. These may include a combination of ZDV and another drug called 3TC or Nevirapine. Studies suggest that these treatments, even for short durations, may help reduce the risk of the baby contacting the virus.
Zidovudine (also known as ZDV, AZT and Retrovir®) was the first drug licensed to treat HIV. Now it is used in combination with other anti-HIV drugs and is often used to prevent perinatal transmission of HIV. ZDV should be given to HIV-infected women beginning in the second trimester and continuing throughout pregnancy, labor and delivery. Side effects include nausea, vomiting and low red or white blood cell counts
DIAGNOSIS OF HIV/AIDS.
Diagnosis of HIV include HIV Antibody test, Antibody/ Antigen combination test and CD4 T-cell count.
Antibody Screening Tests
These tests check for a kind of protein that the body produce in response to HIV infection, within 2 to 8 weeks of infection. They are also called Immunoassay or ELISA tests. They are generally very accurate, but they don’t detect early HIV infection. Usually, this test involve the use of blood sample. Some immunoassay tests check urine or fluids from your mouth (not saliva), there are not many antibodies in the mouth, so this might not give a positive result even if the person is infected. Rapid versions of these blood and oral fluid tests give results in 30 minutes, but they may give false negatives.
Antibody/Antigen Combination Tests
These tests involve the use of blood samples. They are very accurate and detect HIV 20 days earlier than antibody screening tests. They check for HIV antigen, a protein called p24 that is part of the virus that shows up 2-4 weeks after infection, as well as HIV antibodies in the blood. A rapid antibody/antigen combination test give result in 20 minutes.
This detect the virus itself in the blood. It can diagnose HIV about 10 days after infection. It is expensive so it is usually not the first test. But if you’re at high risk and you have flu-like symptoms, your doctor may want to use it.
CD4 T-cell count
This is used to monitor immune system function in HIV-positive people. Declining CD4 T-cell counts are considered to be a marker of progression of HIV infection. A normal CD4 count range from 500 cells/mm3 to 1000 cells/mm3 but it is below 200 in HIV patients. In HIV-positive people, AIDS is officially diagnosed when the count drops below 200 cells/μL or when certain opportunistic infections occur.
TREATMENT OF HIV/AIDS
There is no cure, but there are many medicines that fight HIV infection and lower the risk of infecting others. People who get early treatment can live with the disease for a long period of time. Loss of CD4 cells makes it hard for the body to fight off infections and certain HIV-related cancers. HIV drugs prevent HIV from multiplying (making copies of itself), which reduces the amount of HIV in the body. Having less HIV in the body gives the immune system chance to recover.
NIAID (National Institute of Allergy and Infectious diseases) and other researchers have develop drugs that fight both HIV infection and its associated infections and cancers. In combination with early detection through HIV testing, available HIV therapies can greatly extend years and quality of life for infected people. This resulted in a dramatic decrease in deaths of people living with HIV/AIDS all over the world.
Antiretroviral drugs are used for HIV treatment though it cannot cure the disease. there will still remain some HIV in the body but it boost the immune system which is then strong enough to fight off infections and certain HIV-related cancers. By reducing the amount of HIV in the body, HIV medicines also reduce the risk of HIV transmission.
Antiretroviral (ARV) HIV drugs are classified into six drug classes based on how each drug interferes with the HIV life cycle. These six classes include the nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), fusion and entry inhibitors, pharmacokinetic enhancers, and integrase strand transfer inhibitors (INSTIs).
HIV treatment involve the use of combination of drugs. Examples of these drugs include:
- Abacavir/dolutegravir/lamivudine (Triumeq).
- Dolutegravir/rilpivirine (Juluca).
- Elvitegravir / cobicista t/ emtricitabine / tenofovir disoproxil fumarate (Stribild).
- Elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide (Genvoya).
- Efavirenz /emtricitabine /tenofovir disoproxil fumarate (Atripla).
- Emtricitabine / rilpivirine / tenofovir disoproxil fumarate (Complera).
- Emtricitabine / rilpivirine / tenofovir alafenamide (Odefsey).
Bictegravir, emtricitabine, and tenofovir alafenamide (approval from the FDA expected by the end of February 2018).
RATE OF HIV/AIDS IN NIGERIA.
According to the survey done in 2016, Nigeria has the second largest HIV epidemic in the whole world. Although HIV prevalence among adults is remarkably small (2.9%) compared to other sub-Saharan African countries such as South Africa (18.9%) and Zambia (12.4%), the size of Nigeria’s population means 3.2 million people were living with HIV in 2016. 220, 000 new infections and 160,000 AIDS related death were detected, 31% of our adults and 21% of our children were on antiretroviral drugs.
Today, Nigeria still remain the second largest HIV epidemic in the world and has one of the highest new infection rates in sub-Saharan Africa. HIV infection is prevalent among sex workers, lesbians, gay, children that are orphaned and drug addicts. Many people living with HIV in Nigeria are unaware of their status due to the country falling short providing the recommended number of HIV testing and counselling sites.
Low access of antiretroviral treatment remains an issue for people living with HIV, meaning that there are still many AIDS-related deaths in Nigeria. Punitive laws against homosexuality has meant that men who have sex with men are now even more vulnerable to HIV infection and face many difficulties accessing HIV services.
Nigeria also has the fourth largest tuberculosis epidemic in the world, as co-infection of HIV. TB co-infection now becoming an increasing concern for people living with HIV. There is need to provide more publicity, health assurance and more health care facilities for people living with HIV.
LIST OF HOSPITALS THAT TREAT HIV/AIDS IN NIGERIA.
- National orthopaedic hospital, Ikorodu, Lagos.
- Saint Nicholas hospital, Victoria island, Lagos.
- Lagos mainland hospital, Yaba, Lagos.
- Nasfat Health And HIV Initiatives, Ilupeju, Lagos.
- Nigerian Institute of Medical Research, Yaba, Lagos.
- Federal Medical Centre, Umuahia.
- Adamawa State.
- Federal Medical Centre, Yola.
- General Hospital, Ganaye, Adamawa.
- General Hospital, Mubi.
- Elyon Life Care, Uyo.
- Emmanuel General Hospital, Eket.
- General Hospital, Ikot Abasi.
- Saint Luke Hospital, Akwa Ibom.
- Nnamdi Azikiwe Teaching Hospital Nnewi.
- Saint Charles Borromero Catholic Hospital, Onitsha.
- General Hospital, Ekwulobia.
- General Hospital, Akwa.
- Comprehensive Health Centre, Anaocha, Nneni.
- Comprehensive Health Centre, Dunukosia, Ukpo.
- Comprehensive Health Centre, Ohi, Umunya.
- General Hospital, Onitsha.
- Rushgreen Hospital, 4, Uawannabampa Rd, Onitsha.
- Specialist Hospital, Azare.
- Bauchi Specialist Hospital, Bauchi.
- General Hospital, Toro.
- Niima Consultant Hospital, Bauchi.
- General Hospital, Alkaleri.
- Federal Medical Centre, Yenagoa.
- General Hospital, Okolobiri.
- General Hospital, Dass.
- General Hospital, Calabar.
- Holy Trinity Hospital, Ikom.
- Comprehensive Health Centre, Boje/Boki.
- Central Hospital Sapele Rd. Benin City.
Faith Mediplex, Giwaamu, Opposite Church of God Mission, Airport Road, Benin.
- Central Hospital, Benin Edo State.
- Central Hospital, Ika South, Agbor.
- University of Benin Teaching Hospital, Benin.
- Comprehensive Health Centre, Ovia South East, Udo.
- Irrua Specialist Hospital, Edo.
- Irrua Specialist Teaching hospital, Esan.
- Primary Health Centre, Ovia North East, Oluku, Edo State.
- Federal Medical Centre, Iddo Ekiti.
- Ahmadu Bello University Teaching Hospital, Zaria
- St. Gerald’s Catholic Hospital, Kaduna.
- Mothers Welfare Group (Old ABU Campus), Kaduna.
- General Hospital, Kwoi.
- General Hospital, Zango Kataf.
- Army Reference Hospital, Kaduna.
- General Hospital, Saminaka.
- Barau Dikko Specialist Hospital.
- St. Louis Hospital Zonkwa, Kaduna.
- General Hospital, Kafanchan.
- Federal medical Centre, Birnin Kebbi.
- Sir Yahaya Memorial Hospital, Kebbi.
CONCLUSION / Advice.
It is advisable to visit your doctor immediately you notice any of the above signs and symptoms. Go for check up every three month, early detection of HIV infection prevent it from developing into AIDS. Infected people should take their medications regularly to avoid infecting others. HIV/AIDS could be deadly if not treated early.