How is AIDS Diagnosed?

As HIV progresses to AIDS, the body's CD4 lymphocyte (white blood cell) count decreases. When the CD4 count falls below 200 cubic millimeters per blood (the average CD4 count is 800-1,500), the patient can be diagnosed with AIDS. This process can take as long as 10 years or more. Rare complications, such as AIDS associated dementia and reoccurring tuberculosis, can also be used to diagnose AIDS, since these illnesses would not normally infect someone with a healthy immune system. Alternatively, there is a list of symptomatic diseases that prompt physicians when to suspect defective cell-mediated immunity.

Diseases Symptomatic of Defective Cell-Mediated Immunity
  • Candidiasis of bronchi, trachea, or lungs
  • Candidiasis, esophageal
  • Cervical cancer, invasive
  • Coccidioidomycosis, disseminated or extrapulmonary
  • Cryptococcosis, extrapulmonary
  • Cryptosporidiosis, chronic intestinal (greater than 1 month's duration)
  • Cytomegalovirus disease (other than liver, spleen, or nodes)
  • Cytomegalovirus retinitis (with loss of vision)
  • Encephalopathy, HIV-related
  • Herpes simplex: chronic ulcer(s) (greater than one month duration); or bronchitis, pneumonitis, or esophagitis
  • Histoplasmosis, disseminated or extrapulmonary
  • Isosporiasis, chronic intestinal (greater than one month duration)
  • Kaposi's sarcoma
  • Lymphoma, Burkitt's (or equivalent term)
  • Lymphoma, immunoblastic (or equivalent term)
  • Lymphoma, primary, of brain
  • Mycobacterium avium complex or M. kansasii, disseminated or extrapulmonary
  • Mycobacterium tuberculosis, any site (pulmonary or extrapulmonary)
  • Mycobacterium, other species or unidentified species, disseminated or extrapulmonary
  • Pneumocystis carinii pneumonia
  • Pneumonia, recurrent
  • Progressive multifocal leukoencephalopathy
  • Salmonella septicemia, recurrent
  • Toxoplasmosis of brain
  • Wasting syndrome due to HIV

Factors that Complicate HIV Control

HIV is an equal opportunity infection. Anyone can contract it, just as anyone can transmit it. Nearly a quarter of the people with HIV, in fact, do not know they have it (Know Curriculum, 2007 revision). A primary strategy to mitigate HIV transmission is to influence how society controls infection rates. To help you identify high-risk groups, please refer to the list below:

What Increases the Likelihood of Contracting HIV?

HIV is transmitted through body fluids, such as semen, vaginal secretions, blood and breast milk, however this alone does not determine how likely you are to contract HIV. There are many components to take into consideration in addition to the exposure.

Sexually transmitted infections, such as herpes and syphilis, cause skin breaks, through which HIV can enter the body. Chlamydia causes inflammation, which increases HIV viral loads in secretions and shedding. Sores caused by genital ulcers also offer additional entry points for HIV.

Women who are infected with HIV have increased HIV viral loads during their menstrual periods. It is recommended to avoid sex around this time, or to use a condom. If using birth control, always pair it with a condom as it is speculated that birth control can potentially alter the vaginal environment, according to WHO research (conclusions are still not entirely clear). The WHO has found that nonoxyl-9 spermicides irritate the lining of the vagina and can increase susceptibility to HIV.

If needles are used recreationally, and shared with others, it is best to use new, sterile needles, instead of sharing them. If needles must be reused, a mixture of water and bleach can be drawn and emptied to reduce the threat of contamination. Repeated needle entry into the body dramatically increases the chances of HIV transmission.

In mothers, HIV can be transmitted two ways: through breast milk, and unmanaged vaginal delivery. Anti-retroviral medication decreases viral loads in the body, which helps boost delivery success rates, especially when a C-section is used, though surgery can increase infection risk. HIV medications, if used incorrectly, can potentially cause defects in the child. Thus, it is important to encourage open communication about medications being taken.

Overall health and nutrition can impact how well the immune system takes care of the body. If healthy, the immune system has a better chance of stopping HIV in the beginning. If you are depressed, do exercise, try new hobbies, or share your feelings, as depression can weaken your immune system.

In younger people, (ages 15-24), the likelihood of HIV being transmitted increases with the number of unprotected sexual partners. An interesting cultural phenomenon shows that traditional monogamy values aid in the decline of HIV infection rates. Consistent condom use or mutual or solo masturbation are advisable alternatives. Alternative forms of affection can help prevent unnecessary sexual exposure as well (e.g. kisses and hugs).