HEALTH SERIES: HIV/AIDS Pt 3 – Prevention and Diagnosis – Dr.Chin Akano
In this part, i shall be discussing how HIV infection can be diagnosed and how to prevent it.
How can HIV infection be diagnosed
The only way to diagnose this infection at the moment is through blood tests.
Many HIV-positive people are unaware that they are infected with the virus, so it is necessary for at risk individuals to always check their HIV status as soon as possible and those that have symptoms to do so immediately.
Early diagnosis of the infection is essential as treatment commenced early enough in the illness leads to a much better outcome than when started very late in the illness.
There are two common blood tests for diagnosing HIV infection
a) Screening test known as ELISA which stands for enzyme -linked immunosorbent assay
b) confirmatory tests such as western blot or immunofluorescence assay (IFA).
Only specimens that are repeatedly reactive by ELISA and positive by IFA or reactive by Western blot are considered HIV-positive and indicative of HIV infection.
Testing post exposure is recommended initially and at six week, three months, and six months.
c) After the confirmation that an individual is HIV positive with the above tests, then another test known as CD4 count is done.
This checks the level of CD4 T cells in your blood stream. CD4 T cell is the type of white blood cells in the blood which helps in fighting infection for you.
This count gives the doctor an idea of how bad your infection is and whether to start treatment immediately or defer it.
In d US and UK, HIV infected individuals who are not ill are started on treatment when their CD4 count is 350 but if if unwell, treatment is started immediately even if the CD4 count is above 500.
CD4 count of 200 and below indicates a very bad immunity level and this is usually the case in the late stage of HIV otherwise referred to as AIDS
How can HIV infection be prevented?
The commonest cause of HIV transmission is unprotected sexual relationship ( vaginal, anal and oral) and, also through sharing sex toys with a HIV positive- person
So protected and sensible sexual activities largely reduce your risk of contacting HIV. If one can abstain if unmarried, by all means do so but if that is not possible then the under-listed measures will help you avoid contacting HIV.
* A condom is the most effective form of protection against HIV.
A condom has to be worn consistently and correctly for it to give you the desired protection during vaginal, anal and oral sex performed on men and women.
We should remember that HIV can be passed on before ejaculation, through pre-come and vaginal secretions, and from the anus.
It is very important that condoms are put on before any sexual contact occurs between the penis, vagina, mouth or anus.
* Use of water based Lubricants like K-Y Jelly can make sex safer by reducing the risk of vaginal or anal tears caused by dryness or friction and it can also prevent a condom from tearing.
Please note that only water-based lubricant (such as K-Y Jelly) can be used for this purpose. Oil-based lubricants such as vaseline or massage and baby oil should never be used with condoms as they weaken the latex in condoms and can cause them to break or tear.
* For those that indulge in oral sex, a dental dam is helpful in preventing the spread . This is a small sheet of latex that works as a barrier between the mouth and the vagina or anus to reduce the risk of STIs during oral sex.
Other Means of Prevention
* Proper screening of blood before transfusion
* Avoiding needle sharing for drug abusers and in hospitals. Please if you inject drugs be it illicit drugs or prescribed injections don’t share needles as this could expose you to HIV and other viruses found in the blood like hepatitis B and C
*Post exposure prophylaxis: This is how to prevent you from contacting a HIV infection following an exposure to e.g. after a needle stick injury or unprotected sex or any other exposure with suspicious circumstances liable to transmit HIV to you.
This is achieved by taking a course of anti-retroviral treatment immediately or latest 72 hours after exposure . The medication is taken for up to a month.
*Then how do we prevent HIV from being passed from a HIV positive woman to her unborn child in the womb?
Infection from HIV infected pregnant woman to her baby is prevented by putting her on anti-retroviral medication and also avoiding vaginal delivery. Caesarian section (CS) is the preferred means of delivery in this circumstance
Infection from an infected mother to her new born baby is prevented by continuing on medication and avoiding breast feeding.
Finally i like to say that there is no available vaccine for HIV or AIDS.
Series will continue tomorrow on how to manage and live with HIV infection and also prognosis.
Thank you for reading.
Dr.Chin Akano