Anonymous HIV treatment clinic. Interview with the chief physician of a private clinic for people with HIV. AIDS also occurs in four stages

“The results of work with HIV-infected patients in the capital in many respects have already reached the indicators established by the State Strategy... The capital’s healthcare provides the necessary medical care for HIV infection to all persons staying in the city without exception”

A.I. Mazus, head of the Moscow AIDS Center
Moscow Medicine, 2017

Registered residents of Moscow

By the end of 2018, the total number of HIV-infected people identified since the beginning of the epidemic in Moscow, among people with permanent registration in the city (for brevity, “registered”), reached 60.6 thousand people. Of these people, about 11.8 thousand died for various reasons or dropped out, and 48.7 thousand people were alive and remained in the city.

As of the end of 2018, 20.2 thousand people (41% of those alive) were receiving antiretroviral therapy.

Cumulative number of HIV-positive people and the number of people receiving therapy among those prescribed in Moscow

Calculation according to MGC AIDS data
Number of deaths for 2011 and 2012 — estimate based on Rosstat data on AIDS mortality in Moscow

Treatment is considered effective if the virus is not detected in the blood, in other words, the viral load is suppressed. There were only 16.5 thousand such people in Moscow in 2018 - a third of the registered Muscovites living with HIV.

Cascade of treatment for prescribed Muscovites in 2018

Thousands

Data: MGC AIDS, TsNIIOIZ Ministry of Health

The goal of the World Health Organization and the Joint United Nations Program on HIV/AIDS (UNAIDS):

"By 2020 90% of all people those diagnosed with HIV infection should receive stable antiretroviral therapy. U 90% of people receiving antiretroviral therapy, viral suppression should be observed."

• For an HIV-infected person: early initiation of therapy means preserving the immune system, health and life.
• For people without HIV: A suppressed viral load in people with HIV reduces the risk of spreading the virus.

In Russia, since 2013, provision of therapy has been allowed, and since 2016, it has been recommended for everyone.

In Moscow, the start of therapy is allowed for everyone, provided they are willing to take it for life.

A break in therapy is a serious risk for both the HIV-infected person and society, since after it resistance to the drugs used quickly develops, and new, “stronger” strains of the virus can spread. From this point of view, the position of the IGC seems justified.

However, it appears that the MHC is not making enough efforts to convince people living with HIV that they need to take lifelong therapy (which also includes optimal selection of drugs with a convenient dosage schedule and a minimum of side effects), simply by delaying it.

Unregistered residents of Moscow

Very little is known about the fate of people with HIV living in Moscow without permanent registration (non-residents, Russian citizens without registration anywhere, foreigners). In fact, we only know the total number of those who were diagnosed with HIV.

Cumulative number of identified HIV-positive Moscow residents without permanent registration in the city

Data: MGC AIDS

What happened to these people?

Most of the nonresidents were registered in the Moscow region, so we can assume that they registered and received treatment there. Some foreigners were expelled - out of sight of the Moscow authorities (but could return).

Until 2013, nonresidents from other regions of Russia could register with the MHC if they had a long-term registration in Russia, and in addition, until 2017 they had the opportunity to register and receive treatment at the Federal Scientific and Methodological AIDS Center. However, by 2017, both of these “shops” were closed.

Deregistration of non-residents from the MGC

Moscow court denies HIV treatment to Siberian man

On September 10, the Tverskoy Court of Moscow considered the case of Vyacheslav P. to the Moscow City Center for the Prevention and Control of AIDS, which without warning removed him from the register. The court declared the institution's actions legal. The reason is that Vyacheslav does not have a Moscow registration; he has been living in the capital for 10 years under temporary registration. No longer receiving medical care, the young man with a severe stage of HIV infection was admitted to the hospital and from there went to court. The AIDS center won the case...

He learned his diagnosis in 2010... “At that time, in order to register with the Moscow AIDS Center and receive treatment, you needed a residence permit or temporary registration... I began bureaucratic procedures: I signed an agreement to rent an apartment, I registered for five years and submitted an application to the Moscow Health Department... After that, I registered and regularly donated blood and had fluorography.”

In January 2015, Vyacheslav once again came to take tests and at the registry learned that he had been deregistered. He submitted an application to the Moscow Department of Health to be assigned to the MGCS. But he received a refusal with the following wording: “Temporary registration is not the basis for registration at the dispensary.”

“At the end of August 2015, I took tests for my immune status and viral load at a paid clinic... my immune status dropped to 10 cells... I began to periodically lose consciousness... Friends saw the condition I was in, and the other day they called me an ambulance that took me to the infectious diseases hospital. The doctors did tests and said that “the indicators are bad,” but did not name them.”

How many people have lost access to treatment? Such data have not been published. At the end of 2013, 44,925 people were subject to surveillance in the MGC, including 25,793 “city residents.” Thus, 19,132 people were registered without permanent registration. Starting from 2014, registration data in the MGC was provided only for “city residents.” Presumably, all 19 thousand “non-resident” people were removed from the register and could no longer receive free medicines at the MHC.

Denial of medications to patients of the Federal Medical Center

Until 2017, nonresidents could register and receive medications at the Federal Scientific and Methodological Center for the Fight against AIDS (subordinate to Rospotrebnadzor), but in 2017, the Russian Ministry of Health refused to supply medications to this institution. At the same time, the MHC also did not want to register nonresident patients of the FNMC.

Moscow again denied treatment to HIV patients from other regions

The capital's health department again refused treatment to HIV patients who do not have permanent Moscow registration. The department cites the fact that attachment to the city center for the prevention and control of AIDS is possible only if an annual supply of drugs is transferred from those regions in which patients permanently reside...

Lawyers and representatives of patient organizations insist that refusing patients violates Art. 21 of the federal law “On the fundamentals of protecting the health of citizens in the Russian Federation”, relevant orders of the Ministry of Health and government decree. The latter also states that if a person with HIV moves from one region to another, information about him is excluded from the register of his “native” region and transferred to the authorities of the new place of residence...

Previously, the Federal AIDS Center provided medications to nonresidents with HIV in Moscow. However, in August, the Federal Center ran out of its last supplies and, according to the decision of the Ministry of Health, all patients had to be assigned to the city center. Officially this is 1200 people. The head of the Federal AIDS Center, Vadim Pokrovsky, cites calculations according to which there are at least 20 thousand nonresident HIV-infected people in Moscow.

Expulsion of foreigners with HIV

The topic of expulsion of foreigners with HIV is one of the favorites of the Moscow authorities, since it is obviously popular among wide sections of the registered population of the city.

From the point of view of fighting the epidemic, persecution and infringement of the rights of HIV-infected people, including foreigners, is unproductive, since it leads to the fact that these people are not treated and serve as a source of the virus for others.

The practice of expelling foreigners was also declared illegal by the Russian Constitutional Court.

The Constitutional Court of the Russian Federation has banned the expulsion of foreigners with HIV

The department received three complaints from HIV-infected foreign citizens, stateless persons and members of their families who are citizens of Russia. The applicants are challenging a number of legislative norms... According to the complainants, the essence of these norms boils down to the undesirability of the stay of HIV-infected foreigners on the territory of the Russian Federation only on one formal basis - the presence of the disease.

The Constitutional Court ruled that the contested norms in their interrelation are recognized as inconsistent with the Constitution of the Russian Federation...

In its ruling, the Constitutional Court noted that a similar issue had already been the subject of its consideration.

However, as is well known, neither common sense nor the Constitutional Court of Russia rules Moscow.

“By order of the Moscow Government dated September 11, 2016... a premises (isolator) was designated for residence until the deportation of foreign citizens with tuberculosis and HIV infection... Ensure cooperation in the exchange of information about identified foreign citizens with infectious diseases that pose a danger for others..."

From the State Report on the sanitary and epidemiological well-being of the population in Moscow in 2016

Data sources

Reports by V.I. Kharchenko, head of the department of clinical epidemiology and counseling at the Moscow AIDS Center, for 2016 and 2018.

“Epidemic situation of HIV infection in Russia”, analytical report for 2018, Central Research Institute for Organization and Informatization of Health Care of the Russian Ministry of Health.

“State report on the state of sanitary and epidemiological well-being of the population in the city of Moscow” for 2013 and 2016, Department of Rospotrebnadzor for the city of Moscow.

At the time of publication, all data sources used were publicly available on the Internet.

Where to treat HIV? A question that arises in many patients after tests confirm the presence of the human immunodeficiency virus in the blood. In principle, treatment of diagnosed HIV must be carried out directly in the clinic to which the infected person is geographically attached, i.e. at the place of actual residence. To do this, you need to make an appointment with an infectious disease specialist. It is this specialist who is competent to manage this infection.

Where else is AIDS treated? If an infectious disease doctor does not conduct appointments at a local clinic, then the patient has every right to go to any other medical institution that is more fully staffed. If necessary, the place where HIV can be treated will be the district clinic. An infected patient should not be refused admission here.

Where is the best place to treat HIV? If we consider the treatment of the disease from this side, then it is more prudent to contact specialized medical institutions. Doctors from AIDS centers have more practical experience in treating the human immunodeficiency virus than infectious disease doctors. Where to treat an HIV-infected person is decided by the patient himself.

Clinical examination of an HIV-infected person

The purpose of medical examination is to prolong the full life of a sick person. The main tasks of clinical examination include:

• monitoring the dynamics of pathology development;
• identifying symptoms of deterioration in the patient’s general condition;
• providing a full range of medical and preventive care to a sick person;
• preventing the formation of opportunistic infections, which are concomitant diseases and indicate the progression of HIV infection;
• providing psychological support.

Medical examination of the patient is carried out based on four basic principles:

• Voluntariness. Treatment and monitoring of the development of the virus is carried out solely with the personal consent of the patient.
• Confidentiality. The patient has every right to keep his diagnosis confidential. In addition, a minimum number of people know about the presence of the virus in a particular person.
• Availability. Rehabilitation centers provide all types of assistance to an infected person.
• Multidisciplinary. Providing all types of medical services that may be required in an outpatient setting.

An indispensable part of medical examination is providing the necessary psychological assistance to patients with confirmed HIV infection.

It is a disease caused by the human immunodeficiency virus, characterized by acquired immunodeficiency syndrome, which contributes to the occurrence of secondary infections and malignancies due to the profound inhibition of the body's protective properties. HIV infection has a varied course. The disease can last only a few months or last up to 20 years. The main method for diagnosing HIV infection remains the identification of specific antiviral antibodies, as well as viral RNA. Currently, patients with HIV are treated with antiretroviral drugs that can reduce viral reproduction.

General information

It is a disease caused by the human immunodeficiency virus, characterized by acquired immunodeficiency syndrome, which contributes to the occurrence of secondary infections and malignancies due to the profound inhibition of the body's protective properties. Today, the world is experiencing a pandemic of HIV infection; the incidence of the disease in the world's population, especially in Eastern Europe, is steadily growing.

Characteristics of the pathogen

The DNA-containing human immunodeficiency virus belongs to the Lentivirus genus of the Retroviridae family. There are two types: HIV-1 is the main causative agent of HIV infection, the cause of the pandemic, the development of AIDS. HIV-2 is a less common type, found mainly in West Africa. HIV is an unstable virus, it dies quickly outside the host’s body, is sensitive to temperature (reduces infectious properties at a temperature of 56 ° C, dies after 10 minutes when heated to 70-80 ° C). It is well preserved in blood and its preparations prepared for transfusion. The antigenic structure of the virus is highly variable.

The reservoir and source of HIV infection is a person: an AIDS sufferer and a carrier. No natural reservoirs of HIV-1 have been identified; it is believed that the natural host in nature is wild chimpanzees. HIV-2 is carried by African monkeys. Susceptibility to HIV has not been observed in other animal species. The virus is found in high concentrations in blood, semen, vaginal secretions and menstrual fluid. It can be isolated from human milk, saliva, tear secretion and cerebrospinal fluid, but these biological fluids pose less of an epidemiological danger.

The likelihood of transmitting HIV infection increases in the presence of damage to the skin and mucous membranes (injuries, abrasions, cervical erosion, stomatitis, periodontal disease, etc.) HIV is transmitted using the blood-contact and bio-contact mechanism naturally (through sexual contact and vertically: from mother to child) and artificial (mainly realized through the hemopercutaneous transmission mechanism: during transfusions, parenteral administration of substances, traumatic medical procedures).

The risk of contracting HIV from a single contact with a carrier is low; regular sexual contact with an infected person significantly increases it. Vertical transmission of infection from a sick mother to a child is possible both in the prenatal period (through defects in the placental barrier) and during childbirth, when the child comes into contact with the mother’s blood. In rare cases, postnatal transmission through breast milk has been reported. The incidence among children of infected mothers reaches 25-30%.

Parenteral infection occurs through injections using needles contaminated with the blood of HIV-infected individuals, through blood transfusions of infected blood, and non-sterile medical procedures (piercing, tattoos, medical and dental procedures performed with instruments without proper treatment). HIV is not transmitted through household contact. Human susceptibility to HIV infection is high. The development of AIDS in people over 35 years of age, as a rule, occurs within a shorter period of time from the moment of infection. In some cases, immunity to HIV is noted, which is associated with specific immunoglobulins A present on the mucous membranes of the genital organs.

Pathogenesis of HIV infection

When the human immunodeficiency virus enters the bloodstream, it invades macrophages, microglia and lymphocytes, which are important in the formation of the body’s immune responses. The virus destroys the ability of immune bodies to recognize their antigens as foreign, colonizes the cell and begins reproduction. After the multiplied virus is released into the blood, the host cell dies, and the viruses invade healthy macrophages. The syndrome develops slowly (over years), in waves.

At first, the body compensates for the massive death of immune cells by producing new ones; over time, compensation becomes insufficient, the number of lymphocytes and macrophages in the blood decreases significantly, the immune system is destroyed, the body becomes defenseless against both exogenous infection and bacteria inhabiting organs and tissues. normal (which leads to the development of opportunistic infections). In addition, the mechanism of protection against the proliferation of defective blastocytes - malignant cells - is disrupted.

The colonization of immune cells by the virus often provokes various autoimmune conditions, in particular, neurological disorders are characteristic as a result of autoimmune damage to neurocytes, which can develop even before the clinical manifestations of immunodeficiency appear.

Classification

In the clinical course of HIV infection, there are 5 stages: incubation, primary manifestations, latent, stage of secondary diseases and terminal. The stage of primary manifestations can be asymptomatic, in the form of primary HIV infection, and can also be combined with secondary diseases. The fourth stage, depending on the severity, is divided into periods: 4A, 4B, 4C. The periods go through phases of progression and remission, varying depending on the presence of antiretroviral therapy or its absence.

Symptoms of HIV infection

Incubation stage (1)– can range from 3 weeks to 3 months, in rare cases it extends to a year. At this time, the virus is actively multiplying, but there is no immune response to it yet. The incubation period of HIV ends either with the clinical manifestation of acute HIV infection or with the appearance of HIV antibodies in the blood. At this stage, the basis for diagnosing HIV infection is the detection of the virus (antigens or DNA particles) in the blood serum.

Stage of primary manifestations (2) characterized by the manifestation of the body's reaction to active replication of the virus in the form of a clinic of acute infection and an immune reaction (production of specific antibodies). The second stage can be asymptomatic; the only sign of developing HIV infection will be a positive serological diagnosis for antibodies to the virus.

Clinical manifestations of the second stage occur according to the type of acute HIV infection. The onset is acute, observed in 50-90% of patients three months after infection, often preceding the formation of HIV antibodies. An acute infection without secondary pathologies has a fairly varied course: fever, various polymorphic rashes on the skin and visible mucous membranes, polylymphadenitis, pharyngitis, linear syndrome, and diarrhea may be observed.

In 10-15% of patients, acute HIV infection occurs with the addition of secondary diseases, which is associated with a decrease in immunity. These can be tonsillitis, pneumonia of various origins, fungal infections, herpes, etc.

Acute HIV infection usually lasts from several days to several months, on average 2-3 weeks, after which in the vast majority of cases it enters a latent stage.

Latent stage (3) characterized by a gradual increase in immunodeficiency. The death of immune cells at this stage is compensated by their increased production. At this time, HIV can be diagnosed using serological tests (antibodies to HIV are present in the blood). A clinical sign may be enlargement of several lymph nodes from different, unrelated groups, excluding the inguinal lymph nodes. At the same time, no other pathological changes in the enlarged lymph nodes (pain, changes in surrounding tissues) are noted. The latent stage can last from 2-3 years to 20 or more. On average it lasts 6-7 years.

Stage of secondary diseases (4) characterized by the occurrence of concomitant (opportunistic) infections of viral, bacterial, fungal, protozoal origin, malignant tumors against the background of severe immunodeficiency. Depending on the severity of secondary diseases, 3 periods of progression are distinguished.

• 4A – loss of body weight does not exceed 10%, infectious (bacterial, viral and fungal) lesions of the integumentary tissues (skin and mucous membranes) are noted. Performance is reduced.
• 4B - weight loss of more than 10% of total body weight, prolonged temperature reaction, prolonged diarrhea without an organic cause is possible, pulmonary tuberculosis may occur, infectious diseases recur and progress, localized Kaposi's sarcoma, hairy leukoplakia are detected.
• 4B - general cachexia is noted, secondary infections acquire generalized forms, candidiasis of the esophagus, respiratory tract, Pneumocystis pneumonia, extrapulmonary tuberculosis, disseminated Kaposi's sarcoma, and neurological disorders are noted.

Substages of secondary diseases undergo phases of progression and remission, varying depending on the presence or absence of antiretroviral therapy. In the terminal stage of HIV infection, secondary diseases that have developed in the patient become irreversible, treatment measures lose their effectiveness, and death occurs several months later.

The course of HIV infection is quite diverse; all stages do not always occur; certain clinical signs may be absent. Depending on the individual clinical course, the duration of the disease can range from several months to 15-20 years.

Peculiarities of the HIV clinic in children

HIV in early childhood contributes to delayed physical and psychomotor development. Recurrence of bacterial infections in children is observed more often than in adults; lymphoid pneumonitis, enlarged pulmonary lymph nodes, various encephalopathies, and anemia are not uncommon. A common cause of child mortality due to HIV infections is hemorrhagic syndrome, which is a consequence of severe thrombocytopenia.

The most common clinical manifestation of HIV infection in children is a delay in the rate of psychomotor and physical development. HIV infection received by children from mothers ante- and perinatally is noticeably more severe and progresses faster, in contrast to that in children infected after one year.

Diagnostics

Currently, the main diagnostic method for HIV infection is the detection of antibodies to the virus, which is carried out primarily using the ELISA technique. In case of a positive result, the blood serum is examined using the immunoblotting technique. This makes it possible to identify antibodies to specific HIV antigens, which is a sufficient criterion for final diagnosis. Failure to detect a characteristic molecular mass using antibody blotting, however, does not exclude HIV. During the incubation period, the immune response to the introduction of the virus has not yet been formed, and in the terminal stage, as a result of severe immunodeficiency, antibodies cease to be produced.

If HIV is suspected and there are no positive immunoblotting results, PCR is an effective method for detecting viral RNA particles. HIV infection diagnosed by serological and virological methods is an indication for dynamic monitoring of the immune status.

Treatment of HIV infection

Therapy for HIV-infected individuals involves constant monitoring of the body’s immune status, prevention and treatment of secondary infections that arise, and control over the development of tumors. Often, people living with HIV require psychological help and social adaptation. Currently, due to the significant spread and high social significance of the disease on a national and global scale, support and rehabilitation of patients is being provided, access to social programs is expanding, providing patients with medical care, facilitating the course and improving the quality of life of patients.

Today, the predominant etiotropic treatment is the prescription of drugs that reduce the reproductive abilities of the virus. Antiretroviral drugs include:

• NRTIs (nucleoside transcriptase inhibitors) of various groups: zidovudine, stavudine, zalcitabine, didanosine, abacavir, combination drugs;
• NTRTIs (nucleotide reverse transcriptase inhibitors): nevirapine, efavirenz;
• protease inhibitors: ritonavir, saquinavir, darunavir, nelfinavir and others;
• fusion inhibitors.

When deciding to start antiviral therapy, patients should remember that the drugs are used for many years, almost for life. The success of therapy directly depends on strict adherence to the recommendations: timely, regular use of medications in the required dosages, adherence to the prescribed diet and strict adherence to the regimen.

Emerging opportunistic infections are treated in accordance with the rules of effective therapy against the causative agent (antibacterial, antifungal, antiviral agents). Immunostimulating therapy is not used for HIV infection, since it contributes to its progression; cytostatics prescribed for malignant tumors suppress the immune system.

Treatment of HIV-infected people includes general strengthening and body-supporting agents (vitamins and biologically active substances) and methods of physiotherapeutic prevention of secondary diseases. Patients suffering from drug addiction are recommended to undergo treatment in appropriate dispensaries. Due to significant psychological discomfort, many patients undergo long-term psychological adaptation.

Forecast

HIV infection is completely incurable; in many cases, antiviral therapy gives little effect. Today, on average, HIV-infected people live 11-12 years, but careful therapy and modern medications will significantly extend the life of patients. The main role in containing the developing AIDS is played by the psychological state of the patient and his efforts aimed at complying with the prescribed regimen.

Prevention

Currently, the World Health Organization is carrying out general preventive measures to reduce the incidence of HIV infection in four main areas:

• education on safe sexual relations, distribution of condoms, treatment of sexually transmitted diseases, promotion of a culture of sexual relations;
• control over the production of drugs from donor blood;
• managing the pregnancy of HIV-infected women, providing them with medical care and providing them with chemoprophylaxis (in the last trimester of pregnancy and during childbirth, women receive antiretroviral drugs, which are also prescribed to newborn children for the first three months of life);
• organization of psychological and social assistance and support for HIV-infected citizens, counseling.

Currently, in world practice, special attention is paid to such epidemiologically important factors in relation to the incidence of HIV infection as drug addiction and promiscuity. As a preventive measure, many countries provide free distribution of disposable syringes and methadone substitution therapy. As a measure to help reduce sexual illiteracy, courses on sexual hygiene are being introduced into educational programs.

How and with what is AIDS treated in Russia, when every year there are more and more patients and the disease acquires the status of an epidemic? This question interests not only HIV-positive people, but also healthy people.

HIV is characterized by inhibition of the body's protective functions and the appearance of defects in the immune system due to the entry of a retrovirus into the body. They become infected through the biological fluids of a sick person: through sexual contact, through blood, breast milk, amniotic fluid.

If appropriate treatment is not taken, acquired immunodeficiency syndrome (AIDS) may occur. Concomitant diseases appear that lead to death.

Where in Russia is HIV treated effectively?

Every city has AIDS centers where you can get a free blood test. If it turns out to be positive, the patient is referred to the attending physician.

Since HIV medicine in Russia can only be obtained through the state program (pharmacies do not sell antiretroviral drugs), you need to find out from a specialist what documents you need to collect and where to go.

In recent years, attempts have been made to bring HIV treatment under control in Russia. Patients must register with a specialized center, then periodically undergo a course of therapy and be tested for the presence of the virus in the blood (determine the “viral load”). In such centers you can diagnose the disease, receive inpatient and outpatient treatment, as well as consultation with a psychologist.

How is HIV treated in Russia?

At the moment, the issue of importing drugs for antiretroviral therapy has become acute in the country. For patients, this type of treatment is a salvation, because when taking these medications, infection of healthy cells in the body is stopped and the disease becomes chronic. Thus, it is possible to avoid the appearance of acquired immunodeficiency syndrome and improve the quality of life.

Russia first began purchasing HIV medicine from foreign suppliers relatively recently. At first, antiretroviral therapy was available only in Moscow. Over time, people in other cities had the opportunity to receive this treatment.

Unfortunately, the drugs are expensive, so the state cannot provide all patients with full treatment, but it is doing everything possible to eliminate this problem.

Russian cure for HIV 2016

Is it true that a cure for HIV has been found in Russia? The company Viriom, engaged in biotechnological research, together with the foreign pharmaceutical company Roche, took on the development of a new drug that is resistant to mutations, does not allow retroviruses to develop resistance, suppresses infection, as a result of which the viral load is reduced to almost ideal values.

You need to wait about two years for the medicine; in combination with other drugs, the treatment will be most effective.

Today, out of ten existing drugs for antiretroviral therapy, eight are produced in the Russian Federation. Four drugs are only bottled and packaged by pharmaceutical companies; the rest begin their journey with purification of the substance.

AIDS treatment in Russia will become available to every patient with this diagnosis. A lot is being done to ensure that the drug can go through the full production cycle in the country: from preparing the substance to packaging and labeling.

Clinical trials of new anti-HIV drugs are currently underway in Russia. In just a year, the final stages of testing are planned, as well as the release of four domestically produced antiretroviral drugs.

The human immunodeficiency virus is a pathology that destroys the body's natural defenses. Its danger is that it reduces the body's resistance to various infections, contributing to the development of serious diseases and their complications.

It is completely impossible to cure the disease, since its structure is constantly changing, which does not allow pharmacists to create substances that can destroy it. Treatment for HIV infection is aimed at strengthening the immune system and blocking the activity of the virus.

The disease has four stages, the last of which – AIDS (acquired immunodeficiency syndrome) – is terminal.

HIV infection has a very long incubation period. After entering the body, the virus does not manifest itself for a long time, but continues to destroy the immune system. A person begins to get sick more severely and for a longer period of time, since the immune system is unable to cope even with “harmless” infections, which give complications, worsening health conditions more and more.

At the terminal stage, the immune system is completely destroyed, which gives impetus to the development of oncological tumors, severe damage to the liver, kidneys, heart, respiratory system, etc. The result is the death of the patient from one of the diseases of these organs.

HIV has four types, of which the first two are diagnosed in 95% of cases of infection, the third and fourth are extremely rare.

The virus is not resistant to environmental influences, antiseptics, alcohol solutions, and acetone. It also does not tolerate high temperatures and dies already at 56 degrees within half an hour, and when boiled it is destroyed instantly.

At the same time, its cells remain viable when frozen (they are able to “live” 5-6 days at a temperature of 22 degrees); in solutions of narcotic substances they remain active for about three weeks.

For a long time, HIV was considered a disease of drug addicts, homosexuals and women of easy virtue. Today, among the carriers of the virus there are people with high social status and heterosexual orientation. Neither adults nor children are immune from infection. The main route of transmission is biological body fluids. Pathogenic cells are found in:

• blood;
• lymph;
• sperm;
• cerebrospinal fluid;
• vaginal secretion;
• breast milk.

The risk of infection increases in proportion to the number of pathogenic cells in these fluids, and at least ten thousand viral particles are required to transmit infection.

Methods of infection

The main routes of transmission of the virus are considered to be

• Unprotected sexual intercourse.

According to statistics, infection through this route is diagnosed in 75% of patients, but the risk of transmitting pathogenic cells is the lowest: about 30% of sexual partners become infected during the first vaginal contact, about 50% during anal contact, and less than 5% during oral contact.

The risk of genitourinary pathologies (gonorrhea, syphilis, chlamydia, fungi), trauma and microdamage to the mucous membranes of intimate organs (scratches, ulcers, erosions, anal fissures, etc.), and frequent sexual contact with an infected person increases the risk.

Women are more likely to accept the virus than men, since the area of ​​the vagina and direct contact with pathogenic cells is larger.

• Intravenous injections.

The second most popular way, since more than half of drug addicts suffer from it. The reasons are the use of one syringe or utensils to prepare the solution, as well as unprotected intimate contacts with dubious partners while under the influence of drugs.

• Intrauterine path.

During pregnancy, the risk of the virus entering the placenta does not exceed 25%; natural childbirth and breastfeeding increase it by another 10%.

• Penetrating wounds from non-sterile instruments: infection occurs during surgical operations in dubious clinics, tattooing, manicure procedures, etc.

• Direct blood transfusion, untested organ transplantation.

If the donor is HIV positive, transmission is 100%.

The possibility of infection depends on the strength of the recipient's immunity. If the natural defense is strong, the course of the disease will be weaker and the incubation period itself will be longer.

Manifestations of pathology

Symptoms of HIV infection are a manifestation of treatable diseases caused by a weakened immune system, which makes diagnosis very difficult, since a person takes only the necessary tests, treats the consequences of the disease, without even knowing about his true status. There are slight differences depending on the stages of infection.

There are no symptoms characteristic of the virus: the manifestations of the disease are individual and depend on the general health of the patient and the diseases caused by it.

The first stage is the incubation period. This is the initial stage, developing from the moment pathogenic cells enter the body until one year. In some patients, the first symptoms appear within a couple of weeks, in others - no earlier than several months.

The average incubation period is one and a half to three months. During this period, symptoms are completely absent; even tests do not show the presence of the virus. A dangerous disease can be detected at an early stage only if a person has encountered one of the possible routes of infection.

The second stage is the stage of primary manifestations. They arise as a reaction of the immune system to the active proliferation of harmful cells. Usually occurs 2-3 months after infection, lasting from two weeks to several months.

It can happen in different ways

• Asymptomatic when the body produces antibodies and there are no signs of infection.
• Spicy.

The stage is typical for 15-30% of patients, the manifestations are similar to those of acute infectious pathologies:

• temperature increase;
• fever;
• enlarged lymph nodes;
• skin rashes;
• bowel disorders;
• inflammatory processes of the upper respiratory tract;
• increase in the size of the liver and spleen.

In rare cases, the development of autoimmune pathologies is possible.

• Acute with secondary pathologies – typical for most patients.

Weakened immunity allows existing representatives of opportunistic microflora to actively reproduce, which leads to exacerbation or the emergence of infectious diseases. At this stage, it is not difficult to cure them, but soon their relapses become more frequent.

The third stage is a deterioration in the functioning and condition of the lymphatic system. Lasts from two to 15 years, depending on how the immune system copes with viral cells. Enlargement of lymph nodes occurs in groups (except for the inguinal ones) that are not interconnected.

After three months, their size returns to a healthy state, pain on palpation disappears, elasticity and mobility return. Sometimes relapses occur.

The fourth stage is terminal – the development of AIDS. The immune system is practically destroyed, the virus itself multiplies unhindered. All remaining healthy cells are susceptible to destruction, many of them degenerate into malignant ones, and severe infectious pathologies develop.

AIDS also occurs in four stages

• The first occurs after 6-10 years. It is characterized by a decrease in body weight, rashes on the skin and mucous membranes containing purulent contents, fungal and viral infections, and diseases of the upper respiratory tract. It is possible to cope with infectious processes, but therapy is long-term.
• The second develops after another 2-3 years. Weight loss continues, body temperature rises to 38-39 degrees, weakness and drowsiness occur. Frequent diarrhea, lesions of the oral mucosa, fungal and viral lesions of the skin are observed, the manifestations of all previously diagnosed infectious pathologies intensify, and pulmonary tuberculosis develops.

Conventional medications are unable to cope with the disease; only antiretroviral therapy can alleviate the symptoms.

• The third stage occurs 10-12 years after infection. Symptoms: exhaustion, weakness, lack of appetite. Pneumonia develops, viral infections worsen, and healing of their manifestations does not occur. Pathogenic microflora covers all internal and external organs and their systems, diseases are acute and give new complications.

The duration of HIV infection from the moment of infection until the death of the patient varies from person to person. Some die after 2-3 years, others live 20 years or more. Cases have been recorded of people dying from the virus within a few months. A person’s lifespan depends on his general health and the type of virus that has entered the body.

Features of HIV in adults and children

The clinical picture of the disease in representatives of the stronger sex does not differ from the manifestations that develop when the immune system is weakened. Girls suffer the infection more severely, as they begin to experience menstrual irregularities.

Menstruation occurs with severe pain, becomes heavy, and bleeding is observed in the middle of the cycle. A frequent complication of the virus is malignant formations of the reproductive system. Cases of inflammation of the genitourinary system are becoming more frequent, and their course is more severe and longer.

In babies and newborns, the disease does not manifest itself for a long time; there are no external signs. The only symptom by which one can suspect the presence of pathology is a delay in the mental and physical development of the child.

Diagnosis of the disease

It is difficult to detect HIV at an early stage, since the symptoms are absent or similar to the manifestations of treatable pathologies: inflammatory processes, allergies, infectious diseases. The disease can be detected by chance, during a routine medical examination, admission to a hospital, or registration during pregnancy.

The main diagnostic method is a special test, which can be done both in the clinic and at home.

There are a lot of diagnostic methods. Every year, scientists develop new tests and improve old ones, reducing the number of false positive and false negative results.

The main material for research is human blood, but there are tests that can make a preliminary diagnosis by examining saliva or urine using scrapings from the surface of the oral cavity. They have not yet found widespread use, but are used for home preliminary diagnostics.

HIV testing in adults is carried out in three stages:

• screening test - gives a preliminary result, helps to identify people who have been infected;
• reference – carried out to persons whose screening results are positive;
• confirming – establishes the final diagnosis and duration of presence of the virus in the body.

This phased examination is associated with the high cost of research: each subsequent analysis is more complex and expensive, so it is not economically feasible to carry out a full complex for all citizens. During the study, antigens are identified - cells or particles of the virus, antibodies - leukocytes produced by the immune system to pathogenic cells.

The presence of harmful cells can be determined only after seroconversion is achieved - a state when the number of antibodies is sufficient to be detected by test systems. From the moment of infection until the onset of seroconversion, a “window period” occurs: during this time, transmission of the virus is already possible, but no test can detect it. This period lasts from six to twelve weeks.

If the diagnostic results are positive, you should contact your doctor to prescribe antiretroviral therapy. Which doctor treats HIV infection? An infectious disease specialist who is usually present at the central clinic of a city or regional center.

Treatment of human immunodeficiency virus

Once the virus enters the body, it remains there forever. Although research into the infection has been going on for decades, scientists have not been able to invent drugs that can destroy pathogenic cells. Therefore, almost 100 years after the discovery of the virus, the answer to the question of whether HIV infection can be treated remains a sad “No.”

But medicine is constantly inventing drugs that can slow down the activity of HIV, reduce the risks of developing pathologies, help cope with them faster and prolong the life of the infected person, making it full. Treatment of HIV infection involves taking antiretroviral therapy drugs, prevention and treatment of concomitant inflammatory processes.

Therapy is taking medications, but it is impossible to cure immunodeficiency using traditional medicine. Refusal of pharmaceutical products in favor of unconventional recipes is a direct path to the development of AIDS and the death of the patient.

The effectiveness of treatment depends on many factors, but the most important condition for therapy is the patient’s responsible attitude towards the prescribed treatment. In order for it to produce results, medications should be taken at a strictly defined time, their dosage should be observed, and interruptions in treatment should not be allowed. Diet and healthy lifestyle are also recommended.

If these recommendations are followed, the number of protective cells increases dramatically, the virus is blocked, and even highly sensitive tests often cannot detect it. Otherwise, the disease continues to progress and leads to dysfunction of vital organs: heart, liver, lungs, endocrine system.

For HIV infection, the most effective treatment is antiretroviral therapy (HAART). Its main task is to prevent the development of complications and concomitant pathologies that can shorten the patient’s life. HAART also helps improve the patient’s quality of life and make it full.

If therapy is carried out correctly, the virus goes into remission and secondary pathologies do not develop. Such treatment also has a positive effect on the psychological state of the infected person: feeling supported and knowing that the disease can be “slowed down,” he returns to his usual way of life.

In our country, all antiretroviral drugs are provided to a person free of charge after he receives the status of an HIV-positive patient.

Features of antiretroviral therapy

HAART is prescribed on an individual basis, and the tablets included in it depend on the stage of development of the infection. At the initial stage, specialized treatment is not prescribed; it is recommended to take vitamins and special mineral complexes that help strengthen the body’s natural defenses.

Chemotherapy is indicated as a preventive method, but only for those individuals who have been in contact with an HIV-positive person or a potential carrier of the virus. Such prevention is effective only in the first 72 hours after possible infection.

In the second and subsequent stages, therapy is prescribed based on the results of clinical tests that determine the state of immunity. The terminal stage, that is, the presence of acquired immunodeficiency syndrome, requires mandatory medication. In pediatrics, HAART is always prescribed, regardless of the clinical stage of the child’s disease.

This approach to treatment is determined by the standards of the Ministry of Health. But new research shows that early initiation of antiretroviral therapy produces better treatment results and a more positive effect on the patient's condition and life expectancy.

HAART includes several types of drugs that are combined with each other. Since the virus gradually loses sensitivity to the active substances, the combinations are changed from time to time, which makes it possible to increase the effectiveness of treatment.

Several years ago, scientists introduced a synthetic drug called Quad, which included the main properties of prescribed drugs. A huge advantage of the medicine is taking only one tablet per day, which greatly facilitates treatment. This remedy has virtually no side effects, is easier to tolerate by the body, and solves the problem of loss of sensitivity to active components.

Many patients are interested in whether it is possible to block the activity of the virus using traditional methods and how to treat HIV infection at home? It should be remembered that such treatment is possible, but only if it is auxiliary and agreed with the treating doctor.

Folk recipes are shown to strengthen the body's defenses. This can include decoctions and infusions of medicinal herbs, the use of gifts of nature rich in vitamins, minerals and beneficial microelements.

Preventive actions

The immunodeficiency virus is a disease that can be prevented, but it cannot be cured. Today, developed countries have developed special programs aimed at preventing HIV and AIDS, which are monitored at the state level. Every person should know the basics of preventive measures, since there is no guarantee that infection will not occur.

You can avoid serious pathology if you treat your own intimate life responsibly. You should avoid sexual contact with questionable people, and always use condoms when having sex with a new sexual partner about whose condition there is no reliable information.

It is important that the sex partner is one and permanent, and has medical reports confirming the absence of HIV.

One of the popular myths is that a condom is unable to protect against the virus, since the latex pores are larger than the virus cells. This is wrong. Today, barrier contraception is the only way to prevent infection during sexual intercourse.

If a person suffers from drug addiction and injects drugs, he should always use disposable medical instruments, give injections with sterile gloves, and have individual containers for preparing a narcotic solution. To avoid becoming a victim of direct transmission of the virus through the blood, you should refuse blood transfusions.

To carry out procedures where there is access to blood, choose trusted establishments, ensure that their employees carry out all manipulations with gloves, and that instruments are disinfected in the presence of the client.

If HIV is present in a woman who is preparing to become a mother, the baby’s condition is monitored throughout the pregnancy. Cesarean section and refusal of breastfeeding can reduce the risk of infection of the child. It will be possible to determine the baby’s HIV status no earlier than six months later, when the mother’s antibodies to the virus leave the baby’s body.

Artificial insemination methods can prevent severe infection in a child.

An expectant HIV-positive mother should eliminate all factors that reduce the baby’s immunity: stop smoking, stop drinking alcohol, eat more vitamins, cure all infectious and inflammatory diseases, treat chronic ailments to prevent their recurrence during pregnancy.

By following these rules, you can prevent infection with a dangerous pathology and prevent its transmission to healthy people. Since there is no cure for the disease, the only way to rid the world of the virus is to block its spread.