Basic General Information
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Sep / Oct VOL III NO 5.
Dr C H Asrani

HIV stands for Human Immuno-deficiency Virus and this HIV causes a disease complex known as AIDS (Acquired Immuno Deficiency Syndrome). Thus, HIV is the virus and AIDS is the disease caused. They are not synonyms. To understand them better, let us dissect them out.

HIV: Self explanatory - a Virus that affects Humans causing Deficiency of Immune system. HIV is highly infectious.

AIDS: Acquired: because it is not an inborn condition, but acquired during or after birth.

Immune - Deficiency: deficiency in the body's natural defense mechanism or the immune system.

Syndrome: a group of symptoms affecting multiple systems, all of which are due to the body's diminished ability to fight diseases.

It is important to remember that everyone who has contracted HIV infection will develop full blown AIDS over a period of time (max 10 yrs) depending upon their general health and natural defense mechanism of the body.

What does HIV look like?
Just as all viruses, the HIV is also very small and can only be seen through an electron microscope. It is so small that about 10,000 viruses can be placed in circle, having a diameter of one mm. (pic)

How does hiv affect the body?
HIV destroys our lymphocytes - 25% of the total white blood cells, essential for destroying disease-causing organisms. These lymphocytes normally multiply in response to any infection. There are two types of lymphocytes: B cells & T cells. B cells secrete large amounts of antibodies when they come in contact with bacteria or viruses. T cells on the other hand destroy the specific disease causing organisms. They are also called 'killer cells' because of their killer action.

How does HIV spread?
HIV infection spreads through 3 main routes:
Direct - sexual intercourse or deep kissing. Oral or anal sex also leads to transmission of virus from one partner to the other. More than 75% people are estimated to get it through sexual transmission.
Indirect - body fluids of the infected person like blood, vomit, excreta etc and infected syringes. HIV is present in all body fluids of an infected person. It is however more in number in blood, semen and vaginal fluids.
Vertical - mother to child transmission during pregnancy or delivery.

The probability of getting the infection, with one encounter, is not the same by all routes.

What then decides the fate of transmission?
Four main conditions must be fulfilled if HIV is to be transmitted through any one of the three routes mentioned above. These include:

1. HIV must be present in the body fluids, especially the semen, vaginal fluids, blood or blood products.
2. HIV must live during the period it is out of the body. It can live for a long time in blood, stored at cold temperatures for transfusion but lives for a short time in all other situations as the body fluids dry very easily. HIV cannot survive in dried body fluids.
3. There must be convenient portal for entry. The normal skin forms a very effective barrier and HIV will find it difficult to enter through intact skin. The virus can easily enter the body from wherever there is damage to the skin or the skin is more delicate (such as vagina or anus).
4. The number of viruses in the body fluids must be adequate to infect others after it is transferred to contact with body fluids. If the number of viruses that enter another person is less, then the infection may not occur.

Women are at greater risk of developing HIV infection through unprotected sex. This means that the risk of transmission of HIV from man to woman is higher than that from woman to man, for the following reasons

• The semen from the infected male sexual partner remains in the woman's vagina for a longer time. Longer contact between infected semen and delicate wall of the vagina increases the risk of HIV infection.
• The surface area of the vagina is very large compared to the urethra in men. Larger surface area provides greater opportunity for the virus to enter the body.
• A large number of women who have sexually transmitted infections of their reproductive tract, may not themselves have any symptoms at all. In the absence of any symptoms, they will not know they have the infections and will therefore not take appropriate treatment. These STDs allow greater opportunity for the HIV to enter the body and cause infection.

1. Sexually transmitted diseases increase the risk of HIV infection because they allow easy entry for the HIV.
2. Anal Sex. Irrespective of whether it is hetero or homo sexual, it increases their risk of HIV. This is because the delicate skin inside the anus gets damaged more easily during sexual act.
3. Sex during menstruation with a woman having HIV infection increases the risk of transmitting HIV to the male partner.
4. Oral Sex has low risk of transmission of HIV. The risk is higher in case there are wounds, cuts or injuries in the mouth.
5. Blood transfusion has a small risk of transmitting HIV. Although the government has made testing the blood for HIV before transmission compulsory, the test may be negative during window period (up to 3 - 6 months).
6. Intravenous drug injections have a very high risk of transmission of HIV especially among drug abusers who share needles to inject addictive drugs. Intravenous injections with sterilized needles and syringes have no risk of transmitting HIV.
7. Injections in the muscles or below the skin have very low risk of transmitting HIV. Pricking the skin for tattooing, piercing ears, nose etc. have low risk of transmitting HIV infection if sterilized needles are used.
8. Pregnant women can transmit the HIV infection to their unborn child either during pregnancy or during childbirth.
9. Breast-feeding has low risk of transmitting HIV infection to the baby. The risks of bottle-feeding are higher than the risks of HIV infection due to breast-feeding. This is why it is recommended that women with HIV infection continue to breast feed their baby.

1. Hugging, Kissing, Shaking hands and Kissing on the cheeks, hands etc.
2. Coughing or sneezing
3. Insect or mosquito bites
4. Sharing clothes or towels
5. Using the same equipments such as telephones.
6. Eating from the same utensils
7. Swimming pools
8. Sharing the same toilets
9. Being with infected people in crowds or public places
10. Nursing People with HIV infection
11. Washing clothes, bed sheets etc. used by people with HIV infection.

To understand why HIV infection does not cause immediate symptoms, it is important to understand what happens in the body, soon after the entry of HIV. As mentioned earlier, HIV infects a large number of T (killer) lymphocytes soon after it enters the body. It multiplies rapidly in the T4 (CD4) cells. During the early or acute stage of the infection, the blood will contain a large number of viral particles. These particles rapidly spread through various organs and infect them. They particularly infect the organs of the lymphatic system. People with HIV infection do not develop persistent severe symptoms for up to 10 years after the virus enters the body. Children born with HIV infection may however develop the symptoms within two years. The symptoms appear because of the gradually diminishing defence mechanism of the body. This is the stage when AIDS develops.

Most symptoms or AIDS are due to opportunistic infections that occur, taking advantage of the body's poor defence mechanism. The symptoms of AIDS are divided into major and minor symptoms. As per the definition of AIDS given by WHO, a person is said to have full blown AIDS if he/she has at least two major signs and at least one minor sign and there is no other cause of poor immune mechanism. The term "AIDS related illness" is used when a person has some signs and symptoms, has antibodies to HIV in the blood but does not have two major and one minor sign.

Signs and Symptoms of AIDS
Minor Signs:

1. Cough for more than one month, not responding to routine treatment
2. Enlargement of the lymph nodes in the various parts of the body.
3. One of the common symptoms of AIDS is an infection of the mouth called candidiasis (due to candida albicans). Candidiasis results in thick, white, fur like coating on the tongue and rarely on the roof of the mouth. It can cause dryness of the mouth, difficulty in swallowing and altered sense of taste. This infection is not common among people with normal defence mechanism because their body is able to fight the infection successfully. Candidiasis may also be present in the elderly with poor defence mechanism, sick children and babies who are bottle fed. It can also affect the vagina in women. Candidiasis in people with AIDS can also spread to the lungs and digestive tract.
4. Dermatitis: itchy skin lesions all over the body.
5. Infection due to Herpes viruses: Herpes simplex and Herpes zoster are the two common infections in AIDS. Though Herpes can affect anyone, it is severe in people with AIDS. The painful sores usually occur inside or around the mouth, genital area or area around the anus. Chronic herpes simplex, another viral infection that affects the nervous system. It results in small irritating or painful fluid filed blisters on the skin and inner lining of body cavities that open outside, such as mouth, respiratory tract, urinary tract, etc. More than one attack of Herpes of any part of the body should make one suspect HIV/AIDS or some other condition destroying the immune system.

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