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by Alicia M Prater PhD

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AIDS stands for Acquired Immunodeficiency Syndrome, a syndrome of opportunistic and rare diseases caused by the eradication of the immune system by HIV, the Human Immunodeficiency Virus. AIDS is the final, fatal stage of HIV infection based on the definition provided by health organizations ( CDC, WHO ). People sometimes refer to HIV as the AIDS virus because the visible manifestation of HIV infection is that final stage. It can take years, even decades, for an HIV-positive individual to reach this stage, but they are infective to sexual partners the entire time and may not even know they have the virus. When initially infected or exposed to the virus, the body tries to fight the virus off and flu-like symptoms may appear. This is the early, or acute, stage of infection. After infection of the immune cells, HIV can lie dormant within these cells for years, sometimes decades. This is the middle, or chronic, stage.

The virus is transmitted by body fluids coming into contact with other body fluids - blood to blood in shared needles, blood transfusions in the mid 1980s when screening was not available, and sexual contact of semen to blood or the vaginal lining. The different strains of HIV are transmitted in different ways. One particular type of HIV (HIV-1M (Major) clade e) excels at being taken up by vaginal dendritic cells, and it is even more infective if there is inflammation, which is what is the case when other STDs are already infecting a woman. Dendritic cells are one type of immune cell that HIV infects, the most well known though are T cells.

HIV infects T cells by attaching to proteins on their surface and then injecting their genetic material and enzymes necessary for its propagation into the cells. After the dormant period, when HIV hides safely from the host immune system, the virus replicates at the host cell's expense, and then bursts out to infect even more T cells. This also means that when the body tries to fight the infection it produces more HIV in the process. A no win situation once HIV has entered the system! As time goes on there are so few immune cells left that the body cannot protect itself from new or common infections and the person succumbs to death. This is what we know as AIDS, the final, or crisis, stage of HIV infection.

HIV/AIDS drugs stop the virus from propagating and hold it in a perpetual state of dormancy. This dormancy prevents the immune system breakdown, or at least postpones it and slows it to increase the life span of the infected individual. If a person is not treated early enough, the drugs will not work to prevent the onset of AIDS. It is very important to be on HIV medications, ARV's (anti retrovirals) and antiproteases, even when the infected individual does not yet have AIDS. To think that not having yet been diagnosed with "full blown AIDS" means a person is not sick is not accurate. This thinking is what leads to unknowingly spreading the disease and suffering through opportunistic infections like kaposi's sarcoma, pneumocystis carnii pneumonia, and fungal infections.

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