For now, HIV remains incurable

About 38 million people in the world have an infection with the Human Immunodeficiency Virus (HIV), which can lead to Acquired Immunodeficiency Syndrome if it is not treated properly (AIDS). Leonor Huerta, an expert at UNAM's Institute of Biomedical Research (IIBO), says that the National Center for the Prevention and Control of HIV and AIDS (CENSIDA) says that about 342,000 people in Mexico have had this disease.

The scientist from this university's Immunology and Virology Laboratory says that since 1983 when the first case was found in Mexico, 37% of the people who got the disease have died.

In our country, an average of 8,000 new HIV infections are reported each year. Since it is a disease that can be controlled but not completely gotten rid of, people who have it will need to take antiviral drugs and be monitored by doctors for the rest of their lives.

It is important to make sure that the person gets this care as soon as they are diagnosed so that the infection doesn't get worse and costs more in terms of the patient's quality of life and the amount of care they need from health systems.

Twenty percent of all HIV patients in the world are women or one in five. This shows that HIV doesn't just affect gay men. Its spread and clinical development don't depend on a person's gender. Instead, they depend on how they live and when they get medical care.

It's a good idea to run campaigns to let people know about the risk of getting the infection and the fact that it can go unnoticed for years. If you think you might have been infected, it is important to get a diagnostic test.

Also, it should be stressed that if the test comes back positive, you should see a doctor even if your symptoms are mild or not there at all. It is important to start treatment as soon as possible to give the patient the best chance of getting better.

CENSIDA says that the risk of getting it is 35 times higher for people who inject drugs, 30 times higher for people who work in the sex industry, 28 times higher for gay men, and 14 times higher for transgender women.

Because antiretroviral treatments are available, a person with HIV will likely have a similar quality of life to a healthy person. To reach this goal, it is important to keep an eye on the patient's health, including the amount of virus in the blood and the number of CD4 T-lymphocytes. The doctor may suggest that you lead a healthy life to avoid getting other long-term diseases that are common in people with HIV, such as diabetes and heart disease.

There is still no way to get rid of the infection: "there is no way back, what is possible, if detected in time, is the most favorable evolution possible with the help of drugs, which can control the infection" In fact, antiviral treatments have cut the number of deaths caused by this infection by 50%. As long as people stick to their treatments, the virus can be managed and kept under control.

Many different drugs can be used to treat HIV infection and how they are given depends on the patient. Patients can live a pretty normal life today, thanks to new treatments, as long as they keep an eye out for any possible side effects.

Activation of the HIV

HIV mostly infects cells called CD4 T-lymphocytes, which are important for making the immune system respond to foreign agents in a specific way. HIV particles or cells that already have the virus inside them attach to the surface of healthy cells and send the virus's DNA to them. The virus genes are then added to the cell's DNA, making them a permanent part of it.

Even though many people around the world are working on making an HIV vaccine, it is still not certain that one will be available to the public soon. One of the main reasons it's hard to make vaccines is that the virus copies itself inside immune system cells that are already working (CD4 T lymphocytes). So, there needs to be a careful balance between getting a good immune response and letting the virus keep spreading.

On December 1, people get together to help those who are living with HIV and to remember those who have died. In 1988, this was the first international day to honor the fight against a disease that can be prevented.

HIV can change in many ways, which makes it hard for the immune system to respond to it. This is another reason why making vaccines is hard. In this way, the current pandemic brought on by the SARS-CoV-2 virus has shown us what it means to deal with a virus that has changed a lot.

Even though there are effective antivirals available, we can't stop this pandemic because it takes too long to start treatment. This is mostly because the disease doesn't show any symptoms at first. People don't know they have it until they have serious symptoms and test positive.

This means that they are less likely to live a good life and that the infection has had a long time to spread to other people. If someone is thought to have done something dangerous, like having unprotected sex with more than one person, they should get tested. The best way to deal with an infection is to find it early and treat it well.

HIV could be eliminated by 2030

It would be a huge leap to avoid its transmission; the vaccine is in phase three, being tested in Mexico and seven countries. Contagion has advanced in women: one for every four infected men. The first great contemporary pandemic has become chronic and is celebrating its 40th anniversary. However, the United Nations is coordinating efforts to eliminate the transmission of the virus, which has claimed the lives of more than 35 million people worldwide, by 2030.

In Mexico, actions to combat the Human Immunodeficiency Virus (HIV) were making progress in meeting the 2020 and 2025 goals; however, COVID-19 broke in and the projects were delayed. However, the main goal is the elimination of transmission in less than a decade. This was stated by Roberto Vázquez Campuzano, an academic at UNAM's Faculty of Medicine (FM), who has three decades of experience in HIV epidemiological surveillance in Mexico.

"HIV did not worsen with COVID-19. We now have 320,000 cases registered in Mexico; in 2020 there were just over 9,000 new cases, and so far in 2021 we have 6,500 more cases," he informed. A member of the Department of Emerging Diseases and Emergencies of the Institute of Epidemiological Diagnosis and Reference (InDRE), Roberto Vázquez reminded that in the world only 84 percent of the people who have contracted HIV know it. "We have to get tested, be aware that transmission occurs through sexual, blood, or perinatal routes, and be aware of our risk. And if we test positive, we should request our access to retroviral treatment," he emphasized.

Vaccine

A member of the Committee of Experts for the Diagnosis of HIV, Vázquez Campuzano made it clear that the consolidation of the vaccine against this disease would be an enormous leap in the prevention of its transmission because with four decades living with this pandemic, all known strategies for the production of reagents have been tried and failed. "The Mosaic project, as the vaccine has been called, uses different antigens of the combined virus. It is a substance that is being tested in eight countries in the world, including Mexico. These phase three trials have to run for at least two or three years to see if there is any effect on the population," he said.

We had a long time without a phase three vaccine. The last one in this stage was approximately in 2009 and it did not work; now we are hopeful that this time it will be able to produce the immunity we expect. "It is a vaccine produced by a U.S. pharmaceutical company. Many strategies have been used before: non-human viral vectors, canary viruses, plant baculoviruses, and it has not been possible to consolidate, so this time it is very hopeful, although we have to wait for the results," he noted.

Children and women

Infection in children has decreased significantly, said the university researcher. He added that our country is committed to eliminating perinatal HIV transmission, and 97 percent of the goal has been met so far. "That remaining three percent is from the rural population that is farther from the reach of the health sector, which unfortunately does not have access to health services. Most of the cases occur in young children, newborns; we have just over 2,000 cases in infants between one and four years of age," she said.

In the case of Mexican women, the specialist explained, this pandemic originally affected seven men for every woman; currently, there are four men for every woman. Eighty percent of the infections occur in men and 18 to 19 percent in women. "The infection has rebounded in women, it has been gaining ground and it is also due to the type of transmission. When the virus was discovered, it was said that the risk factors were homosexuality, hemophilia, the use of injected drugs; however, sexual transmission between heterosexuals has gained a lot of ground again," he pointed out.

Finally, the university academic clarified that the fundamental difference between HIV and AIDS is that the first is an infection like those produced by any other virus that goes through several acute and chronic stages; and the second is the most advanced stage of the infection, where our immune system loses its capacity to respond and opportunistic infections occur. The first ones in Mexico were Herpes zoster and Tuberculosis.

Myth: Having HIV means you have AIDS

HIV and AIDS have constantly been heard as synonyms, however, it is important to clarify that they are not and a diagnosis of the Human Immunodeficiency Virus does not always mean condemnation for the person who has acquired it. The virus attacks the defense cells of the human body called CD4 T-lymphocytes, altering or nullifying their function. The infection causes a progressive deterioration of the immune system and when uncontrolled, evolves more rapidly into what is commonly known as AIDS and is defined by the presence of any of the more than twenty opportunistic infections or HIV-related cancers.

The virus is found in blood, sex organ fluids (pre-ejaculatory fluid, semen, vaginal discharge), and breast milk and can, therefore, be transmitted through vaginal, anal, or oral sex with an infected person, transfusion of contaminated blood, or sharing of needles, syringes or other sharp instruments. It can also be transmitted from mother to child during pregnancy, childbirth, and breastfeeding. Once HIV is inside the body's cells, it uses them to replicate without causing any prior discomfort, which is why this stage is known as asymptomatic. It is because of this stage that the infected person is not treated promptly and some discomfort is detected when the infection has evolved into such a disease. Without early diagnosis and treatment, there is a greater chance that HIV infection will develop into AIDS, which is why life expectancy and quality of life are considerably reduced.

Currently, the only way to know if you have HIV is through a laboratory test that detects antibodies against the virus in blood or saliva and the way to treat infected people is through various antiretroviral drugs and comprehensive medical care that allow increasing life expectancy and quality of life.