HIV / AIDS - Full extract 

Up to September 30 1999 there have been 19,931 documented cases of HIV infection in Australia. 8,200 have gone on to develop AIDS and among this number there have been 5,805 deaths. No other illness in recent history has had such a sudden and continuing impact on people's lives.

 AIDS stands for the Acquired Immune Deficiency Syndrome and is the most serious stage of a disease that results from infection with HIV, the Human Immunodeficiency Virus. HIV attacks and breaks down the body's immune system, leading to severe illnesses and overwhelming infections. Conditions that are normally of no concern become life-threatening and extremely difficult to treat. Infection with HIV causes a spectrum of illness, from being HIV positive and feeling perfectly well, through to the most severe form of AIDS. 

When a person has been infected with HIV, an antibody appears in the blood. This can be detected by a simple blood test; the person is said to become HIV-positive. It may take from three weeks to three months for a person who has come into contact with the HIV virus to develop a positive blood test. This is called the window period . In this time a person can carry the the virus and still have a negative blood test. Before any HIV test is performed, a detailed discussion with the doctor is essential; both positive and negative tests have major implications. Initially it was thought that only a proportion of HIV-positive people went on to develop AIDS. We now know that everyone who becomes HIV-positive eventually progresses to AIDS, though it may take 10 years or more for this to occur. 

The first case of AIDS was diagnosed in the USA in 1981, the first case in Australia in 1982. The actual HIV virus was isolated the following year. It is not certain where the virus originated. Although it has been isolated from blood samples taken as far back as the early 1960's, it is essentially a new disease. More recently another infection, HIV-2, has been isolated from patients in West Africa. Although routine HIV antibody tests now include HIV-2, so far there has been only a few documented cases in Australia. 

In the early 1980's about 300 Australian people acquired HIV by receiving blood transfusions or blood products contaminated with the virus. Since May 1985 all blood in the Australian Red Cross Blood Bank is tested for HIV-1 and more recently HIV-2. It is now almost impossible for anyone in Australia to become infected with HIV from a blood transfusion. Babies have acquired HIV from mothers during pregnancy, at birth and occasionally from breast milk. There have also been very rare occurrences of acquiring HIV from surgical contamination. However, the two main ways of getting HIV are by unsafe sex with someone who has the virus, and by injecting drugs using contaminated needles or syringes. 

So far the sexual transmission of HIV in Australia has occurred mainly amongst homosexual and bisexual men, and occasionally their partners. The pressing question is how rapidly it will spread by heterosexual contact, as it already has in Africa, several Asian countries and in some areas of the USA. It has been observed that the presence of other sexually transmitted conditions, such as genital herpes, increases the risk of acquiring HIV by sexual contact. 

All people need to be thoroughly aware of what safer sex is all about, and they need to learn about it from an early age. AIDS is an emotive subject and sometimes this can cloud people's thinking. Although we have an enviable record in Australia for prompt response and public education, a strong and continued commitment is required. 

After the initial massive impact on the gay community, the HIV / AIDS story has entered another phase. The rate of spread of the disease in Australia has slowed considerably but will simmer away at a steady rate for many years to come, with heterosexual spread becoming more common. 

Internationally, HIV / AIDS has become a disease of the poor. The major obstacles in many countries have become poverty, illiteracy and government inactivity. In some areas of the world the disease goes completely unchecked. As yet there is no cure for HIV / AIDS. 

Several drugs like AZT that have been shown to be effective in increasing the lifespan of people with AIDS, and reducing the risk of transmission of HIV from mothers to their infants. There are also a number of medications for treating the infections and complications from AIDS. 

Preventing transmission of HIV infection to other people is fundamental; safer sexual practices are so important in this regard. Lifestyle factors can help to maintain health in people with HIV / AIDS. Regular medical checks are also important to monitor immune system function and to detect early signs of infection. 

Health Tip:
* HIV / AIDS is a condition that, in one way or another, has impact on us all. Continuing community education is of vital importance.

Dr. Andrew Pattison: Common Consultations
North East Valley Division General Practice, Melbourne, Australia.   Disclaimer
  - Last modified: August 18, 2001