Clinical Features and Management of HIV/AIDS in Adults

Human immunodeficiency virus (HIV) infection is transmitted through sex, vertically from mother to child or through sharing of needles by intravenous drug users. Untreated, the infection results in progressive depletion of CD4 T lymphocytes resulting in progression to the acquired immunodeficiency syndrome (AIDS) on average 8–10 years after initial infection. Individuals with AIDS are susceptible to opportunistic infections and malignancies. Tuberculosis is the most frequent cause of hospitalization and death in people living with HIV in lower- and middle-income countries. Combination antiretroviral therapy (ART) is highly effective at suppressing viral replication when taken with optimal adherence. This results in the maintenance or restoration of immune function and prevention of opportunistic infections. International guidelines now recommend that all patients diagnosed with HIV initiate ART at the time of diagnosis regardless of CD4 count. This is of benefit to individual health, restoring life expectancy to approximate that of HIV-negative people in the same setting and very effectively reduces the risk of onward transmission.