Dear Eve,

I am still not clear on the difference between HIV and AIDS. I think that as a person gets AIDS they will soon die, and some people are telling me that this is not so. Who is right?

ER - still confused

Dear ER,

HIV, the Human Immuno-deficiency Virus, is the virus that causes or leads to AIDS. This virus attacks the immune system of the infected person and gradually destroys the person's natural defence against infections, therefore breaking down the immune system.

Some persons when they get infected, show no signs or symptoms of the virus attacking the immune system. But the virus, over time, destroys the cells which it attacks. These are mainly the T-cells or fighter cells, also called the CD4 cells.

In a non-infected person the T-cells or CD4 cells usually number over 1,000. It is universally accepted in the medical community that when an infected person has a T-cell count or CD4 count of 200 or below that they have reached the stage of AIDS (Acquired Immune Deficiency Syndrome). Usually when this happens persons have had both major and minor opportunistic infections.

These opportunistic infections happen to HIV-infected persons when their own immune system has been made ineffective by the virus. They are not able to fight off even minor infections. So AIDS is medically determined. In other words, a medical doctor usually makes this diagnosis when an HIV-infected individual has a CD4 count of 200 or less, as well as two major and one minor opportunistic infections. In the literature, AIDS is described as a Syndrome (a class of illnesses) that HIV-infected persons develop because they have acquired the AIDS-causing virus -- HIV.

Not everyone that reaches the stage of AIDS dies. My T-cell count in 1997 when I became ill fell to two. Fortunately, I was able to take drugs that enabled me to continue living. My last count was over 700 and my viral load that was very high has been undetected for many years. Medically, I am a person with AIDS who is doing well.

Since 2006, persons who are HIV-infected have had access to free antiretroviral (ARV) drugs.

The ARV treatment can delay the onset of AIDS by improving the body's immune system through the increase of CD4 cells and the decrease of the viral load.

Can a HIV test not detect the infection?

Dear Eve,

Is it possible to do a test and the test misses that you have HIV?

RT

Dear RT,

When a person gets infected with HIV, it sometimes takes from six weeks to three months before antibodies to HIV can be detected in the blood. In some people it takes up to six months from initial exposure to the time when antibodies are detected in the blood. The HIV test searches for the presence of antibodies that are developed by your body as a response to being infected with HIV.

If you do a HIV test in what is called the 'window period', which is the time when the antibodies are being formed, then naturally the test cannot pick up something that is not there.

It is very important that persons who are doing a HIV test do pre- and post-test counselling so they will be able to discuss these matters.

There is no wrong time to do a HIV test, but if you think that you have been exposed to the virus today, you can do a test tomorrow but it might not give you the results of last night's exposure, you might have to be prepared to do another test, bearing in mind the 'window period'.

You can send your questions or comments relating to HIV or related issues to info@eveforlife.org or write to Eve for Life, C/O Jamaica Observer.