HIV

Signs & symptoms

Many people don't have any symptoms when they first become infected with HIV. Some have a flu-like illness, called HIV sero-conversion syndrome, 接触病毒一两个月后. 这种疾病可能会引起各种症状，包括:

• Diarrhea
• Enlarged liver or spleen
• Fever
• Enlarged or swollen lymph nodes
• Headache
• Muscle pain
• Nausea and vomiting
• Neurologic symptoms
• 腹部，手臂，腿和脸上有皮疹
• Sore throat
• Thrush, a common fungal infection of the mouth caused by Candida, a yeast-like fungus

These symptoms usually disappear in a week to a month and may be mistaken for other viral infections. During this period, people are very infectious and HIV is present in large quantities in genital fluids.

An infected person may not experience severe symptoms for eight to 10 years or more. This period – called the asymptomatic period – varies in length for each person. Some people may have symptoms within a few months and others may be symptom-free for years.

Children born with HIV usually have symptoms within two years of birth. 儿童可能生长缓慢或经常生病.

随着免疫系统的减弱，可能会出现其他并发症. For many people, the first signs of infection are large lymph nodes or swollen glands that may be enlarged for more than three months. Other symptoms before the onset of AIDS include:

• Fevers and sweats
• Herpes infections that cause severe mouth, genital or anal sores
• Lack of energy
• Pelvic inflammatory disease in women that does not respond to treatment
• Persistent skin rashes or flaky skin
• Shingles, a painful nerve disease often accompanied by a rash or blisters
• Short-term memory loss
• Weight loss

Diagnosis

验血是诊断艾滋病毒最常见的方法. These tests look for antibodies to the virus that the body creates in an attempt to fight the virus.

接触病毒的人应立即接受检测, although it can take the body anywhere from six weeks to a year to develop antibodies to the virus. Follow-up tests may be needed depending on the initial time of exposure.

Early testing is crucial. If you test positive for the virus, you and your doctor will discuss and develop a treatment plan that can help fight HIV and ward off complications. Early testing also can alert you to avoid high-risk behavior that can spread the virus to others.

Most health care providers offer HIV testing, often with appropriate counseling. 匿名和免费的测试也是可用的. During testing, 十大赌博平台排行榜会询问你的症状, medical history and risk factors, and perform a physical examination.

Tests for HIV and AIDS

诊断艾滋病毒和艾滋病的主要检查包括:

• ELISA test. ELISA, which stands for enzyme-linked immunosorbent assay, is used to detect HIV infection. If an ELISA test is positive, the Western blot test is usually administered to confirm the diagnosis. If an ELISA test is negative, but you think you may have HIV, 你应该在一到三个月后再做一次检查. ELISA对慢性HIV感染非常敏感, but because antibodies aren't produced immediately upon infection, you may test negative during a window of a few weeks to a few months after being infected. Even though your test result may be negative during this window, you may have a high level of the virus and be at risk of transmitting infection.
• Home tests. The only home test approved by the U.S. Food and Drug Administration is called the Home Access Express Test, which is sold in pharmacies.
• Saliva tests. A cotton pad is used to obtain saliva from the inside of your cheek. The pad is placed in a vial and submitted to a laboratory for testing. Results are available in three days. 阳性结果应通过血液检查确认.
• Viral load test. 这个测试测量你血液中HIV的数量. Generally, it's used to monitor treatment progress or detect early HIV infection. Three technologies measure HIV viral load in the blood: reverse transcription polymerase chain reaction (RT-PCR), branched DNA (bDNA) and nucleic acid sequence-based amplification assay (NASBA). 这些测试的基本原理是相似的. HIV is detected using DNA sequences that bind specifically to those in the virus. 重要的是要注意不同测试的结果可能不同.
• Western blot. This is a very sensitive blood test used to confirm a positive ELISA test result.

For more information, please see FAQ: HIV Testing.

Treatments

At this time, there is no cure for HIV or AIDS, but medications are effective in fighting HIV and its complications. 治疗的目的是减少你体内的艾滋病毒, keep your immune system as healthy as possible and decrease the complications you may develop.

You and your doctor will work together to develop a treatment plan that best meets your needs. Three main factors will be considered when designing your treatment plan:

• 你开始治疗的意愿和准备
• The stage of your disease
• Other health problems

The U.S. Food and Drug Administration (FDA) has approved a number of drugs for treating HIV and AIDS.

It's important that you take your medications exactly as prescribed. 这是治疗成功的关键部分. Our program offers pharmacy services to help you maintain your drug regimen and to answer any questions you may have.

Most medications have side effects, which your doctor will discuss with you. Individuals respond differently to medications and side effects may vary. Our doctors, nurses and pharmacists can help you manage these side effects.

AIDS medications

Although there is no cure for acquired immunodeficiency syndrome (AIDS), medications have been highly effective in fighting HIV and its complications. 药物治疗有助于减少体内的HIV病毒, keep your immune system as healthy as possible and decrease the complications you may develop.

Some of the drugs approved by the FDA for treating HIV and AIDS are listed below.

核苷类逆转录酶抑制剂

These drugs interrupt the virus from duplicating, 可以减缓艾滋病毒在体内的传播. They include:

• Abacavir (Ziagen, ABC)
• 二脱氧肌苷(Videx, di脱氧肌苷，ddI)
• Emtricitabine (Emtriva, FTC)
• Lamivudine (Epivir, 3TC)
• Stavudine (Zerit, d4T)
• Tenofovir (Viread, TDF)
• Zalcitabine (Hivid, ddC)
• Zidovudine (Retrovir, ZDV or AZT)

Combinations of NRTIs make it possible to take lower doses and maintain effectiveness. 这些药物包括复方比韦(齐多夫定和拉米夫定), Trizivir (Zidovudine, Lamivudine and Abacavir), Epzicom (Abacavir and Lamivudine) and Truvada (Tenofovir and Lamivudine). 我们预计未来会有更多的联合用药.

Side effects of NRTIs

Side effects from taking NRTIs vary, depending on the individual. We recommend that you consult with your doctor regarding any side effects you experience. Common side effects include:

• Abacavir (Ziagen, ABC). Side effects may include fever, rash, fatigue, vomiting, diarrhea, abdominal pain, malaise or fatigue, 食欲不振，呼吸系统出现症状.
• Dideoxyinosine (Videx, ddI). 副作用可能包括恶心、呕吐和腹胀. 更严重的副作用包括胰腺炎和 peripheral neuropathy. Peripheral neuropathy is a common neurological disorder resulting from damage to the peripheral nerves. Symptoms of peripheral neuropathy include a sharp, burning pain sensation in the hands or legs.
• Lamivudine (Epivir, 3TC). Side effects may include cough, diarrhea, dizziness, headache, loss of appetite, 轻微的胃痉挛或疼痛和睡眠困难. 更严重的副作用包括灼烧, tingling, or pain in the hands, arms, feet, or legs; chills; ear, nose, or throat problems; fever; muscle aches; nausea; pale skin; severe stomach pain; skin rash; unusual tiredness or weakness; vomiting; and yellow eyes or skin.
• Stavudine (Zerit, d4T). 副作用可能包括周围神经病变. Symptoms of peripheral neuropathy include a sharp, burning pain sensation in the hands or legs. 在极少数情况下，司他夫定也可能引起胰腺炎.
• Tenofovir (Viread, TDF). 副作用可能包括虚弱和缺乏能量, headache, diarrhea, nausea, vomiting and intestinal gas. More serious side effects include liver or kidney failure and pancreas disease.
• Zalcitabine (Hivid, ddC). 副作用可能包括口腔溃疡和周围神经病变. Symptoms of peripheral neuropathy include a sharp, burning pain sensation in the hands or legs.
• Zidovudine (Retrovir, ZDV or AZT). Side effects may include diarrhea, nausea, vomiting, headache, insomnia, weakness and fatigue, bone marrow suppression, anemia and neutropenia. Neutropenia refers to an abnormally low number of neutrophils in the blood. Neutrophils, a type of white blood cell, help fight bacterial infections. Neutropenia isn't a disease but a sign of an underlying problem. 在轻微的情况下，它可能不会引起任何症状. Severe neutropenia increases the risk of infection of the lungs, kidneys, blood and skin.

Protease inhibitors (PI)

These FDA-approved drugs interrupt virus replication at a later step in the virus life cycle. Protease inhibitors include:

• Amprenavir (Agenerase, APV)
• Atazanavir (Reyataz, ATV)
• Fosamprenavir (Lexiva, FOS)
• Indinavir (Crixivan, IDV)
• Lopinavir (Kaletra, LPV/r)
• Ritonavir (Norvir, RIT)
• 沙奎那韦(Fortovase, Invirase, SQV)

Side effects of PIs

Side effects from protease inhibitors vary, depending on the individual. We recommend that you consult with your doctor to discuss any side effects you may experience. The following is a list protease inhibitors and their possible side effects:

• Amprenavir (Agenerase, APV). Side effects include nausea, diarrhea, vomiting, rash, numbness around the mouth and abdominal pain. About 1 percent of people have serious skin reactions, including Stevens-Johnson syndrome.
• Atazanavir (Reyataz, ATV). Side effects include headache, rash, stomach pain, vomiting, depression, increased cough, trouble sleeping, tiredness, back pain, joint pain, as well as numbness, 手或脚的刺痛或灼痛. More serious side effects include yellowing of the eyes or skin, change in heart rhythm, diabetes and high blood sugar, diarrhea, infection, nausea and blood in the urine.
• Fosamprenavir (Lexiva, FOS). 副作用可能包括皮疹、恶心和腹泻.
• Indinavir (Crixivan, IDV). 副作用包括味觉的改变, diarrhea, nausea, vomiting, dizziness or drowsiness, general feeling of weakness, headache, stomach pain and trouble sleeping. 更严重的副作用包括肾结石, changes in body fat, 血友病患者出血增加, high sugar and fat levels in the blood and onset or worsening of diabetes.
• Lopinavir (Kaletra, LPV/r). Side effects include abdominal pain, abnormal stools or bowl movements, diarrhea, feeling weak or tired, headache and nausea. In addition, patients taking Lopinavir should be monitored for possible liver problems. 患有肝病的人服用此药, such as hepatitis B or hepatitis C, 他们的肝脏状况可能会恶化. A small number of patients have experienced severe liver problems.
• Nelfinavir (Viracept, NFV). Side effects include diarrhea, weakness, headache, nausea and abdominal pain.
• Ritonavir (Norvir, RIT). Ritonavir often is used in combination with other protease inhibitors (PIs), 这种方法被称为“利托那韦增强”.“研究表明，少量的利托那韦, taken in combination with other PIs, can boost or increase the strength and effectiveness of some drugs and may overcome drug and food interactions. In some cases, Ritonavir boosting reduces the number of pills necessary or how often they're taken. The disadvantage is that Ritonavir interacts with many drugs, both prescription and over the counter. It is important that you speak with your doctor about all your medications before taking Ritonavir. Side effects include general weakness, 手脚有灼烧感或刺痛感, stomach pain, diarrhea, constipation, indigestion, flatulence, nausea, vomiting, loss of appetite, change in sense of taste, headache, dizziness, drowsiness, insomnia, fever, throat irritation, abnormal thinking, rash, sore throat and sweating. 更严重的影响包括胰腺疾病, changes in body fat, 血友病患者出血增加, high sugar and fat levels in the blood and onset or worsening of diabetes.
• 沙奎那韦(Fortovase, Invirase, SQV). 副作用与肠胃系统有关, including diarrhea, nausea, stomach-intestinal pain, heartburn, rectal gas, vomiting, altered taste sensation, headache, fatigue, depression, sleep disturbance including insomnia, anxiety, sex drive disorder, muscle aches, rash, 肝炎和异常脂肪再分配.

Other AIDS medications

Fusion inhibitors

Fusion inhibitors are a new class of drugs that act against HIV by preventing the virus from fusing with the inside of a cell, preventing it from replicating. The group of drugs includes Enfuvirtide, also known as Fuzeon or T-20.

高效抗逆转录病毒疗法(HAART)

In 1996, highly active antiretroviral therapy (HAART) was introduced for people with HIV and AIDS. HAART – often referred to as the anti-HIV "cocktail" – is a combination of three or more drugs, such as protease inhibitors and other anti-retroviral medications. The treatment is highly effective in slowing the rate at which the HIV virus replicates itself, 可以减缓艾滋病毒在体内的传播. HAART的目标是减少你体内的病毒数量, or the viral load, 达到血液测试无法检测到的程度.

非核苷类逆转录酶抑制剂

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) block the infection of new cells by HIV. These drugs may be prescribed in combination with other anti-retroviral drugs. NNRTs include:

• Delvaridine (Rescriptor, DLV)
• Efravirenz (Sustiva, EFV)
• Nevirapine (Viramune, NVP)