By Chris Tobias

Human Immunodeficiency Virus (HIV) is a chronic viral infection that targets the immune system, weakening its ability to fight infections and diseases. If left untreated, HIV can progress to Acquired Immunodeficiency Syndrome (AIDS), a life-threatening condition. Beyond its profound effects on the individual, HIV can also impact children born to parents with the virus. This article explores what happens to the body when infected with HIV and examines its effects on children, with a focus on medical advancements and preventive measures.

What Happens to the Body When Infected with HIV?

1. How HIV Attacks the Immune System

HIV primarily targets CD4 cells, also known as T-helper cells or T-cells, which are critical for immune function. The virus:

• Enters CD4 Cells: HIV binds to specific receptors on CD4 cells, allowing it to enter and hijack the cell’s machinery to replicate itself.
• Destroys CD4 Cells: As the virus multiplies, it destroys the infected cells, reducing the body’s ability to mount an immune response.
• Weakens Immunity Over Time: A declining CD4 count leaves the body vulnerable to opportunistic infections and cancers, such as tuberculosis, pneumonia, and Kaposi’s sarcoma.

2. Stages of HIV Infection

HIV progresses through three main stages:

• Acute HIV Infection: Occurs 2-4 weeks after exposure. Symptoms resemble the flu, including fever, sore throat, and fatigue, as the body responds to high levels of viral replication.
• Chronic HIV Infection (Clinical Latency): The virus continues to replicate at lower levels. This stage can last several years without symptoms if untreated, but the virus progressively damages the immune system.
• AIDS: The most severe stage, characterized by a CD4 count below 200 cells/mm³ and the presence of opportunistic infections. Without treatment, life expectancy is typically less than three years.

The Full Effects of HIV on the Body

1. Immune System Damage

• Reduced Immunity: As CD4 cells are destroyed, the immune system becomes less effective at combating infections and diseases.
• Increased Risk of Infections: Common infections, such as colds and flu, become severe, and rare infections, such as toxoplasmosis, may occur.

2. Systemic Effects

HIV affects multiple organ systems:

• Neurological: HIV-associated neurocognitive disorders (HAND) can lead to memory loss, confusion, and motor impairments.
• Cardiovascular: Chronic inflammation caused by HIV increases the risk of heart disease.
• Respiratory: Higher susceptibility to pneumonia and tuberculosis.
• Gastrointestinal: HIV can lead to chronic diarrhea, weight loss, and malabsorption of nutrients.

3. Long-Term Complications

Even with antiretroviral therapy (ART), individuals may experience:

• Chronic Inflammation: Persistent low-level inflammation contributes to aging-related diseases.
• Metabolic Disorders: ART can cause side effects such as insulin resistance and dyslipidemia.
• Bone Density Loss: Increased risk of osteoporosis and fractures.

Effects of HIV on Children Born to HIV-Positive Parents

1. Risk of Mother-to-Child Transmission

HIV can be transmitted from mother to child during pregnancy, childbirth, or breastfeeding. Without intervention, the transmission rate ranges from 15% to 45%. However, with proper medical care, the risk can be reduced to below 1%.

2. Outcomes for HIV-Positive Children

If a child contracts HIV:

• Weakened Immune System: Similar to adults, the virus damages the child’s immune system, making them vulnerable to infections and illnesses.
• Growth and Development Delays: HIV can affect a child’s physical growth, cognitive development, and overall health.
• Opportunistic Infections: Children are more prone to severe infections, such as cytomegalovirus and pneumocystis pneumonia.

3. Effects on HIV-Exposed, Uninfected (HEU) Children

Even when children are not infected, exposure to HIV in utero or during breastfeeding can have long-term effects:

• Immune System Alterations: Studies suggest that HEU children may have an underdeveloped immune response, increasing their susceptibility to infections.
• Higher Morbidity Rates: HEU children are at a greater risk for respiratory and gastrointestinal infections compared to children born to HIV-negative mothers.
• Potential ART Effects: Exposure to antiretroviral drugs during pregnancy can cause mild birth defects or metabolic changes in some cases, though these risks are generally outweighed by the benefits of preventing HIV transmission.

Prevention and Management

1. For Individuals with HIV

• Antiretroviral Therapy (ART): ART suppresses viral replication, reduces the viral load to undetectable levels, and prevents progression to AIDS. When taken consistently, ART also prevents transmission to sexual partners.
• Regular Monitoring: Routine blood tests to monitor CD4 counts and viral load help assess the effectiveness of treatment.

2. For Pregnant Women with HIV

• Early Intervention: Starting ART before or during pregnancy significantly reduces the risk of transmission.
• Safe Delivery Practices: Cesarean delivery may be recommended to minimize transmission risks during childbirth.
• Avoid Breastfeeding: In countries like the U.S., formula feeding is encouraged to prevent HIV transmission through breast milk. In resource-limited settings, breastfeeding with ART may be safer than formula feeding without ART due to malnutrition risks.

3. For HIV-Exposed Infants

• Post-Exposure Prophylaxis (PEP): Newborns may be given ART for several weeks after birth to reduce the risk of infection.
• Regular Testing: Early testing ensures timely diagnosis and treatment if the child is HIV-positive.

Advances in Research and Care

1. Prevention Breakthroughs

• Pre-Exposure Prophylaxis (PrEP): For HIV-negative partners of HIV-positive individuals, PrEP significantly reduces the risk of contracting the virus.
• Maternal ART: Advances in maternal ART regimens have nearly eradicated mother-to-child transmission in countries with robust healthcare systems.

2. Cure Research

While no cure for HIV currently exists, innovative treatments such as gene editing and therapeutic vaccines offer hope for eradicating the virus in the future.

The Human and Social Impact

1. Stigma and Mental Health

• Social Stigma: Individuals with HIV often face discrimination, which can affect their mental health, employment, and relationships.
• Psychological Burden: Anxiety, depression, and stress are common among individuals living with HIV and their families.

2. Economic Costs

• Healthcare Expenses: Lifelong treatment and monitoring can impose significant financial burdens.
• Impact on Employment: Reduced productivity and inability to work due to illness further compound economic challenges.

Conclusion

HIV profoundly affects the body, leading to immune system deterioration and systemic complications if untreated. For children born to HIV-positive parents, the virus poses unique risks, from potential transmission to immune alterations in uninfected infants. Advances in medical care, particularly the widespread use of ART, have significantly improved outcomes for individuals living with HIV and their children. However, continued research, prevention efforts, and education are essential to further reduce the human and societal impact of this global health challenge. Through vigilance and compassion, individuals and families affected by HIV can achieve healthier and more fulfilling lives.

Brother Paul Toomer Muhammad contributed to this article. As a member of Community Board 5 and an active member the Community Advisory Board for NYC Health and Hospitals, he has access to information that keeps him well informed of the community health and needs assessment. He is aware of the human capital and financial impact on the constituents of the community as a result of health policies. The details of these articles are informative and promote a compelling argument for more dialog to take action in our communities. 

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