Human immunodeficiency virus (HIV)

• Appropriate management and treatment allows patients who have contracted HIV to live out full lives.
• 97% of those surveyed who receive treatment were virally suppressed.
• Pre-exposure prophylaxis is key to reducing the risk of acquiring HIV in some patients.
• A nurses' role is vital in this process; this includes advocating contraception use, prescribing pre-exposure prophylaxis and encouraging HIV testing.

Human Immunodeficiency Virus (or HIV) is a retrovirus that specifically targets CD4+ T Lymphocyte cells within the immune system of an infected host. CD4+ T cells ordinarily formulate the immune response to infection by identifying foreign antigens and then generating an antibody response. These cells quickly become ineffective in patients with HIV, left untreated their immune system deteriorates to become dangerously weak, and they become susceptible to severe opportunistic infections from organisms that would ordinarily be harmless (Touloumi and Hatzakis, 2000; Faulhaber and Aberg, 2009).

The severity of HIV infections can be measured by the amount of virus found within the host, commonly referred to as the ‘viral load’ figure (Terrence Higgins Trust, 2016). Patients with a high viral load have overwhelming HIV infection, which causes rapid CD4+ T cell destruction and a low ‘CD4+ count’ (<350 per microliter) (Faulhaber and Aberg, 2009). HIV is separated into three phases of

Each year approximately 6,000 new cases of HIV are diagnosed within the UK, adding to over 100,000 people who are known to be living with HIV (Skingsley et al, 2015; Terrence Higgins Trust, 2015). It is difficult to quantify the exact number of people living with HIV, as almost one in five people who have HIV are unaware of their positive HIV status, which is a public health concern (National Institute for Health and Care Excellence (NICE), 2014; Skingsley et al, 2015).

HIV is most common amongst men who have sex with men (MSM) within the UK, with around 1 in 18 MSM being HIV positive; rising to 1 in 8 within areas of London (National AIDS Trust (NAT), 2014). Black-African people have the second highest incidence, and account for two-thirds of HIV infection within the heterosexual HIV positive population, with incidence of 56 per 1000 aged 15–59 years (Public

Symptoms associated with primary HIV infection are often severe enough to cause the sufferer to seek health care advice and this provides an opportunity to make an early diagnosis of HIV. Unfortunately, all too often this opportunity is missed and the diagnosis is delayed, exposing the patient to the risks of delayed treatment (Baggaley, 2008). The symptoms of primary HIV infection are vague. They feature in a number of presentations which are relatively benign and commonly seen in primary care. This fact, combined with a lack of awareness of primary HIV infection, most likely explains why early diagnosis is not always made. Signs and symptoms of HIV include:

• fever with rash
• sore throat with swollen glands in the neck
• muscle aches
• joint pains
• headaches
• mucosal ulceration (Boon et al, 2006)