In addition to CD4-cell counts of less than 200, AIDS is defined by the presence of one or more of 26 conditions, most of which are "opportunistic" infections that a healthy person could easily fight off. These include highly aggressive forms of certain cancers such as lymphomas (cancers of the immune system) and a type of skin cancer called Kaposi's sarcoma. Other opportunistic infections are:

  • Pneumocystis carinii pneumonia (PCP)
  • severe cytomegalovirus infection
  • toxoplasmosis
  • diarrhea caused by Cryptosporidium or Isospora organisms
  • candidiasis
  • cryptococcosis
  • chronic herpes simplex infection

People with opportunistic infections experience symptoms such as coughing, shortness of breath, seizures, severe and persistent diarrhea, fever, vision loss, severe headaches, weight loss, extreme fatigue, nausea, vomiting, lack of coordination, coma, abdominal cramps, difficult or painful swallowing, and mental changes such as confusion and forgetfulness.

In addition to treatment for such separate conditions, which can be very difficult to coordinate, adults with CD4-cell counts of less than 200 are given drug treatment to prevent the occurrence of PCP, which is one of the most common and deadly opportunistic infections associated with HIV Regardless of CD4-cell counts, people who survive PCP must take these drugs for the rest of their lives.

The course of AIDS varies widely. Many people with AIDS are so debilitated by their symptoms that they are unable to hold a job or perform simple household chores. Others may go through periods of devastating illness followed by periods of normal functioning.

Despite years of research, there is still no vaccine for AIDS. Thus the only way to prevent infection by HIV is to avoid behaviors that allow transmission of the virus. This means not using intravenous drugs, not sharing needles if you use intravenous drugs, and not using anyone else's toothbrush, razor, or other implements that could be contaminated with blood. Also, of course, it means practicing safer sex (see page 181). People who have a history of other STDs are more vulnerable to infection with HIV, and should be treated immediately for any STD they may acquire.

It is not necessary to avoid normal contact with people infected with HIV, even if they have developed full-blown AIDS. That's because HIV is not spread through casual contact, including contact with:

  • food utensils and food
  • towels and bedding
  • doorknobs
  • swimming pools
  • telephones
  • toilet seats

HIV also is not spread by hugging, holding hands, or having other physical contact in which neither blood nor semen is exchanged.

If you do have to come into contact with the blood of someone whom you have reason to suspect may be infected with HIV, or if you are infected and there is any possibility of getting your blood on someone else, you should wear latex gloves or take other protective measures.

Researchers around the world are working to develop HIV vaccines and new therapies for AIDS and its associated conditions. Some vaccines and many drugs are in the testing stage. At the same time, researchers are trying to determine exactly how HIV damages the immune system so they can more precisely target their efforts. Of special interest to researchers are the 50 or so persons known to have been infected with HIV more than 10 years ago who have never developed AIDS. Do they have a less virulent form of the virus? Or does something in their genetic makeup protect them from AIDS? The answers may point the way toward a vaccine or, perhaps someday, a cure.

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