What is HIV?

Updated: Apr 09, 2019
  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Human immunodeficiency virus (HIV) infection has evolved from a disease that was predictably fatal to a chronic disease that can be effectively managed with contemporary antiretroviral therapy (ART) regimens. As a result of improved HIV care, the life expectancy in persons with HIV infection is similar to that in the general population. [1, 2] HIV treatment guidelines now recommend ART in all HIV-infected individuals, regardless of CD4 cell count. [3, 4]

Diagnosis of HIV infection soon after infection and early initiation of ART are highly important, as both have been associated with improved CD4 count gains during ART, a reduced risk of acquired immunodeficiency syndrome (AIDS) development, reduced T-cell activation, and greater vaccine responsiveness. [5, 6]

Primary care providers (PCPs) are experiencing new challenges and opportunities in the current era of HIV infection. Understanding HIV risk factors and groups at highest risk is important, as targeted testing by PCPs plays an important role in diagnosing new HIV cases and preventing transmission to others.

In 2016, an estimated 39,782 new HIV infections occurred in the United States. [7] Most (67%) of these occurred in gay and bisexual men. Blacks/African Americans accounted for 44% of HIV diagnoses, although they comprise only 12% of the US population. [7]

In addition to being on the front line for both HIV diagnosis and prevention, PCPs are increasingly involved in the co-management of HIV-infected patients with an HIV specialist. [8] PCPs provide expertise in preventive care and management of chronic conditions, such as cardiovascular disease, osteoporosis, and renal disease, which have become increasingly important for aging individuals with HIV infection.


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