What is HIV

Human Immunodeficiency Virus (HIV) is a retrovirus that attacks the human immune system, specifically CD4 T lymphocytes. These cells play a crucial role in defending the body against infections and diseases.

Over time, HIV reduces the number of CD4 cells, weakening immunity and increasing vulnerability to opportunistic infections and certain cancers.

Transmission

HIV spreads through the exchange of infected bodily fluids such as:

• Blood
• Semen
• Vaginal fluids
• Breast milk

Common modes include unprotected sexual contact, contaminated needles, blood transfusion with infected blood, and mother-to-child transmission during pregnancy, childbirth, or breastfeeding.

Disease Progression

Acute Infection

• Initial stage after infection
• Flu-like symptoms may appear
• High viral load

Clinical Latency

• Virus remains active but reproduces at low levels
• May last several years
• Often asymptomatic

Acquired Immunodeficiency Syndrome (AIDS)

• Advanced stage of HIV infection
• Severe immune damage
• Presence of opportunistic infections or certain cancers

Management and Treatment

There is currently no complete cure for HIV. However, it can be effectively managed using Antiretroviral Therapy (ART).

• ART suppresses viral replication
• Reduces viral load to undetectable levels
• Allows CD4 cell recovery
• Prevents progression to AIDS
• Reduces transmission risk

Early diagnosis and consistent treatment are essential for long-term survival and quality of life.

CCR5-delta 32 Mutation

CCR5 is a co-receptor on CD4 cells used by HIV to enter the cell.

The CCR5-delta 32 mutation prevents the formation of functional CCR5 receptors, thereby blocking the virus from entering CD4 cells.

• Individuals with two copies of the mutation show strong resistance to HIV
• Rare globally
• More common in people of European ancestry

This mutation has been used in rare cases of HIV remission through stem cell transplantation.

Bone Marrow or Stem Cell Transplant

Bone marrow transplantation, also known as hematopoietic stem cell transplant, replaces diseased bone marrow with healthy stem cells.

Types:

• Autologous transplant: Uses patient’s own cells
• Allogeneic transplant: Uses donor cells

In rare cases, transplants from donors carrying the CCR5-delta 32 mutation have resulted in long-term remission of HIV.

However, this procedure is high-risk and used primarily for treating blood cancers, not as a routine HIV therapy.

Public Health Significance

• HIV remains a major global health issue
• Prevention includes safe sexual practices, needle safety, blood screening, and awareness programs
• National and international strategies focus on testing, treatment access, and stigma reduction

HIV management represents a significant intersection of virology, immunology, biotechnology, and public health policy.