For many people, HIV and AIDS may seem like the same thing. They’re often mentioned together, sometimes even termed as HIV/AIDS. But the reality is, they’re very different.

In recognition of Sexually Transmitted Diseases Month this April, we’re taking a few minutes to explain what makes HIV and AIDS different. Read on as Michael Davis, MD, Medical Director of Cempa Community Care’s Clinical Services, offers some insight.

“The most basic difference is that HIV is a virus, while AIDS is a clinical syndrome,” Dr. Davis says. “Think of it like a staph infection — staph is a germ on the skin, but once it gets through the skin, it causes an infection. HIV is a virus, but over time it can destroy immune cells in the body, causing AIDS.”

How HIV Progresses
HIV, which stands for human immunodeficiency virus, is transmitted through blood to blood contact, most frequently by sexual intercourse or through IV drug use. 

“Once HIV is in the body, it attacks a type of cell known as the CD4 positive T-cells,” Dr. Davis says. “It’s very sneaky. It attacks and kills the cells that tell your immune system what to do. Essentially, that’s like taking out the generals in a war.”

In a gradual progression, those cells are removed one by one.

“Over time, those T-cells diminish,” Dr. Davis says. “That process on average takes 5 to 10 years until the point at which you don’t have enough T-cells to tell the rest of your immune system what to do. At that point, you have AIDS. You don’t have enough capacity to fight off opportunistic infections.”

As recently as the late 80s/early 90s, being diagnosed with HIV was considered the beginning of the end. But today, those who have HIV can live happy, healthy, and fulfilling lives, because antiretroviral pills, one pill once per day, slows the progression of HIV in the body.

How HIV Becomes AIDS
HIV can remain in the body for many years without developing into AIDS, formally called acquired immune deficiency syndrome. With today’s treatment options, T-cell depletion after developing HIV infection doesn’t happen.

Even in someone who has HIV and isn’t receiving treatment, it typically takes around 10 years before the CD4 T-cells deplete to a level that the immune system is significantly impacted.

A normal CD4 level is between 500 and 1500. When the CD4 level of someone with HIV reaches 200 or below, he or she is considered to have AIDS. The presence of AIDS-defining illnesses, such as invasive cervical cancer, cytomegalovirus, histoplasmosis, lymphoma, recurrent pneumonia, or wasting syndrome, is also a determining factor in the diagnosis of AIDS.

Clearing Up Misconceptions
As mentioned above, HIV was previously considered simply a segue into the more serious and eventually deadly AIDS. The reality is different. A person may never develop AIDS despite an HIV diagnosis.

“That’s the most common misconception that we spend most of our time dealing with in new patient encounters,” Dr. Davis says. “Many people think that HIV is a terminal condition associated with the end of life. But that’s not the case.” 

In fact, with medical advancements, HIV is considered a chronic medical condition that can be managed.

“HIV is a chronic infection, and it is now often treated for a normal lifespan,” Dr. Davis says. “If I’m 40 and I was diagnosed with HIV and diabetes and I took medication for both, I’d live longer with HIV than I would with diabetes.”

Many people who have HIV also have other chronic medical issues, so the care they receive through Cempa focuses on both managing HIV and the other health conditions.

“The key to taking care of people with HIV is remembering that they’re whole people,” Dr. Davis says. “We know the treatments that work, so now it’s about helping people manage other factors in their lives. That’s why Cempa provides the scope of the services that we do — to help treat that whole person.”

And the biggest message we can share with those who have HIV? “There is hope,” Dr. Davis says.

Cempa has been committed to providing care for those with HIV in the Chattanooga area since 1986. We offer a full spectrum of HIV-related services, including diagnostic tests, physical exams, medication adherence counseling, mental health support, nutritional guidance, and case management.