Glossary of Important Terminology Used in The Graying of AIDS

AIDS

Short for “acquired immune deficiency syndrome,” the life-threatening stage of HIV infection. A medical diagnosis for people whose immune systems are so damaged that either (a) their CD4 count drops below 200, or (b) they develop one or more opportunistic infections or cancers known as AIDS-Defining Conditions (ADCs).

Antibody
Proteins tailored by the immune system to attack specific antigens (unwelcome elements like viruses) introduced into the body. Most tests used to look for HIV infection look for HIV antibodies in blood or oral fluid (different from saliva). Most peoples’ bodies produce enough antibodies to show up on an HIV test within 3 months of infection, although it can take longer for some. During this “window period” —which can last from 2 weeks to 6 months—a person can infect others, whether or not their test indicates that they are positive.

ARV
Short for “antiretroviral therapy.” HIV, a retrovirus, inserts its genetic code into the cells it invades, which then act like tiny copy machines, helping the virus replicate. Retroviruses cannot be cured, but each of the seven different classes of ARV medications available (including protease inhibitors) interferes in some way with the “copying” process; in the US they are usually prescribed in combination. It is important not to skip doses of these medicines if they are to remain effective and prevent the virus from mutating into a drug resistant strain. (See also “HAART/Combination Therapy)

Asymptomatic
Regardless of what tests may show is going on inside the body, the person is feeling fine and not experiencing any symptoms from their infection. This does not mean the virus is gone, but rather that it is affecting the body in ways that are not noticeable to the patient.

CD4 cell/T-cell
A type of white blood cell that, in a healthy immune system, attacks and defeats germs that can cause illness. HIV reduces the number of these cells in the body, allowing illnesses to take hold. A high CD4 count is good because it means the body has more of these cells to fight infections and cancers. If an HIV-positive person’s CD4 count drops below 200, their diagnosis shifts to AIDS, whether or not their CD4 count goes back up again later.

Co-infection/Co-morbidities
Having more than one ailment at any given time (like HIV/AIDS and Hepatitis or HIV/AIDS and Heart Disease).

Cross-infection/Reinfection/Superinfection
Infection with more than one version, or strain, of HIV.

Dementia
Physical changes in the brain that can affect aspects of a person’s ability to function (including memory, speech, and basic motor functions) as well as their personality (including mood, behavior, and judgment). Older people with HIV may display symptoms of dementia if they: (1) develop AIDS-Related Dementia (or HIV encephalopathy), an AIDS-defining condition associated with later-stage infection; (2) develop medical conditions like Alzheimer’s Disease or stroke that can cause dementia; (3) suffer from mental decline resembling dementia as a result of dehydration, medication side effects, or drug interactions; or (4) develop a neurocognitive disorder that is mild to moderate in nature but may require special testing to diagnose.

Epidemic/Pandemic
An epidemic is an outbreak of disease across a population; a pandemic is even more wide-spread, often crossing national boundaries. HIV/AIDS is both an epidemic in the US and a worldwide pandemic.

HAART/Combination Therapy
Short for “highly active antiretroviral therapy.” HAART refers to a treatment approach in which multiple ARV from different classes are taken in combination to treat HIV infection (sometimes called combination therapy). HIV mutates quickly, sometimes making the virus less vulnerable to certain medications over time (treatment resistant); combination therapy helps to protect against this.

Harm Reduction
Refers to a practical approach to risk reduction that acknowledges that people may choose to engage in risky behaviors and aims to help them be “safer” while doing so. Safer sex tips and needle exchange programs (where used syringes are traded for new ones) are examples of harm reduction strategies.

HIV
Short for “Human Immunodeficiency Virus.” HIV attacks a person’s immune system, making it more difficult for their body to fight off infection. A person infected with HIV is said to be “HIV-positive,” or “Positive”; a person who does not have the virus is “HIV-negative,” or “Negative”. There are two types of HIV: HIV-1 is most common worldwide and is what most Americans mean when they talk about HIV; HIV-2 is found mostly in West Africa. Medications effective against HIV-1 do not necessarily work against HIV-2.

IDU
Short for “intravenous drug user.” A person who uses syringes to shoot drugs directly into their body. Sharing injection equipment puts IDUs at high risk for HIV and other infections, such as hepatitis.

MSM
Short for “men who have sex with men.” A term used to describe men who have had sex with one or more men, regardless of whether they consider themselves to be gay, bisexual, “only experimenting,” or do not label their sexual orientation in any of these ways.

Neuropathy
Nerve damage that can occur anywhere in the body, but often used as shorthand for peripheral neuropathy which occurs in the hands, feet, arms, and legs. Sensations can include pain, tingling, burning, numbness and paralysis. Can result from HIV infection or as a side effect of some medications.

Opportunistic Infections (OIs)
Illnesses that take advantage of weakened immune systems. A person with HIV who develops one or more of these infections or cancers (also known as “AIDS-Defining Conditions“) is said to have “progressed” to an AIDS diagnosis.

PCP
Short for “Pneumocystis Carinii Pneumonia.” A life-threatening form of pneumonia particularly common in people with weakened immune systems and the most common “opportunistic infection” affecting people with HIV. PCP is an “aids-defining condition,” meaning that an HIV-positive person who develops PCP has progressed to an “AIDS” diagnosis.

STI/STD
Short for “sexually transmitted infection/disease.” Many STIs cause breaks in the skin, increasing the risk for sexual transmission of HIV. Condoms can protect against both STIs and HIV.

Strain
Some viruses, like the common flu or HIV, evolve rapidly into different versions or strains that may not respond to the same antibodies or medications that effectively curbed the original strain. This is why flu vaccinations are more effective some years than others, and why HIV medications that may initially work well for a patient can stop working over time.

Universal Precautions
Techniques used by health care professionals to protect themselves and others against the spread of disease (including use of protective equipment, like gloves, and the proper disposal of medical waste, like used syringes). In most interactions with patients with HIV/AIDS, goggles and face masks are unnecessary.

Viral Load
The amount of HIV in an infected person’s blood. Usually, when a person’s viral load goes up (meaning they have more virus in their body), they become sicker and are at greater risk of transmitting HIV to other people. As there is currently no cure for HIV, the goal is to reduce their viral load to undetectable levels—so low that the virus cannot be detected by available tests.

Wasting Syndrome
Involuntary weight loss (at least 10% of body mass) in combination with diarrhea, fever, or weakness lasting at least 30 days. The bulk of what is lost is “lean body cell mass,” meaning that while it may be a combination of muscle, fat, and bone, it is mostly muscle.

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