Fighting AIDS: Why the Goal Is to Diagnose HIV Before Symptoms Appear

HIV (human immunodeficiency virus), the virus that causes AIDS (acquired immunodeficiency syndrome), can hide in the body for many years before symptoms appear. Meanwhile, it is quietly killing part of the immune system. That is why the goal is catching HIV before symptoms appear, making routine testing essential so people know they are infected and can be treated, explains Stacey Rizza, M.D., an infectious diseases expert and HIV researcher at Mayo Clinic.

“The problem with HIV is it kills part of our immune cells, called the CD4 cell. And that makes people vulnerable to getting infections as well as cancers,” Dr. Rizza says. “It can hide away in the body in a latent state for many years. And that’s why it’s so difficult to cure HIV.”

“People may feel fine, but they’re slowly living with the virus killing part of the immune system,” Dr. Rizza adds. “And when the immune system gets low, people get significant and serious infections and cancers.”

World AIDS Day, observed Dec. 1, raises awareness about HIV/AIDS and pays tribute to those affected by the disease. While there has been much progress fighting HIV/AIDS, it is still common around the world, Dr. Rizza says. Globally, about 39 million people are living with HIV infection, according to the World Health Organization.

HIV can spread through sexual contact, sharing infected needles, contact with infected blood, and, less commonly, it can pass from mother to child. Many people do not know they have HIV, and that is why routine screening is important, Dr. Rizza says.

“We used to estimate that about 13% of society that has HIV doesn’t know that they’re infected. That’s gone down to about 8%. But it’s still not low enough,” Dr. Rizza says. “We would like to know that everybody who has HIV knows their diagnosis, gets connected to care and starts treatment so that they can protect themselves and decrease their risk of presenting to others and infecting others.”

Though people with HIV now enjoy longer and healthier lives due to improved treatments, the challenges of curbing the ongoing HIV epidemic persist.

To protect yourself from HIV, practice safe sex; don’t inject drugs, don’t share needles or other drug injection devices; and get tested.

Anyone who suspects exposure through sexual contact, needle use or workplace incidents should reach out to their healthcare team or visit the emergency department. PrEP is a medication used to reduce the risk of HIV infection in those who are at very high risk.

“Our goal is to diagnose people before they get to AIDS — to diagnose them when they have early-stage HIV, get them on treatment early on before the immune system is hurt, before the virus hurts any other part of the body and before they can infect other people,” Dr. Rizza says. “If you start treatment during HIV at some point in the spectrum and you’re stabilized, the virus is suppressed, and the immune system goes back to a normal level.”

There’s no universal cure for HIV/AIDS, but medications can help control it and stop it from getting worse. These antiviral treatments have cut down AIDS deaths worldwide. Research and hope for a cure continues, Dr. Rizza says.

“Every year, we see a few more people get functionally cured of HIV, which means they’ve gone through some kind of intervention that they no longer need to take the pills, but the virus stays completely suppressed. At Mayo Clinic, we are doing research on HIV cure. And several other places around the world are doing this research. And it’s incredibly exciting,” she says. “I wait for the day that we can cure most of our patients rather than treat most of our patients.”

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