People infected with HIV often cannot be tested

The corona pandemic hides the fact that there are other serious viral diseases: an HIV diagnosis is still a shock for those affected. The fear of exclusion in particular makes life difficult for many.

As soon as the house is visited, hide the medicines. Making excuses for colleagues about the regular check-up visits to the doctor. In the parking lot in front of the HIV clinic, make sure that nobody sees you. This is the life of Anja, who found out in 2014 that she is HIV positive. “It’s like a double life,” says the 41-year-old. Forty years ago, on June 5, 1981, the CDC first reported the mysterious new disease. The medical situation has improved. Little has changed in terms of the discrimination that many of those affected were confronted with afterwards.

The mother of two small children from Hessen is called Anja. Only her husband, who is also HIV positive, knows about her infection. She wants to remain anonymous. She is afraid of reactions, like the other day in the hospital when she was brought in by ambulance with a broken bone and the paramedic yelled at her in the emergency room, where she said the infection, what happened to her – she should have said that immediately. She doesn’t have to, Anja knows. When the HIV infection is treated well, the viral load is so low that it can no longer be detected. In this way, HIV-positive people cannot infect others.

According to a new survey by Deutsche Aidshilfe, a good half of those who are HIV-positive still experience discrimination. Almost 100,000 people were living with HIV / AIDS in Germany at the end of 2019, almost 11,000 of whom do not know anything about it. The Austrian AIDS Society assumes that there are around 9,000 HIV-infected people in Austria. And that almost ten percent of those infected with HIV do not know about their infection because they have not yet been tested and therefore have not yet received any treatment. If left untreated, HIV infection will weaken the immune system so severely that life-threatening diseases will develop. One then speaks of AIDS (acquired immunodeficiency syndrome).

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“Stigma and discrimination are reasons why the HIV pandemic is not over after 40 years worldwide,” says the virologist and AIDS researcher Hendrik Streeck, who most recently made a name for himself as a corona expert. “We could contain the pandemic much better than we are.” In many countries people who are infected with HIV or have an increased risk of infection have to live in secret. Many would not be tested out of fear and concern about the consequences or there are hardly any test options. “There are currently too many infected people who can pass the virus on.”

In Eastern Europe and in countries such as Egypt, South Sudan and Pakistan or in West Africa, the number of new infections continues to rise. Particular risk factors are unprotected sexual intercourse and sharing syringes while using drugs.

The consequences of the corona pandemic on HIV infections cannot yet be foreseen, says Streeck. In many places, fewer people would have had their tests – and many would no longer have received their medication regularly.

How is it that the vaccine against the coronavirus was developed so quickly, but not against the HI virus in 40 years? It is about different types of viruses, says the virologist Josef Eberle from the Max von Pettenkofer Institute for Hygiene and Medical Microbiology in Munich.

The coronavirus also changes relatively slowly, while the HI virus changes very quickly. “In just four to six weeks, as many variants develop in a single HIV-infected person as in the coronavirus worldwide, not in a whole year,” says Eberle. Furthermore, in the case of the coronavirus, antibodies can be “stuck” like stickers on the key of the virus for the cell, which prevents penetration. “With HIV, on the other hand, the surface proteins are well hidden on the virus,” says Eberle.

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Once HIV is in the body, you can’t get it out – even if it can be suppressed well with medication, explains the expert. The blueprint of the virus remains in long-lived cells. The coronavirus is different: “It has to multiply constantly, otherwise it will die out.”

Eberle doubts whether there will ever be HIV vaccines. Hendrik Streeck is at least a little more confident. Some HIV vaccine studies are ongoing. “Of course, the HIV pandemic is better contained if we have a cure or a vaccine,” says Streeck. “But both are still a long way off.”

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