HIV or human immunodeficiency virus is a retrovirus that binds to receptors found on membranes of immune system T cells. When HIV attacks a cell, the virus is internalized, copied into DNA, then migrates into the nucleus where it inserts itself as part of the host DNA. In many cases, the inserted viral genes remain dormant, sometimes for as long as ten or more years. AIDS or Acquired Immune Deficiency Syndrome is a collection of 26 clinical conditions (the most common are Kaposi's sarcoma and lymphomas) that are the result of prolonged HIV infection.
Once a person is infected with HIV, the immune cells begin to lose normal function. Antibodies are produced in response, and other T lymphocytes form to help fight off infection. Shortly thereafter, a period of latency ensues in which there are no symptoms and, depending on the health and lifestyle of the patient, the course of infection may last for years. During this time, billions of T cells are infected and destroyed, but half are replaced. Half the virus particles are also destroyed.
The immune system continues to destroy HIV and replace T cells until the body begins to lose its uphill battle. Eventually, so much virus is produced that the immune system can no longer keep up. When this happens, T cell counts begin to decrease from a normal of 600-1200/uL to less than 200/uL. At this stage, the individual becomes susceptible to a myriad of illnesses and major diseases. Here is what the typical immune system profile looks like for someone infected with HIV:
Stage 1: Primary HIV Infection. Initial flu-like symptoms, which may last 4 weeks or longer. At this point, an HIV antibody test may not be positive. The immune system begins to respond by producing antibodies and cytotoxic lymphocytes.
Stage II: Clinically Asymptomatic Stage. Patients in this stage are free from AIDS symptoms for an average of ten years. HIV in the blood may drop to undetectable levels but people remain infectious. The virus is very active in the lymph tissue during this stage.
Stage III: Symptomatic HIV Infection. During this critical stage, the immune system deteriorates, HIV mutates quickly and becomes more pathogenic, and the body can no longer keep up with loss of T cells. As a result, the patient develops one of many different infections and illnesses associated with AIDS.
Stage IV: Progression to AIDS. T4 cell count falls below 200. As the immune system continues to deteriorate, more and more serious illnesses damage the body and eventually leads to death.
Stress, according to current research, can increase severity of infectious viruses such as mononucleosis and can activate dormant viruses such as genital herpes, cold sores, and HIV. Studies have shown, for example, that chronic depression and negative attitudes were associated with a rapid decline of T cells but with increased levels of NK cells in those with positive attitudes. Another study found that subjects who actively fought their disease and were able to cope well with the stress of having HIV significantly prolonged their progression from stages II and III to stage IV.
AZT was the first drug used to treat HIV infection. It has been replaced by more powerful treatments like protease inhibitors, but it's typical for powerful drugs to have even greater side effects. And with greater side effects comes greater stress reactions and the risk of illness and disease not even related to the infection.Currently, there are two problems with the new class of drugs used to treat HIV. Firstly, many patients suffer worse physical side effects that they did with AZT, which adds to the already emotional stress associated with the disease. In some cases, patients are actually regressing because the stress of treatment is causing them to get sick earlier than they would have without treatment. This also makes it difficult to keep HIV infected patients on the strict regiment required for the drug to be as effective as it can be.
Secondly, new, more virulent strains of HIV are beginning to emerge that are resistant to drugs that were effective only a few years ago. Resistance and mutations increase even faster when patients aren't absolutely committed to taking their medication regularly. So today, despite new and more powerful drugs and a decline in mortality rates due to increased life span, it's more critical than ever for patients to use all the means they can to help alleviate the stress associated with HIV and its treatment.
One team of researchers believes they may have discovered one of the ways in which stress causes the progression of HIV and AIDS. They found that Prolactin and Growth Hormone, both of which are released during stress reactions, can promote retroviral production because of their effect on virus-producing cells. Individuals who are depressed, who cannot cope well with life events, who are physically challenged, and whose lifestyles contribute to daily stress are the ones most prone to immune system breakdown, falling T cell counts, and rapid progression of the disease.
In light of these findings, doctors are now treating patients both physically and psychologically. They have seen how rapidly a patient can deteriorate, even when he or she is faithful in taking medications. And they now know that the body will take its cues - both positive and negative - from the mind. In the fight against a disease like AIDS, the connection between mind and body can make the difference between dying from AIDS or living long enough to see a cure or a better treatment.