Detecting early signs of HIV

One cannot determine the HIV status of another person by merely looking at them.Despite this, several studies have been done worldwide to determine the early signs and symptoms of HIV.

Some of the studies suggest that continuous abdominal pains, sore throat, fever, headaches, muscle or joint pains, nausea, vomiting, diarrhoea, lack of appetite and weight loss are some of the early manifestations of HIV.

These signs can manifest within two to four weeks after exposure to HIV in some people while in others it can be two to three months.

Ministry of Health and Child Care (MOHCC) also recently revealed that there are several oral manifestations that are linked to early HIV infections.

Dr Dorcus Goredema said oral manifestations may include lesions (open sores) which range from white to red or red and white combinations. “Candidiasis or infection of the oral environment by the candida species is among the earliest and most common findings in HIV-infected patients,” said Dr Goredema.

Candidiasis is defined as any of a variety of infections caused by fungi of the genus candida, occurring most often in the mouth and respiratory tract.

She said the wounds that manifest inside the mouth may either be asymptomatic (showing no signs and symptoms) or they may cause a mild discomfort.

“Some of the fungi infections appear as white spots or plaques in the mouth. They may be wiped off with a gauze and in some cases patients may report burning. Such an infection is scientifically called pseudo-membranous candidiasis. Its diagnosis is usually made upon clinical examination,” she explained.

“Another type of yeast infection can occur on the surface and at the edges of the tongue, and this type is scientifically called erythematous candidiasis. With this type of infection, patients may also report burning inside their mouths.”

Cracks (red fissures) or ulcers that develop on the edge (commissures) of the mouth is another sign of early HIV infection manifestation.

These ulcers are traditionally associated with migraines and headaches, especially during the night. Popularly known as zvidzimu in Shona, the condition is scientifically called angular cheilitis.

Dr Goredema said red fissures or cracks normally appear together with inter-oral fungal infection. This type of inter-oral fungal infection can also affect the esophagus as it connects the mouth to the stomach. Unfortunately, these ulcers can be passed from one person to another through kissing, especially when the next person has a weak immune.

Babies are most exposed to such infections if their mothers are also infected. However, the candidiasis can be treated with several anti-fungal creams.

The Ministry of Health and Child Care suggests that oral health and HIV are closely linked. Supporting its view, the health ministry asserts that most people living with HIV and not on treatment have high chances of developing Kaposi Sarcoma (KS), a form of cancer.

KS is a cancer that develops from the cells that line lymph or blood vessels. It usually appears as tumors on the skin or on mucosal surfaces such as the mouth’s interior. The surface of the tongue (palate) is the most common site where the development of KS starts. In its early stages, the tumor appears as a red to purple bruise.

Although HIV is mostly transmitted during unprotected sex, there are some cases where the virus can be transmitted during oral sex.

National Aids Council (NAC) monitoring and evaluation manager, Mr Amon Mpofu, said HIV can be transmitted during oral sex if there are cuts in the mouth or sexual organ.

“Oral sex has become part of foreplay for most couples these days. The act can, however, contribute to the risks of HIV transmission if it is done with infected partners,” said Mr Mpofu.

“Even though oral sex carries a lower risk of HIV transmission than other sexual activities, the risk is not zero. It is difficult to measure the exact risk because people who practice oral sex may also practice other forms of sex during the same encounter. When transmission occurs, it may be the result of oral sex or other riskier sexual activities such as anal or vaginal sex.”

Mr Mpofu said: “If the person receiving oral sex has HIV, their blood, semen, pre-seminal fluid, or vaginal fluid may contain the virus. If the person performing oral sex has HIV and cuts in their mouth, blood may enter the body of the person receiving oral sex through the lining of the urethra, vagina, cervix or anus. The blood can also penetrate where there are cuts on the sexual organ.”

He said several factors may increase the risk of HIV transmission through oral sex, including oral ulcers, bleeding gums, genital sores, and the presence of other sexually transmitted diseases.

“Performing oral sex on an HIV-infected man, with ejaculation in the mouth, is the riskiest oral sex activity,” he added.