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During primary infection, the level of HIV may reach several million virus particles per milliliter of blood. This weakens the immune system and allows opportunistic infections.T cells are essential to the immune response and without them, the body cannot fight infections or kill cancerous cells.
Pre-exposure prophylaxis (Pr EP) with a daily dose of the medications tenofovir, with or without emtricitabine, is effective in a number of groups including men who have sex with men, couples where one is HIV positive, and young heterosexuals in Africa.The risk of acquiring HIV from a needle stick from an HIV-infected person is estimated as 0.3% (about 1 in 333) per act and the risk following mucous membrane exposure to infected blood as 0.09% (about 1 in 1000) per act.Preventive treatment involves the mother taking antiretrovirals during pregnancy and delivery, an elective caesarean section, avoiding breastfeeding, and administering antiretroviral drugs to the newborn.The World Health Organization recommends treating all children less than 5 years of age; children above 5 are treated like adults.Measures to prevent opportunistic infections are effective in many people with HIV/AIDS.The most effective vaccine trial to date, RV 144, was published in 2009 and found a partial reduction in the risk of transmission of roughly 30%, stimulating some hope in the research community of developing a truly effective vaccine.
Treatment recommendations for children are somewhat different from those for adults.
however, the pattern of transmission varies among countries.
As of 2014, most HIV transmission in the United States occurred among men who had sex with men (83% of new HIV diagnoses among males aged 13 and older and 67% of total new diagnoses).
Even cases that do get seen by a family doctor or a hospital are often misdiagnosed as one of the many common infectious diseases with overlapping symptoms.
Thus, it is recommended that HIV be considered in people presenting an unexplained fever who may have risk factors for the infection.
Between 50 and 70% of people also develop persistent generalized lymphadenopathy, characterized by unexplained, non-painful enlargement of more than one group of lymph nodes (other than in the groin) for over three to six months.