The abbreviation AIDS (also AIDS) stands for Acquired immune Deficiency of syndromes (English for acquired immune defect syndrome). AIDS is an immunodeficiency illness and the consequence of an infection with the rear virus (HIV), which causes a gradual destruction of the immune system. The result are secondary infections (also opportunistische infections called) and Tumore, which define the syndrome AIDS in certain combination. Despite treatment these subsequent illnesses lead sooner or later to death. To the diagnosis anti-bodies or virus components in the blood are looked for. Already before occurring symptoms virus-restraining medicines are used, which extend the life expectancy together with the treatment of the secondary infections and which increase quality of life.

Infection

The rear virus will transfer blood, sperm, Vaginalsekret, Liquor and mother's milk with the body fluids. Potential entrance gates are fresh, still bleeding wounds in mucous membranes (binding skin, mouth, nose, Vaginal and Analschleimhaut) and/or not sufficiently verhornte, easily verletzliche places of the outer skin (acorn, inside of the foreskin). As most frequent infection ways to call the Vaginal or Analverkehr without use of condoms is, then also taking up oral traffic (mucous membrane contact with sperm and/or Menstruationsblut; with intact mouth mucous membrane the contact with or Vaginalsekret represents a negligible infection risk, likewise passive oral traffic) and the use (more lent) of contaminated syringes with the intravenous drug consumption. Homosexual men are considered as group of risks, since frequent partner changes and Analverkehr are far common in the scene. As high the risk is with the sexual intercourse, depends particularly on the virus load in the seed liquid, in the sheath secretion and in the blood. This is high immediately after the infection, before anti-bodies formed, particularly, decreases then however first and rises in late stages of the illness.

Blood transfusions are likewise a possible source of infection, which has meaning however today in Germany by the 1985 introduced routine investigations of the blood donors hardly still. In addition, a residual risk is present here, since between infection of the donor and the demonstrability in the HIV test up to three months can elapse.

The risk of an infection of a child by an HIV infected nut/mother during the pregnancy or during the birth becomes estimated on 15% to 30%. With well-known HIV infection the nut/mother the risk of a transmission can be decreased on the child by the gift of antiretroviraler medicines and the birth by Kaiserschnitt on approx. 2%. A transmission of the virus when satisfying is likewise possible.

The risk to be infected by tongue kisses can be excluded, if no bleeding wounds, so for example injuries of the gums, are present in the mouth. The HIV concentration in tears, sweat and saliva is not sufficient for an infection after today's knowledge level likewise. In addition the AIDS epidemiology lets an infection appear extremely improbable by insect bites or by droplet infection. Humans, who were exposed to an acute infection danger, should visit as soon as possible (ideal-proves within two hours) a physician, in order to leave themselves advised and to accomplish a Postexpositionelle prophylaxis (PEP) if necessary. At expiration of 48 hours a medicamentous PEP is not than meaningfully judged any more.

PMID 6132270 PMID 6133990 PMID 7491134

Probability of infection

The probability of infection is with most transmission paths between 1:100 and 1:1000. Most important exception is the transmission of the nut/mother on the child during the birth with a probability of infection of approx. 15 % and a blood transfusion contaminated by, where the infection risk amounts to 95 %.

The following frequentnesses is average values, which were determined by partner studies and epidemiological studies. The individual risk can be very much higher. Thus at the same time available other sex illness increases the infection risk by 5 - to 10 times, a high virus load of the carrier even around 10 - to 30-fache. Sexual intercourse during the rule bleeding of the woman is connected with a increased infection risk for both partners, cut men has a smaller infection risk. Altogether the infection risk does not seem to be constant over the number of contacts, so that the risk of individual contacts is possibly substantially too low indicated. With better medicines the transmission risk possibly sinks.

• Unprotected vaginaler sexual intercourse with a HIV positive partner is connected with a risk of an HIV infection of approx. 0.05 - 0.15 % for the woman, and between 0,03 - 5.6 % for men, tendentious however smaller for men somewhat than for women.

• The infection risk for oral traffic with the man (Fellatio) is taken up, with the sperm to the mouth, is smaller, an infection is however impossible. An infection by ("desire drops ") is very improbable. With oral traffic with the Mrs. (Cunnilingus) the risk is likewise regarded as smaller than with the vaginalen sexual intercourse. Also the risk with the so-called Rimming is estimated as extremely small.

• With Analverkehr frequently small tears at the mucous membrane arise. Accordingly the risk for the passive participant is with the Analverkehr around 0,8 % and around 0,3 % for the active participant.

• Other Sexualpraktiken, with which no contact exists to mucous membranes, blood, sperm or Vaginalsekret, has an extremely small infection risk.

• The infection risk by needle passes depends much on the situation. The infection risk is indicated on the average as 0,3 % and rises with the following factors: very deep injuries (16-fach increased), visible blood-pure on the needle or needle was before in a Vene or a Arterie of the carrier (5-fold in each case increased), with high virus load of the carrier (6-fach increases). The risk with hollow needles is higher than with closed needles.

• The risk, itself when common use a usually when squirting heroin to infect lies around 0,7 % and sinks with the temporal distance between the injections, however only slowly, since into the included viruses for a long time can remain infectious, partly also still after days. A Auskochen of the needles is generally possible, if it is accomplished for a long time enough, however is suitable commercial needles not for it because the used plastics are not accordingly hitzefest. A chemical disinfection (alcohol or other disinfectants) is not sufficient, because it is not ensured that the substances penetrate completely into the

The possibility of a post office exposition prophylaxis partly exists. This consists of general measures (wash the Penis after traffic, expressions of the pass wounds and treatment with disinfectant) and specific measures like the gift of antiretroviralen medicines. After an infection suspicion a physician should be visited always immediately, who informed about possible measures and she can also introduce.

PMID 1403641, PMID 10430236, PMID 8601226, PMID 15090833, PMID 9091805

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