What are the ways HIV can spread?

Human Immunodeficiency Viruses (HIV)

This article focuses on the virus itself. For information on the infection it causes, please refer to HIV/AIDS. For other uses of the term "HIV," see HIV (disambiguation).
Note: "AIDS virus" redirects here. For the computer virus, see AIDS.

Scientific Classification:

Virus
Realm: Riboviria
Kingdom: Pararnavirae
Phylum: Artverviricota
Class: Revtraviricetes
Order: Ortervirales
Family: Retroviridae
Subfamily: Orthoretrovirinae
Genus: Lentivirus
Groups Included:
Human immunodeficiency virus 1 (HIV-1)
Human immunodeficiency virus 2 (HIV-2)
Other lentiviruses:
Bovine immunodeficiency virus
Caprine arthritis encephalitis virus
Equine infectious anemia virus
Feline immunodeficiency virus
Simian immunodeficiency virus
Visna-maedi virus
Description:

Human immunodeficiency viruses (HIV) are two species of Lentivirus (a subgroup of retroviruses) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition characterized by the progressive failure of the immune system. This weakened immune system allows life-threatening opportunistic infections and cancers to develop. Without treatment, the average survival time after HIV infection is estimated to be 9 to 11 years, depending on the HIV subtype.

In most cases, HIV is a sexually transmitted infection, occurring through contact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids. Research has demonstrated that HIV is untransmittable through condomless sexual intercourse when the HIV-positive partner maintains a consistently undetectable viral load (this applies to both same-sex and opposite-sex couples). Non-sexual transmission can occur from an infected mother to her infant during pregnancy, during childbirth through exposure to her blood or vaginal fluid, and through breast milk. Within these bodily fluids, HIV exists as both free virus particles and within infected immune cells.

HIV infects vital cells in the human immune system, including helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells. HIV infection leads to a decrease in CD4+ T cell levels through various mechanisms. These mechanisms include:

Pyroptosis of abortively infected T cells
Apoptosis of uninfected bystander cells
Direct viral killing of infected cells
Killing of infected CD4+ T cells by CD8+ cytotoxic lymphocytes that recognize infected cells.
When CD4+ T cell numbers fall below a critical level, cell-mediated immunity is lost, and the body becomes increasingly susceptible to opportunistic infections, leading to the development of AIDS.

HIV is a member of the genus Lentivirus, within the family Retroviridae. Lentiviruses share many morphological and biological properties. Many species are infected by lentiviruses, which are characteristically responsible for long-duration illnesses with extended incubation periods. Lentiviruses are transmitted as single-stranded, positive-sense, enveloped RNA viruses. Upon entering a target cell, the viral RNA genome is converted (reverse transcribed) into double-stranded DNA by a virally encoded enzyme, reverse transcriptase, which is transported with the viral genome within the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase, and host co-factors. Once integrated, the virus may become latent, allowing it and its host cell to evade detection by the immune system for an indeterminate period. The HIV virus can remain dormant in the human body for up to ten years after the initial infection; during this time, the virus does not cause symptoms. Alternatively, the integrated viral DNA may be transcribed, producing new RNA genomes and viral proteins, utilizing host cell resources. These components are then packaged and released from the cell as new virus particles, initiating a new replication cycle.

Two types of HIV have been identified: HIV-1 and HIV-2. HIV-1 was the first discovered and was initially termed lymphadenopathy-associated virus (LAV) and human T-lymphotropic virus 3 (HTLV-III). HIV-1 is more virulent and infectious than HIV-2 and is responsible for the majority of HIV infections worldwide. The lower infectivity of HIV-2, compared to HIV-1, means that fewer people exposed to HIV-2 will become infected per exposure. Due to its relatively limited transmission capacity, HIV-2 is largely confined to West Africa.

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