HIV (human immunodeficiency virus)
Also called: HIV infection, HIV/AIDS, AIDS, advanced HIV disease, human immunodeficiency virus
HIV is a virus that slowly weakens the body's defence (immune) system. It passes through blood, sex and from mother to baby. There is no cure yet, but daily treatment keeps the virus under control, so people can live long, healthy lives and do not pass it on.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
HIV (human immunodeficiency virus) attacks the immune system, the part of the body that fights infections. Without treatment, the immune system gets weaker over many years. In the end the body can no longer fight serious infections such as tuberculosis (TB) and pneumonia, or some cancers. This late stage is called advanced HIV or AIDS (acquired immunodeficiency syndrome).
HIV is passed on when blood, semen, vaginal fluid or fluid from the back passage of a person with HIV gets into another person's bloodstream. This mostly happens through sex without a condom, shared needles and syringes, unsafe blood or medical equipment, and from a mother to her baby. HIV is not passed on by hugging, kissing, shaking hands, or sharing food, cups or toilets.
WHO estimates that about 41 million people were living with HIV around the world at the end of 2025, and about 32 million of them were on treatment. Many people feel well for years and do not know they have HIV, so testing is the only way to find out.
Today's medicines, called antiretroviral therapy (ART), stop the virus from multiplying. When ART lowers the virus in the blood so far that tests cannot find it (an undetectable viral load), the person stays healthy and cannot pass HIV to a sexual partner. Having HIV is a health condition, not a matter of blame, and every person deserves respect, privacy and care.
In Pakistan
In Pakistan, an estimated 180,000 people live with HIV, but only a small share are on treatment, and a 2019 outbreak in Ratodero, Sindh, mostly affected children and was thought to be linked to unsafe reuse of needles and syringes. HIV treatment (ART) is provided free of cost at government HIV treatment centres; a 2021 report counted 45 such centres across the four provinces.
Symptoms
- No symptoms at all for many years, which is very common
- A short flu-like illness about 2 to 6 weeks after the virus enters the body
- High temperature (fever)
- Sore throat
- Swollen glands in the neck, armpits or groin
- Muscle aches and tiredness
- A skin rash
- Later, without treatment: repeated or serious infections such as TB or pneumonia
Causes and risk factors
Causes
- The human immunodeficiency virus, which is carried in blood, semen, vaginal fluid and fluid from the back passage
- Vaginal, anal or oral sex without a condom with a person whose HIV is not controlled by treatment
- Sharing needles, syringes or other injecting equipment
- Reused or unclean needles, syringes and medical tools, or a transfusion of blood that was not properly screened
- Passing from a mother with HIV to her baby during pregnancy or birth, when the mother's virus is not controlled
What makes it more likely
- Having a partner, now or in the past, who has HIV
- Having sex without a condom, or with several partners
- Having another sexually transmitted infection
- Injecting drugs and sharing equipment
- Selling sex
- Being a man who has sex with men, or a transgender woman, without using condoms
- Receiving injections, blood or procedures where equipment is reused or not sterilised
- Having been raped or sexually assaulted
Complications
Without treatment, HIV slowly destroys the immune system. The body then has trouble fighting germs that a healthy body can usually control. These are called opportunistic infections. Common examples are TB, pneumonia and a fungal infection of the brain lining called cryptococcal meningitis. Some cancers are also more likely. This stage is called advanced HIV disease or AIDS, and it can be life-threatening. The virus can also be passed to a baby during pregnancy or birth. If medicines are missed often, the virus can become resistant, which means the usual medicines stop working.
When to see a doctor
- You may have been exposed to HIV in the last 72 hours (for example sex without a condom or a needlestick injury): go to a hospital emergency department or HIV clinic straight away, as emergency medicine may stop the infection
- Signs of a serious infection, such as a long-lasting cough, fever, breathlessness or weight loss: see a doctor promptly, as TB and pneumonia can be serious in people with HIV
- A positive result on a first HIV test: go to an HIV clinic for a confirmatory blood test and to start care
- You are pregnant and have HIV, or have never had an HIV test: tell your doctor early so your baby can be protected
- You have stopped or run out of your HIV medicine: contact your treatment centre quickly
Are you a PMDC-registered doctor who treats HIV (human immunodeficiency virus)? List your profile free.
Diagnosis
HIV can only be found with a test, because many people have no symptoms. A first HIV test is usually a blood test. If the result is positive, a second blood test at a clinic confirms it. If the result is negative but the possible exposure was very recent, the test may need to be repeated a few weeks later. The US CDC advises that every teenager and adult is tested at least once, and that people at higher risk are tested every year.
After HIV is confirmed, the doctor checks the CD4 count (the number of a type of immune cell, which shows how strong the immune system is), kidney function, blood count and hepatitis B. People are also checked for TB, and those with a very low CD4 count have a blood test for a fungus called cryptococcus. Once treatment starts, the viral load (the amount of virus in the blood) is measured to check that the medicines are working.
Treatment
- Everyone with HIV can start treatment, whatever their CD4 count or stage; WHO advises starting within seven days of diagnosis, and on the same day if the person is ready
- Treatment (ART) is usually a combination of three medicines, often in one tablet; a common first choice is dolutegravir with tenofovir and lamivudine, and your doctor decides the medicines and the dose
- Take ART every day for life; do not stop or skip it, because the virus comes back and can become resistant
- The viral load is checked about 6 and 12 months after starting, then usually once a year; extra adherence support is given if it is not low enough
- People with a weak immune system may also get medicines to prevent infections, such as cotrimoxazole, TB preventive treatment and, if the cryptococcus test is positive, fluconazole
- People who need TB treatment as well need their HIV medicines reviewed by the doctor, because rifampicin affects some HIV medicines
- Women with HIV who are pregnant or planning a pregnancy should discuss their medicines with their doctor, who plans the safest treatment to protect mother and baby
Medicines in Pakistan
Medicines a doctor may use, by group. Read the role: some are only for special cases. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| Integrase inhibitors | the usual third medicine in the preferred first-line combination, given with two NRTIs | Dolutegravir (3 brands) |
| Nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) | the backbone of treatment; two of these are given together with a third medicine | Tenofovir disoproxil (58 brands), Lamivudine (29 brands) |
| Non-nucleoside reverse transcriptase inhibitors (NNRTIs) | an alternative third medicine, for example for people who cannot take dolutegravir; chosen by the doctor | Efavirenz (7 brands) |
| Sulphonamide antibiotic combination (cotrimoxazole) | prevents some serious infections in people with a low CD4 count or more advanced HIV | Sulfamethoxazole + Trimethoprim (61 brands) |
| TB preventive treatment | offered to people with HIV after active TB has been ruled out, to lower the chance of developing TB | Isoniazid (6 brands) |
| Azole antifungals | given early to people whose blood test shows cryptococcus, to prevent cryptococcal meningitis | Fluconazole (217 brands) |
Also used (not yet in our price list): emtricitabine (an NRTI used in some combinations)
Self-care and prevention
Self-care
- Take your HIV medicine every day, at the same time if possible, and keep all clinic visits and viral load tests
- Tell your doctor or pharmacist about every other medicine you take, including TB medicines, iron, calcium, antacids and medicines for fits or diabetes, as some affect HIV medicines
- Tell your treatment centre about any side effects instead of stopping your medicine; with dolutegravir, sleep problems may improve if it is taken in the morning
- Do not smoke, keep alcohol low, eat a healthy diet and stay active
- Women should ask about cervical cancer screening and about contraception that suits them
- Seek early help for cough, fever or weight loss, and have the regular TB checks your clinic offers
- Ask for counselling if you feel worried or low; you have a right to confidential care
Prevention
- Use condoms during sex, especially with a new partner or a partner whose HIV status you do not know
- Never share needles, syringes or injecting equipment, and ask for a new sealed syringe for every injection
- Get tested for HIV if you may have been at risk; the US CDC advises everyone to be tested at least once
- People with HIV who keep an undetectable viral load on treatment do not pass HIV on through sex
- Pregnant women should be tested, and mothers with HIV should take treatment to protect their baby
- After a possible exposure, go to a hospital or HIV clinic within 72 hours to ask about emergency HIV medicine; people at high ongoing risk can ask a doctor about preventive medicine (PrEP)
Common questions
Can HIV be cured?
There is no cure yet. But HIV treatment keeps the virus under control. The US CDC notes that a young person who starts treatment early and keeps taking it can expect to live almost as long as other people.
Can I pass HIV on if I am on treatment?
If your treatment has lowered the virus so far that tests cannot find it (undetectable), you cannot pass HIV to a sexual partner. Keep taking your medicine every day and have your viral load checked as advised, so it stays undetectable.
Can HIV spread through touching, food or sharing a toilet?
No. HIV is not passed on by hugging, kissing, shaking hands, or sharing food, cups, plates or toilets. People with HIV can live, eat and work normally with family and others.
What are the first signs of HIV?
Some people get a short flu-like illness with fever, sore throat, rash, swollen glands and tiredness a few weeks after infection. Many people have no signs at all for years. A test is the only way to know.
Is HIV treatment free in Pakistan?
A 2020 report in the Journal of the Pakistan Medical Association said that HIV treatment (ART) is provided free of cost at government HIV treatment centres. Ask your doctor or the provincial AIDS control programme where the nearest centre is.
Sources
- World Health Organization. HIV statistics, globally and by WHO region, July 2026 (Information sheet) (2026).
- World Health Organization / Pan American Health Organization. Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy (2017).
- US Centers for Disease Control and Prevention (MMWR). Vital Signs: HIV Diagnosis, Care, and Treatment Among Persons Living with HIV — United States, 2011 (2014).
- National Department of Health, Republic of South Africa. 2019 ART Clinical Guidelines for the Management of HIV in Adults, Pregnancy, Adolescents, Children, Infants and Neonates (2019).
- NHS. HIV and AIDS (n.d.).
- NHS. HIV and AIDS (n.d.).
- Journal of the Pakistan Medical Association. Challenges of Antiretroviral Treatment for Human Immunodeficiency Virus Infection in Pakistan (2021).
- Journal of the Pakistan Medical Association. Is Pakistan at the cusp of an ART resistance? (2020).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.