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The Call-On-Doc Guide to HIV

Published on Feb 29, 2024 | 3:49 PM

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Estimated to affect around 1.2 million Americans, the human immunodeficiency virus, or HIV, is a prominent sexually transmitted disease in the United States and globally. (1) Having first been reported in what is now Kinshasa, the capital of the Democratic Republic of the Congo, in 1959, the STD would go on to spread globally, being the subject of great concern in 1981 during the AIDs pandemic in the United States during Ronald Reagan’s presidency. (2)(3) Known to destroy immune cells as it progresses, HIV can result in a number of different symptoms and can remain in the body for the rest of the person’s lifetime before developing into acquired immunodeficiency syndrome (AIDS). While there is no HIV cure, HIV treatment reduces the viral load in the blood, suppresses symptoms, heavily reduces the chance of spread, and forces the infection into dormancy. 

What are usually the first signs of HIV?

When it comes to recognizing whether you have HIV or not, getting tested is the only way to know for sure. (4) In the early stage, the condition can easily be confused with conditions like the flu and other sexually transmitted diseases, making regular STD screening important for anyone considered sexually active. 

HIV symptoms are defined in three stages that help to identify its level of progression in the human body. The stages recognized as acute HIV infection, clinical latency, and then acquired immunodeficiency syndrome, the first symptoms tend to arise two to four weeks after the initial sexual exposure as part of the infection’s first stage. (5) 

Stage 1: Also known as an acute HIV infection or acute retroviral syndrome (ARS), HIV in the first stage begins replicating at an aggressive rate and targets the immune system, specifically destroying CD4 cells or T cells. (6) Most often lasting a week to a month, the body will try to fight off the sexually transmitted infection, resulting in flu-like symptoms These symptoms can include: 

  • Rash: While there’s no specific HIV rash, the infection can cause red bumps and skin discoloration. Those with lighter skin tones will see their skin turn reddish, and those with darker skin tones will turn dark purplish but can be brown as well. (7)
  • Fever: In response to the HIV infection, the body goes into a process called “seroconversion,” which means it is developing antibodies designed to fight the infection directly. Occurring in up to 90% of patients that contract HIV, the body then increases its internal temperature and causes a fever to occur in an attempt to kill the infection. (8) 
  • Fatigue: As with other infections and diseases, HIV will activate the immune system as it works to defend the body. (9) A person in this stage will feel sluggish and may assume they are fighting off another disease or infection due to it being such a common symptom.
  • Headache: There are a number of reasons why HIV patients get headaches, with it often being from stress, strain, or a magnesium deficiency. Due to it being a common symptom throughout multiple different conditions, it can also often be caused by a factor unrelated to the HIV infection. 
  • Sore Throat: A frequent symptom of many different types of conditions, a sore throat as an HIV symptom indicates your body is fighting off the initial infection. Often confused with strep throat or tonsillitis, the symptom can make swallowing difficult and generally irritate the patient. (10)
  • Swollen Lymph Nodes: Infections, including HIV, can cause lymph node swelling as pathogens reach them via lymph fluid, often affecting nodes in the neck, armpits, and groin. Swollen lymph nodes may appear shortly after HIV contraction, with some individuals not exhibiting other symptoms for several years, gradually spreading to more nodes as the infection advances. (11)
  • Muscle and Joint Pain: Early HIV infection can cause muscle and joint pain due to factors such as immune activation, inflammatory response, and viral replication. The body's immune system response to the presence of the virus, along with inflammation and the rapid replication of HIV within the body, can contribute to the development of these symptoms.

While these symptoms are meant to combat an HIV infection, the natural response should not be considered effective against the condition, and those at this stage should seek out treatment immediately. There has never been an instance where the human body has successfully cleared an HIV infection once it has been successfully transmitted via blood or sex. (12) 

Stage 2: In the second stage of HIV infection, known as the chronic or clinical latency stage, the virus continues to replicate at lower levels that don’t warrant an immune system response. It varies heavily on how long it lasts, with many cases lasting up to around a decade, and can last longer or advance to the next stage faster, depending on the patient. The virus can still be spread despite the patient’s lack of symptoms. (6)

Stage 3: In the third stage of HIV infection, known as AIDS (Acquired Immunodeficiency Syndrome), the immune system is severely compromised, leaving the individual vulnerable to opportunistic infections and certain types of cancers. Without treatment, AIDS can lead to life-threatening illnesses and a significant decline in health. The diagnosis of AIDS is typically made based on the presence of specific opportunistic infections or a low CD4 cell count below a certain threshold, indicating advanced immune suppression. (6)

What are HIV symptoms in women vs men?

What HIV does to your body starts at the smallest level, as it constantly attacks the immune system and progressively reduces your ability to naturally resist other conditions. Additionally, how HIV affects the body may differ slightly based on gender, with men and women having unique symptoms that can indicate an HIV infection or other sexually transmitted disease. While most of the time, the condition is the same for both genders, it's important to understand the symptoms that it can develop. 

HIV in Men: As HIV progresses throughout the body, it can affect a man’s hormones via the testicles, visibly show up as painful sores on the penis, and can make urination and ejaculation uncomfortable. More specifically, these symptoms can arise as: 

  • Hypogonadism: HIV-related hypogonadism refers to a condition where there is a deficiency in the production of sex hormones, such as testosterone, due to the effects of HIV infection. This can lead to symptoms such as reduced libido, erectile dysfunction, loss of muscle mass, fatigue, loss of facial or body hair, and mood changes. (13)
  • Prostatitis: Prostatitis is inflammation of the prostate gland that occurs in individuals living with HIV or other sexually transmitted diseases. It can lead to symptoms such as pelvic pain, discomfort during urination or ejaculation, frequent urination, and urinary tract infections. HIV-related prostatitis may result from direct infection of the prostate by the virus, immune system dysfunction, or opportunistic infections, and it requires medical evaluation and treatment to manage symptoms and prevent complications.
  • Recurring Genital Ulcers: Similar to patients with herpes, HIV can result in genital ulcers that can recur unless a patient seeks treatment. Also occurring in the mouth and anus, the sores are reported to be painful and sensitive. (14)

HIV in Women: Most often in the later stages of an HIV infection, women may experience HIV symptoms that affect the genitals and urinary tract. Possible without treatment, these symptoms can include: 

  • Irregular Periods: HIV can cause irregular periods in women due to its impact on the reproductive system and hormonal balance. The virus can disrupt the normal functioning of the hypothalamus and pituitary gland, affecting the regulation of hormones involved in the menstrual cycle. Additionally, HIV-related inflammation and immune system activation can contribute to menstrual irregularities by interfering with the production and release of reproductive hormones. (15)
  • Stomach Pain: HIV can cause stomach pain in women, specifically the ovaries, fallopian tubes, and urinary tract. The condition leaves the body more open to infection and diseases that affect the region, making women more vulnerable to commonly occurring conditions that are often avoided through good health.  (16)
  • Vaginal Yeast Infections: Vaginal yeast infections occur more frequently in women with HIV. Due to the fungus naturally occurring in the vaginal microbiome, a weakened immune system affected by HIV can weaken the vagina’s natural balance and result in more frequent yeast infections or more instances of bacterial vaginosis. (17)

When do HIV symptoms appear?

HIV symptoms can appear at different times for different individuals. In general, symptoms of acute HIV infection may appear within 2 to 4 weeks after initial infection, although it can take up to several months for symptoms to manifest in some cases.

Most patients report there being no symptoms in the resulting second stage, which can last several years and severely weaken the body. If HIV treatment is not sought out, the person will develop AIDS and not only become sick far more frequently but have severe difficulty staying healthy.

Can HIV be asymptomatic?

Of the over one million people suspected of having HIV, it's estimated that 15 percent, or one in seven people, are living without an HIV diagnosis. (17) While it's less common in the first stage for HIV to be asymptomatic, it's still possible. Not only that but the second stage of HIV is known to be asymptomatic as its viral load remains low enough not to trigger an immune system response while still directly affecting the body. It is possible for HIV to be asymptomatic up until a person develops AIDS, where the body will begin to get bombarded by both the initial infection and conditions that it could normally stave off through the immune system. 

Do HIV symptoms come and go?

Yes, HIV symptoms can arise and fade within a month and not recur thereafter. While the symptoms may fade, the infection is still present and can be spread. 

Can HIV symptoms be mistaken for something else?

HIV symptoms can definitely feel similar to conditions that affect the upper respiratory system, like Covid-19, influenza, and strep throat due to fever, fatigue, muscle aches, and sore throat. Additionally, there are a number of sexually transmitted diseases that may be mistaken for the disease. 

Common sexually transmitted diseases like chlamydia and gonorrhea are frequent subjects of confusion for those with HIV symptoms, which is why Call-On-Doc recommends regular double or triple testing when you are sexually active. Additionally, herpes and syphilis are two conditions that can be similar to HIV, due to how they develop in the body and the symptoms produced. 

What causes HIV?

HIV is caused by a retrovirus, specifically the HIV-1 and HIV-2 strains. (2) A retrovirus is a type of RNA virus that replicates by converting its RNA genome into DNA and integrating it into the host cell's genome. This process, called reverse transcription, is carried out by an enzyme called reverse transcriptase, which is unique to retroviruses. Once it infects a person, HIV spreads by a few means, namely: 

  • Unprotected Sexual Intercourse: HIV can be transmitted through vaginal, anal, or oral sex with an infected partner, particularly if condoms or other barrier methods are not used.
  • Sharing Needles: Sharing needles, syringes, or other injection equipment contaminated with HIV-infected blood can transmit the virus. This applies to injecting drugs, steroids, hormones, or even tattooing or body piercing procedures done with unsterilized equipment.
  • From Mother to Child: HIV can be passed from an HIV-positive mother to her child during pregnancy, childbirth, or breastfeeding. However, effective medical interventions such as antiretroviral therapy (ART) during pregnancy and childbirth significantly reduce the risk of transmission.
  • Blood Transfusions and Organ Transplants: In the past, HIV could be transmitted through blood transfusions or organ transplants from infected donors. However, rigorous screening of blood and organ donations has greatly reduced this risk in many countries.
  • Occupational Exposure: Healthcare workers or others may be at risk of HIV transmission if they are accidentally stuck with needles or other sharp objects contaminated with HIV-infected blood.

Can HIV be spread through saliva?

No, HIV cannot be spread through saliva. The virus is not present in sufficient quantities in saliva to transmit infection. 

Can HIV be transmitted through urine?

While there are some tests to detect HIV through urine, the infection cannot be passed on through that bodily fluid. The infection is not able to survive for long outside of the body and is not available in strong enough concentrations in urine or feces to pass onto another subject. (18) 

Can HIV be transmitted through sweat?

No, HIV cannot be transmitted through sweat. The virus is not present in sweat, and therefore, it is not a mode of transmission for HIV.

Can HIV be transmitted through breast milk?

Yes, HIV can be transmitted through breast milk. If a mother is HIV-positive, there is a risk of passing the virus to her infant through breastfeeding. However, antiretroviral therapy (ART) can significantly reduce this risk, and in many settings, alternative feeding methods are recommended to prevent mother-to-child transmission of HIV.(19)

How is HIV diagnosed?

The only way to know for sure a person has HIV is through testing, specifically through screening and then confirmatory testing. As detailed in Call-On-Doc Focus: When to get Tested for HIV, the most reliable and common types of tests in each category include: 

Screening Tests

Confirmatory Tests

  • Rapid antibody

  • Lab-based antibody

  • Lab-based Antigen and Antibody

  • Western Blot

  • HIV-1/HIV-2 differentiation immunoassay

  • Viral Detection

Screening tests for HIV are designed to quickly identify individuals who may be infected with the virus. These tests are often rapid and relatively inexpensive, making them suitable for widespread use. However, screening tests may sometimes produce false-positive results due to factors such as cross-reactivity with other antibodies or antigens, leading to the need for confirmation tests.

Confirmation tests for HIV are more specialized laboratory-based assays that are performed to confirm the presence of HIV infection in individuals who have tested positive on a screening test. These tests are typically more sensitive and specific than screening tests, helping to distinguish true HIV infection from false positives. Confirmation tests directly detect specific HIV antibodies or the genetic material (RNA or DNA) of the virus, providing a definitive diagnosis of HIV infection.

Both screening and confirmation tests are needed in HIV testing protocols to ensure accurate diagnosis and appropriate management of individuals who test positive for HIV. Screening tests help identify individuals who may be infected with HIV, while confirmation tests confirm the diagnosis and rule out false-positive results, ensuring that individuals receive the necessary medical care and support.

A positive screening test for HIV can sometimes be confused with other conditions or factors that may cause false-positive results. For example, certain medical conditions, recent vaccinations, or pregnancy can lead to false-positive results on HIV screening tests. Therefore, confirmation tests are essential to confirm the presence of HIV infection and distinguish true positives from false positives, ensuring accurate diagnosis and appropriate management of individuals who test positive for HIV.

Are HIV tests accurate?

Current HIV tests are highly accurate, with negative results having over a 99.9 percent accuracy rate, though accuracy depends on factors such as the type of test used and the timing of testing in relation to exposure. Initially, HIV infection is difficult to detect during the acute stage, but it becomes easier to diagnose over time as it progresses to the chronic stage.

Does HIV have a window period?

Yes, HIV has a window period, which refers to the time between when a person is first infected with HIV and when HIV tests can reliably detect the virus. During this period, individuals may test negative for HIV even though they are infected, as their immune system has not yet produced enough antibodies or antigens for detection. The length of the window period varies depending on the type of test used, but it can range from a few weeks to a few months. It's essential to consider the window period when interpreting HIV test results, especially if testing is soon after potential exposure. 

Will HIV go away?

No, HIV does not go away on its own nor by the body’s natural means. HIV is a chronic viral infection that persists for life if left untreated. However, with proper medical care and adherence to HIV treatment, people living with HIV can effectively manage the virus and lead long, healthy lives. 

Can HIV be treated?

Yes, HIV can be treated effectively with antiretroviral therapy (ART), which helps suppress the replication of the virus in the body, allowing individuals to live long, healthy lives. Additionally, there are preventive measures Call-On-Doc offers to reduce the risk of HIV transmission:

Pre-exposure prophylaxis (PrEP): PrEP involves taking a daily medication regimen of antiretroviral drugs by HIV-negative individuals who are at high risk of HIV infection, such as those with an HIV-positive partner or individuals engaging in high-risk behaviors like unprotected sex or injection drug use. When taken consistently as prescribed, PrEP can significantly reduce the risk of acquiring HIV.

Post-exposure prophylaxis (PEP): PEP is an emergency measure taken within 72 hours of potential exposure to HIV, such as unprotected sex or needle-sharing with an HIV-positive individual. It involves taking a 28-day course of antiretroviral drugs to prevent HIV infection. PEP should be initiated as soon as possible after exposure for maximum effectiveness.

What is the difference between HIV PrEP and HIV PEP?

HIV PrEP (Pre-exposure prophylaxis) and HIV PEP (Post-exposure prophylaxis) are both preventive strategies used to reduce the risk of HIV transmission, but they differ in timing and usage. 

HIV PrEP

HIV PEP

  • Taken regularly by HIV-negative individuals.

  • Daily medication regimen of antiretroviral drugs.

  • Reduces the risk of acquiring HIV before exposure.

  • Suitable for high-risk populations.

  • Taken after potential transmission from an HIV-positive partner

  • Course is started within 72 hours after initial exposure

  • Course extends over a 28-day period

  • Reduces the risk of acquiring HIV after exposure.

PrEP involves taking a daily medication regimen of antiretroviral drugs by HIV-negative individuals who are at high risk of HIV infection, such as those with an HIV-positive partner or individuals engaging in high-risk behaviors like unprotected sex or injection drug use. When taken consistently as prescribed, PrEP can significantly reduce the risk of acquiring HIV. 

PEP is an emergency measure taken within 72 hours of potential exposure to HIV, such as unprotected sex or needle-sharing with an HIV-positive individual. It involves taking a 28-day course of antiretroviral drugs to prevent HIV infection. PEP should be initiated as soon as possible after exposure for maximum effectiveness. 
 

Is HIV manageable?

While there is no cure, there are practices that help a person stay as healthy as possible alongside HIV treatment. When undergoing antiretroviral therapy, individuals living with HIV lead long, healthy lives and are able to gain a sense of normalcy. Healthy lifestyle choices and habits additionally make HIV treatment more effective. 

What habits and changes make HIV treatment more effective?

There are a number of habits and changes a patient can commit to so that HIV does not rule their life and develop into AIDs. These can include: 

  • Adherence to HIV Medication: Consistently taking antiretroviral therapy (ART) as prescribed is crucial for managing HIV effectively and keeping viral load suppressed, which helps maintain immune function and prevents HIV-related complications.
  • Nutritious Diet for Immune Support: Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins provides essential nutrients to support immune function, which is particularly important for individuals living with HIV.
  • Adequate Rest for Immune Health: Prioritize getting enough sleep each night to support immune function and overall health. Quality sleep aids in the body's ability to repair and regenerate cells, which is essential for people living with HIV.
  • Stress Management for Immune Support: Practice stress-reducing techniques such as mindfulness, meditation, or deep breathing exercises to manage stress effectively. Chronic stress can weaken the immune system and exacerbate HIV-related health issues.
  • Avoiding Substance Abuse for Treatment Adherence: Avoid or reduce the use of alcohol, recreational drugs, and tobacco, as substance abuse can interfere with HIV treatment adherence and increase the risk of complications.
  • Regular Medical Check-ups for Monitoring: Schedule regular check-ups with healthcare providers for routine monitoring of HIV progression, medication effectiveness, and management of any co-existing health conditions or side effects of treatment.
  • Mental Health Support for Coping: Prioritize mental health by seeking support from mental health professionals or joining support groups, as living with HIV can be emotionally challenging, and addressing mental health concerns is essential for overall well-being.
  • Safer Sex Practices for Preventing Transmission: Practice safer sex by consistently using condoms and discussing HIV status with sexual partners. Open communication and adherence to safer sex practices help prevent the transmission of HIV to partners.
  • Preventing Opportunistic Infections: Take steps to reduce the risk of opportunistic infections by practicing good hygiene, staying up-to-date on vaccinations, and avoiding exposure to infectious agents whenever possible.
  • Maintaining Social Connections for Support: Cultivate supportive relationships with friends, family, and peers within the HIV community to foster a sense of belonging, reduce isolation, and access emotional support when needed.

Can HIV be prevented

Over the last decades, HIV and AIDS have been reduced to a condition that we as a society can manage. While not an easy endeavor, the following steps will help you understand how: 

  • Safe Sex Practices: Communicating with your partner, using condoms, and getting tested regularly is the best way to prevent HIV, as it is most commonly spread sexually. For more information, read Call-On-Doc Focus: The Importance of Using Condom Sense
  • Pre-Exposure Prophylaxis (PrEP): PrEP involves taking a daily medication regimen of antiretroviral drugs by HIV-negative individuals who are at high risk of HIV infection, such as those with an HIV-positive partner or individuals engaging in high-risk behaviors like unprotected sex or injection drug use. When taken consistently as prescribed, PrEP can significantly reduce the risk of acquiring HIV.
  • Needle Exchange Programs: For individuals who inject drugs, using clean needles and syringes obtained from needle exchange programs or syringe service programs helps prevent the transmission of HIV and other bloodborne infections.
  • Post-Exposure Prophylaxis (PEP): PEP is an emergency measure taken within 72 hours of potential exposure to HIV, such as unprotected sex or needle-sharing with an HIV-positive individual. It involves taking a 28-day course of antiretroviral drugs to prevent HIV infection.
  • Early Detection and Treatment: Regular HIV testing and early diagnosis are essential for accessing timely medical care and treatment. Effective antiretroviral therapy (ART) can suppress HIV replication in the body, reduce the viral load to undetectable levels, and prevent transmission to sexual partners.
  • Education and Awareness: Promoting HIV education and awareness helps empower individuals to make informed decisions about their sexual health, access available prevention methods, and seek appropriate medical care and support.

When it comes to having the best chance of avoiding an HIV infection, HIV PEP and HIV PrEP prove to be some of the best options available. Call-On-Doc makes both available to anyone needing either treatment while also offering 50% off partner treatment so you can help manage the spread. The entire process is easy, private, and designed to bring you peace of mind!

Source

  1. “Basic Statistics | HIV Basics | HIV/AIDS | CDC.” Centers for Disease Control and Prevention, https://www.cdc.gov/hiv/basics/statistics.html.
  2. Sharp, Paul M, and Beatrice H Hahn. “Origins of HIV and the AIDS pandemic.” Cold Spring Harbor perspectives in medicine vol. 1,1 (2011), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234451/. 
  3. “Timeline of The HIV and AIDS Epidemic.” HIV.gov, https://www.hiv.gov/hiv-basics/overview/history/hiv-and-aids-timeline/.
  4. “Who Should Get Tested?” HIV.gov, https://www.hiv.gov/hiv-basics/hiv-testing/learn-about-hiv-testing/who-should-get-tested.
  5. “Symptoms of HIV.” HIV.gov, https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/symptoms-of-hiv.
  6. “The Stages of HIV Infection | NIH.” HIVinfo, https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection.
  7. Varma, Avi, and Lindsay Modglin. “HIV Rash: What Does It Look Like and How Is It Treated?” Healthline, https://www.healthline.com/health/hiv-rash-symptoms-treatments#causes.
  8. Nall, Rachel. “HIV fever: Symptoms, causes, and duration.” Medical News Today, https://www.medicalnewstoday.com/articles/323845.
  9. Murrell, Daniel. “HIV fatigue: Causes and treatments.” Medical News Today, https://www.medicalnewstoday.com/articles/323890.
  10. Ries, Julia. “Early Warning Signs Of HIV: 7 Symptoms You Shouldn't Ignore.” HuffPost, 1 December 2023, https://www.huffpost.com/entry/early-warning-signs-hiv-symptoms_l_655b9172e4b0c0333becf900.
  11. Cherney, Kristeen. “HIV Swollen Lymph Nodes: Symptoms and Treatment Options.” Healthline, https://www.healthline.com/health/hiv-aids/swollen-lymph-nodes.
  12. Narain, Charvy. “Fighting HIV on World AIDS Day.” University of Oxford, 1 December 2015, https://www.ox.ac.uk/news/science-blog/fighting-hiv-world-aids-day.
  13. ​​Gomes, Ana Coelho et al. “Hypogonadotropic hypogonadism in human immunodeficiency virus-infected men: uncommonly low testosterone levels.” Endocrinology, diabetes & metabolism case reports vol. 2017 17-0104. 6 Sep. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5592708/. 
  14. Sousa, João Dinis et al. “The Impact of Genital Ulcers on HIV Transmission Has Been Underestimated-A Critical Review.” Viruses vol. 14,3 538. 5 Mar. 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8953520/. 
  15. Ellerbrock TV, Wright TC, Bush TJ, Dole P, Brudney K, Chiasson MA. Characteristics of menstruation in women infected with human immunodeficiency virus. Obstet Gynecol. 1996 Jun, https://pubmed.ncbi.nlm.nih.gov/8649685/. 
  16. “HIV and women's health.” Office on Women's Health, https://www.womenshealth.gov/hiv-and-aids/living-hiv/hiv-and-womens-health.
  17. “Too Many People Living with HIV in the US Don't Know It.” HIV.gov, 10 June 2019, https://www.hiv.gov/blog/too-many-people-living-hiv-us-don-t-know-it.
  18. “Human Immunodeficiency Virus Transmission in Household Settings -- United States.” Centers for Disease Control and Prevention, https://www.cdc.gov/mmwr/preview/mmwrhtml/00030972.htm.
  19. “Human Immunodeficiency Virus (HIV) | Breastfeeding | CDC.” Centers for Disease Control and Prevention, https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hiv.html.
  20. “HIV: PrEP and PEP.” MedlinePlus, https://medlineplus.gov/hivprepandpep.html.

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Wayne C. Hahne,

English graduate and Call-On-Doc’s medical resource guide, Wayne C. Hahne is an experienced and passionate medical education content expert. Through diligent research, provider interviews and utilizing the industry's leading resources for wellness information, it is Mr. Hahne’s personal mission to educate the general public on medical conditions with in-depth and easy-to-understand written guides.

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