HIV AIDS history and symptoms: Difference between revisions

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* '''Blurry vision or vision loss'''
* '''Blurry vision or vision loss'''
:* Suggestive of CMV retinitis
:* Suggestive of CMV retinitis
==Common Symptoms==
The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy [[immune system]]s. Most of these conditions are infections caused by [[bacteria]], [[virus]]es, [[fungus|fungi]] and [[parasite]]s that are normally controlled by the elements of the immune system that HIV damages. [[Opportunistic infection]]s are common in people with AIDS.<ref name=Holmes>{{
cite journal
| author=Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg KA
| title=Review of human immunodeficiency virus type 1-related opportunistic infections in sub-Saharan Africa
| journal=Clin. Infect. Dis. | year=2003 | pages=656&ndash;662 | volume=36 | issue=5
| pmid=12594648
}}</ref>
Additionally, people with AIDS often have systemic symptoms of infection like [[fever]]s, [[sweat]]s (particularly at night), swollen glands, chills, weakness, and [[weight loss]].<ref name=Guss>{{
cite journal
| author=Guss DA
| title=The acquired immune deficiency syndrome: an overview for the emergency physician, Part 1
| journal=J. Emerg. Med. | year=1994 | pages=375&ndash;384 | volume=12 | issue=3
| pmid=8040596
}}</ref><ref name=Guss2>{{
cite journal
| author=Guss DA
| title=The acquired immune deficiency syndrome: an overview for the emergency physician, Part 2
| journal=J. Emerg. Med. | year=1994 | pages=491&ndash;497 | volume=12 | issue=4
| pmid=7963396
}}</ref>
===Tuberculosis===
Symptoms are usually constitutional and are not localized to one particular site, often affecting [[bone marrow]], [[bone]], urinary and [[gastrointestinal tract]]s, [[liver]], regional [[lymph node]]s, and the [[central nervous system]].<ref name=Decker>{{
cite journal
| author=Decker CF, Lazarus A
| title=Tuberculosis and HIV infection. How to safely treat both disorders concurrently
| journal=Postgrad Med. | year=2000 | pages=57&ndash;60, 65&ndash;68 | volume=108 | issue=2
| pmid=10951746
}}</ref>
Specific neurological impairments are manifested by cognitive, behavioral, and motor abnormalities that occur after years of HIV infection and is associated with low CD4<SUP>+</SUP> T cell levels and high plasma viral loads. Prevalence is 10&ndash;20% in Western countries<ref name=Grant>{{
cite book
| author = Grant I, Sacktor H, McArthur J
| year = 2005
| title = The Neurology of AIDS
| chapter = HIV neurocognitive disorders
| chapterurl = http://www.hnrc.ucsd.edu/publications_pdf/2005grant1.pdf
| editor = H. E. Gendelman, I. Grant, I. Everall, S. A. Lipton, and S. Swindells. (ed.)
| edition = 2nd
| pages = 357&ndash;373
| publisher = Oxford University Press
| location = London, UK
| format= PDF
| id = ISBN 0-19-852610-5
}}</ref> but only 1&ndash;2% of HIV infections in India.<ref name=Satischandra>{{
cite journal
| author=Satishchandra P, Nalini A, Gourie-Devi M, et al | title=Profile of neurologic disorders associated with HIV/AIDS from Bangalore, South India (1989&ndash;1996)
| journal=Indian J. Med. Res. | year=2000 | pages=14&ndash;23 | volume=11 | issue=
| pmid=10793489
}}</ref><ref name=Wadia>{{
cite journal
| author=Wadia RS, Pujari SN, Kothari S, Udhar M, Kulkarni S, Bhagat S, Nanivadekar A
| title=Neurological manifestations of HIV disease
| journal=J. Assoc. Physicians India | year=2001 | pages=343&ndash;348 | volume=49 | issue=
| pmid=11291974
}}</ref> This difference is possibly due to the HIV subtype in India.
===Cryptococcal Meningitis===
It can cause fevers, [[headache]], [[Fatigue (medical)|fatigue]], [[nausea]], and [[vomiting]]. Patients may also develop [[seizure]]s and confusion; left untreated, it can be lethal.
<!---
Infection with HIV-1 is associated with a progressive decrease of the CD4+ T cell count and an increase in viral load, the level of HIV in the blood. The stage of infection can be determined by measuring the patient's CD4+ T cell count and viral load and the sign and symptom depends upon the stage of the viral infection.
==Signs and symptoms==
The stages of HIV infection are:
# [[HIV signs and symptoms#Acute infection|Acute infections]] (also known as primary infection).
# [[HIV signs and symptoms#Latent stage|Latency]]
# AIDS. 
===Acute infection===
'''Duration:''' Last for several weeks.
'''Symptoms:''' fever, lymphadenopathy (swollen lymph nodes), pharyngitis (sore throat), rash, myalgia (muscle pain), malaise, and mouth and esophageal sores.
To read more about acute HIV infection, click [[HIV acute infection|'''here''']]
===Latent stage===
'''Duration:''' Last for two weeks to twenty years or more.
'''Symptoms:''' None
=== AIDS===
The final stage of HIV infection, is defined by low CD4+ T cell counts (fewer than 200 per microliter), various opportunistic infections, cancers and other conditions.
==WHO classification based on HIV infection symptoms==
{|border="1" cellpadding="2" cellspacing="0"
|-
!colspan=4|'''Classification of HIV Stages in Adults and Adolescents'''
|-
| style="text-align:center"|'''Quantity (%) of CD4 lymphocites per ml blood'''
| colspan=3 align="center"|    '''Clinical Stage'''
|-
|
| style="text-align:center"|A
| style="text-align:center"|B
| style="text-align:center"|C
|-
|
|Asymptomatic, acute (primary) or primary generalized lymphadenopaphy
|style="text-align:center"|Symptomatic non '''А''' non '''С'''
|style="text-align:center"|AIDS related diseases
|-
|style="text-align:center"| ≥500 (≥29%)
|style="text-align:center"|'''A1'''
|style="text-align:center"|'''B1'''
|style="text-align:center"|'''C1'''
|-
|style="text-align:center"| 200–499 (14–28%)
|style="text-align:center"|'''A2'''
|style="text-align:center"|'''B2'''
|style="text-align:center"|'''C2'''
|-
|style="text-align:center"| <200 (<14%) = AIDS indicator
|style="text-align:center"|'''A3'''
|style="text-align:center"|'''B3'''
|style="text-align:center"|'''C3'''
|}
--->


==References==
==References==

Revision as of 20:44, 4 November 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Acute HIV should be suspected in patients with flu-like or mononucleosis-like symptoms within 2-4 weeks of exposure to HIV virus or participation in high risk behaviors. Although a significant proportion of patients are asymptomatic, those who manifest an acute illness present with fever, lymphadenopathy, rash, fatigue, and myalgia. This stage is usually followed by a clinical latency period throughout which patients may not experience any symptoms. AIDS defines the final stage of HIV infection and indicates significant immune compromise. AIDS classically presents with weight loss, night sweats, fatigue, and symptoms of opportunistic infections (or AIDS-defining illnesses) such as diarrhea, mucosal sores, cough, and cognitive and neurological deficits.

History

A generalized graph of the relationship between HIV copies (viral load) and CD4 counts over the average course of untreated HIV infection; any particular individual's disease course may vary considerably. Template:Legend-line Template:Legend-line
  • AIDS should be suspected in patients with flu like symptoms within 2-4 weeks of exposure to HIV virus or participated in a high risk behaviour like unprotected sex with patners of unknown HIV status or sharing needles or contaminated blood transfusion.
  • Many people describe the flu as very severe and "worst flu ever"
  • Many HIV positive people do not have any symptoms and will not complain of any symtoms untill they progress to full blown AIDS
  • HIV affects nearly every organ system. People with AIDS also have an increased risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system known as lymphomas.
  • After the diagnosis of AIDS is made, the current average survival time with antiretroviral therapy (as of 2005) is estimated to be more than 5 years,[1] but because new treatments continue to be developed and because HIV continues to evolve resistance to treatments, estimates of survival time are likely to continue to change. Without antiretroviral therapy, death normally occurs within a year. Most patients die from opportunistic infections or malignancies associated with the progressive failure of the immune system.[2]
  • The rate of clinical disease progression varies widely between individuals and has been shown to be affected by many factors such as host susceptibility and immune function health care and co-infections,[2] as well as factors relating to the viral strain.[3][4]
  • The specific opportunistic infections that AIDS patients develop depend in part on the prevalence of these infections in the geographic area in which the patient lives.

Symptoms

Acute Retroviral Syndrome

  • Within 2-4 weeks after HIV infection, patients may complain of flu-like or mononucleosis-like symptoms. This phase is known as the acute retroviral syndrome. The common symptoms include:

Clinical Latency Stage

Patient may experience no symptoms or mild symptoms. Virus can be detected at this stage and patients are able to transmit the disease at this stage.

AIDS

Symptoms can include the following.

Symptoms of Opportunistic Infections

Opportunistic infections can produce a wide variety of symptoms that can often unmask AIDS in patients without previously documented HIV infection. These infections are known as AIDS-defining illnesses.

Pulmonary Infections

  • Cough
  • Dry: Suggestive of Pneumocystis jirovecii pneumonia
  • Productive: Suggestive of bacterial or fungal pneumonia
  • Hemoptysis
  • Suggestive of tuberculosis or fungal pneumonia
  • Dyspnea
  • Chest pain

Gastrointestinal Infections

  • Chest pain
  • Suggestive of esophageal candidiasis
  • Abdominal pain
  • Chronic diarrhea
  • Bloody diarrhea

Neurological Diseases

  • Focal neurological deficits
  • Memory loss and cognitive decline
  • Suggestive of AIDS-Dementia complex or primary CNS lymphoma
  • Fever, headache, meningeal signs and symptoms
  • Suggestive of meningitis, consider cryptococcal meningitis

Skin and Mucosal Disease

  • Purpulish rash that responds poorly to treatment
  • Massive lymphadenopathy
  • Suggestive of malignant lymphoma
  • Mucosal leasions that respond poorly to treatment
  • Suggestive of HPV related tumors (Oral/Anal squamous cell carcinoma, invasive cervical cancer)

Other manifestations

  • Blurry vision or vision loss
  • Suggestive of CMV retinitis

References

  1. Schneider MF, Gange SJ, Williams CM, Anastos K, Greenblatt RM, Kingsley L, Detels R, Munoz A (2005). "Patterns of the hazard of death after AIDS through the evolution of antiretroviral therapy: 1984–2004". AIDS. 19 (17): 2009&ndash, 2018. PMID 16260908.
  2. 2.0 2.1 Lawn SD (2004). "AIDS in Africa: the impact of coinfections on the pathogenesis of HIV-1 infection". J. Infect. Dis. 48 (1): 1&ndash, 12. PMID 14667787.
  3. Campbell GR, Watkins JD, Esquieu D, Pasquier E, Loret EP, Spector SA (2005). "The C terminus of HIV-1 Tat modulates the extent of CD178-mediated apoptosis of T cells". J. Biol. Chem. 280 (46): 38376&ndash, 39382. PMID 16155003.
  4. Senkaali D, Muwonge R, Morgan D, Yirrell D, Whitworth J, Kaleebu P (2005). "The relationship between HIV type 1 disease progression and V3 serotype in a rural Ugandan cohort". AIDS Res. Hum. Retroviruses. 20 (9): 932&ndash, 937. PMID 15585080.

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