Early HIV symptoms, (one to four weeks) can
mimic that of mononucleosis-like symptoms. Symptoms include, swelling
of the lymph nodes, headache, fever, loss of appetite, sweating, and
sore throat. Often times this can be mistaken as having the flu or
another viral-type infection. Some people may develop skin rashes on
the chest, abdomen and/or back.
HIV Symptoms in this second stage of
infection usually occur anytime after four weeks. Seroconversion is the
point at which antibodies to HIV can be detected. Eventually the body
will produce enough antibodies specific for the HIV virus; white blood
cells called B lymphocytes, in which a blood test will reveal that a
person has been infected by the HIV virus. Often times, people will
lead a fairly healthy period where no symptoms are present. However, if
the person is aware of a positive blood test, they may have
psychological symptoms of depression and anxiety about the future. It
can be up to five years before a person develops any physical signs.
This time period is dependent on many factors. Chiefly, it is the
person's large amount of CD4 cells (helper cells to the immune system,
helping to fight viruses). In addition, age and the general health
condition of the person can also play a role. An immune system that has
been trying to battle the HIV infection eventually weakens and will
make the person more susceptible to opportunistic infections.
Early Symptoms of HIV infection
As the immune system becomes increasingly
compromised, the body is not able to fight off infections that a normal
intact immune system could suppress. Early HIV symptoms occur usually
when a person has a CD4 count of 300 or below, but can happen at even
higher CD4 counts. The most common are thrush, Herpes Zoster
(shingles), Herpes Simplex, Oral Hairy Leukoplakia, Idiopathic
Thrombocytopenic Purpura and Pneumococcal Pneumonia.
This is the most common infection among hiv
positive people. Thrush is a condition that is located in the mouth and
is caused by a fungus called Candida Albicans. White patches on the
walls of the mouth, gums, and on the tongue is a good indication of
this fungal infection. In addition, people may have a burning sensation
and an altered sense of taste. Thrush is irritating more than anything
and can be easily treated with drugs such as Clotrimazole Troches and
Herpes Zoster (Shingles)
Herpes Zoster is the virus that causes
chicken pox in children. Anyone who had chicken pox as a child has the
virus for Herpes Zoster in the nerves of their body. Immune
deficiencies and stress tend to be the two main factors that cause the
reactivation of the virus leading to shingles.
Symptoms: Shingles looks like a red rash that normally appears in a
specific area and may look like a band around the body. In addition,
headaches, fatigue and fever may accompany the rash.
Treatment: Generally analgesics are used to control the pain. The
correct one is based on the severity of the pain. Oral Acyclovir, best
when started as early as possible, is also used to decrease the
severity of the symptoms.
Herpes Simplex is a common sexually
transmitted disease. In HIV - AIDS patients, it may become a chronic
condition. With further deterioration of the immune system, the
frequency of Herpes Simplex along with the severity may increase.
Symptoms: Most often Herpes Simplex affects the rectal, genital,
and esophageal regions of the body. Painful lesions are observed that
can erupt into ulcerations of the area.
The main drug to treat Herpes Simplex
infections is Oral Acyclovir 200mg, four times a day for two weeks or
longer until the lesions disappear. New forms of Acyclovir-like drugs
are being produced that have an increased effect on the disease.
Oral hairy leukoplakia
This is an infection of the mouth
that resembles thrush and its cause is unknown. Unless the person is in
pain from the infection, generally treatment is not given, as it
eventually disappears on its own.
This condition is when a person develops antibodies,
which attack cells called platelets, which are responsible for allowing
the blood to clot. This condition can go unnoticed and is not detected
until a routine blood test is performed.
bruising and bleeding.
are several approaches to treating this disorder. The use of Zidovudine
(AZT), Prednisone, IV Gamma Globulin, Splenectomy, Danazol, or no
treatment at all.
This is an infection of the lung and is one
of the most common causes in people with AIDS. This infection can
sometimes be prevented by the use of Pneumococcal vaccine. Ask your
doctor about this possibility.
Diarrhea is found in both early and late
stages of hiv. There are many different microbes that can be
responsible for diarrhea. It is often hard to define the cause of
diarrhea, but by analyzing stool samples, the organism responsible can
sometimes be uncovered. However, often times it is unknown what the
cause is, since either the HIV virus or some other opportunistic
infection may be the cause. It can also be intermittent. One day a
person may have a regular bowel movement and the next day they may have
severe diarrhea. It can be treated by antidiarrheals.
Weight loss is caused by an increase in the
metabolic rate of the body or how fast the body burns calories for
fuel, which results in a decrease of weight. This can happen due to
many factors such as opportunistic infections, fever, or the HIV virus
Fever is very common among HIV infected
individuals. It has many different origins including the HIV virus
itself and other opportunistic infections. Fever can occur in both in
the early and late stages. In later stages, it is often accompanied by
night sweats and chills, which indicate that the body may be trying to
fend off some type of opportunistic infection.
Fatigue is a very common complaint amongst hiv infected
individuals. The sources, like that listed with fever are also
numerous. Other causes can be from depression, anemia, and side effects
of some of the drugs used to treat hiv.
Later Stage AIDS and Opportunistic Infections
As the immune system becomes increasingly
compromised, the body is not able to fight off more serious infections
that a normal intact immune system could suppress. Some of these
infections can be life threatening in a person with AIDS and are
usually the cause of death in the AIDS patients. The current definition
of someone in late stage AIDS is when their CD4 count dips below 200.
Opportunistic infections are infections that a normal intact immune
system can fight off, but could prove to be life threatening to a
immunocompromised person. The two most common opportunistic infections
are Pneumocystic Pneumonia and Kaposi's Sarcoma. Others include:
Tuberculosis, Mycobacterium Avium Complex, HIV-Related Lymphoma,
Toxoplasmosis Encephalitis, Cytomegalovirus Infection,
Cryptocococcosis, and Cryptosporidiosis.
Pneumocystic Pneumonia (PCP)
A parasite called Pneumocystis Carinii is
responsible for this condition. Since PCP is the most common
opportunistic infection, prophylaxis (the use of drugs to prevent the
infection) is important. It is usually started in patients with CD4
counts under 200. Early medical intervention and prophylaxis against
PCP can improve the chances of keeping the infection at bay.
The symptoms of PCP are very similar to that of Pneumococcal Pneumonia;
fever, respiratory problems, etc.
Trimethoprim/Sulfmethoxazole (Bactrim, Septra), Dapsone, Pentamadine.
This is a condition in which tumors of the
blood vessels develop. The cause is unknown although it is known that
it is a malignancy originating in the endothelial or lymphatic cells.
Tumors can arise anywhere on the skin, in the gastrointestinal tract,
mouth, lungs, groin, brain, liver and lymph glands. The tumor takes on
the appearance of a purple or black spots.
Small non-painful lesions are present. (red, brown, or purple in color)
Local lesions are treated only if they are painful or interfering with
cosmetic problems. The common treatment is radiotherapy, cryotherapy,
or intralesional injections with Vinblastine. These therapies can help
reduce the condition but reoccurrence is common. Systemic lesions are
treated with chemotherapy. Other therapies are under current
Tuberculosis (Mycobacterium Tuberculosis “MTB”)
MTB can occur in both early and late stages
of the hiv disease. It is not as necessary to have a weakened immune
system to contract MTB. One of the major problems with this disease is
the development of multiple-drug resistant strains being produced, thus
making it a great challenge to treat. Another problem with reoccurrence
of MTB is non-compliance to treatment of patients with MTB.
Night sweats, fever, cough, and weight loss.
Isoniazid (INH) along with Pyridoxine (Vitamin B6). Other combinations
with INH include Ethambutol, Rifampin or Streptomycin.
Mycobacterium Avium Complex (MAC)
MAC generally occurs in the later stages of
the disease, in patients with CD4 counts below 100. It is very common
to find MAC in up to 50% of patients at autopsy.
chills, night sweats, fever, weight loss, diarrhea, and abdominal pain.
With such non-specific symptoms, it makes it difficult to diagnose MAC
combination of drugs is used to treat MAC infection. These include
using Clarithomycin and one or two other drugs such as Ethambutol
and/or Clofazamine. Other drugs may include Amikacin, Azithromycin,
Ciprofloxin and Rifampin. Once a person has started treatment for MAC,
they are treated for life.
HIV-Related Lymphoma (Tumors of the lymph glands)
large lymph glands in the neck, around the groin region or under the
Radiation and chemotherapy are the main treatments to irradiate the
Toxoplasmosis is caused by the
parasite,Toxoplasmosis Gondii, which is commonly found in the stools of
cats and in uncooked meats. This parasite causes an infection in the
brain leading to neurological impairment and seizures.
Headaches, fevers, lethargy, confusion and seizures. Uncoordinated
walking and loss of balance may also occur. The latter two symptoms are
the most common.
and/or Pyrimethamine. If the person is allergic to sulfa
(Sulfadiazine), the drug Clindamycin may be substituted. In addition,
folinic acid is administered. Recent evidence has shown that AZT may
also help in the treatment of toxoplasmosis. Treatment continues for
life once toxoplasmosis has been diagnosed.
Cytomegalovirus Infection (CMV)
About 90% of AIDS patients eventually
develop Cytomegalovirus. CMV may appear as a mono-like illness. This
virus is very similar to that of Toxoplasmosis Gondii and Pneumocystis
CMV is located in the blood, it is distributed to all parts of the
body, causing infections in many different organs. Most common are
infections in the eye (retinitis; inflammation of the eye) and lung
infections, which lead to pneumonia.
Gangciclovir and Foscarnet.
A fungus found in the soil, Cryptococcus
Neoformas, can develop in many different areas of the body. The most
serious site of infection is in the brain.
Fatigue, fever, nausea and vomiting. Accompanying headaches are not
always specific to one region of the head. Encephalitis, which is the
inflammation of the brain, may be present, as well as altered mental
states, memory loss, confusion, and behavioral changes.
Amphotericin B with or without flucystine (5FU). Once stabilized, the
patient is treated with Fluconazole for life.
The most common route of infection is
through drinking water that contains Cryptosporidium
Diarrhea and weight loss.
This is a difficult disease to treat and there are no current effective
treatments although active research and clinical trials are closing in
on the treatment of this disease.