AIDS & HIV

Aids / HIV

AIDS & HIV

Human Immunodeficiency Virus (HIV), a virus that enters the body through the transmission of bodily fluids and then begins to attack the immune system cells (T Lymphocytes) in order to reproduce itself. HIV seriously weakens anindividuals’ immune system and eventually the individual will contract AIDS. Acquired Immunodeficiency Syndrome (AIDS), a combination of signs and symptoms characterized by the lack of an effective immune system (the internal defense against infection, such as viruses and bacteria).

 

Symptoms

The symptoms experienced can be directly due to the HIV infection, but most likely are due to the many other infections that take hold because of the immunodeficiency. For ease of reading, the symptoms have been arranged into categories with separate sub-headings. Please remember that this is just an overview of symptoms and if you believe you might have been infected with HIV you should consult a physician immediately.

 

Generalized Symptoms

These symptoms are experienced by most HIV infected individuals, but are not linked to any one particular infection and are considered signs of an HIV infection, but by no means definitive proof.

Diarrhea

Diarrhea is found in both early and late stages of HIV. Many different microbes can be responsible for diarrhea. Very often it is hard to pinpoint the organism responsible, due to the fact that often times it is unknown what the cause is, since the HIV may cause it or another opportunistic infection may be causing it. Diarrhea may also be intermittent; one day a person may have a regular bowel movement and the next day, severe diarrhea. The use of anti-diarrheals can effectively remedy this symptom.

 

Weight Loss

Weight loss is caused by an increase in the metabolic rate of the body. Consult a physician on possible solutions to this condition. Typically, appetite stimulants are used to treat this symptom.

 

Fever

Fever is very common among HIV infected individuals and can occur in both early and late stages of the infection. In later stages, it is often accompanied by night sweats and chills, indicating that the body may be trying to fend of some type of opportunistic infection.

 

Fatigue

Fatigue is a very common complaint among infected individuals. The possible sources are numerous as fatigue is a common sign of many different infections. Depression, anemia, and side effects of some of the drugs used to treat HIV can also cause fatigue.

Initial HIV Infection (1 to 4 weeks after infection)

Early symptoms of HIV can mimic that of the symptoms experienced by mononucleosis. Symptoms include, swelling of the lymph nodes, headache, fever, loss of appetite, sweating, and sore throat. Often times this is mistaken as having the flu or another viral-type infection. Some people develop skin rashes on the chest, abdomen or back. Blood tests at this early stage will not reveal the antibodies to HIV yet, as they have not yet developed. Therefore, many people are not aware that they have been infected. Even if they have seen a doctor, it may be dismissed as a simple viral infection. This stage in almost all people dissipates due to the ability of the immune system to fight off the initial infection.

 

Seroconversion (4+ weeks after infection)

Seroconversion is the point at which antibodies to HIV can be detected in your blood. It can take many weeks for the body to produce the appropriate antibodies. 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. It can take up to five years before a person develops any physical signs. This time period is chiefly dependent upon the amount of CD4 cells in the individuals’ body. In addition, age and the general health of the person can also play a role. The weakening of the immune system, which has been trying to combat the HIV infection, will make the person more susceptible to opportunistic infections.

 

Opportunistic Infections (Early Stages of HIV)

As the immune system becomes increasingly compromised, the body is not able to fight off infections that a healthy, intact immune system could suppress. Early 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 virus, oral hairy leukoplakia, idiopathic thrombocytopenic purpura and pneumococcal pneumonia.

 

Thrush

This is the most common infection among HIV positive people. Thrush is a condition of the mouth caused by a fungus called Candida albicans. White patches on the walls of the mouth, gums, and on the tongue are good indications of this fungal infection. To complement this, people may have a burning sensation and an altered sense of taste. Thrush is easily treated with prescription drugs such as clotrimazole troches and nystatin.

 

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. Shingles look like a red rash that normally appear in a specific area and may look like a band around the body. In addition, headaches, fatigue and fever may accompany the rash. Generally, analgesics are used to control the pain. Oral acyclovir, best when started early, is also used to decrease the severity of the symptoms.

 

Herpes Simplex Virus (HSV)

In HIV/AIDS patients, herpes may become a chronic condition. With further deterioration of the immune system, the frequency of HSV along with the severity of the symptoms may increase. Please see the section on Herpes for more information about this virus and the symptoms associated with it. Oral Hairy Leukoplakia This is an infection of the mouth that resembles thrush and its cause is yet known. This infection eventually disappears on its own and unless the person is in pain, no treatment will be prescribed.

 

Idiopathic Thrombocytopenic Purpora (ITP)

This condition is caused by a person developing antibodies that attack cells called platelets (allow blood to clot) in the blood stream. This condition is only detected once a typical blood test is performed. People afflicted with ITP will experience excessive bruising and bleeding. There are several approaches to treating this disorder, Zidovudine (AZT), Prednisone, IV gamma globulin, a splenectomy, Danazol, or no treatment at all.

 

Pneumococcal Pneumonia

This is an infection of the lung and is one of the most common causes of death in people with AIDS. Infection can sometimes be prevented by the use of Pneumococcal vaccine. Please consult your doctor about this possibility.

AIDS and Opportunistic Infections (Later Stages of HIV)

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. 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, Cryptococcus, and Cryptosporidium.

Pneumocystic Pneumonia (PCP)

A parasite called pneumocystis carinii is responsible for this form of pneumonia. Since PCP is the most common opportunistic infection, prophylaxis (the use of drugs to prevent the infection) are important. 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. This form of pneumonia can be treated using Trimethoprim/sulfmethoxazole (Bactrim, Septra), Dapsone, or Pentamadine.

Kaposi’s Sarcoma

This is a condition in which tumors of the blood vessels develop. The exact cause is unknown, but it is known that Kaposi’s sarcoma 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 spot. The only symptom is small non-painful lesions, with a red, brown or purple 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.

Tuberculosis (Mycobacterium Tuberculosis (MTB))

MTB can occur in both early and late stages of the HIV disease. It is not 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 in the body, making it challenging to treat. People afflicted with tuberculosis typically suffer from night sweats, fever, cough, and weight loss. Isoniazid (INH) along with pyridoxine (Vitamin B6) can help combat MTB. Other combinations with INH include ethambutol, rifampin or streptomycin.

Mycobacterium Avium Complex (MAC)

MAC usually occurs in HIV patients with CD4 counts below 100. This complex is marked by fatigue, chills, night sweats, fever, weight loss, diarrhea, and abdominal pain. Due to its rather non-specific symptoms, MAC is difficult to diagnose. A combination of drugs is used to treat MAC infections. These include; Clarithomycin, Ethambutol, Clofazamine, Amikacin, Azithromycin, Ciprofloxin and Rifampin. MAC treatments are for the rest of an individual’s life.

HIV-Related Lymphoma

Tumors of the lymph glands. Causes very large lymph glands in the neck, around the groin region or under the arms. Tumors are treated with radiation or chemotherapy.

Toxoplasmosis Encephalitis

Toxoplasmosis is caused by a parasite, Toxoplasmosis Gondii, commonly found in cat feces and uncooked meat. This parasite causes an infection in the brain leading to neurological impairment and seizures. Headaches, fevers, lethargy, confusion and seizures are symptoms of this infection. Uncoordinated walking and loss of balance may also occur, these latter two symptoms are the two most common symptoms. Treatment for toxoplasmosis is for the rest of an individual’s life. Sulfadiazine or Clindamycin and/or Pyrimethamine. In addition, folinic acid is typically administered. Recent evidence has shown that AZT may also help in the treatment of toxoplasmosis.

Cytomegalovirus Infection (CMV)

About 90% of AIDS patients eventually develop cytomegalovirus. CMV may come on as a mono-like illness. This virus is very similar to that of Toxoplasmosis gondii and Pneumocystis carinii. Since CMV is located in the blood, it is distributed to all parts of the body, causing infections in many different organs. Infections in the eye (retinitis; inflammation of the eye) are common along with lung infections leading to pneumonia. Current medications to deal with this infection are gangciclovir and foscarnet.

Cryptococcus

This is a fungus found in soil, Cryptococcus neoformas, which can develop in many different areas of the body. The most serious and lethal site of infection is in the brain. The symptoms for a cryptococcus infection are: fatigue, fever, nausea and vomiting. Accompanying headaches are not always specific to one region of the head and encephalitis (inflammation of the brain) may be present along with altered mental states, memory loss, confusion, and behavioral changes. Amphotericin B with or without flucystine (5FU) is an effective medication for this fungus. Once stabilized, the patient is treated with fluconazole for life.

Cryptosporidium

Most commonly contracted from contaminated drinking water. The tell tale signs of cryptosporidium is diarrhea and weight loss. There are no currently available effective treatments for this disease.

 

Transmission

People can be infected with HIV and look healthy. So, you cannot tell who has HIV and who doesn’t, but these people can still transmit HIV by any of the accepted methods of transmission. HIV has been observed in bodily fluids such as blood, sexual fluids (semen and vaginal fluids), saliva, tears, and breast milk. However, only blood and sexual fluids have been observed to transmit HIV. Therefore, HIV is contracted through unprotected oral sex, anal or vaginal sexual intercourse (no condom used) or the sharing of needles or syringes with an infected person. Women infected with HIV can pass the virus to their babies during pregnancy, birth, and breast-feeding. Some people have become infected by receiving blood transfusions; since 1985 careful screening and laboratory testing of all blood donations began, this possibility has now been greatly reduced (almost impossible). You cannot get HIV from any other way than the methods indicated above. Most scientists agree that although transmission of HIV through deep or prolonged kissing may be possible because of potential blood contact, it is very unlikely. Latex condoms have been shown to help prevent HIV infection and other sexually transmitted diseases. But you have to use condoms correctly every time you have sex; vaginal, anal, or oral. Condoms made of plastics such as polyurethane are also highly effective for protection, however, condoms made of lambskin do not offer good protection against HIV. If you plan to have your ears pierced or get a tattoo, make sure you go to a qualified person who uses brand-new or sterile equipment. Don’t be shy about asking questions. Responsible technicians will explain the safety measures they follow.

 

Treatment

The only way to tell if you have been infected with HIV is by taking an HIV-anti-body blood test, which identifies the antibodies specific to HIV in your blood stream, white blood cells called B lymphocytes. This test should be done through an HIV testing site, doctor’s office, or clinic. You can be infected with HIV and have no symptoms at all; You might feel perfectly healthy, but if you’re infected you can pass the virus on to others. If you believe you have been at risk for catching HIV you should consult a health professional immediately. Currently, there is no 100% effective treatment for AIDS or HIV, though effective life prolonging medicines have been created to help in combating HIV and the opportunistic infections that can take hold. Please consult a physician to understand more about possible treatments and the options that are open to you.

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