AIDS

The Symptoms of HIV/AIDS – the First Stage

HIV infection comes in three stages. The first stage is called acute infection or seroconversion, and it typically happens within two to six weeks after exposure or becoming infected.

The initial symptoms of acute HIV infection may include:

• Headache
• Diarrhea
• Nausea and vomiting
• Fatigue
• Aching muscles
• Sore throat
• Red rash that doesn’t itch, usually on the torso.
• Fever

The Period Without Symptoms of HIV – the Second Stage

After the first seroconversion period, the immune system loses the battle with HIV and symptoms go away. HIV infection goes into its second stage, which can be a long period without symptoms, called the asymptomatic (or latent ) period. This is when people may not know they are infected and can pass HIV on to others. This period can last 10 or more years.

During this period without symptoms, HIV is slowly killing the CD4 T-cells and destroying the immune system. Blood tests during this time can reveal the number of these CD4 T-cells. Normally, a person has a CD4 T-cell count between 450 and 1,400 cells per microliter. For an HIV-infected person, the number of CD4 T-cells steadily drops, making them vulnerable to other infections — and in danger of developing AIDS.

HIV Infection and AIDS – the Third Stage

AIDS (acquired immune deficiency syndrome) is the advanced stage of HIV infection. When the CD4 T-cell number drops below 200, people are diagnosed with AIDS.

Some people don’t know they were infected with HIV, and only discover their HIV infection after experiencing some of these HIV-related symptoms:

• Being tired all of the time
• Swollen lymph nodes in the neck or groin
• Fever lasting for more than 10 days
• Night sweats
• Unexplained weight loss
• Purplish spots on the skin that don’t go away
• Shortness of breath
• Severe, long-lasting diarrhea
• Yeast infections in the mouth, throat, or vagina
• Easy bruising or unexplained bleeding

DIAGNOSIS

Home test

A Food and Drug Administration-approved home test is available. To do the test, you swab fluid from your upper and lower gums. If the test is positive, you need to see your doctor to confirm the diagnosis and discuss your treatment options. If the test is negative, it needs to be repeated in three months to confirm the results.

Tests to tailor treatment

If you receive a diagnosis of HIV/AIDS, several types of tests can help your doctor determine what stage of the disease you have. These tests include:

• CD4 count. CD4 cells are a type of white blood cell that’s specifically targeted and destroyed by HIV. Even if you have no symptoms, HIV infection progresses to AIDS when your CD4 count dips below 200.
• Viral load. This test measures the amount of virus in your blood. Studies have shown that people with higher viral loads generally fare more poorly than do those with a lower viral load.
• Drug resistance. This blood test determines whether the strain of HIV you have will be resistant to certain anti-HIV medications.

RECOMMENDED MEDICATIONS

Medicines used to treat HIV are called antiretrovirals. Several of these are combined for treatment called antiretroviral therapy, or ART.

You may be able to take several medicines combined into one pill. This reduces the number of pills you have to take each day.

Medicine choices

• Nucleoside/nucleotide reverse transcriptase inhibitors, such as abacavir, emtricitabine, and tenofovir.
• Nonnucleoside reverse transcriptase inhibitors (NNRTIs), such as efavirenz, etravirine, and nevirapine.
• Protease inhibitors (PIs), such as atazanavir, darunavir, and ritonavir.
• Entry inhibitors, such as enfuvirtide and maraviroc.
• Integrase inhibitors, such as dolutegravir and raltegravir.

Treatment response

Your doctor will monitor your viral load and CD4 counts to determine your response to treatment. Viral load should be tested at the start of treatment and then every three to four months during therapy. CD4 counts should be checked every three to six months.

HIV treatment should reduce your viral load to the point that it’s undetectable. That doesn’t mean your HIV is gone. It just means that the test isn’t sensitive enough to detect it. You can still transmit HIV to others when your viral load is undetectable.