(updated for Winter Term 2004)
Stages of HIV Disease
- Different classifications used
- We will use 3-stages
- acute infection
- asymptomatic
- late stage
- Basis for different classifications
- clinical, biological, testable, etc.
Time course of the stages
- Rapid progression occurs (about 10%)
- AIDS within 2-3 years after infection
- “Normal” progression
- AIDS within 5-10 years after infection
- Slow progression (10-20%)
- NO AIDS even 10-20 years after infection
Acute phase
- Symptoms resembe Flu or mononucleosis
- No antibodies made yet
- Typical symptoms:
- fever, sore throat, headache, swollen glands, sometimes a rash, vomiting, diarrhea, or thrush.
- Usually lasts 2-8 weeks
Other features of Acute Phase
- Highly infectious by normal routes
- Tests negative by antibody test
- Lymph nodes seeded with infected cells
Asymptomatic stage
- Lasts for years
- Most definitely NOT a quiet time for the virus
- 1-10 billion new virus made every day
- many T-cells destroyed every day
- lots of mutants accumulating, lots of T-cells with new specificities accumulation too.
Other features of This Stage
- Antibodies detectable
- Still infectious, but maybe less so
- Generally good health
Late stage: pre-AIDS
- Beginning of late stage
- weight loss, night sweats, fever, malaise, loss of appetite, diarrhea, swollen glands
- Destruction of lymph glands (breakdown of the network that traps everything)
- Drop in T-cell count
- thrush, bacterial infections, fungal and viral infections
AIDS-Related Complex
- An old term for the beginning of the late (symptomatic) stage of HIV Disease
Late Stage: AIDS
- New definition
- not dependent on health
- T-cell count of less than 200 per milliliter of blood
- HIV positive test
- Old definition
- two diseases from a list of about 20 (including PCP, Kaposi’s sarcoma, cryptosporidium, etc.
- A person has AIDS if either definition applies
Viral Load
- Auring acute phase, a huge bloom of free virus
- During asymptomatic stage, much lower, but constant
- As T-cells disappear and lymph nodes degrade, another (terminal) bloom of virus and full progression to AIDS
Pediatric AIDS
- Progression is much more rapid
- clinical symptoms usually within 6 monhs
- death usually within 2 years
- drugs are extending that, but…
- Spectrum of diseases are different in Pediatric AIDS
- more bacterial diseases, more bacterial and viral pneumonia, little KS or PCP
Some of the “non-AIDS” Diseases that come with HIV Disease (T-cells still over 200)
- Bacterial infections and skin infections
- Shingles
- thrush
- severe athlete’s foot
Some of the AIDS related diseases (T cells under 200)
- Tuberculosis (disseminated)
- Pneumocystis carinii pneumonia
- Cryptococcal meningitis
- Toxoplasmosis
- Cryptosporidium infection
- Cytomegalovirus infections
- Kaposi’s sarcoma