Sexually transmitted infections (STIs)

Human Immunodeficiency Virus (HIV): Signs And Symptoms - Health

Human immunodeficiency virus (HIV) can move through stages: acute HIV (stage 1), clinical latency (stage 2), and AIDS (stage 3). The symptoms of each stage can look different. Those in an early stage of HIV can have flu-like symptoms, while those in an advanced stage can have severe infections.   

HIV affects the immune system's ability to fight infections. You can get HIV or pass HIV to someone through blood, semen and pre-seminal fluid, rectal fluid, vaginal fluid, and breast milk that contains the virus. The virus is transmitted from person to person when these body fluids come into contact with your body's tissue, blood, or broken skin (e.G., open wounds).

The method of transmission of HIV can vary. You may get or pass HIV through:

Perinatal transmission from birth parent to child (i.E., through pregnancy, childbirth, or breastfeeding)

Sharing needles, syringes, and other drug injection equipment

Unprotected vaginal or anal sex

Acute (sudden) HIV starts two to four weeks after you get the virus. Acute HIV is also known as primary HIV. The virus multiplies very quickly in the immune system during this stage. Two-thirds of people in this stage experience flu-like symptoms, while some people don't have symptoms at all. Symptoms in the acute stage can last a few days to several weeks and may include: Chills Fatigue Fever Mouth ulcers Muscle aches Night sweats Rash Sore throat Swollen lymph nodes Symptoms can last a few days to several weeks. Acute-stage HIV symptoms can mimic other conditions, like the flu or common cold. It's important to not assume that you have HIV. You may consider getting tested for the virus if you think you may have been exposed to HIV. The clinical latency stage, or chronic HIV, is the second stage of HIV. The virus continues to multiply but much more slowly than in the acute stage during this stage. You might not experience any symptoms as a result. You can still transmit the virus to someone else even if you have no symptoms if you are not taking any treatment for HIV. People can stay in the clinical latency stage for an average of 10 years without treatment. Symptoms and disease progression vary from person to person. You can move through this stage more quickly or slowly than the average time. You can decrease your viral load (the amount of HIV that you have that you can transmit to someone else) to an undetectable level if you are taking treatments. This stage can last for several decades while you're on treatment. HIV can continue to slowly multiply and weaken your immune system over time and without treatment. This can result in the third and final stage of HIV: acquired immunodeficiency syndrome (AIDS), also known as late-stage HIV. AIDS symptoms include: Colored blotches or patches on or under the skin and inside the mouth, nose, and eyelids Depression Diarrhea that lasts for more than seven days Feeling extremely tired  Memory loss  Pneumonia Rapid weight loss (sometimes called wasting) Recurring fever Sores on the mouth, buttocks, and genitals Swollen lymph nodes in the armpits, neck, and groin that last a long time You may receive an AIDS stage diagnosis if: The number of CD4 cells in your blood falls below 200 cells per cubic millimeter of blood (200 cells/mm3). You develop one or more opportunistic infections regardless of how many CD4 cells you have. AIDS symptoms are often related to opportunistic infections (OIs) or an AIDS-defining illness. Certain illnesses occur more frequently and severely in people with AIDS. OIs occur when HIV has caused too much damage to the body's immune system and can no longer fight off infections. Some OIs include:  Taking HIV medications as prescribed can slow disease progression and prevent AIDS. You can live with AIDS for about three years without treatment. Your life expectancy can shorten to one year if you develop an OI and are not taking treatment.  Deciding whether to take treatment or not isn't always a choice. Not everyone has access to necessary healthcare services. This can be due to poverty, lack of insurance, racial disparities in the healthcare system, cultural stigma about HIV, and other factors. The only way to know if you have HIV is to get tested. Knowing your HIV status is a powerful way to help take care of yourself and your partners.  Keep in mind: Don't rely only on symptoms as a way to tell if you are living with HIV. HIV symptoms can mimic other conditions. You might not have any symptoms at all. Reach out to a healthcare provider or local clinic to learn more about testing if you think you may have been exposed to HIV. You can get a test for HIV at a healthcare provider's office, local health department, and family planning clinics, among others. You can also test for HIV at home. Testing is available for free if you have health insurance. Some testing sites still offer tests for free or on a sliding scale based on your income if you do not have insurance. Please visit HIV.Gov's testing overview here for more information about testing. Use the CDC resource here to find an HIV testing site near you.  HIV is a serious and chronic (long-lasting) condition that attacks and destroys CD4 cells in your immune system. HIV can progress through three stages: the acute stage, the clinical latency stage, and the AIDS stage. Your symptoms may change depending on your HIV's current stage.  It's good practice to get tested if you think you may have been exposed to HIV. Testing is the only way you can confirm a diagnosis and rule out other conditions. Thanks for your feedback!

World AIDS Day: Know The Early Symptoms Of HIV - Hindustan Times

World AIDS Day: AIDS (acquired immune deficiency syndrome) is a much dreaded disease which currently has not cure. It is caused by HIV (human immunodeficiency virus) and a person who has the condition is susceptible to multiple organ failure and overwhelming infections.

World AIDS Day is observed every year on December 1(Pixabay)

Not every person who gets infected with HIV ends up with AIDS. With proper medication and care, this number is now greatly reduced. But those who do land with AIDS, have multisystem organ failure due to the infection.

HIV infection has become more manageable over the years due to better health facilities enabling people with HIV to lead longer and healthier lives.

ALSO READ: WHO discusses new Covid variant possibly evolved in untreated AIDS patient. What we know so far

There were an estimated 37.7 million people living with HIV at the end of 2020. In 2020, 680000 people died from HIV-related causes and 1.5 million people acquired HIV, according to WHO.

World AIDS Day is celebrated every year on December 1 to spread awareness about HIV/AIDS. It has become one of the most widely recognized international health days and aims to raise awareness, commemorate those who have died, and celebrate victories such as increased access to treatment and prevention services.

Early symptoms

While many people may not show earlier symptoms at all for several years, some will show symptoms resembling flu like fever, headache, fatigue, sore throat among others. These symptoms typically arise within one or two months of the infection, while in some people it can be two weeks.

Dr Bela Sharma, Additional Director, Internal Medicine, Fortis Memorial Research Institute, Gurugram lists initial symptoms of HIV.

The early symptoms of HIV can include:

* Fever

* Headache

* Fatigue

* Swollen lymph glands

* Rash

* Sore throat

* Muscle/joint pain

* Night sweats

* Diarrhea

* As the condition progresses, people with HIV may develop a weakened immune system.

* Infections that were once minor, such as canker sores in the mouth, or a tooth abscess or cavity, may cause significant pain. It may become more difficult for people with HIV to recover from these infections.

* A person may notice that they have more frequent minor infections, such as colds or yeast infections.

* They may also notice that they are sick more often than before, or for longer periods of time.

* Some people may get very ill from infections that would normally not be life threatening.

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Dementia Caused By HIV/AIDS: Scale, Symptoms, Treatments - WebMD

Decline in mental processes is a complication of advanced HIV infection.

Although the specific symptoms vary from person to person, they may be part of a single disorder known as AIDS dementia complex, or ADC. Other names for ADC are HIV-associated dementia and HIV/AIDS encephalopathy.

Common symptoms include decline in thinking, or "cognitive," functions such as memory, reasoning, judgment, concentration, and problem solving.

Other common symptoms are changes in personality and behavior, speech problems, and motor (movement) problems such as clumsiness and poor balance.

When these symptoms are severe enough to interfere with everyday activities, a diagnosis of dementia may be warranted.

AIDS dementia complex typically occurs as the CD4+ count falls to less than 200 cells/microliter. It may be the first sign of AIDS. With the advent of antiretroviral therapy (ART), the frequency of ADC has declined. ART may not only prevent or delay the onset of AIDS dementia complex in people with HIV infection, it can also improve mental function in people who already have ADC.

AIDS dementia complex is caused by the HIV virus itself, not by the opportunistic infections that commonly occur in advanced HIV. We do not know exactly how the virus damages brain cells.

HIV may affect the brain through several mechanisms. Viral proteins may damage nerve cells directly or by infecting inflammatory cells in the brain and spinal cord. HIV may then induce these cells to damage and disable nerve cells. HIV causes generalized inflammation, which can cause memory issues, as well as other aging processes, including heart disease.

AIDS dementia complex can affect behavior, memory, thinking, and movement. At first, symptoms are subtle and may be overlooked, but they gradually become troublesome. The symptoms vary widely from person to person.

Symptoms of early dementia include:

Reduced productivity at work

Poor concentration

Mental slowness

Difficulty learning new things

Changes in behavior

Decreased libido

Forgetfulness

Confusion

Word-finding difficulty

Apathy (indifference)

Withdrawal from hobbies or social activities

Depression

Initially, a subtle disease can progress to more severe symptoms such as:

Sleep disturbances

Psychosis -- Severe mental and behavioral disorder, with features such as extreme agitation, loss of contact with reality, inability to respond appropriately to the environment, hallucinations, and delusions

Mania -- Extreme restlessness, hyperactivity, very rapid speech, poor judgment

Seizures

Without ART, these symptoms gradually worsen. They can lead to a vegetative state, in which the person has minimal awareness of his or her surroundings and is incapable of interacting.

In a person who's known to have an HIV infection, cognitive, behavioral, or motor symptoms suggest that the person might have ADC. It's important to consider, however, other possible causes of these symptoms, such as metabolic disorders, infections, degenerative brain diseases, stroke, tumor, and many others. Your healthcare provider will carry out an evaluation to determine the cause of your symptoms. This will likely include a medical interview, physical and mental status exams, CT or MRI scans, neuropsychological testing, and, possibly, a spinal tap.

Imaging Studies

CT scan and MRI may detect changes in the brain that support the diagnosis of AIDS dementia complex. Brain changes in ADC worsen over time, so these studies may be repeated periodically. Importantly, these scans help rule out other potentially treatable conditions such as infection, stroke, and brain tumor.

A CT scan or an MRI gives a detailed, 3-dimensional picture of the brain. These scans can show brain atrophy (shrinkage) that is consistent with ADC, as well as changes in the appearance of different parts of the brain.

Lab Tests

No lab test confirms the diagnosis of AIDS dementia complex. If you have lab tests, they serve to rule out conditions that might cause similar symptoms. You may have blood drawn for multiple tests.

Your healthcare provider may test your cerebrospinal fluid (CSF). This clear fluid is made in normal cavities in the brain called ventricles, which are seen on a CT scan or an MRI. The fluid surrounds the brain and spinal cord. It cushions and protects these structures and may distribute both beneficial and harmful substances. CSF can be tested for various abnormalities that are related to dementia symptoms. A sample of the CSF is obtained with a lumbar puncture, also called a spinal tap. This procedure involves the removal of a sample of CSF from the spinal canal in the lower back.

Electroencephalography

For electroencephalography (EEG), a series of electrodes are attached to the scalp. The electrical activity of the brain is read and recorded. In the later stages of ADC, the electrical activity (which appears as waves) is slower than normal. EEG also is used to see whether a person is having seizures.

Neuropsychological Testing

Neuropsychological testing is the most accurate method of pinpointing and documenting your cognitive abilities. This can help give a more accurate picture of the problems and thus can help in treatment planning. It might be repeated later to monitor changes in symptoms.

The testing involves answering questions and performing tasks that have been carefully prepared for this purpose. The test is given by a neurologist, psychologist, or other specially trained professional. It addresses your ability to think mood, anxiety level, and experience of delusions or hallucinations.

Testing assesses cognitive abilities such as:

Memory

Attention

Orientation to time and place

Use of language

Abilities to carry out various tasks and follow instructions

Reasoning, abstract thinking, and problem solving are also tested.

Just as there is no cure for AIDS, there is no cure for AIDS dementia complex. However, ADC can be controlled in some people by other appropriate treatments; the most important treatment is effective ART.

If you have AIDS dementia complex, you should remain physically, mentally, and socially active as long as you are able.

Stay active. Daily physical exercise helps maximize body and mental functions and maintains a healthy weight. This can be as simple as a daily walk.

Engage in as much mental activity as you can handle. Keeping your mind working may help keep cognitive problems to a minimum. Puzzles, games, reading, and safe hobbies and crafts are good choices.

Don't stop seeing your friends and relatives. Your social life is not only enjoyable but keeps your mind active and your emotions in balance.

A balanced and nutritious diet that includes plenty of fruits and vegetables helps maintain a healthy weight and prevent malnutrition and constipation. You should not smoke both for health and safety reasons.

Combination antiretroviral therapy (ART), which is effective in controlling HIV infection, also protects many HIV-positive people from developing AIDS dementia complex. In cases  of advanced HIV in which ADC is present, ART can partially or completely reduce symptoms of ADC.

No specific treatment is available for cognitive decline in AIDS. Specific symptoms such as depression and behavioral disturbances are sometimes relieved by drug therapy.

These "psychoactive" drugs are not appropriate for everyone. Your health care provider may consult a specialist in brain disorders (neurologist or psychiatrist) to determine the best treatment.

If you have AIDS dementia complex, you should have regular and frequent visits with your health care provider. These visits allow repeat testing to monitor your condition, review of symptoms, and adjustments to treatment if needed. The visits also permit the health care provider to assess whether your care is appropriate.

Persons with advanced dementia may require inpatient care in a nursing home or similar facility.

Combination antiretroviral therapy (ART) can delay or prevent the development of AIDS dementia complex in people with HIV infection, especially if it is given early in the course of the disease. There is no other known way of preventing ADC.

In people who already have advanced HIV and ADC, combination ART will likely result in some improvement in symptoms.  If there is no response to ART, the outlook may be poor. For some, the dementia worsens over a period of months until the person is no longer able to care for himself. He or she becomes bedridden, unable to communicate, and dependent on others for care.

AIDS dementia complex can be one of the most difficult of all HIV/AIDS complications for you and those who care for you. The condition affects every aspect of your life, including family relationships, work, financial status, social life, and physical and mental health. You may feel overwhelmed, depressed, frustrated, angry, or resentful.

While understandable, these feelings do not help the situation and usually make it worse. This is why support groups were invented. Support groups are groups of people who have lived through the same difficult experiences and want to help themselves and others by sharing coping strategies.

Support groups meet in person, on the telephone, or on the Internet. The following organizations may help you find a support group that is right for you. You can also ask your health care provider or behavior therapist, or go on the Internet. If you do not have access to the Internet, go to the public library.

Centers for Disease Control and Prevention, National Prevention Information Network(800) HIV-0440 (800-448-0440)(888) 480-3739 TTY1-301-519-0459 InternationalEmail: [email protected]Web Site: npin.Cdc.Gov

Family Caregiver Alliance/National Center on Caregiving(800) 445-8106Email: [email protected]Web Site: www.Caregiver.Org

National Alliance for Caregiving(301) 718-8444Email: [email protected]Web Site: www.Caregiving.Org

Media file 1: CT scan of the brain of a patient with AIDS dementia complex (ADC) shows diffuse atrophy (loss of tissue) and ventricular enlargement and attenuation (dark areas) around the ventricles in the white matter.

Media type: CT

Media file 2: T2-weighted MRI shows ventricular enlargement and large areas of hyperintense signal in the subcortical white matter of both frontal lobes.

Media type: MRI

Media file 3: Photomicrograph from a patient with AIDS dementia complex (ADC) shows perivascular and parenchymal infiltrates of lymphocytes and macrophages. These often form microglial nodules. Contributed by Dr. Beth Levy, Saint Louis University School of Medicine, St. Louis.

Media type: Photo

Media file 4: Photomicrograph from patient with AIDS dementia complex (ADC) illustrates the intense astrogliosis (scarring) that is characteristic of HIV encephalitis. Contributed by Dr. Beth Levy, Saint Louis University School of Medicine, St. Louis.

Media type: Photo

Media file 5: Multinucleated giant cells, as shown here, are a hallmark of HIV encephalitis and harbor the virus. Contributed by Dr. Beth Levy, Saint Louis University Health Sciences Center, St. Louis.

Media type: Photo

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