HIV infection

Definition

HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight.

Alternative Names

Causes

Acute HIV infection may be associated with symptoms resembling mononucleosis or the flu within 2 to 4 weeks of exposure. HIV seroconversion (converting from HIV negative to HIV positive) usually occurs within 3 months of exposure.

People who become infected with HIV may have no symptoms for up to 10 years, but they can still transmit the infection to others. Meanwhile, their immune system gradually weakens until they are diagnosed with AIDS. Acute HIV infection progresses over time to asymptomatic HIV infection and then to early symptomatic HIV infection and later, to AIDS

Most individuals infected with HIV will progress to AIDS if not treated. However, there is a tiny subset of patients who develop AIDS very slowly, or never at all. These patients are called long-term non-progressors.

HIV has spread throughout the United States. Higher concentrations of the disease are found in inner cities.

Related topics:

• Acute HIV infection
• Asymptomatic HIV infection
• Early symptomatic HIV infection
• AIDS

Symptoms

Any symptoms of illness may occur, since infections can occur throughout the body. Special symptoms relating to HIV infection include:

• Sore throat
• Mouth sores, including candidal infection
• Muscular stiffness or aching
• Headache
• Diarrhea
• Swollen lymph glands
• Fever
• Fatigue
• Rash of various types, including seborrheic dermatitis
• Frequent vaginal yeast infections

Note: At the time of diagnosis with HIV infection, many people have not experienced any symptoms.

Exams and Tests

• HIV ELISA/Western blot may show positive HIV antibody. If it is negative and the patient has definite risk factor for HIV infection, the test should be repeated in 3 months.
• Lower-than-normal CD4 cell count may show suppression of the immune system by the virus.
• HIV RNA viral load indicates the amount of virus in the bloodstream.
• Blood differential may show abnormalities.

Treatment

Drug therapy is often recommended for patients who are committed to taking all their medications and have a CD4 count between 200 and 350 (indicating immune system suppression).

It is extremely important that patients take all doses of their medications, otherwise the virus will rapidly become resistant to the medications. Therapy is always given with a combination of antiviral drugs.

People with HIV infection need to receive education about the disease and treatment so that they can be active partners in decision making with their health care provider.

Support Groups

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See AIDS - support group.

Outlook (Prognosis)

HIV is a chronic medical condition that can be treated, but not yet cured. There are effective means of preventing complications and delaying, but not preventing, progression to AIDS. At the present time, not all persons infected with HIV have progressed to AIDS, but time has shown that the vast majority do.

Possible Complications

• Opportunistic infections
  • Pneumocystis carinii pneumonia
  • Candidiasis
  • Cytomegalovirus infection
  • Toxoplasmosis
  • Cryptococcus
  • Cryptosporidium enterocolitis (or other protozoal)
  • Mycobacterium avium complex (MAC)
  • Tuberculosis
  • Bacillary angiomatosis
  • Salmonella infection in the bloodstream
  • Progressive multi-focal leukoencephalopathy (viral infection of the brain)
• HIV dementia
• Malignancies (cancers)
• HIV lipodystrophy
• Chronic wasting from HIV infection

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have had a possible or actual exposure to AIDS or HIV infection.

Prevention

• Use protection when having sexual contact with persons known or suspected of being infected with HIV.
• If you have sex with numerous people or with people who have multiple partners, always use protection.
• Avoid intravenous (IV) drugs. If IV drugs are used, avoid sharing needles or syringes. Always use new needles. (Boiling or cleaning them with alcohol does not guarantee sterility.)
• If you have sex with people who use IV drugs, always use protection.
• People with AIDS or who have had positive HIV antibody tests may pass the disease on to others. They should not donate blood, plasma, body organs, or sperm. They should not exchange genital fluids during sexual activity.
• Avoid oral, vaginal, or anal contact with semen from HIV-infected individuals.
• Avoid unprotected anal intercourse, since it causes small abrasions in the rectal tissues, through which HIV in an infected partner's semen may be injected directly into the recipient's blood.
• Safer sex behaviors may reduce the risk of acquiring the infection. There is a slight risk of acquiring the infection even if "safe sex" is practiced with the use of condoms, due to the possibility of the condom breaking. Abstinence is the only sure way to prevent sexual transmission of the virus.