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AIDS

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Alternative Names:

Acquired immune deficiency syndrome

Symptoms:

The symptoms of AIDS are primarily the result of infections that do not normally develop in individuals with healthy immune systems. These are called opportunistic infections.

Patients with AIDS have had their immune system depleted by HIV and are very susceptible to such opportunistic infections. Common symptoms are fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss.

See the signs and tests section below for a list of common opportunistic infections and major symptoms associated with them.

Note: Initial infection with HIV can produce no symptoms. Most people, however, do experience flu-like symptoms with fever, rash, sore throat, and swollen lymph nodes, usually two weeks after contracting the virus. Some people with HIV infection remain without symptoms for years between the time of exposure and development of AIDS.

Signs and tests:

The following is a list of AIDS-related infections and cancers that people with AIDS acquire as their CD4 count decreases. Previously, having AIDS was defined as having HIV infection and getting one of these additional diseases. Now it is additionally defined as a CD4 count below 200, even without an opportunistic infection. Many other illnesses and corresponding symptoms may develop in addition to those listed here.

Common with CD4 count below 350 cells/ml:

• Herpes simplex virus -- causes ulcers/vesicles in the mouth or genitals, occurring more frequently and more severely in an HIV-infected patient than before HIV infection
• Tuberculosis -- infection by the tuberculosis bacteria that predominately affects the lungs, but can affect other organs such as the bowel, lining of the heart or lungs, brain, or lining of the central nervous system
• Oral or vaginal thrush -- yeast infection of the mouth or genitals
• Herpes zoster (Shingles) -- ulcers/vesicles over a discrete patch of skin caused by the varicella zoster virus
• Non-Hodgkin's lymphoma -- cancer of the lymph glands
• Kaposi's sarcoma -- Cancer of the skin, lungs, and bowel, associated with a herpes virus (HHV-8). Can occur at any CD4 count, but more likely at lower CD4 counts, and more common in men than women

CD4 count below 200 cells/ml

• Pneumocystis carinii pneumonia, "PCP pneumonia," now called Pneumocystic jiroveci pneumonia
• Candida esophagitis -- painful yeast infection of the esophagus
• Bacillary angiomatosis -- Skin lesions caused by a bacteria called Bartonella, which is usually acquired from cat scratches

CD4 count below 100 cells/ml

• Cryptococcal meningitis -- infection of the lining of the brain by a yeast
• AIDS dementia -- worsening and slowing of mental function, caused by HIV itself
• Toxoplasmosis encephalitis -- infection of the brain by a parasite, which is frequently found in cat feces; causes discrete lesions in the brain
• Progressive multifocal leukoencephalopathy -- a viral disease of the brain caused by a virus (called the JC virus) that results in a severe decline in cognitive and motor functions
• Wasting syndrome -- extreme weight loss and loss of appetite, caused by HIV
• Cryptosporidium diarrhea -- Extreme diarrhea caused by one of several related parasites

CD4 count below 50/ml

• Mycobacterium avium -- a blood infection by a bacterium related to tuberculosis
• Cytomegalovirus infection -- a viral infection that can affect almost any organ system, especially the large bowel and the eyes

In addition to the CD4 count, HIV RNA load, and basic screening lab tests, regular vaginal Pap smears are important to monitor in HIV infection, due to the increased risk of cervical cancer in immunocompromised patients. . Anal Pap smears to detect potential cancers may also be important in both HIV infected men and women.

• Review Date: 5/26/2006
• Reviewed By: Monica Gandhi MD, MPH, Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.

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