No one is immune from diseases, everyone can become infected with some kind of illness, for example, HIV infection. Today, everyone knows about this very well-known disease, for which there are simply no drugs to treat. Today we will talk about this disease, find out the stages of HIV infection, symptoms and much more related to
What is HIV?
Today, this abbreviation is called a virus, which is the strongest causative agent of an infectious disease. The disease has more than one stage of development.
There are different stages of HIV, but the most recent form of the disease among them is AIDS (acquired immunodeficiency syndrome). A syndrome is a collection of several signs of a particular disease. Immunodeficiency is a serious damage to the body's immune system, which is why a person's immunity simply cannot resist most infections.
Immunity
Now let's talk about immunity. Immunity is a special function of our body that protects a person from infections transmitted by a variety of ways and means. The immune system constantly produces special molecules called antibodies that fight various pathogens in the body (antigens).
When viruses or bacteria enter the human body, the so-called immune response is activated, the main role in which is played by specific blood cells called lymphocytes. Lymphocytes are able to recognize various pathogens, as well as block their effect on the body, and then simply destroy viruses. Blood cells contribute to increased production of antibodies.
Do not forget, a little later we will talk in detail about what stages of HIV infection there are!
What is HIV?
HIV is a special group of so-called retroviruses, which are also referred to as lentiviruses (some professionals call such viruses slow, since the destructive effect on the body is far from instantaneous). The word "slow" suggests that the first symptoms of the disease may appear only after ten years. It is important to note that half of the carriers of HIV disease do not know that they are infected until 10 years after infection.
Immediately after an HIV infection somehow enters the blood of a healthy person, it attaches very slowly to the body's blood cells, which are responsible for immunity. Experts explain this by the fact that on the surface of such cells there are special molecules called
Some time after that, a slow multiplication of the HIV infection begins to take place right inside these small cells. Then the infection spreads on its own throughout human body, and only after that an immune response occurs. The very first hit is received by various lymph nodes, which contain a large number of cells of the immune system.
Development of HIV
For a long period of development of the disease, the body simply cannot respond to HIV infection. This is explained only by the fact that the immune cells of the body are severely damaged, which is why they cannot fully perform their functions. The result of that HIV stage has a diverse and very complex, most often characterized by a sharp variability, it is believed that the cells of the immune system simply cannot detect the virus, so that it can easily destroy the carrier's body.
HIV continues to progress: the disease affects a huge number of lymphocytes of immune cells, due to which their number decreases. When their number becomes critical, the last of all HIV stages comes - AIDS, which we will talk about today.
The stages of HIV in women and men are very different. The very first stage of HIV is the incubation period, and the very last is a terrible infectious disease that everyone has probably heard of - AIDS.
Ways of transmission of HIV infection
As you understand, HIV is a terrible infection, which is not so difficult to catch. Yes, HIV is not transmitted by airborne droplets, like, for example, a very common infectious disease - hepatitis A. Now we will talk in detail about how you can get HIV infection.
Sexual intercourse: use protection if you are not sure!
Sex is the most common way HIV is transmitted. A man's sperm contains a sufficient amount of infection, because the virus, according to experts, accumulates in spermatozoa, which, once in the girl's vagina, begin to spread in her body.
It is also worth noting that even more HIV-infected cells are located in the semen at a time when a man has some kind of inflammatory disease, such as urethritis or epididymitis. At this time, in the seminal fluid of a young man there is an incredible amount of inflammatory cells that contain the infection.
In addition, it becomes much easier if your partner has any other infectious diseases, which, most likely, will also be transmitted to you along with HIV, which you may not even know about. HIV can be in the penis of a man, and in the vagina and even the uterus of a girl.
It's important to know! During anal sex, the likelihood that HIV infection contained in semen enters the body through the rectum increases greatly. Even more than that, during anal intercourse, the risk of causing some kind of injury to the girl's rectum, in other words, direct contact with blood, incredibly increases.
Don't forget, today you will also learn about what is the acute stage of HIV and much more!
Blood transfusion
The world-famous procedure of transfusing blood from one person to another, it turns out, can also cause infection with a terrible infectious disease, which is known in the world as HIV infection.
Few people know that infection can easily hide in some components of the blood. If HIV-infected blood is transfused into a perfectly healthy person, infection will occur in about 90-99%.
The risk of infection disappears with the introduction of improved immunoglobulin, as well as various special “helpers” of it, which you can learn more about from your doctor.
Not so long ago, a special procedure was introduced in our country for those who want to be a donor - testing for the detection of HIV infection. Due to this introduction, the risk of getting the disease in this way has been significantly reduced.
It is important to know that in the event that the donor became infected quite recently and various antibodies have not yet formed in his body, most likely the person to whom the blood will be transfused will also become infected.
Since we are talking about blood, it is worth noting another common way of infection. Drug addicts always use old and used syringes, so most of these people are already carriers.
How does HIV develop? Symptoms in the early stages: fever, bad mood, low performance, and so on.
Mother is a child
It is not uncommon for HIV to be passed from mother to child. As you understand, this disease, widespread in our world, has a unique ability to penetrate through a special placenta in the body of a girl carrying a child. Because of this ability, infection of the child can occur either during childbirth or during pregnancy (carrying a child).
In European countries, the percentage probability that a child will be transmitted HIV is 13%, but in Africa, for example, it exceeds 45%. The magnitude of such a risk directly depends on the level at which the medicine of a particular country / state is located at the time of a woman's pregnancy. Moreover, doctors urge girls who are HIV carriers not to breastfeed their baby, as there is a decent chance that a baby can become HIV-infected when breastfeeding. Experts have proven that mother's breast milk contains molecules that can transmit the infection to the baby.
Infection in the hospital
Often there are situations when medical staff becomes infected from patients, or vice versa. The probability is 0.3%, and only if there is sexual contact between them or an accidental cut.
Of course, this can still happen, but it is very rare.
So we talked about the ways of transmitting such a serious disease. A little later we will talk about the acute stage of HIV infection. By the way, this form of HIV is not the most difficult, but it is still a serious disease that cannot be cured.
Now let's talk about the stages of HIV and their symptoms.
HIV incubation period
This is the time during which the very first clinical manifestations of HIV infection occur. The incubation period is the time between the initial infection and the first signs that you are infected. The duration of this period varies from 14 days to six months or more. When the virus is at this stage, special testing can easily determine it, but the main problem is that a person could already have time to infect other people. The next stages of HIV will be much more serious, and we will talk about them!
Acute infectious period of HIV
Experience shows that this stage most often passes without any symptoms, but it is still worth noting situations when HIV-infected patient common fever begins, stomatitis, sharp increase lymph nodes or spleen, pharyngitis, diarrhea or encephalitis. It can last 2-3 days or 1-2 months. At this stage HIV symptoms, as you can see, they are their own, they are listed a little higher. The disease is incurable, but it is best to visit a doctor! You must understand that if you have HIV, the symptoms in the early stages are almost no different from a number of other diseases, so if you notice something similar, contact a professional immediately.
disease development
At this stage, the disease may still not manifest itself, but HIV continues to multiply - the concentration of infected molecules in the blood increases significantly. During this period, the body is no longer able to resist. The latent stage lasts from 2-3 years, on average 6-7 years. However, there were cases when this period lasted more than 20 years! Symptoms of HIV in the early stages, photos of which, to put it mildly, sometimes even scare, are listed a little higher.
Secondary stage and AIDS
The concentration of the virus in the blood continues to increase rapidly. The patient has the main signs that he is sick. The immune system has already completely surrendered and is no longer able to protect the body from various viruses at all. The patient feels tired, has a high temperature and sweats profusely. During such a period, you just need to run to a doctor who will try to help. The last stages of HIV, the photos of which you probably saw, are frightening, because a person is already on the verge of life and death.
AIDS is considered the last stage of the infection. During this period, the number of cells that are still able to protect the body reaches zero. The immune system practically dies, a person becomes defenseless, any virus (even the weakest) can infect him. The body slowly dies, some organs cease to function. At this stage, a person can simply lie down and never get up again in his life. There may also be very real problems with breathing and the brain. Over time, the person dies. This stage lasts from 1 to 3 years.
See your doctor if you are diagnosed with HIV at an early stage, otherwise it may be too late later.
Try to visit doctors more often, so as not to find out in ten years that you once contracted HIV infection!
Infection with the human immunodeficiency virus is the starting point at the onset of the disease. After infection with the virus, a long journey begins in 5 stages. They are divided into active and passive, some of them last for weeks, while others may not be diagnosed by doctors for a long time. Let's consider these stages in more detail.
Are the stages of HIV infection always the same?
In 2001 V.I. Pokrovsky proposed the famous classification which includes 5 stages:- First manifestations.
- Latent.
- secondary diseases.
- Ultimate (AIDS).
As can be seen from the example, the progression of HIV infection directly depends on T-lymphocytes. The fewer of them, the faster the infection develops and more seriously affects the human body.
T-lymphocytes play a fundamental role in the body's immunity. They are the main lymphocytes that recognize cells with a foreign antigen and additionally perform the function of their instantaneous destruction.
The classification of the stages of HIV infection proposed by Pokrovsky very accurately describes any kind of virus. Considering that one HIV cell can create up to a billion copies of itself every 24 hours, and the ability to multiple mutations only complicates and, one thing remains unchanged: HIV infection absolutely always has exactly 5 stages. Each of them is the same in its structure and effect on the human body, regardless of the strain of the virus, its mutations and other features.
First 3 stages of HIV infection
First of all, we will consider only 3 stages of this disease, since they are quite close in terms of their effect on the human body as a whole, and they also have a low AR (limitation of life activity):Incubation stage
It reports from the moment of infection with the virus (actual or expected) and until the appearance of complications characteristic of HIV infection, or the production of antibodies in the body. Often, this stage lasts from 21 to 90 days.Depending on the speed of passing the first stage, we can assume the speed of development of all subsequent ones. This is not always an indication that HIV infection will spread quickly, but, nevertheless, the connection between these processes exists and is confirmed in medical practice.
stage of acute infection
During this process, various kinds of exacerbations, physiological changes, etc. begin to occur. This stage is divided into three forms:- 2-A, the complete absence of any;
- 2-B, acute infection (symptoms difficult to diagnose, very similar to those of other types of infection);
- 2-B, acute infection in the presence of secondary diseases (fever, pharyngitis, rash, diarrhea, weight loss, thrush, etc.).
Latent
The longest stage of HIV infection. Its duration in most cases ranges from 2-3 to 20+ years.During this stage, a gradual, but extremely long-term effect of the disease on the body is diagnosed. In particular, there is a decrease in the total number of CD4 lymphocytes in the blood. As for clinical manifestations, there is only one thing - an increase in lymph nodes (however, it may not be). When comparing the minimum and maximum duration of the stage, doctors distinguish 6-7 years. This is the statistical duration of the 3rd stage of the disease. After its completion, complications begin, which with great difficulty lend themselves to all kinds of treatment and inevitably lead to the gradual death of a person - these are the last stages of the disease.
4 and 5 stages of HIV infection
We divided the stages for a reason, because during the following changes in the patient's body, the most life-threatening processes begin. If the first 3 stages are the time in which or affects it and takes root, now the virus begins to destroy literally everything around it. And this process begins with the 4th stage.Let's consider the last stages in more detail.
Secondary diseases
During these processes, it is rapidly destroyed the immune system a person, and the infection develops many times faster, with corresponding consequences. The following diseases appear:- permanent (oral cavity, genitals,);
- leukoplakia of the tongue;
- candidiasis of the genital organs and in the mouth;
- rapid weight loss;
- inflammation of the respiratory tract;
- lesions of the peripheral nervous system;
- others, life-threatening and requiring immediate treatment of the disease.
On average, this stage lasts no more than two years.
AIDS
The dying stage of the disease is also called terminal. Its maximum possible duration does not exceed 3 years.The processes that occur during this stage of HIV infection do not make sense to describe. Due to the fact that their number, to put it mildly, is huge. It would be redundant to mention them all. However, from the features of this stage, it is necessary to highlight such consequences that are characteristic of each of the carriers of the disease:
- the emergence of opportunistic infections;
- lesions of internal organs and corresponding systems in the body are no longer treatable, even the most powerful drugs and any other types of therapy cannot influence the spread of the disease and help the dying;
- HAART (highly active antiretroviral therapy) has no effect.
HIV infection develops in stages. The direct effect of viruses on the immune system leads to damage to various organs and systems, the development of tumor and autoimmune processes. Without highly active antiretroviral therapy, the life expectancy of patients does not exceed 10 years. Application antiviral drugs helps to slow down the progression of HIV and the development of acquired immunodeficiency syndrome - AIDS.
Signs and symptoms of HIV in men and women on different stages diseases have their own color. They are varied and increase in severity. The clinical classification of HIV infection proposed in 1989 by V. I. Pokrovsky, which provides for all manifestations and stages of HIV from the moment of infection to the death of the patient, has become widespread in the Russian Federation and the CIS countries.
Rice. 1. Pokrovsky Valentin Ivanovich, Russian epidemiologist, professor, doctor of medical sciences, president of the Russian Academy of Medical Sciences, director of the Central Research Institute of Epidemiology of Rospotrebnadzor.
Incubation period of HIV infection
The incubation period of HIV infection is determined by the period from the moment of infection to clinical manifestations and / or the appearance of antibodies in the blood serum. HIV in the "inactive" state (the state of inactive replication) can be from 2 weeks to 3-5 years or more, while the general condition of the patient does not noticeably worsen, but antibodies to HIV antigens already appear in the blood serum. This stage is called the latent phase or the "carrier" period. Immunodeficiency viruses, when they enter the human body, begin to reproduce themselves immediately. But the clinical manifestations of the disease appear only when a weakened immune system ceases to properly protect the patient's body from infections.
It is impossible to say exactly how long HIV infection manifests itself. The duration of the incubation period is influenced by the route and nature of infection, the infectious dose, the age of the patient, his immune status, and many other factors. When transfusing infected blood, the latent period is shorter than when the infection is transmitted sexually.
The period from the moment of infection to the appearance of antibodies to HIV in the blood (seroconversion period, window period) ranges from 2 weeks to 1 year (up to 6 months in weakened people). During this period, the patient still lacks antibodies and, thinking that he is not infected with HIV, continues to infect others.
Examination of contact persons with HIV-infected patients allows diagnosing the disease at the “carrier” stage.
Rice. 2. Oral candidiasis and herpes sores are indicators of a malfunction of the immune system and may be early manifestations of HIV infection.
Signs and symptoms of HIV in men and women in stage IIA (acute febrile)
After the incubation period, the stage of primary manifestations of HIV infection develops. It is due to the direct interaction of the patient's body with the immunodeficiency virus and is divided into:
- IIA - acute febrile stage of HIV.
- IIB - asymptomatic stage of HIV.
- IIB - stage of persistent generalized lymphadenopathy.
The duration of the IIA (acute febrile) stage of HIV in men and women is from 2 to 4 weeks (usually 7 to 10 days). It is associated with a massive release of HIV into the systemic circulation and the spread of viruses throughout the body. Changes in the patient's body during this period are nonspecific and so diverse and multiple that it creates certain difficulties in diagnosing HIV infection by a doctor during this period. Despite this acute febrile phase passes on its own even without specific treatment and passes into the next stage of HIV - asymptomatic. Primary infection in some patients is asymptomatic, in other patients the most severe clinic of the disease quickly unfolds.
Mononucleosis-like syndrome in HIV
In 50 - 90% of cases of HIV patients in the early stages of the disease, men and women develop a mononucleosis-like syndrome (acute retroviral syndrome). This condition develops as a result of the active immune response of the patient to HIV infection.
Mononucleosis-like syndrome occurs with fever, pharyngitis, rash, headaches, muscle and joint pain, diarrhea and lymphadenopathy, the spleen and liver are enlarged. Less commonly, meningitis, encephalopathy, and neuropathy develop.
In some cases, acute retroviral syndrome has manifestations of some opportunistic infections that develop against the background of deep suppression of cellular and humoral immunities. There are cases of oral candidiasis and candidal esophagitis, pneumocystis pneumonia, cytomegalovirus colitis, tuberculosis and cerebral toxoplasmosis.
In men and women with mononucleosis-like syndrome, the progression of HIV infection and the transition to the stage of AIDS is faster, and an unfavorable outcome is noted in the next 2-3 years.
In the blood, there is a decrease in CD4-lymphocytes and platelets, an increase in the level of CD8-lymphocytes and transaminases. There is a high viral load. The process is completed within 1 to 6 weeks even without treatment. AT severe cases patients are hospitalized.
Rice. 3. Feeling tired, malaise, headache, muscle and joint pain, fever, diarrhea, severe night sweats are symptoms of HIV in the early stages.
Intoxication syndrome in HIV
In the acute febrile stage, 96% of patients have an increase in body temperature. The fever reaches 38 0 С and lasts 1-3 weeks and often. Half of all patients develop headache, muscle and joint pain, fatigue, malaise, severe night sweats.
Fever and malaise are the most common symptoms of HIV during the febrile period, and weight loss is the most specific.
Enlarged lymph nodes with HIV
74% of men and women have enlarged lymph nodes. For HIV infection in the febrile stage, a gradual increase in the beginning of the posterior cervical and occipital, then submandibular, supraclavicular, axillary, ulnar and inguinal lymph nodes is especially characteristic. They have a pasty consistency, reach 3 cm in diameter, are mobile, not soldered to the surrounding tissues. After 4 weeks, the lymph nodes take on normal sizes, but in some cases there is a transformation of the process into persistent generalized lymphadenopathy. An increase in lymph nodes in the acute stage occurs against the background of elevated body temperature, weakness, sweating, and fatigue.
Rice. 4. Enlarged lymph nodes are the first signs of HIV infection in men and women.
Rash in HIV
In 70% of cases, a rash appears in men and women in the early acute period of the disease. Erythematous rash (areas of reddening of different sizes) and maculopapular rash (areas of seals) are more often recorded. Features of the rash in HIV infection: the rash is abundant, often purple in color, symmetrical, localized on the trunk, its individual elements can also be located on the neck and face, does not peel off, does not bother the patient, is similar to rashes with measles, rubella, syphilis and. The rash disappears within 2 to 3 weeks.
Sometimes patients have small hemorrhages in the skin or mucous membranes up to 3 cm in diameter (ecchymosis), with minor injuries, hematomas may appear.
In the acute stage of HIV, a vesiculo-papular rash often appears, which is characteristic of a herpes infection and.
Rice. 5. A rash with HIV infection on the trunk is the first sign of the disease.
Rice. 6. Rash with HIV on the trunk and arms.
Neurological disorders in HIV
Neurological disorders in the acute stage of HIV are noted in 12% of cases. Lymphocytic meningitis, encephalopathy and myelopathy develop.
Rice. 7. A severe form of herpetic lesions of the mucous membrane of the lips, mouth and eyes is the first sign of HIV infection.
Gastrointestinal symptoms
In the acute period, every third man and woman develops diarrhea, nausea and vomiting are noted in 27% of cases, abdominal pain often appears, and body weight decreases.
Laboratory diagnosis of HIV in the acute febrile stage
Replication of viruses in the acute stage is most active, however, the number of CD4 + lymphocytes always remains more than 500 per 1 μl, and only with a sharp suppression of the immune system, the indicator drops to the level of development of opportunistic infections.
The CD4/CD8 ratio is less than 1. The higher the viral load, the more contagious the patient is during this period.
Antibodies to HIV and the maximum concentration of viruses in the stage of primary manifestations are found at the end of the acute febrile stage. In 96% of men and women, they appear by the end of the third month from the moment of infection, in the remaining patients - after 6 months. The analysis for the detection of antibodies to HIV in the acute febrile stage is repeated after a few weeks, since it is the timely administration of antiretroviral therapy during this period that is most beneficial for the patient.
Antibodies to HIV p24 proteins are detected, with the help of ELISA and immunoblot, antibodies produced by the patient's body are detected. Viral load (identification of virus RNA) is determined by PCR.
A high level of antibodies and low levels of viral load occur with an asymptomatic course of HIV infection in the acute period and indicate the control of the patient's immune system over the level of the number of viruses in the blood.
In a clinically pronounced period, the viral load is quite high, but with the advent of specific antibodies it falls, and the symptoms of HIV infection weaken and then disappear altogether even without treatment.
Rice. 8. Severe form of oral candidiasis (thrush) in an HIV patient.
How older age patient, the faster HIV infection progresses to the stage of AIDS.
Signs and symptoms of HIV in men and women in stage IIB (asymptomatic)
At the end of the acute stage of HIV infection, a certain balance is established in the patient's body, when the patient's immune system restrains the reproduction of viruses for many months (usually 1-2 months) and even years (up to 5-10 years). On average, the asymptomatic stage of HIV lasts 6 months. During this period, the patient feels satisfactorily and leads a normal life for him, but at the same time, is a source of HIV (asymptomatic virus carrier). Highly active antiretroviral therapy prolongs this stage for many decades, during which the patient leads a normal life. In addition, the likelihood of infection of others is significantly reduced.
The number of lymphocytes in the blood is within the normal range. The results of ELISA and immunoblotting studies are positive.
Signs and symptoms of HIV in men and women in stage IIB (persistent generalized lymphadenopathy)
Generalized lymphadenopathy is the only sign of HIV infection during this period. Lymph nodes appear in 2 or more, anatomically unrelated places (except for the inguinal regions), at least 1 cm in diameter, which persist for at least 3 months, provided there is no causative disease. The most frequently enlarged posterior cervical, cervical, supraclavicular, axillary and ulnar lymph nodes. Lymph nodes either increase or decrease, but they persist constantly, soft, painless, mobile. Generalized lymphadenopathy should be differentiated from bacterial infections (syphilis and brucellosis), viral infections (infectious mononucleosis and rubella), protozoal infections (toxoplasmosis), tumors (leukemia and lymphoma), and sarcoidosis.
The cause of skin lesions during this period is seborrhea, psoriasis, ichthyosis, eosinophilic folliculitis, common scabies.
The defeat of the oral mucosa in the form of leukoplakia indicates the progression of HIV infection. Skin and mucosal lesions are recorded.
The level of CD4-lymphocytes gradually decreases, but remains more than 500 in 1 μl, the total number of lymphocytes is above 50% of the age norm.
Patients during this period feel satisfactory. Labor and sexual activity in both men and women are preserved. The disease is discovered by chance during a medical examination.
The duration of this stage is from 6 months to 5 years. At the end of it, the development of asthenic syndrome is noted, the liver and spleen increase, body temperature rises. Patients are concerned about frequent SARS, otitis media, pneumonia and bronchitis. Frequent diarrhea leads to weight loss, fungal, viral and bacterial infections develop.
Rice. 9. The photo shows signs of HIV infection in women: recurrent herpes of the skin of the face (photo on the left) and mucous lips in a girl (photo on the right).
Rice. 10. Symptoms of HIV infection - leukoplakia of the tongue. The disease can undergo cancerous degeneration.
Rice. 11. Seborrheic dermatitis (left photo) and eosinophilic folliculitis (right photo) are manifestations of skin lesions in stage 2 HIV infection.
Stage of secondary diseases of HIV infection
Signs and symptoms of HIV infection in men and women in stage IIIA
Stage IIIA of HIV infection is a transitional period from persistent generalized lymphadenopathy to an AIDS-associated complex, which is a clinical manifestation of HIV-induced secondary immunodeficiency.
Rice. 12. The most severe shingles occurs in adults with severe suppression of the immune system, which is observed, including with AIDS.
Signs and symptoms of HIV infection in stage IIIB
This stage of HIV infection is characterized in men and women by pronounced symptoms of impaired cellular immunity, and according to clinical manifestations, there is nothing more than an AIDS-associated complex, when the patient develops infections and tumors that are not found in the AIDS stage.
- During this period, there is a decrease in the CD4/CD8 ratio and the blast transformation reaction rate, the level of CD4-lymphocytes is recorded in the range from 200 to 500 per 1 μl. In the general analysis of blood, leukopenia, anemia, thrombocytopenia increase, in the blood plasma there is an increase in circulating immune complexes.
- The clinical picture is characterized by prolonged (more than 1 month) fever, persistent diarrhea, profuse night sweats, pronounced symptoms of intoxication, weight loss of more than 10%. Lymphadenopathy becomes generalized. There are symptoms of damage to internal organs and the peripheral nervous system.
- Diseases such as viral (hepatitis C, widespread), fungal diseases (oral and vaginal candidiasis), persistent and long-term bacterial infections of the bronchi and lungs, protozoal lesions (without dissemination) of internal organs, in a localized form, are detected. Skin lesions are more common, severe, and longer in duration.
Rice. 13. Bacillary angiomatosis in HIV patients. The causative agent of the disease is a bacterium of the genus Bartonella.
Rice. 14. Signs of HIV in men in the later stages: damage to the rectum and soft tissues (photo on the left), genital warts (photo on the right).
Signs and symptoms of HIV infection in stage IIIB (stage AIDS)
IIIB stage of HIV infection represents a detailed picture of AIDS, characterized by deep suppression of the immune system and the development of opportunistic diseases that occur in severe form, threatening the life of the patient.
Rice. 15. Expanded picture of AIDS. In the photo, patients with neoplasms in the form of Kaposi's sarcoma (photo on the left) and lymphoma (photo on the right).
Rice. 16. Signs of HIV infection in women in the late stages of HIV. Pictured is invasive cervical cancer.
The more severe the symptoms of HIV in the early stages and the longer they appear in the patient, the faster AIDS develops. In some men and women, an erased (low-symptomatic) course of HIV infection is observed, which is a good prognostic sign.
Terminal stage of HIV infection
The transition to the terminal stage of AIDS in men and women occurs when the level of CD4-lymphocytes decreases to 50 and below in 1 µl. During this period, an uncontrolled course of the disease is noted and an unfavorable outcome is expected in the near future. The patient is exhausted, depressed and loses faith in recovery.
The lower the level of CD4-lymphocytes, the more severe the manifestations of infections and the shorter the duration of the terminal stage of HIV infection.
Signs and symptoms of HIV infection in the terminal stage of the disease
- The patient develops atypical mycobacteriosis, CMV (cytomegalovirus) retinitis, cryptococcal meningitis, widespread aspergillosis, disseminated histoplasmosis, coccidioidomycosis and bartonnellosis, leukoencephalitis progresses.
- Disease symptoms overlap. The patient's body is rapidly depleted. Due to constant fever, severe symptoms of intoxication and cachexia, the patient is constantly in bed. Diarrhea and loss of appetite leads to weight loss. dementia develops.
- Viremia increases, CD4-lymphocyte counts reach critically minimal values.
Rice. 17. Terminal stage of the disease. Complete loss of the patient's faith in recovery. In the photo on the left is an AIDS patient with severe somatic pathology, in the photo on the right is a patient with a common form of Kaposi's sarcoma.
HIV prognosis
The duration of HIV infection is on average 10-15 years. The development of the disease is influenced by the level of viral load and the number of CD4-lymphocytes in the blood at the beginning of treatment, the availability of medical care, the patient's adherence to treatment, etc.
Factors of progression of HIV infection:
- It is believed that with a decrease in the level of CD4-lymphocytes during the first year of the disease to 7%, the risk of the transition of HIV infection to the stage of AIDS increases by 35 times.
- The rapid progression of the disease is noted with the transfusion of infected blood.
- Development of drug resistance of antiviral drugs.
- The transition of HIV infection to the stage of AIDS is reduced in people of mature and old age.
- The combination of HIV infection with other viral diseases negatively affects the duration of the disease.
- Bad nutrition.
- genetic predisposition.
Factors that slow down the transition of HIV infection to the stage of AIDS:
- Timely initiation of highly active antiretroviral therapy (HAART). In the absence of HAART, the death of the patient occurs within 1 year from the date of diagnosis of AIDS. It is believed that in regions where HAART is available, the life expectancy of HIV-infected people reaches 20 years.
- No side effects on taking antiretroviral drugs.
- Adequate treatment of comorbidities.
- Sufficient food.
- Rejection of bad habits.
The human immunodeficiency virus belongs to the group of retroviruses that provokes the development of HIV infection. This disease can proceed in several stages, each of which differs in the clinical picture, the intensity of manifestations.
HIV stages
Stages of development of HIV infection:
- incubation period;
- primary manifestations - acute infection, asymptomatic and generalized lymphadenopathy;
- secondary manifestations - lesions of internal organs of a persistent nature, lesions of the skin and mucous membranes, diseases of a generalized type;
- terminal stage.
According to statistics, HIV infection is most often diagnosed at the stage of secondary manifestations and this is due to the fact that the symptoms of HIV become pronounced and begin to disturb the patient during this period of the course of the disease.
At the first stage of the development of HIV infection, certain symptoms may also be present, but they, as a rule, proceed in a mild form, the clinical picture is blurred, and the patients themselves do not turn to doctors for such “little things”. But there is one more nuance - even if the patient seeks qualified medical help at the first stage of the course of HIV infection, specialists may not diagnose the pathology. Moreover - at this stage of development of the disease in question, the symptoms will be the same in men and women - this is often confusing for physicians. And only at the secondary stage is it quite realistic to hear the diagnosis of HIV infection, and the symptoms will be individual for male and female.
How long does it take for HIV to show up?
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The first signs of HIV infection go unnoticed, but they are there. And appear on average in the period from 3 weeks to 3 months after infection. A longer period is also possible.
Signs of secondary manifestations of the disease in question can also appear only many years after infection with HIV infection, but manifestations can also occur as early as 4-6 months from the moment of infection.
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After a person has contracted HIV infection, no symptoms or even small hints of the development of any pathology are observed for a long time. Just this period is called the incubation period, it can last, in accordance with the classification of V.I. Pokrovsky, from 3 weeks to 3 months.
No examinations and laboratory tests of biomaterials (serological, immunological, hematological tests) will help to identify HIV infection, and the infected person himself does not look sick at all. But it is the incubation period, without any manifestations, that is of particular danger - a person serves as a source of infection.
Some time after infection, the patient enters the acute phase of the disease - the clinical picture during this period may be the reason for the diagnosis of HIV infection "in question".
The first manifestations of HIV infection in the acute phase of the course strongly resemble the symptoms of mononucleosis. They appear on average in the period from 3 weeks to 3 months from the moment of infection. These include:
When examining a patient, a doctor can determine a slight increase in the size of the spleen and liver - the patient, by the way, may complain of recurrent pain in the right hypochondrium. The skin of the patient may be covered with a small rash - pale pink spots that do not have clear boundaries. Often there are complaints from infected people about a long-term violation of the stool - they are tormented by diarrhea, which is not removed even by specific medications and a change in diet.
Please note: with such a course of the acute phase of HIV infection, lymphocytes / leukocytes in an increased number and atypical mononuclear cells will be detected in the blood.
The above signs of the acute phase of the disease in question can be observed in 30% of patients. Another 30-40% of patients live an acute phase in the development of serous meningitis or encephalitis - the symptoms will be radically different from those already described: nausea, vomiting, fever to critical levels, severe headache.
Often the first symptom of HIV infection is esophagitis, an inflammatory process in the esophagus, which is characterized by swallowing problems and chest pain.
In whatever form the acute phase of HIV infection proceeds, after 30-60 days all the symptoms disappear - often the patient thinks that he has completely recovered, especially if this period of the pathology was almost asymptomatic or their intensity was low (and this can also be ).
During the course of this stage of the disease in question, there are no symptoms - the patient feels great, does not consider it necessary to appear in a medical facility for a preventive examination. But it is at the stage of an asymptomatic course that antibodies to HIV can be detected in the blood! This makes it possible to diagnose pathology at one of the early stages of development and begin adequate, effective treatment.
The asymptomatic stage of HIV infection can last several years, but only if the patient's immune system has not undergone significant damage. The statistics are rather contradictory - only 30% of patients begin to develop symptoms within 5 years after an asymptomatic course of HIV infection. next stages, but in some infected, the asymptomatic stage of the course proceeds rapidly, lasting no more than 30 days.
This stage is characterized by an increase in almost all groups of lymph nodes, this process does not affect only the inguinal lymph nodes. It is noteworthy that it is generalized lymphadenopathy that can become the main symptom of HIV infection, if all previous stages of development of the disease in question proceeded without any manifestations.
Lymph nodes increase by 1-5 cm, remain mobile and painless, and the surface of the skin above them has absolutely no signs of a pathological process. But with such a pronounced symptom as an increase in groups of lymph nodes, the standard causes of this phenomenon are excluded. And here, too, there is a danger - some doctors classify lymphadenopathy as difficult to explain.
The stage of generalized lymphadenopathy lasts 3 months, about 2 months after the onset of the stage, the patient begins to lose weight.
Secondary manifestations
It often happens that it is the secondary manifestations of HIV infection that serve as the basis for a qualitative diagnosis. Secondary manifestations include:
The patient notes a sudden increase in body temperature, he develops a dry, obsessive cough, which eventually turns into a wet one. The patient develops intense dyspnea with minimal physical activity and the general condition of the patient is rapidly deteriorating. Therapy carried out with the use of antibacterial drugs (antibiotics) does not give a positive effect.
Generalized infection
These include herpes, tuberculosis, cytomegalovirus infection, candidiasis. Most often, these infections affect women and, against the background of the human immunodeficiency virus, they are extremely difficult.
Kaposi's sarcoma
This is a neoplasm / tumor that develops from the lymphatic vessels. It is more often diagnosed in men, has the appearance of multiple tumors of a characteristic cherry color, located on the head, trunk and in the oral cavity.
Damage to the central nervous system
At first, this is manifested only by minor problems with memory, a decrease in concentration. But in the course of the development of pathology, the patient develops dementia.
Features of the first signs of HIV infection in women
If infection with the human immunodeficiency virus occurred in a woman, then secondary symptoms will most likely manifest themselves in the form of development, progression of generalized infections - herpes, candidiasis, cytomegalovirus infection, tuberculosis.
Often, secondary manifestations of HIV infection begin with a banal menstrual cycle disorder, inflammatory processes in the pelvic organs, for example, salpingitis, can develop. Often diagnosed and cancer of the cervix - carcinoma or dysplasia.
Features of HIV infection in children
Children who were infected with the human immunodeficiency virus during pregnancy (intrauterine from the mother) have some features in the course of the disease. First, the disease begins its development at 4-6 months of age. Secondly, the earliest and main symptom of HIV infection during intrauterine infection is considered to be a disorder of the central nervous system - the baby lags behind his peers in physical and mental development. Thirdly, children with human immunodeficiency virus are prone to progression of digestive system disorders and the appearance of purulent diseases.
The human immunodeficiency virus is still an unexplored disease to the end - too many questions arise both in diagnosis and in treatment. But doctors say that only the patients themselves can detect HIV infection at an early stage - it is they who should carefully monitor their health and periodically undergo preventive examinations. Even if the symptoms of HIV infection are hidden, the disease develops - only a timely test analysis will help save the patient's life for several years.
Answers to popular questions about HIV
Due to the large number of requests from our readers, we decided to group the most common questions and answers to them in one section.
Signs of HIV infection appear approximately 3 weeks to 3 months after the hazardous exposure. An increase in temperature, sore throat and swollen lymph nodes in the first days after infection may indicate any pathology, except for the human immunodeficiency virus. During this period (doctors call it the incubation period), not only are there no symptoms of HIV, but deep laboratory blood tests will not give a positive result.
Yes, unfortunately, this is rare, but it happens (in about 30% of cases): none characteristic symptoms during the acute phase, a person does not notice, and then the disease passes into a latent phase (this is, in fact, an asymptomatic course for about 8 to 10 years).
Most modern screening tests are based on enzyme immunoassay (ELISA) - this is the "gold standard" of diagnosis, while an accurate result can be expected no earlier than 3 to 6 months after infection. Therefore, the analysis must be taken twice: 3 months after a possible infection and then another 3 months later.
First, you need to take into account the period that has passed since a potentially dangerous contact - if less than 3 weeks have passed, then these symptoms may also indicate a common cold.
Secondly, if more than 3 weeks have already passed after a possible infection, then you should not make yourself nervous - just wait and undergo a specific examination 3 months after the dangerous contact.
Thirdly, fever and swollen lymph nodes are not "classic" signs of HIV infection! Often, the first manifestations of the disease are expressed by pain in the chest and a burning sensation in the esophagus, a violation of the stool (a person is worried about frequent diarrhea), a pale pink rash on the skin.
The risk of contracting HIV infection through oral sex is minimized. The fact is that the virus does not survive in the environment, therefore, for it to be transmitted orally, two conditions must come together: there are wounds / abrasions on the partner's penis and wounds / abrasions in the partner's oral cavity. But even these circumstances do not in every case lead to infection with HIV infection. For your own peace of mind, you need to pass a specific HIV test 3 months after a dangerous contact and undergo a “control” examination after another 3 months.
There are a number medicines used for post-exposure prophylaxis of HIV. Unfortunately, they are not available for free sale, so you will have to go to an appointment with a therapist and explain the situation. There is no guarantee that such measures will 100% prevent the development of HIV infection, but experts say that taking such drugs is quite advisable - the risk of developing the human immunodeficiency virus is reduced by 70-75%.
If there is no opportunity (or courage) to see a doctor with a similar problem, then there is only one thing left - to wait. It will be necessary to wait 3 months, then undergo an HIV test, and even if the result is negative, it is worth taking a control test after another 3 months.
No! The human immunodeficiency virus does not survive in the environment, therefore, with people who are HIV-positive, you can without hesitation use common dishes, bed linen, visit the pool and bathhouse.
There are risks of infection, but they are quite small. So, with a single vaginal intercourse without a condom, the risk is 0.01 - 0.15%. With oral sex, the risks are from 0.005 to 0.01%, with anal sex - from 0.065 to 0.5%. Such statistics are provided in the clinical protocols for the WHO European Region of HIV/AIDS Treatment and Care (p. 523).
In medicine, cases are described when married couples, where one of the spouses was HIV-infected, lived sexually without using condoms for several years, and the second spouse remained healthy.
If a condom was used during sexual intercourse, it was used according to the instructions and remained intact, then the risk of becoming infected with HIV is minimized. If, after 3 or more months after a dubious contact, symptoms resembling an HIV infection appear, then you just need to contact a therapist. An increase in temperature, an increase in lymph nodes may indicate the development of SARS and other diseases. For your own peace of mind, you should take an HIV test.
To answer this question, you need to know at what time and how many times a similar analysis was given:
- a negative result in the first 3 months after a dangerous contact cannot be accurate, doctors talk about a false negative result;
- negative response of the HIV test after 3 months from the moment of dangerous contact - most likely the subject is not infected, but it is necessary to do another test 3 months after the first one for control;
- negative HIV test response 6 months or more after a dangerous contact - the subject is not infected.
The risks in this case are extremely small - the virus quickly dies in the environment, therefore, even if the blood of an infected person remains on the needle, it is almost impossible to become infected with HIV by injuring yourself with such a needle. Dried biological fluid (blood) cannot contain the virus. However, after 3 months, and then again - after another 3 months - it is still worth taking an HIV test.
Tsygankova Yana Alexandrovna, medical observer, therapist of the highest qualification category.
Oleksandr Vitvitskiy, Deputy Director of the Zaporozhye Regional Charitable Foundation “Gender Zed” answers questions about HIV infection
– Today, when they hear the word “HIV” or “AIDS”, many people think that this is a sentence. What is your opinion on this: is it possible to live with such a disease?
– Today, HIV infection is rather a chronic disease that can be controlled with proper treatment. Those. if a person has been found to have a human immunodeficiency virus, or rather antibodies to this virus (as a rule, they are found during the test), then he will need to pass a series of tests to assess the state of immunity. If medical indications suggest the appointment of treatment, then it must be started. Lifelong antiretroviral therapy helps to control and contain the development of HIV infection, while the person continues to lead a full life, with the exception of small restrictions.
– Explain the difference between HIV and AIDS. And which one is more dangerous?
– HIV is the human immunodeficiency virus that causes AIDS (acquired immunodeficiency syndrome). HIV can weaken the immune system to a point where the body begins to develop comorbidities that a healthy immune system can usually deal with.
AIDS is usually diagnosed after a certain time, at the last stage of the course of HIV infection, when a person develops one or more very serious diseases, most often if a person for some reason did not take antiretroviral drugs to maintain immunity and suppress the development of the disease. That is, HIV infection can lead to AIDS only in case of untreated or late diagnosis of the disease.
And if you speak correctly, then you can “get infected with HIV” or “get sick with HIV infection”, but you cannot “get AIDS” or “get AIDS”, because it is impossible to get sick immediately with the last stage of the disease.
Who can get HIV? It is said that it is people of non-traditional sexual orientation who are most often ill with HIV infection. Is it true?
– Anyone can become infected with HIV, regardless of affiliation to any social group. If earlier it was believed that HIV infection could only occur in homosexuals, commercial sex women or injecting drug users, now a fairly wide range of people are living with HIV and they did not necessarily lead a risky lifestyle in the past.
- And, nevertheless, a banal, but very painful question: is it possible to become infected with HIV infection in everyday life?
– There are four fluids that can contain a sufficient dose of HIV to infect: blood, semen, vaginal secretions, and breast milk. Based on this, HIV can be transmitted to a healthy person in the following cases:
- sexual contact, including oral, vaginal and anal sex;
– through blood, such as blood transfusion or sharing of needles and syringes;
- from mother to child, because pregnant women can transmit the virus to the fetus through their general blood circulation, or a nursing mother can transmit the virus to the baby through breast milk.
In everyday life, HIV is NOT transmitted in any way. Through hugging or kissing with an HIV-positive person, sharing dishes, bathroom, toilet, pool, towels,
It is absolutely impossible to get infected through mosquito bites. And also in saliva, tears, sweat and other fluids of the virus, there is so little virus that it is impossible to become infected with them.
– What are the first signs of the disease? What, first of all, should a person pay attention to?
– HIV-positive people may be asymptomatic for 10 years or more, but they can still transmit the infection to others during that time. The acute phase of HIV infection usually lasts from a couple of weeks to several months, sometimes with symptoms that are inherent in a normal ARVI, moving into a long asymptomatic stage.
There are no individual symptoms or manifestations that can be used to determine with certainty whether a person has HIV. Thus, only the result of an HIV test can reliably show the fact of the presence / absence of HIV infection in the body.
- How affordable are antiretroviral drugs for a Ukrainian patient?
– Today, any HIV-positive person in the Zaporozhye region who needs treatment receives antiretroviral therapy free of charge. To do this, you need to register with the Zaporozhye AIDS Center.
- How long can a person live if they become infected with HIV, but will be treated correctly?
- On the this moment it is difficult to make any predictions regarding life expectancy with HIV, since with proper treatment, regular medication, a person can live a very, very long time. In addition, new drugs are constantly emerging that have less side effects and higher efficiency.
How can you protect yourself from infection today?
– The first step to protection against HIV is to have information. The best way to protect against infection is to have knowledge of the routes of transmission.
At the beginning of a relationship, it is best to immediately establish that both partners are healthy by passing tests for HIV infection. In this case, it is important to remember the existence of a "window period" - the period of time from the moment of infection to the appearance of an organism's response to the penetration of the virus in the form of antibody production. During the window period, which lasts an average of 2-3 months, sometimes up to 6 months, it is still impossible to determine antibodies by any laboratory. Therefore, there is a clear recommendation to retake the test six months after the first test.
A condom should always be used during penetrative sex, as its correct use greatly reduces the risk of HIV transmission.
The risk of transmitting the virus from an infected mother to her child is reduced to almost zero if the mother takes antiviral drugs and receives the necessary information and counseling. An important factor is also special care during pregnancy and childbirth.
- Alexander, what events world day solidarity with HIV-positive people is your organization planning?
– By December 1, Zaporozhye Regional charitable foundation Gender Zed, together with the European AIDS Treatment Group, is planning a second "School of Tolerance" in Zaporozhye, a three-day training course for students of local universities.
During the School, participants will receive basic information about human rights, will have the opportunity to think about such topics as tolerance, sexuality, stereotypical views, HIV infection, etc. Special attention will be given to discrimination against minorities.
Based on materials newspaper "Your Doctor", journalist Daria Kotsilo.
