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Early symptomatic HIV infection





Definition:

Early symptomatic HIV infection is the stage of viral infection caused by HIV (human immunodeficiency virus) when symptoms have begun but before the development of AIDS (which involves life-threatening infections).


Alternative Names: AIDS-related complex - ARC; Chronic symptomatic HIV infection

Causes, incidence, and risk factors:

Early symptomatic HIV infection is characterized by signs and symptoms typical of HIV infection but not full-blown AIDS. These symptoms are usually not present in asymptomatic HIV infection .

The onset of symptoms signals the transition from HIV infection to HIV disease. However, at this stage of HIV infection, the person does not have AIDS symptoms such as opportunistic infections and/or certain cancers or a CD4 count of less than 200.

Risk factors for HIV infection are sexual contact with an infected sexual partner that includes exchange of semen or vaginal secretions, intravenous drug use, receipt of blood transfusion or blood components, or being born to an HIV-positive mother.




Symptoms:

mouth disorders
- oral hairy leukoplakia of tongue, caused by a viral infection
- oral thrush (a yeast infection of the mouth)
- gingivitis
prolonged diarrhea
skin disorders
- seborrheic dermatitis
- molluscum contagiosum
- chronic dermatophyte infection (fungal infection of the skin or nails)
swollen lymph glands
sweating, excessive -- night sweats
bacterial pneumonia
prolonged fever
prolonged fatigue
malaise (vague feeling of discomfort)
weight loss
joint pain
peripheral neuropathy
pap smear that shows cervical dysplasia
recurrent herpes zoster -- herpes infection that occurs over a very small patch of skin
a rare disease called ITP (idiopathic thrombocytopenic purpura) -- where the number of platelets in the bloodstream is very low



Signs and tests:

HIV ELISA/Western blot positive for HIV antibodies

Lab tests that indicate immune system suppression include:

CD4 lymphocyte count decreased
CBC , WBC less than 4,000
platelet count less than 100,000
skin test anergy -- no response to special skin tests used to test for infection or immune function



Treatment:

Many of the symptoms of early symptomatic HIV infection can be successfully treated with medications. More important, the treatment of the HIV infection can prevent the onset of many of these conditions.

Antiviral therapy suppresses the replication of the HIV infection in the body. A combination of several antiretroviral agents, termed Highly Active Anti-Retroviral Therapy (HAART) has been highly effective in reducing the number of HIV particles in the blood stream, and as a result, increasing the CD4 count.

Although people on HAART have suppressed levels of HIV, they can still transmit the virus to others through sex or needle sharing. HAART is not a cure for HIV, but the treatment slows disease progression and may strengthen the immune system (immune reconstitution).