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Latent infection of HIV

Then everything settles down. The person now has a positive test, and feels completely well - no symptoms at all. The virus often seems to disappear completely from the blood again. However, during this latent phase, HIV can be found in large quantities in lymph nodes, spleen, adenoid glands and tonsils. We do not know how many people will go on to the next stage. As we saw in an earlier chapter, at first doctors thought it might only be one in ten, then two or three out of ten. Now it looks as though at least nine out of ten will develop further problems.

San Francisco studies show that in developed countries, without use of the latest therapies, 50% with HIV develop AIDS in ten years, 70% in fourteen years. Of those with AIDS, 94% are dead in five years. The rate of progression can be much faster in those with weakened immunity from other causes---drug users or those in developing countries, for example.  It can be far slower in those on various treatments.

Most scientists and doctors are convinced that if we follow up infected people for long enough---maybe for twenty to thirty years or more if they are getting good treatment---then all or nearly all will die of AIDS, unless they have died of something else in the meantime such as a heart attack or cancer. How long can someone live before some infection triggers production of more virus and death of more white cells?

The next stage begins when the immune system starts to break down. This is often preceded by subtle mutations in the virus, during which it becomes more aggressive in damaging white cells. New HIV symptoms develop. Several glands in the neck and armpits may swell and remain swollen for more than three months without any explanation. This is known as persistent generalised lymphadenopathy (PGL).