HIV & AIDS

Stage, Symptoms, Window

Period
• Time from initial infection with HIV until antibodies
are detected by a single test
• Usually 3-8 weeks before antibodies are detected
• May test false-negative for HIV antibodies during
this time period
• Can still pass the virus to others during this period
 What
Does the HIV Test Mean?
Positive Negative
+ -
• HIV antibodies • No HIV antibodies
present detected
• May not be infected
• Infected and can
(consider the
infect others window period)
• Need to begin • Consider retesting
treatment
 Stage 1-HIV (Primary)
• Mononucleosis-like, cold or flu-like symptoms
may occur 6 to 12 weeks after infection.
– lymphadenopathy
– fever
– rash
– headache
– Fatigue
– diarrhea
– sore throat
– neurologic manifestations.
– no symptoms may be present
 Primary HIV Syndrome
• Symptoms are relatively nonspecific.
• HIV antibody test often negative but becomes
positive within 3 to 6 months, this process is
known as seroconversion.
• Large amount of HIV in the peripheral blood.
• Primary HIV can be diagnosed using viral load
titer assay or other tests.
• Primary HIV syndrome resolves itself and HIV
infected person remains asymptomatic for a
prolonged period of time, often years.
 Stage 2-HIV (Asymptomatic)
• Lasts for an average of ten years
• This stage is free from symptoms
• There may be swollen glands
• The level of HIV in the blood drops to low
levels
• HIV antibodies are detectable in the bloo
 Stage 3-HIV (Symptomatic)
• By the third stage of HIV infection there has been a lot of damage to
immune system, serious infections or bacterial and fungal diseases . These
infections are referred to as ‘opportunistic infections’.

• Symptoms that you may have during this time can include:
-weight loss
-chronic diarrhoea
-night sweats
-a fever
-a persistent cough
-mouth and skin problems
-regular infections
-serious illnesses or disease
 Other Opportunistic Infections
• Respiratory system
– Pneumocystis Carinii Pneumonia (PCP)
– Tuberculosis (TB)
– Kaposi's Sarcoma (KS)
• Gastro-intestinal system
– Cryptosporidiosis
– Candida
– Cytomegolavirus (CMV)
– Isosporiasis
– Kaposi's Sarcoma
• Central/peripheral Nervous system
– Cytomegolavirus
– Toxoplasmosis
– Cryptococcosis
– Non Hodgkin's lymphoma
– Varicella Zoster
– Herpes simplex
• Skin
– Herpes simple
– Kaposi's sarcoma
– Varicella Zoster
Oral Candidiasis (thrush)
 Oral Hairy Leukoplakia

• Being that HIV reduces immunologic activity, the

intraoral environment is a prime target for chronic
secondary infections and inflammatory processes,
including OHL, which is due to the Epstein-Barr virus
under immunosuppressed conditions
 Kaposi’s sarcoma (KS)
• Kaposi’s sarcoma
(shown) is a rare cancer
of the blood vessels that
is associated with HIV. It
manifests as bluish-red
oval-shaped patches that
may eventually become
thickened. Lesions may
appear singly or in
clusters.
 Stage 4-HIV (AIDS)

The immune system

weakens too much
as CD4 cells decrease in
number
 AIDS
• CD4 count drops below 200 person is considered to
have advanced HIV disease
• If preventative medications not started the HIV infected
person is now at risk for:
– Pneumocystis carinii pneumonia (PCP)
– cryptococcal meningitis
– toxoplasmosis
• If CD4 count drops below 50:
– Mycobacterium avium
– Cytomegalovirus infections
– lymphoma
– dementia
– Most deaths occur with CD4 counts below 50.
 Other Opportunistic Infections
• Respiratory system
– Pneumocystis Carinii Pneumonia (PCP)
– Tuberculosis (TB)
– Kaposi's Sarcoma (KS)
• Gastro-intestinal system
– Cryptosporidiosis
– Candida
– Cytomegolavirus (CMV)
– Isosporiasis
– Kaposi's Sarcoma
• Central/peripheral Nervous system
– Cytomegolavirus
– Toxoplasmosis
– Cryptococcosis
– Non Hodgkin's lymphoma
– Varicella Zoster
– Herpes simplex
• Skin
– Herpes simple
– Kaposi's sarcoma
– Varicella Zoster
 Infants with HIV
• Failure to thrive
• Persistent oral candidiasis
• Hepatosplenomegaly
• Lymphadenopathy
• Recurrent diarrhea
• Recurrent bacterial infections
• Abnormal neurologic findings.