AIDS - Symptoms

A person who has been infected with HIV is likely to pass through three stages of the disease. Not all individuals experience all of the stages.

Acute Retroviral Syndrome

Acute retroviral syndrome is a term used to describe a group of symptoms that can resemble mononucleosis (pronounced MON-o-NOO-klee-O-siss; see infectious mononucleosis entry). Mononucleosis is a flu-like infection. Its symptoms include fever, fatigue, muscle aches, loss of appetite, upset stomach, weight loss, skin rash, headache, and swollen lymph nodes. These symptoms occur in 50 to 70 percent of all men who are HIV positive and in 45 to 90 percent of all women with the infection. The symptoms develop between one and six weeks after infection and last for two to three weeks.

Latency Period

After entering a person's lymph nodes, the virus becomes latent. Latency means that the virus is still present in the body, but that there are no signs of infection. Therefore, a person may appear to be perfectly healthy even though blood tests show that the virus is present.

HIV infection has an unusually long latency period. It may last for ten years or more. During this period, the virus continues to reproduce itself in the lymph nodes. As a result, certain abnormal conditions and symptoms may develop. These include the following:

• Persistent Generalized Lymphadenopathy (PGL). As HIV continues to reproduce, it can cause swelling of the lymph nodes known as persistent generalized lymphadenopathy (pronounced lim-fad-uhn-AP-uh-thee). The nodes become larger, but are usually not sore or painful. The lymph nodes most commonly affected are those in the neck, jaw, groin, and armpits. PGL affects between 50 to 70 percent of all patients during latency.
• Constitutional Symptoms. Many patients will develop low-grade fevers, fatigue, and general weakness. The virus may also cause a loss of appetite, a decrease in the body's ability to absorb food, and an increased rate of metabolism, the process by which the body converts food to energy. These changes result in a condition called wasting in which a person continually loses weight and energy.
• Other Symptoms. At any time during the course of HIV infection, the virus may cause problems with organs and tissues throughout the body. A common problem is a yeast infection in the mouth known as thrush. Ulcers and open sores can also develop in the mouth. The virus can also damage the digestive system. Patients may develop diarrhea or malnutrition as a result. The virus can also destroy cells in the lungs, kidneys, and nervous system. Damage to the nervous system leads to a general loss of strength, loss of reflexes, and feelings of numbness or burning sensations in the feet or lower legs.

Late-stage AIDS

Late-stage AIDS is the period of HIV infection when the virus has become very active and has started to cause massive damage to the immune system. One sign of late-stage AIDS is a sharp decrease in the number of white blood cells known as CD4 lymphocytes. The patient also begins to have more frequent and more serious medical problems, such as infectious diseases and cancers (see cancer entry). The infections that occur are called opportunistic infections. That term means that foreign bodies, such as bacteria, have taken advantage of the bodies weakened immune systems.

CD4 cell counts are an important indication of the course of the HIV infection. Doctors use these counts to determine how far the disease has developed and what treatments to use. About 10 percent of those individuals infected with HIV never reach this final stage of disease. Researchers do not know why these individuals are more resistant to the virus than others who do develop late-stage AIDS.

AIDS dementia (pronounced dih-MEN-sha) complex usually occurs late in the progress of AIDS. It is marked by loss of reasoning ability, loss of memory, inability to concentrate, listlessness, and unsteadiness in walking. Scientists do not understand how HIV causes AIDS dementia. There are no treatments for the condition.

Patients in late-stage AIDS may develop inflammation of the muscles, especially in the hip area. They may experience pain in their joints similar to those that occur with arthritis (see arthritis entry). Thrush and ulcers (open sores) in the mouth continue to occur during the late stages of AIDS. Another common condition of this stage is hairy leukoplakia (pronounced looko-PLA-kee-uh) of the tongue. Hairy leukoplakia is characterized by a white area on the tongue that may be flat or slightly raised.

Patients with late-stage AIDS may develop a form of cancer known as Kaposi's (pronounced kuh-PO-seez) sarcoma (KS). KS is a form of skin cancer characterized by reddish-purple blotches or patches. The disease may also occur in the digestive tract or lungs. KS is one of the most common causes of death in AIDS patients.