Symptoms

By Mayo Clinic staff The symptoms of HIV and AIDS vary, depending on the phase of infection. Primary infection The majority of people infected by HIV develop a flu-like illness within a month or two after the virus enters the body. This illness, known as primary or acute HIV infection, may last for a few weeks. Possible symptoms include: Fever Muscle soreness Rash Headache Sore throat Mouth or genital ulcers Swollen lymph glands, mainly on the neck Joint pain Night sweats Diarrhea Although the symptoms of primary HIV infection may be mild enough to go unnoticed, the amount of virus in the blood stream (viral load) is particularly high at this time. As a result, HIV infection spreads more efficiently during primary infection than during the next stage of infection. Clinical latent infection In some people, persistent swelling of lymph nodes occurs during clinical latent HIV. Otherwise, there are no specific signs and symptoms. HIV remains in the body, however, as free virus and in infected white blood cells. Clinical latent infection typically lasts eight to 10 years. A few people stay in this stage even longer, but others progress to more-severe disease much sooner.

Early symptomatic HIV infection As the virus continues to multiply and destroy immune cells, you may develop mild infections or chronic symptoms such as: Fever Fatigue Swollen lymph nodes often one of the first signs of HIV infection Diarrhea Weight loss Cough and shortness of breath Progression to AIDS If you receive no treatment for your HIV infection, the disease typically progresses to AIDS in about 10 years. By the time AIDS develops, your immune system has been severely damaged, making you susceptible to opportunistic infections diseases that wouldn't trouble a person with a healthy immune system. The signs and symptoms of some of these infections may include: Soaking night sweats Shaking chills or fever higher than 100 F (38 C) for several weeks Cough and shortness of breath Chronic diarrhea Persistent white spots or unusual lesions on your tongue or in your mouth Headaches Persistent, unexplained fatigue Blurred and distorted vision Weight loss Skin rashes or bumps When to see a doctor If you think you may have been infected with HIV or are at risk of contracting the virus, see a health care provider as soon as possible.

What are the neurological manifestations of AIDS? DESCRIPTION: Acquired immune deficiency syndrome (AIDS) is the result of an infection with the human immunodeficiency virus (HIV). This virus attacks selected cells of the immune, nervous, and other systems impairing their proper function. HIV infection may cause damage to the brain and spinal cord, causing encephalitis (inflammation of the brain), meningitis (inflammation of the membranes surrounding the brain), nerve damage, difficulties in thinking (i.e., AIDS dementia complex), behavioral changes, poor circulation, headache, and stroke. AIDS-related cancers such as lymphoma and opportunistic infections (OI) may also affect the nervous system. Neurological symptoms may be mild in the early stages of AIDS, but may become severe in the final stages. Complications vary widely from one patient to another. Cerebral toxoplasmosis, a common OI in AIDS patients, causes such symptoms as headache, confusion, lethargy, and low-grade fever. Other symptoms may include weakness, speech disturbance, ataxia, apraxia, seizures, and sensory loss. Progressive multifocal leukoencephalopathy (PML), a disorder that can also occur in AIDS patients, causes weakness, hemiparesis or facial weakness, dysphasia, vision loss, and ataxia. Some patients with PML may also develop compromised memory and cognition. Is there any treatment? TREATMENT: There is no cure for AIDS but recently developed, experimental treatments appear very promising. Some symptoms and complications may improve with treatment. For example, antidementia drugs may relieve confusion and slow mental decline. Infections may be treated with antibiotics. Radiation therapy may be needed to treat AIDS-related cancers present in the brain or spinal cord. What is the prognosis? PROGNOSIS: The prognosis for individuals with AIDS in recent years has improved significantly because of new drugs and treatments, and educational and preventive effor

Table 1: 1993 revised CDC classification Clinical categories CD4 cell categories A Asymptomatic or PGL or acute HIV infection B* Symptomatic (not A or not C) C** AIDS indicator condition 1/ >500/mm3 A1 B1 C1 2/ 200-499/mm3 A2 B2 C2 3/ <200/mm3 A3 B3 C3

Note: all patients in categories A3, B3, C1-3 are reported as AIDS, based on the AIDS indicator conditions and/or a CD4 cell count less than 200/mm3. * Category B: Symptomatic conditions not included in Category C that are a) attributed to HIV infection or indicative of a defect in cell-mediated immunity, or b) considered to have a clinical course or management complicated by HIV infection. Examples of B conditions include but are not limited to: - bacillary angiomatosis; - thrush; - _vulvovaginal candidiasis that is persistent, frequent or poorly responsive to therapy; - cervical dysplasia (moderate or severe); - cervical carcinoma in situ; - _constitutional symptoms such as fever (38.5C) or diarrhoea more than 1 month; - oral hair leukoplakia; - _Herpes zoster involving two episodes or more than 1 dermatome; - idiopathic thrombocytopenic purpura;

- listeriosis; - _pelvic inflammatory disease (especially if complicated by tuboovarian abscess); - peripheral neuropathy. **Category C: Indicator conditions in case definition of AIDS (adults) 1995 - oesophageal, tracheal, bronchi or lungs candidiasis; - invasive cervical cancer; - extrapulmonary coccidioido-mycosis; - extrapulmonary cryptococcosis; - Cryptosporidiosis with diarrhea more than 1 month; - _Cytomegalovirus of any organ other than liver, spleen or lymph nodes; - CMV retinitis (with vision loss) - _Herpes simplex with mucocutaneous ulcer more than 1 month or bronchitis, pneumonitis, oesophagitis; - extrapulmonary histoplasmosis - _HIV-associated demencia: disabling cognitive and/or other dysfunction interfering with occupation or activities of daily living; - _HIV-associated wasting : involuntary weight loss more than 10% of baseline plus chronic diarrhea (>=2 loose stools/day >=30 days) or chronic weakness and documented enigmatic fever; - Isosporis with diarrhea more than 1 month;

- Kaposi's sarcoma; - _Lymphoma, non-Hodgkins of B-cell or unknown immunologic phenotype and histology showing small, noncleaved lymphoma or immunoblastic sarcoma; - disseminated Mycobacterium avium infection; - disseminated or pulmonary Mycobacterium tuberculosis infection; - Nocardiosis; - Pneumocystis carinii pneumonia; - recurrent bacterial pneumonia (>=2 episodes in 12 months); - progressive multifocale leukoencephalopathy; - recurrent non typhi Salmonella septicaemia; - extraintestinal strongylodosis; - toxoplasmosis of internal organ; - Wasting syndrome due to HIV (

Opportunistic Infections
HIV doesn't kill anybody directly. Instead, it weakens the body's ability to fight disease. Infections which are rarely seen in those with with normal immune systems are deadly to those with HIV. People with HIV can get many infections (called opportunistic infections, or OIs). Many of these illnesses are very serious, and they need to be treated. Some can be prevented. This web page has information about opportunistic infections and some other disorders common with HIV Disease.

Bacterial and Mycobacterial

Mycobacterium Avium Complex (MAC, MAI) Salmonellosis Syphilis and Neuroshyphilis Turberculosis (TB) Bacillary angiomatosis (cat scratch disease)

Fungal Infections

Aspergillosis Candidiasis (thrush, yeast infection) Coccidioidomycosis Cryptococcal Meningitis Histoplasmosis

Malignancies

Kaposi's Sarcoma Lymphoma -o Systemic Non-Hodgkin's Lymphoma (NHL) o Primary CNS Lymphoma

Protozoal Infections

Cryptosporidiosis Isosporiasis Microsporidiosis Pneumocystis Carinii Pneumonia (PCP) Toxoplasmosis

Viral Infections

Cytomegalovirus (CMV) Hepatitis Herpes Simplex (HSV, genital herpes) Herpes Zoster (HZV, shingles) Human Papiloma Virus (HPV, genital warts, cervical cancer) Molluscum Contagiosum Oral Hairy Leukoplakia (OHL) Progressive Multifocal Leukoencephalopathy (PML)

Neurological Conditions

AIDS Dementia Complex (ADC) Peripheral Neuropathy

Other Conditions and Complications

Apthous Ulcers Malabsorption