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What are the symptoms of HIV?

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CLINICAL FEATURES: By clinical features, I mean how does an individual know that he or she has contracted the HIV virus after exposure? Obviously, most people are not aware that they have been exposed to the virus when they become infected.{{more}} Most believe that their sexual partners are not infected, or are low risk for the infection. The problem with the HIV virus is that it is a virus and, as such, produces nonspecific viral symptoms. As many as 10 -20% of patients will have no symptoms; by this we mean that they will not even have an idea that they have caught the virus, based on how they feel. The other 80-90% will have classic or common features. Classic features are the feeling or features that were documented long ago, when the virus was first discovered. Not all persons have the classic features, as different persons will experience different things. Common features are the feelings that most people experience.

Common feelings occur about 2-4 weeks after exposure, when the virus has already lodged itself into the immune cells (CD4+ T-helper cells and macrophages). The virus then begins to produce more viral particles and to make itself known (before which it is ‘hiding’ in these cells). The brother to these immune cells, the killer CD8+ cells then destroy these infected immune cells, releasing massive amounts of these viral particles in the blood stream, causing a “viremia”. Patients with a viremia experience the common viral “flu like” illness, like joint and muscle aches and pains, headaches, fever, disorientation, sore throat, nausea and vomiting, skin rash and swollen glans. These are the common symptoms that, unfortunately, are all too common and can be diagnosed as the common flu and hence missed. This is the reason why doctors should enquire of the sexual history of their patients! Unfortunately, too many people, especially men, think that their sexual history is “their business”. Besides, these “feelings” do not occur until 2-3 weeks after the exposure.

The classic feelings are like the common ones, except that they also include swollen liver and spleen, weight loss and a fungal sore throat (thrush). Most persons who experience these other classic symptoms will not know, because all they will have is just some “belly pain” or a bad sore throat. The weight loss is more common during the chronic or late (AIDS) stage of the disease. The above feelings occur during the acute or early stage of the infection, just after the person has caught the virus. The other symptoms that the person has depend on whether he is diagnosed at this stage or not. If he is not diagnosed (the common scenario), then he or she progresses to chronic features. The difference between these acute viral symptoms and the HIV viremia is duration. A “flu” normally lasts 5-7 days not 2-6 weeks. So, the duration should alert the doctor that something else is taking place.

Chronic or long-term features of HIV infection include mainly persistently swollen glands and weight loss. This is the stage at which most patients present, as they usually have “weight loss”. If the patient is given treatment at this stage, they can get better; if not, they may progress over weeks to months to the AIDS complex. Patients who get diagnosed early and are treated then do much better in terms of survival and complications, compared to patients who are diagnosed and treated during the chronic or AIDS stage. The acute symptoms can last for up to 6 weeks, but may resolve in as early as 2 weeks, while the chronic symptoms or feelings may last from months to years before progressing to AIDS. Next week, we will discuss the symptoms of AIDS.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com

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