The stages of HIV and AIDS

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    Des Squire

    Physical needs of a person living with HIV/AIDS
    It is important to note that many people who are diagnosed HIV positive are living longer now than in years gone by. HIV is not an immediate death sentence, and lots can be done to live a happy and healthy life for a number of years.

    A positive diagnosis requires a positive attitude, and there is a lot of support available to help deal with physical and emotional needs and stresses.

    Testing positively or being diagnosed with HIV/AIDS, will lead to feelings of guilty, fear, shock, and anger. These feelings are normal and to be expected.

    You might well be asked for such assistance. Should this occur it is important to remember that confidentiality is expected and required by law!

    The stages of HIV
    It is important to know how someone progresses from being infected with HIV, to being ill and eventually dying. The process can be described in six stages

    Stage 1: Primary or first indications of HIV infection

    This stage comprises the first 4-8 weeks after acquiring the HIV-infection, until the body’s initial immune response develops enough antibodies to reduce the amount of HIV in the body.

    During this period, people are very infectious. It will take some weeks, even months, before the body produces enough “antibodies” (cells which fight the HI virus) to reduce the amount of HIV in the body.

    Some people may develop a flu-like illness, called “seroconversion illness”. Sero-conversion illness may present as follows:
    • Fever, headache, malaise (general feeling of illness)
    • Enlarged lymph nodes (glands of the immune system in the neck and groin)
    • Skin rash
    • Painful muscles and joints
    • Sore throat

    These symptoms usually disappear quite quickly are often mistaken for a cold or flu.

    Stage 2: A-symptomatic or silent phase

    An HIV positive person then enters an a-symptomatic stage during which time he or she remains clinically healthy. This stage can last anything from three years to seven years – sometimes up to 10 years. Although the infection is silent, the virus is continuing its onslaught on the immune system, which is slowly deteriorating.

    Stage 3: Minor symptomatic phase

    As the CD4 cell count gets lower and lower, a variety of minor complications begin to surface because of the weakened immune system. One of the first symptoms experienced by many people infected with HIV is the lymph glands remain enlarged for more than three months.

    Other symptoms often experienced months to years before the onset of AIDS include

    • A lack of energy
    • Weight loss
    • Frequent fevers and sweats
    • Persistent or frequent yeast/thrush infections (oral or vaginal)
    • Persistent skin rashes, dry and itchy skin
    • Pelvic inflammatory disease that does not respond to treatment
    • Short-term memory loss
    • Children may have delayed development or “failure to thrive”
    • Fungal nail infections
    • Recurrent mouth ulcers
    • Recurrent throat infections
    • Shingles

    Stage 4: Symptomatic HIV-disease

    5-8 Years after infection, the immune system finds it more difficult to keep up its defence against the HI-virus so the viral load progressively increases as the CD4 cell count decreases.

    Symptoms are now more severe and may include

    • Recurrent oral and vaginal thrush (Candida)
    • Recurrent Herpes simplex infections (Fever blisters/cold sores)
    • Herpes Zoster infections (Shingles)
    • Hairy fungal growth of the tongue (Hairy leukoplakia)
    • Chronic bacterial skin infections and other skin rashes
    • Chronic diarrhoea and weight loss
    • Swollen lymph glands or shrinking of previously swollen glands
    • Persistent and unexplained fevers and night sweats
    • Reactivation of TB

    Stage 5: Full-blown AIDS

    The infected person now becomes vulnerable to serious opportunistic infections and some cancers. It is at this stage that the person moves from being merely HIV positive to having full-blown AIDS.

    A person with full-blown AIDS, may present with or have symptoms of any of the following

    • A variety of skin rashes and infections
    • Persistent coughing and chest pains from pneumonia and TB
    • Severe vaginal and oral thrush, often extending down the oesophagus, causing pain on swallowing
    • Chronic diarrhoea, nausea and vomiting
    • Headaches and convulsions due to brain infections
    • Poor concentration and memory loss
    • Marked weight loss, tiredness and weakness
    • Skin cancers
    • Enlarged lymph glands, spleen and liver due to lymphoma
    • Blindness due to retinitis
    Stage 6: Terminal stage

    People living with AIDS typically go through periods of being very sick with severe disease, alternating with periods of reasonable health. Death usually occurs within 6 months to 3 years, after developing AIDS.

    You may have heard it said that a person “died of AIDS”. This is not strictly true, as it is usually one of the opportunistic infections that eventually cause death.

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