Chronic symptomatic HIV infection

Alternative names
AIDS-related complex - ARC; Early symptomatic HIV infection

Definition
Early symptomatic HIV infection is the stage of viral infection caused by HIV (human immunodeficiency virus) where symptoms have begun to manifest, but before the development of AIDS (which involves life-threatening infections).

Causes, incidence, and risk factors

Early symptomatic HIV infection is characterized by signs and symptoms typical of HIV infection that are not AIDS-defining. These symptoms are usually not present in asymptomatic HIV infection.

The onset of symptoms signals the transition from HIV infection to HIV disease. However, at this stage of HIV infection, the person does not have AIDS-defining diseases of immune deficiency, such as opportunistic infections and/or certain cancers or a CD4 count of less than 200.

Risk factors for HIV infection are sexual contact with an infected sexual partner that includes exchange of semen or vaginal secretions, intravenous drug use, receipt of blood transfusion or blood components, or being born to an HIV-positive mother.

Symptoms

     
  • mouth disorders       o hairy leukoplakia of tongue       o oral thrush (a yeast infection of the mouth)       o gingivitis  
  • prolonged diarrhea  
  • skin disorders       o seborrheic dermatitis       o molluscum contagiosum       o dermatophyte infection (fungal infection of the skin or nails)  
  • swollen lymph glands  
  • sweating, excessive - night sweats  
  • bacterial pneumonia  
  • prolonged fever  
  • prolonged fatigue  
  • malaise (vague feeling of discomfort)  
  • weight loss  
  • joint pain  
  • peripheral neuropathy  
  • pap smear that shows Cervical dysplasia  
  • recurrent herpes zoster - herpes that occurs over a very discrete patch of skin  
  • a rare disease called ITP (idiopathic thrombocytopenic purpura) - where your platelets are destroyed

Signs and tests

     
  • HIV ELISA/Western blot positive for HIV antibodies

Lab tests that indicate immune system suppression include:

     
  • CD4 lymphocyte count decreased  
  • CBC, WBC less than 4,000  
  • platelet count less than 100,000  
  • skin test anergy - no response to special skin tests used to test for infection or immune function

Treatment

Many of the symptoms of early symptomatic HIV infection can be successfully treated with medications. More important, the treatment of the HIV infection can prevent the onset of many of these conditions.

Antiviral therapy suppresses the replication of the HIV infection in the body. A combination of several antiretroviral agents, termed Highly Active Anti-Retroviral Therapy (HAART) has been highly effective in reducing the number of HIV particles in the blood stream, and as a result, increasing the CD4 count.

Although people on HAART have suppressed levels of HIV, they can still transmit the virus to others through sex or needle sharing. HAART is not a cure for HIV, but the treatment slows disease progression and may strengthen the immune system (immune reconstitution).

Support Groups
For additional information and resources, see AIDS support group.

Expectations (prognosis)
There is no cure for HIV infection or AIDS. However, anti-retroviral therapy and HAART can dramatically improve the length and quality of life for people infected with HIV, and can delay the onset of AIDS. The treatments for conditions associated with early symptomatic HIV disease are variably effective, with some infections and disease processes being more readily treatable with medications.

Complications
Advanced HIV disease (AIDS), characterized by the development of opportunistic infections and malignancies (cancers), may develop.

Calling your health care provider
Call for an appointment with your health care provider if symptoms of chronic symptomatic HIV infection are present.

Call for an appointment with your health care provider if you have chronic symptomatic HIV infection and develop new symptoms.

Prevention
Safer sex behaviors may reduce the risk of acquiring the infection. There is a risk of acquiring the infection even if “safe sex” is practiced with the use of condoms. Abstinence is the only sure way to prevent sexual transmission of the virus.

Do not have sexual intercourse with:

     
  • people known or suspected to be infected with AIDS  
  • numerous partners  
  • people who have multiple partners  
  • people who use IV drugs

Do not use intravenous drugs. If IV drugs are used, do not share needles or syringes.

People with AIDS or who have had positive antibody tests may pass the disease on to others and should not donate blood, plasma, body organs, or sperm. They should not exchange body fluids during sexual activity.

Frequently Asked Questions:

Q: How long does it take for HIV to cause AIDS?

A: About half the people with HIV develop AIDS within 10 years after becoming infected. This time varies greatly from person to person and can depend on many factors. Today, medical treatments can slow the rate at which HIV weakens the immune system, thus preventing the onset of AIDS.

Q: How can I tell if I am infected with HIV?

A: The only way to determine for sure whether you are infected is to be tested for HIV infection. You cannot rely on symptoms to know whether or not you are infected with HIV. Many people who are infected with HIV do not have any symptoms at all for many years.

Q: How good is the current treatment for HIV infection?

A: The current treatment for HIV infection, termed HAART or highly active anti-retroviral therapy is very good. It suppresses the amount of HIV in the blood, allowing the immune system to recover. Mortality from AIDS has dropped since the introduction of HAART.

This treatment, however, is not a cure. Several patients become resistant to the benefits of HAART, and require “rescue” or “salvage” therapy be given in an attempt to continue to suppress HIV in the blood. Why some patients become resistant is unclear, but it may have to do with the strain of the virus and how compliant the patient was with taking his/her medication.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.