· In the absence of ART, disease progression goes through the following clinical stages
o Primary Infection or becoming HIV Infected
§ Most primary infection, i.e. new infection with HIV, usually is not immediately noticed.
§ It presents with short illnesses and flu-like symptoms such as fever, malaise, enlarged lymph nodes, sore throat, skin rash, and/or joint pain soon after being infected.
§ It may last for a few weeks.
§ This acute febrile illness is accompanied by widespread dissemination of the virus to different tissues, especially the lymphoid system. This is called sero-conversion illness.
o Clinically Asymptomatic Stage
§ This stage is free of symptoms, except for the possibility of swollen glands: persistent generalized lymphadenopathy – Persistent Generalized Lymphadenopathy (PGL).
§ However, this is the stage where there is ongoing extensive immunologic fighting/changes and rapid viral replication begins.
§ This may last for an average of eight to ten years.
§ However, disease progression in children and elderly is faster due to high set point.
§ This is WHO Stage1
o Symptomatic HIV
§ Over time, the immune system loses the struggle to contain HIV, resulting in extensive destruction of CD4 cells
§ This is characterised by the occurrence of opportunistic infections (OIs), which is when) symptoms develop
§ The most common symptoms include fever, respiratory infections, cough, TB tuberculosis, weight loss, skin diseases, viral infections, oral thrush, pain, and lymphadenopathy
§ This is WHO Stage 2 or 3, depending on the particular OI seen
o Acquired Immune Deficiency Syndrome (AIDS)
§ AIDS is defined as a point when a person with HIV develops severe immunosuppression, OIs, or malignancies/cancers.
§ Such conditions are: severe weight loss, Kaposi’s sarcoma, Cryptococcus meningitis, PCP, toxoplasmosis, CMV (Cytomegalovirus) retinitis, etc.
§ This is WHO Stage 4
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