Clinical Presentation of HIV/AIDS

·         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

Black and White Blood Pressure Kit

References
Wells BG, DiPiro J, Schwinghammer T (2013), Pharmacotherapy Handbook (6th Ed). New York, NY: McGraw-Hill.

DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey ML, (2008): Pharmacotherapy: A Pathophysiologic Approach (7th ed): New York, NY: McGraw-Hill.

Katz M D., Matthias KR., Chisholm-Burns M A., Pharmacotherapy(2011) Principles & Practice Study Guide: A Case-Based Care Plan Approach: New York, NY: McGraw-Hill.

Schwinghammer TL, Koehler JM (2009) Pharmacotherapy Casebook: A Patient-Focused Approach (7th ed): New York, NY: McGraw-Hill.

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