Alternative names

　　Human immunodeficiency virus infection

　　Definition

　　HIV infection is a viral infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system, resulting in infections that are hard for the body to fight.

　　Causes, incidence, and risk factors

　　Acute HIV infection may be associated with symptoms resembling mononucleosis or the flu within 2 to 4 weeks of exposure. HIV seroconversion (converting from HIV negative to HIV positive) usually occurs within 3 months of exposure.

　　People who become infected with HIV may have no symptoms for up to 10 years, but they can still transmit the infection to others. Meanwhile, their immune system gradually weakens until they are diagnosed with AIDS. Acute HIV infection progresses over time to asymptomatic HIV infection and then to early symptomatic HIV infection and later, to AIDS (advanced HIV infection):

　　HIV Infection (acute HIV infection) ——>early asymptomatic HIV infection ——>early symptomatic HIV infection ——>AIDS.

　　Most individuals infected with HIV will progress to AIDS if not treated. However, there is a tiny subset of patients who develop AIDS very slowly, or never at all. These patients are called non-progressors.

　　HIV has spread throughout the United States. Higher concentrations of the disease are found in inner cities.

　　Related topics:

　　* Acute HIV infection

　　* Asymptomatic HIV infection

　　* Early symptomatic HIV infection

　　* AIDS

　　Symptoms

　　Any symptoms of illness may occur, since infections can occur throughout the body. Special symptoms relating to HIV infection include:

　　* Sore throat

　　* Mouth sores, including candidal infection

　　* Muscular stiffness or aching

　　* Headache

　　* Diarrhea

　　* Swollen lymph glands

　　* Fever

　　* Fatigue

　　* Rash of various types, including seborrheic dermatitis

　　* Frequent vaginal yeast infections

　　Note: At the time of diagnosis with HIV infection, many people have not experienced any symptoms.

　　Signs and tests

　　* HIV ELISA/Western blot may show positive HIV antibody. If it is negative, the test should be repeated in 3 months.

　　* CD4 count may show suppression of the immune system.

　　* HIV RNA viral load indicates the amount of virus in the bloodstream.

　　* Blood differential may show abnormalities.

　　Treatment

　　Drug therapy is often recommended for patients who are committed to taking all their medications and have a CD4 count less than 350 (indicating immune system suppression) or a high viral load (amount of HIV virus in the bloodstream).

　　It is extremely important that patients take all doses of their medications, otherwise the virus will rapidly become resistant to the medications. Therapy is always given with a combination of antiviral drugs.

　　People with HIV infection need to receive education about the disease and treatment so that they can be active partners in decision making with their health care provider.

　　Support Groups

　　The stress of illness can often be helped by joining a support group where members share common experiences and problems. See AIDS - support group.

　　Expectations (prognosis)

　　HIV is a chronic medical condition that can be treated, but not yet cured. There are effective means of preventing complications and delaying, but not preventing, progression to AIDS. At the present time, not all persons infected with HIV have progressed to AIDS, but time has shown that the vast majority do.

　　Complications

　　* Opportunistic infections

　　o Pneumocystis carinii pneumonia

　　o Candidiasis

　　o Cytomegalovirus infection

　　o Toxoplasmosis

　　o Cryptococcus

　　o Cryptosporidium enterocolitis

　　o Mycobacterium avium complex (MAC)

　　o Tuberculosis

　　* HIV dementia

　　* Malignancies (cancers)

　　* HIV lipodystrophy

　　* Chronic wasting from HIV infection

　　Calling your health care provider

　　Call for an appointment with your health care provider if you have had a possible or actual exposure to AIDS or HIV infection.

　　Prevention

　　* Do not have sexual contact with persons known or suspected of being infected with HIV.

　　* Do not have sex with numerous people or with people who have multiple partners. Do not have sex with prostitutes.

　　* Do not use intravenous (IV) drugs. If IV drugs are used, do not share needles or syringes. (Boiling or cleaning them with alcohol does not guarantee sterility.)

　　* Do not have sex with people who use IV drugs.

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

　　* Avoid oral, vaginal, or anal contact with semen.

　　* Avoid anal intercourse, since it causes small abrasions in the rectal tissues, through which HIV in an infected partner's semen may be injected directly into the recipient's blood.

　　* Avoid oral contact with the anus, and do not engage in the insertion of fingers or fists into the anus, as either an active or receptive partner.

　　* Do not allow a partner's urine to enter your mouth, anus, eyes, or open cuts or sores.

　　* 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.

　　Update Date: 2/3/2004

　　Updated by: Kenneth Wener, M.D., Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA. Review provided by VeriMed Healthcare Network.