HIV infection stage of the disease

Clinical manifestations of HIV infection is very diverse. On average, the characteristics of HIV infection is defined as a chronic form of the disease in which people can live different amounts of time without any significant clinical problems. Clinic and course may be affected by various factors (individual immunity, infectious dose during infection, age, comorbidities, etc.).

Classification of diseases

As in the case of other diseases, HIV is a necessary feature of the human condition and its relationship to categories based on certain criteria. Currently there are two types of classification.

The classification of HIV infection, defined by the who in 1990 (revised in 2007), based on the clinical picture. Can also be used in less developed countries where it is not possible to apply a different level of classification (not available testing CD4 lymphocytes). This classification is supposed to diagnose people over the age of 15. Now used less frequently.

Classification divides HIV disease into four phases:

1. Stage 1 – first stage of HIV, the period immediately after there was an infection, often characterized by nonspecific symptoms (fatigue, headache, muscle and joint pain, subfebrile, enlarged lymph nodes, tonsillitis, diarrhea, etc.).
2. Phase 2 – asymptomatic stage is characterized by the presence of pulmonary symptoms or complete absence. As a rule, 2 HIV infection is characterized by persistent generalized lymphadenopathy (enlarged lymph nodes in 3 or more locations, ongoing for more than 3 months).
3. Stage 3 – early symptomatic phase, a subclinical phase. The third stage is accompanied by a simple opportunistic infections developing secondary disorders and diseases in HIV (thrush, infectious esophagitis, pneumonia, Toxoplasma infection, CMV infection, ophthalmic or generalized).
4. Stage 4 – late symptomatic phase. At this stage of HIV infection characterized by the development of more serious opportunistic infections (cerebral toxoplasmosis, recurrent herpes), HIV infection stage 4 is often diagnosed cancer (lymphoma, Kaposi's sarcoma), which precedes the development of acquired immunodeficiency (AIDS). The fourth stage is divided into phases such as 4A, 4B and 4C: 4A – easy weight loss, viral, fungal and bacterial skin lesions, herpes, 4B – strong weight loss, long subfebrile and diarrhea, resistant infections, disorders of internal organs, substage 4B characterized by the development of Kaposi's sarcoma, as a clear harbinger of AIDS, 4V – generalized infections of various nature, candidiasis, pneumonia, tuberculosis, Kaposi's sarcoma (associated with such illness as AIDS), CNS.
5. Stage 5 – end-stage. The development of such diseases as AIDS. Disorder of internal organs and systems may become irreversible. Despite the introduction of intensive therapy, the sick person will die after a few months.

Clinical classification according to the who:

1. Asymptomatic acute HIV infection persistent generalized lymphadenopathy,
2. Moderately significant weight loss, infections of the respiratory tract with recurrent in nature, cold sores, which restores cheilitis, mouth ulcers recurrent nature, the popular itchy skin lesions, seborrheic dermatitis, nail infection fungal nature,
3. Significant weight loss, diarrhea chronic in nature, persisting for more than months, subfebrile persisting for more than a month (37.6°C), intermittent to chronic yeast infection in the mouth, pulmonary tuberculosis, severe bacterial infections (meningitis, pneumonia, sepsis, arthritis, osteomyelitis), gingivitis, stomatitis, anemia (Hgb less than 80/l), neutropenia (<500 cells/µl), thrombocytopenia (less than 50,000 cells/µl),
4. Cerebral toxoplasmosis, Pneumocystis pneumonia, candidiasis of the trachea, esophagus, bronchi and lungs, CMV infection, herpetic infection, chronic (lasting more than a month), recurrent pneumonia (more than 2 times a year), recurrent salmonellae sepsis, extrapulmonary tuberculosis, extrapulmonary cryptococcosis (meningitis), chronic cryptosporidiosis, chronic koktsidioidomikoz, chronic isospora, sarcoma, malignant lymphoma, primary lymphoma of brain, invasive cervical cancer, HIV encephalopathy (AIDS dementia), cachexia, symptomatic HIV-associated nephropathy, symptomatic HIV-associated cardiomyopathy.

Used clinicalclassification number 2 formulated by the Center for control and disease prevention in the United States in 1993, she used often.

Clinical classification

Periods of HIV infection, according to this classification, are divided as follows:

A. Asymptomatic phase: asymptomatic/acute HIV infection, persistent generalized lymphadenopathy, oropharyngeal candidiasis, candidiasis, oral leukoplakia, bacterial angiomatosis, lymphoid interstitial pneumonia.

B. Symptomatic phase: recurrent cold sores, fever or diarrhea lasting more than one month, listeriosis (meningitis), thrombocytopenic purpura, cervical carcinoma or dysplasia, recurrent adnexitis, peripheral neuropathy, cerebral toxoplasmosis, esophageal/pulmonary candidiasis, Pneumocystis pneumonia, generalized CMV infection, retinitis, generalized herpetic infections, pneumonia recurrent nature (more than 2 times per year), tuberculosis, extrapulmonary cryptococcosis.

C. AIDS: chronic cryptosporidiosis, disseminated histoplasmosis, coccidioidomycosis, chronic isosporiasis, Kaposi's sarcoma, malignant lymphoma, primary cerebral lymphoma, and invasive carcinomas cervicocranial, progressive multifocal encephalopathy. How many people live after the development of this stage depends on the timely beginning of treatment.

Stage And

Usually starts within 2-6 weeks after infection. The greater part (70%) is accompanied by symptoms, others are asymptomatic. Symptoms are nonspecific, a person rarely feels the need to go to the doctor. Duration of symptoms is short, generally, signs disappear after a while. The problem with this unrecognized stage lies in the high degree of infectiousness. According to estimates, 50% of newly identified infections were transferred in the course of primary infection.

After the acute stage, the disease enters an asymptomatic phase, which occurs without any significant clinical manifestations. In laboratory tests are determined a significant deviation. Impaired immunity is often minimal. This period may last for 2-8 years. Immunodeficiency gradually deepened, mainly in the field of cellular immunity. The progression of the disease individually. In some people it is slow.

Stage In

Because of the progressive immunodeficiency leads to characteristic infections occurrence or condition. The CD4 cell count falls to 300-500/µl. Some of the symptoms are nonspecific (anemia, peripheral neuropathy), others typical for this stage (thrush, herpes).

Stage C

With slow progression of HIV infection and the absence of effective therapy, this stage comes after 8-10 years after infection. There are the first signs of full blown AIDS. Are more or less serious diseases. In addition to infection are diagnosed and a tumor.

The most common infectious complication of this stage is Pneumocystis pneumonia, usually bilateral, is often resistant to treatment. Without adequate treatment the condition threatens death.

Another common complication of this stage is toxoplasmosis encephalitis. Manifested epileptic seizures, sometimes acute onset of unconsciousness. The prognosis depends on timely and targeted treatment, as well as the location of the lesion.

The stage usually progresses to a fatal outcome of the disease, often due to banal infections.

Laboratory category

Stage of the disease is marked with the letters A, B, C (according to the clinical classification) or numbers 1, 2, 3 (according to the laboratory categories). This leads to 9 possible combinations, that characterize the human condition (for example, HIV infection in stage B2, C1, etc.).

Conclusion

Early treatment and proper individual approach to each infected person can prevent the development of HIV in the last stage – phase of AIDS. Modern therapeutic options can provide a full life HIV-positive man, by minimizing all symptoms of the disease and comorbidities.