HIV is in the first stage. Early symptoms of HIV in men. Ways of transmission

One of the most terrible diseases today is the human immunodeficiency syndrome caused by the virus of the same name. A large number of scientists have been looking for a cure for AIDS for a long time, but, unfortunately, until the virus that destroys human immunity could not be defeated.

This is due to the fact that the virus genetically mutates after entering the body. Once the immune system starts making antibodies, HIV changes.

If a person has been infected with one type of virus, then when another strain enters his body, a new infection is created. In addition, HIV is well masked in the intracellular space, becoming latent.

HIV negatively affects the immune system, gradually depressing it. Thus, a person dies not from the virus as such, but from concomitant diseases, since the body loses its ability to resist the simplest infections.

Nevertheless, a person with HIV can live a long and happy life, have a family and children. For this it is necessary to start treatment immediately after the first signs of infection are found... They do not appear immediately; after infection, it can take from several weeks to several months.

It is possible to diagnose the disease in the early stages only with the use of special diagnostic methods, but according to some signs, it is still possible to assume the presence of a dangerous virus in the body.

The first signs of HIV disease are mild, they are often confused with the common cold or mononucleosis.

Most of us do not like going to doctors, especially for such "trifles". As a result, time is lost because the earlier you start taking special medications, the more successful the treatment will be.

It should also be remembered that no matter how many symptoms appear, a person becomes a carrier of the disease immediately after the virus enters his bloodstream. Therefore, it is very important to monitor your health, regularly undergo examinations, and if alarming symptoms appear, immediately seek help from specialists.

Types of HIV symptoms

The danger of HIV infection is that it practically does not manifest itself at the initial stage of the disease.

The main symptoms of AIDS appear long after infection.

Experts have introduced classification of symptoms of HIV infection, each of which is characteristic for a particular period of the disease:

incubation period can last for two weeks, several months, or a year. The rate of penetration of the virus into all cells of the body depends on several factors, including the state of health of a person, his age and other individual characteristics. At this stage of the disease, there are practically no symptoms. Doctors also call this phase of the disease window period or seroconversion. It ends when a trace of the virus can be found in the blood;
further course of the disease is accompanied by symptoms characteristic of colds, flu or mononucleosis. The patient's temperature rises to 38 ° C, a sore throat appears, and lymph nodes become inflamed. A person in this state feels weak, often there is diarrhea, vomiting, weight loss is noted, and women may also develop thrush. At first, these symptoms do not appear very strongly, but the brighter they become, the closer the final stage of the disease, which is called AIDS. With these symptoms, it is quite difficult to identify HIV. Special attention is paid to the diagnosis only if the patient himself declares contact with HIV-infected people;
secondary symptoms of HIV infection are due to infectious diseasesthat develop against its background. These are staphylococcal skin lesions, oral candidiasis, all kinds of pustular rashes, as well as the occurrence of cancerous tumors.

There are also outward signs of HIV, the appearance of which should alert a person. These include the appearance of a characteristic rash on the skin, it covers almost the entire body. Redness appears, as a rule, 5-10 days after HIV infection.

The main symptoms of the disease include a significant increase in lymph nodes. They become 2-3 times larger, while the skin above them does not change its color. Localization of seals is observed in the groin, neck and armpit area, while the inflamed lymph nodes are not directly connected.

HIV symptoms in men

At the initial stage of the disease, gender does not have much effect on symptoms.

But in the future, some differences arise, the first signs of HIV infection in men appear in this way:

Severe rash on the body... In men, redness on the skin appears more often than in women. In this case, the rash has a brighter color and severity. Such signs appear 3 days after infection, and after a while the redness disappears.
About 1-3 months after infection, a man may experience flu-like condition... The temperature rises sharply, painful sensations in the throat, chills and night sweats appear.
Symptoms rarely occur a month after infection, but the main one is strong enlargement of lymph nodes, not related to each other.
If the infection occurs as a result of sexual contact, then symptoms in men may occur in the early stages, such as mucous discharge from the urethra... It can also be felt pain during urination and discomfort in the perineum.
In most cases, there are no symptoms 3 months after infection... This stage is asymptomatic. At this stage, the man feels completely healthy; it is impossible to detect the virus during special tests.

Every person gets HIV in a different way, and the timing of symptoms will also vary. The duration of the incubation and acute periods depends on how strong the man's immunity is. If he is in good health and in good physical shape, then the first symptoms of the disease may appear several years after infection.

HIV symptoms in women

The timing of HIV manifestation in women is also blurred. But experts note that in a woman's body, HIV infection develops several times slower than in men... There is no scientific explanation for this, perhaps this feature is due to the fact that women are usually more attentive to their health.

Just like in men, the first signs of HIV infection in women do not appear immediately after infection. These include:

seemingly unreasonable increase in temperature body up to 38 ° C, it does not decrease for 2-3 days;
decreased performance, loss of strength and general weakness... Such attacks can be short-term or persistent for a long time;
swollen lymph nodes in the groin area, as well as on the neck and armpits;
heavy menstruationaccompanied by severe pain and discomfort in the pelvic region;
mucous vaginal discharge, after HIV infection, their number increases markedly;
frequent headaches and increased irritability.

In addition, women are characterized by early symptoms such as severe night sweats with high fever and chills... This condition is called generalized lymphadenopathy. When it becomes regular, there is a strong suspicion that a woman is infected with HIV. After a while, it is celebrated drastic weight loss.

The initial stage of HIV infection in women can last from 1 month to a year, but most often antibodies to the virus in the blood can already be detected 3-4 months after infection. At this moment, the next stage of the disease begins.

The symptoms of HIV in women after a month are similar to the manifestations of this disease in men.... A rash may appear on the body, but it will be less bright than that of the stronger sex. You feel a flu-like condition, a sore throat, etc.

Obvious signs of HIV a year after infection occur in almost all patients.

As a rule, at this time, the disease flows into the acute phase, and all the symptoms of pronounced immunodeficiency appear. But it should be remembered that HIV can slow down its development at any stage of the disease, which makes it impossible to accurately determine the timing of each of them. With adequate treatment, a person can live for 10-20 years, and the disease will never reach the final stage, which is irreversible and is called AIDS.

The main symptoms of HIV during pregnancy are the same... The woman experiences a sore throat, her temperature rises, and her lymph nodes are greatly enlarged. Diarrhea may also occur. Pregnancy does not affect the rate at which HIV progresses, but at this time, special attention should be paid to treatment.

If an HIV-positive woman is under constant medical supervision, she will be able to give birth to a healthy child. Studies conducted by leading scientists in the world have not revealed a particular effect of HIV infection on the course of pregnancy. The risk of preterm birth is about the same in HIV-positive and HIV-negative mothers.

Stages

After a long study of HIV, specialists came to the conclusion that the infection in the body develops gradually.

The disease proceeds in several stages:

The first stage is called the incubation period.... On average, it lasts about 3 months, but there are exceptions. After entering the body, the virus begins to actively penetrate into all cells. During the incubation period, there are no clinical manifestations, it is impossible to detect antibodies in the blood. The main symptoms of HIV in the early stages appear later.
The second stage can proceed in different ways.... In some patients, clinical manifestations are also absent, the only reaction to the virus will be the appearance of specific antibodies in the blood. More often than not, HIV-positive people experience flu-like symptoms. These are fever, skin rashes, swollen lymph nodes and sore throat. This picture is observed in more than half of sick people within 3 months after infection. This is how the acute stage of HIV manifests itself. In addition, at this stage, secondary diseases can develop - this is associated with a significant decrease in immunity.
Third stage HIV (subclinical) most often without symptoms. The only sign of infection in this phase is enlarged lymph nodes. This symptom can occur at any time, but for the subclinical stage it is the only one.
The fourth stage is called the secondary disease phase.... During this period, the patient begins to dramatically lose weight, he develops viral and fungal diseases, and malignant tumors may appear.
The fifth stage is called terminal... At this stage, treatment is already ineffective, since the damage to the main body systems is already irreversible.
The most recent stage of HIV is called AIDS - acquired immunodeficiency syndrome. When the infection turns into this disease, the person dies.

How can you get HIV

The human immunodeficiency virus penetrates into all human fluids, but only cases of infection through blood, breast milk, vaginal secretions or semen are described... This is due to the fact that only these biological fluids contain HIV in the concentration necessary for infection.

This virus can enter the human body in three ways:

during intercourse if unprotected... Most people have a stereotype that only homosexuals can get HIV and AIDS. But the virus is transmitted during any sexual intercourse, regardless of the sex of the partners. During anal sex, the likelihood of infection increases. This is due to the fact that the rectal membrane is rather fragile and is abundantly supplied with blood. Oral sex is the least risky because the environment in the oral cavity itself is aggressive for HIV. But this does not mean that infection cannot occur. The only way to protect against sexual transmission of HIV today is a condom. Only a rubber barrier can prevent the virus from entering the body;
ingestion of HIV-infected blood into the body of a healthy person. This is possible with a transfusion of blood or blood products, as well as when using a non-sterile instrument. The chances of contracting HIV in this way are quite low, since today much attention is paid to the health of donors and sterilization of medical instruments. Bloodborne transmission of the virus is more common among drug addicts, where several people often use the same injection syringe;
from HIV positive mother to child... The infection process can occur both during pregnancy and during childbirth. Therefore, HIV-infected women rarely give birth on their own; most often, delivery occurs using a cesarean section. There is also a high risk of infection of a child during breastfeeding, the virus can enter the bloodstream through microcracks in the child's mouth. Sick women doctors do not recommend feeding newborn babies with their own breast milk.

Since HIV infection does not manifest itself for a long time, its detection in the early stages is possible only with special laboratory tests. They can be carried out as part of a preventive examination, but you can take the analysis at any time. This is especially important if there was contact with an HIV-positive person.

HIV infection develops in stages. The direct effect of viruses on the immune system leads to damage to various organs and systems, the development of tumor and autoimmune processes. Without highly active antiretroviral therapy, the life expectancy of patients does not exceed 10 years. The use of antiviral drugs can slow down the progression of HIV and the development of acquired immunodeficiency syndrome - AIDS.

Signs and symptoms of HIV in men and women at different stages of the disease have their own color. They are varied and increase in severity of manifestation. The clinical classification of HIV infection proposed in 1989 by V. I. Pokrovsky, which provides for all manifestations and stages of HIV from the moment of infection to the death of the patient, has become widespread in the Russian Federation and the CIS countries.

Fig. 1. Pokrovsky Valentin Ivanovich, Russian epidemiologist, professor, doctor of medical sciences, president of the Russian Academy of Medical Sciences, director of the Central Research Institute of Epidemiology of Rospotrebnadzor.

The incubation period of HIV infection

The incubation period of HIV infection is determined by the period from the moment of infection to clinical manifestations and / or the appearance of antibodies in the blood serum. HIV in an "inactive" state (a state of inactive replication) can be from 2 weeks to 3-5 years or more, while the general condition of the patient does not noticeably deteriorate, but antibodies in the blood serum to HIV antigens are already appearing. This stage is called the latent phase or the period of "carriage". When immunodeficiency viruses enter the human body, they begin to reproduce themselves immediately. But the clinical manifestations of the disease appear only when the weakened immunity ceases to properly protect the patient's body from infections.

It is impossible to say exactly how long the HIV infection takes place. The duration of the incubation period is influenced by the route and nature of infection, the infectious dose, the patient's age, his immune status and many other factors. With an infected blood transfusion, the latency period is shorter than with sexual transmission.

The period from the moment of infection to the appearance of antibodies to HIV in the blood (seroconversion period, window period) ranges from 2 weeks to 1 year (up to 6 months in weakened people). During this period, the patient's antibodies are still absent and he, thinking that he is not infected with HIV, continues to infect others.

Examination of contact persons with HIV-infected patients makes it possible to diagnose the disease at the "carrier" stage.

Fig. 2. Oral candidiasis and herpes sores are indicators of a malfunction of the immune system and can be early manifestations of HIV infection.

Signs and symptoms of HIV in men and women in IIA (acute febrile) stage

After the incubation period, the stage of the primary manifestations of HIV infection develops. It is due to the direct interaction of the patient's body with the immunodeficiency virus and is divided into:

IIA - acute febrile stage of HIV.
IIB - asymptomatic stage of HIV.
IIB - stage of persistent generalized lymphadenopathy.

The duration of IIA (acute febrile) stage of HIV in men and women is from 2 to 4 weeks (usually 7 to 10 days). It is associated with a massive release of HIV into the systemic circulation and the spread of viruses throughout the body. Changes in the patient's body during this period are of a non-specific nature and are so diverse and multiple that they create certain difficulties in diagnosing HIV infection by a doctor during this period. Despite this, the acute febrile phase passes on its own, even without specific treatment, and passes into the next stage of HIV - asymptomatic. Primary infection in some patients is asymptomatic, in other patients the most severe clinical picture of the disease is rapidly developing.

Mononucleosis-like syndrome in HIV

In 50 - 90% of HIV patients in the early stages of the disease, men and women develop mononucleosis-like syndrome (acute retroviral syndrome). A similar condition develops as a result of the patient's active immune response to HIV infection.

Mononucleosis-like syndrome occurs with fever, pharyngitis, rash, headaches, muscle and joint pains, diarrhea and lymphadenopathy, enlarged spleen and liver. Less commonly, meningitis, encephalopathy, and neuropathy develop.

In some cases, acute retroviral syndrome has manifestations of certain opportunistic infections that develop against the background of deep suppression of cellular and humoral immunities. Cases of the development of oral candidiasis and candidal esophagitis, pneumocystis pneumonia, cytomegalovirus colitis, tuberculosis and cerebral toxoplasmosis are recorded.

In men and women with mononucleosis-like syndrome, the progression of HIV infection and the transition to the AIDS stage is faster, and an unfavorable outcome is observed in the next 2 to 3 years.

In the blood, there is a decrease in CD4 lymphocytes and platelets, an increase in the level of CD8 lymphocytes and transaminases. A high viral load is detected. The process is completed within 1 to 6 weeks even without treatment. In severe cases, patients are hospitalized.

Fig. 3. Feeling tired, malaise, headaches, muscle and joint pains, fever, diarrhea, severe night sweats - symptoms of HIV in the early stages.

Intoxication syndrome in HIV

In the acute febrile stage, body temperature rises in 96% of patients. Fever reaches 38 0 C and lasts 1 - 3 weeks and often. Half of all patients have headache, muscle and joint pain, a feeling of fatigue, malaise, and severe night sweats.

Fever and malaise are the most common symptoms of HIV during a febrile period, and weight loss is the most specific.

Swollen lymph nodes with HIV

In 74% of men and women, enlarged lymph nodes are detected. For HIV infection in the febrile stage, a gradual increase in the first of the posterior cervical and occipital, then the submandibular, supraclavicular, axillary, ulnar and inguinal lymph nodes is especially characteristic. They have a pasty consistency, reach 3 cm in diameter, mobile, not soldered to the surrounding tissues. After 4 weeks, the lymph nodes return to their normal size, but in some cases the transformation of the process into persistent generalized lymphadenopathy is noted. The enlargement of lymph nodes in the acute stage occurs against the background of increased body temperature, weakness, sweating, and fatigue.

Fig. 4. Enlarged lymph nodes are the first signs of HIV infection in men and women.

HIV rash

In 70% of cases, a rash appears in men and women in the early acute period of the disease. Erythematous rash (areas of redness of different sizes) and maculopapular rash (areas of seals) are more often recorded. Features of the rash in HIV infection: the rash is profuse, often purple in color, symmetrical, localized on the trunk, its individual elements can also be located on the neck and face, does not flake off, does not bother the patient, is similar to rashes with measles, rubella, syphilis, etc. The rash disappears within 2 to 3 weeks.

Sometimes patients have small hemorrhages in the skin or mucous membranes up to 3 cm in diameter (ecchymosis), with minor injuries, hematomas may appear.

In the acute stage of HIV, a vesicular-papular rash often appears, characteristic of herpes infection and.

Fig. 5. A rash with HIV infection on the trunk is the first sign of the disease.

Fig. 6. Rash with HIV on the trunk and arms.

Neurological disorders in HIV

Neurological disorders in the acute stage of HIV are observed in 12% of cases. Lymphocytic meningitis, encephalopathy and myelopathy develop.

Fig. 7. Severe form of herpes lesions of the mucous membrane of the lips, mouth and eyes is the first sign of HIV infection.

Gastrointestinal symptoms

In the acute period, every third man and woman develops diarrhea, in 27% of cases there is nausea and vomiting, abdominal pains often appear, and body weight decreases.

Laboratory diagnosis of HIV in the acute febrile stage

Replication of viruses in the acute stage is most active, however, the number of CD4 + lymphocytes always remains more than 500 in 1 μl, and only with a sharp suppression of the immune system, the indicator drops to the level of development of opportunistic infections.

The CD4 / CD8 ratio is less than 1. The higher the viral load, the more infectious the patient is during this period.

Antibodies to HIV and the maximum concentration of viruses in the stage of primary manifestations are found at the end of the acute febrile stage. In 96% of men and women, they appear by the end of the third month from the moment of infection, in the rest of patients - after 6 months. The analysis for the detection of antibodies to HIV in the acute febrile stage is repeated after a few weeks, since it is the timely appointment of antiretroviral therapy during this period that is most useful for the patient.

Antibodies to HIV p24 proteins are detected, antibodies produced by the patient's body are detected using ELISA and immunoblot. Viral load (detection of RNA viruses) is determined using PCR.

High levels of antibodies and low levels of viral load occur during the asymptomatic course of HIV infection in the acute period and indicate the control of the patient's immune system over the level of the number of viruses in the blood.

In a clinically expressed period, the viral load is quite high, but with the appearance of specific antibodies it drops, and the symptoms of HIV infection subside and then disappear altogether, even without treatment.

Fig. 8. Severe candidiasis (thrush) of the oral cavity in an HIV patient.

The older the patient's age, the faster the HIV infection progresses to the AIDS stage.

Signs and symptoms of HIV in men and women in stage IIB (asymptomatic)

At the end of the acute stage of HIV infection, a certain balance is established in the patient's body, when the patient's immune system restrains the multiplication of viruses for many months (usually 1 - 2 months) and even years (up to 5 - 10 years). On average, the asymptomatic stage of HIV lasts 6 months. During this period, the patient feels satisfactory and leads his usual lifestyle, but, at the same time, is a source of HIV (asymptomatic virus carrier). Highly active antiretroviral therapy prolongs this stage for many decades, during which the patient leads a normal life. In addition, the likelihood of infection of others is significantly reduced.

The number of lymphocytes in the blood is within normal limits. The results of ELISA and immunoblotting studies are positive.

Signs and symptoms of HIV in men and women in stage II (persistent generalized lymphadenopathy)

Generalized lymphadenopathy is the only sign of HIV infection during this period. Lymph nodes appear in 2 or more places that are not connected anatomically (except for the groin areas), at least 1 cm in diameter, lasting at least 3 months, provided there is no causal disease. Most often, the posterior cervical, cervical, supraclavicular, axillary and ulnar lymph nodes are enlarged. Lymph nodes sometimes increase, then decrease, but persist constantly, soft, painless, mobile. Generalized lymphadenopathy should be differentiated from bacterial infections (syphilis and brucellosis), viral (infectious mononucleosis, and rubella), protozoal (toxoplasmosis), tumors (leukemia and lymphoma), and sarcoidosis.

The cause of skin lesions during this period is seborrhea, psoriasis, ichthyosis, eosinophilic folliculitis, and common scabies.

The defeat of the oral mucosa in the form of leukoplakia indicates the progression of HIV infection. Skin and mucous membrane lesions are registered.

The level of CD4 lymphocytes gradually decreases, but remains more than 500 in 1 μl, the total number of lymphocytes is above 50% of the age norm.

Patients during this period feel satisfactory. Labor and sexual activity in both men and women is preserved. The disease is detected by chance during a medical examination.

The duration of this stage is from 6 months to 5 years. At the end of it, the development of asthenic syndrome is noted, the liver and spleen increase, the body temperature rises. Patients are worried about frequent SARS, otitis media, pneumonia and bronchitis. Frequent diarrhea leads to weight loss, fungal, viral and bacterial infections develop.

Fig. 9. In the photo there are signs of HIV infection in women: recurrent herpes of the skin of the face (photo on the left) and mucous lips of the girl (photo on the right).

Fig. 10. Symptoms of HIV infection - leukoplakia of the tongue. The disease can undergo cancerous degeneration.

Fig. 11. Seborrheic dermatitis (left photo) and eosinophilic folliculitis (right photo) are manifestations of skin lesions in stage 2 of HIV infection.

Stage of secondary diseases of HIV infection

Signs and symptoms of HIV infection in men and women in stage IIIA

Stage IIIA of HIV infection is a transitional period from persistent generalized lymphadenopathy to AIDS-associated complex, which is a clinical manifestation of HIV-induced secondary immunodeficiency.

Fig. 12. The most severe shingles occurs in adults with severe suppression of the immune system, which is observed, including in AIDS.

Signs and symptoms of HIV infection in stage IIIB

This stage of HIV infection is characterized in men and women by severe symptoms of impaired cellular immunity, and in clinical manifestations there is nothing more than an AIDS-associated complex, when a patient develops infections and tumors that are not found in the AIDS stage.

During this period, there is a decrease in the CD4 / CD8 ratio and the indicator of the blast transformation reaction, the level of CD4 lymphocytes is recorded in the range from 200 to 500 per 1 μl. In the general analysis of blood, leukopenia, anemia, thrombocytopenia are increasing, an increase in circulating immune complexes is noted in the blood plasma.
The clinical picture is characterized by prolonged (more than 1 month) fever, persistent diarrhea, profuse night sweats, severe symptoms of intoxication, weight loss of more than 10%. Lymphadenopathy becomes generalized. Symptoms of damage to internal organs and the peripheral nervous system appear.
Diseases such as viral (hepatitis C, widespread), fungal diseases (oral and vaginal candidiasis), bacterial infections of the bronchi and lungs, persistent and long-term, protozoal lesions (without dissemination) of internal organs, in a localized form, are detected. Skin lesions are more common, more severe, and more prolonged downstream.

Fig. 13. Bacillary angiomatosis in HIV patients. The causative agent of the disease is a bacterium of the genus Bartonella.

Fig. 14. Signs of HIV in men in the later stages: lesions of the rectum and soft tissues (left photo), genital warts (right photo).

Signs and symptoms of HIV infection in stage III (stage AIDS)

IIIB stage of HIV infection presents a detailed picture of AIDS, characterized by a deep suppression of the immune system and the development of opportunistic diseases, proceeding in a severe form, threatening the patient's life.

Fig. 15. A detailed picture of AIDS. The photo shows patients with neoplasms in the form of Kaposi's sarcoma (left photo) and lymphoma (right photo).

Fig. 16. Signs of HIV infection in women in the late stages of HIV. In the photo, invasive cervical cancer.

The more severe the symptoms of HIV in the early stages and the longer they appear in a patient, the faster AIDS develops. Some men and women have an erased (low-symptom) course of HIV infection, which is a good prognostic sign.

Terminal stage of HIV infection

The transition to the terminal stage of AIDS in men and women occurs when the level of CD4-lymphocytes decreases to 50 and below in 1 μl. During this period, an uncontrollable course of the disease is noted and an unfavorable outcome is expected in the near future. The patient is exhausted, depressed, and loses faith in recovery.

The lower the level of CD4-lymphocytes, the more severe the manifestations of infections and the shorter the duration of the terminal stage of HIV infection.

Signs and symptoms of HIV infection in the terminal stage of the disease

The patient develops atypical mycobacteriosis, CMV (cytomegalovirus) retinitis, cryptococcal meningitis, widespread aspergillosis, disseminated histoplasmosis, coccidioidomycosis and bartonnelosis, and leukoencephalitis progresses.
The symptoms of diseases overlap. The patient's body is quickly depleted. Due to the constant fever, severe symptoms of intoxication and cachexia, the patient is constantly in bed. Diarrhea and loss of appetite lead to weight loss. Dementia develops.
Viremia is increasing, and CD4-lymphocyte counts reach critically low levels.

Fig. 17. Terminal stage of the disease. Complete loss of the patient's faith in recovery. In the photo on the left is an AIDS patient with severe somatic pathology, in the photo on the right is a patient with a common form of Kaposi's sarcoma.

Prognosis of HIV infection

The duration of HIV infection is on average 10 - 15 years. The development of the disease is influenced by the level of viral load and the number of CD4-lymphocytes in the blood at the beginning of treatment, the availability of medical care, the patient's adherence to treatment, etc.

Factors in the progression of HIV infection:

It is believed that with a decrease in the level of CD4-lymphocytes during the first year of the disease to 7%, the risk of transition of HIV infection to the AIDS stage increases by 35 times.
Rapid progression of the disease is noted with transfusion of infected blood.
Development of drug resistance of antiviral drugs.
The transition of HIV infection to the AIDS stage is reduced in people of mature and old age.
The combination of HIV infection with other viral diseases negatively affects the duration of the disease.
Poor nutrition.
Genetic predisposition.

Factors slowing down the transition of HIV infection to the AIDS stage:

Highly active antiretroviral therapy (HAART) started on time. In the absence of HAART, the patient's death occurs within 1 year from the date of the diagnosis of AIDS. It is believed that in regions where HAART is available, the life expectancy of HIV-infected people reaches 20 years.
Lack of side effects on taking antiretroviral drugs.
Adequate treatment of comorbidities.
Adequate food.
Rejection of bad habits.

The rate of development of any disease depends on the number of infectious agents that have entered the body, on the type of pathogen and on the general state of human health at the time of infection.

HIV infection is most often diagnosed when clinical manifestations become apparent. Until the moment of manifestation, the disease is asymptomatic, and the viral presence in the blood is not detected.

There are 4 clinical stages of the disease:

incubation period;
stage of primary manifestations;
stage of secondary diseases;
terminal stage (or AIDS).

Consider what are the main symptoms and signs of each stage of HIV infection.

After infection with the immunodeficiency virus, changes in the human body irreversibly begin to occur. The number of viral particles in the blood gradually increases, they attach to the surface of immune cells and destroy them. The main feature of the period is that there are no clinical symptoms of the disease.

They begin to appear on average after 12 weeks. However, this period can be much shorter - from 14 days, and can stretch over years.

At the stage of incubation of HIV in the blood, there are no indicators of the presence of the virus. Antibodies to it have not yet been determined. As a result, the incubation period is usually called the "serological window".

Can an HIV-infected person be outwardly different from a healthy person? No, in appearance he does not differ from other people. The problem is that minor signs that indicate infection are not perceived by a person as a disease. Only in the presence of factors predisposing to infection (contact with an HIV-infected person, working in a medical clinic with contaminated biological material) can symptoms cause suspicion of HIV.

These include:

subfebrile body temperature not exceeding 37.5 ° C;
a slight increase in different groups of lymph nodes;
moderate muscle pain;
weakness, apathy.

Such signs, when the cause of their occurrence is unclear, are an indication for a diagnostic test for HIV infection.

Despite the absence of hematological and clinical manifestations, the patient during the incubation period is dangerous to others. An infected person is already a source of infection that can transmit the disease to other people.

Signs and symptoms at the primary stage of HIV infection

The transition of the disease to the second stage is marked by the development of seroconversion. The process by which specific antibodies begin to be detected in the patient's blood. From this point on, HIV infection can be diagnosed using serological methods for examining biological materials.

The stage of the primary manifestations of HIV can proceed in the form of three independent forms.

Asymptomatic phase

The period is characterized by a complete absence of clinical symptoms. The person considers himself to be absolutely healthy. The phase can last up to several years, but a rapid current is also possible, lasting no more than a month. Statistics show that if a person has an asymptomatic infection for a long time, then after 5 years only 30% of those infected begin to develop symptoms of immune deficiency (AIDS).

Acute HIV infection

The manifestation of primary symptoms develops in 30% of infected people. The first obvious signs appear in 1-3 months after the virus enters the human body.

They resemble the manifestations of infectious mononucleosis:

an increase in body temperature to 37 ° C and above, without visible signs of the disease;
hyperthermia is not eliminated by taking antipyretic drugs;
signs of HIV infection appear in the oral cavity - sore throat, inflammation and enlargement of the palatine tonsils (like a sore throat);
taking antibacterial drugs is not successful;
enlargement and soreness of the lymph nodes in the neck;
an increase in the size of the liver and spleen;
the appearance of diarrhea;
insomnia, increased sweating at night;
small specks of a pale pink color may form on the skin - a maculopapular rash;
apathy, loss of appetite, headaches and weakness.

The stage proceeds in the form of inflammation of the brain and its membranes (meningitis or encephalitis). The characteristic symptoms develop: severe headache, rise in body temperature to 40 ° C, nausea and vomiting.

Another option for the course of the acute phase is esophagitis - inflammation of the esophagus. The disease is accompanied by pain when swallowing, unreasonable pain in the chest.

In any of these cases, leukocytosis, lymphocytosis is found in the patient's blood, and atypical cells - mononuclear cells - appear.

Generalized lymphadenopathy

swollen lymph nodes

This phase is characterized by an increase in lymph nodes. Lymphadenopathy is considered to be the defeat of more than two groups of lymph nodes, the exception of which is the inguinal. Most often, there is an increase in the cervical and supraclavicular nodes. They reach up to 5 cm in diameter and become painful. It is noteworthy that the skin above them does not change, and there is no soldering with the subcutaneous tissue. These symptoms are often the first to appear in an HIV-infected person.

The average duration of this stage is 3 months. By the end, the patient develops cachexia (a sharp, causeless weight loss).

Signs and symptoms of the stage of secondary diseases of HIV infection

The third stage of the development of the disease is characterized by persistent suppression of the human immune system. The peculiarities of the course of the disease in HIV-infected during this period are changes in the blood: a decrease in the level of leukocytes, in particular, the number of T-lymphocytes is significantly reduced.

At the third stage, symptoms appear that are characteristic of various visceral diseases (affecting internal organs).

Kaposi's sarcoma

The disease is characterized by the formation of many spots and bumps of cherry color up to 10 cm in diameter. They are localized on any part of the body: head, limbs, mucous membranes. In fact, these formations are tumors originating from the tissues of the lymphatic vessels.

The prognosis for life with this disease depends on the form of its course. In the acute course of the disease, people live on average 2 years, in the chronic form, life expectancy reaches 10 years.

Pneumocystis pneumonia

With this type of pneumonia, symptoms of the disease develop quickly. First, there is a high body temperature, not knocked down by antipyretic drugs. Then chest pain, cough (first dry, then with phlegm), shortness of breath join. There is a lightning-fast deterioration of the patient's condition. Treatment with antibacterial drugs is ineffective.

Generalized infection

This form of secondary manifestations of HIV is most typical for women. Various infections in patients infected with a retrovirus acquire a generalized course, affecting the entire body as a whole.

Such diseases include:

tuberculous lesion of various organs;
fungal diseases - more often candidiasis;
cytomegalovirus infection, etc.

The course of the disease is extremely severe, with damage to the respiratory system, digestive system, and brain. The development of sepsis is characteristic of them.

Neurological symptoms of HIV infection

With this variant of the course, the brain is affected with depression of cognitive functions. Symptoms will be: decreased memory, decreased concentration, distraction. An extreme manifestation of impaired brain function is the development of progressive dementia.

The above diseases do not always develop with HIV, but their presence helps doctors identify the period of development of the disease.

Signs and symptoms of end-stage HIV infection

The last stage of HIV infection is called acquired immune deficiency syndrome. The symptoms of AIDS are the same in men and women.

In patients with AIDS, cachexia (emaciation) is pronounced, even the simplest infectious and inflammatory diseases are long and difficult. A characteristic feature is a significant increase in the size of the inguinal lymph nodes.

The last period, when HIV infection turns into AIDS, can be characterized by the following forms:

Pulmonary - develops, has a severe course.
Intestinal - associated with disturbances in the processes of digestion and absorption of nutrients. Typical traits: diarrhea, dehydration, weight loss.
Neurological - a severe course of meningitis and encephalitis, the development of malignant neoplasms in the brain and spinal cord. May manifest as epileptic seizures, the duration and frequency of which increase over time.
Mucocutaneous - symptoms appear on the skin, in the genital area. They look like ulcers, erosion, rashes. Often, ulceration can grow into underlying tissues (muscles, bones). Small wounds, cuts, scratches do not heal for a long time, which is an unfavorable prognostic sign.
Widespread - the most severe form of AIDS, in which all organs and systems are affected simultaneously. Death, as a rule, occurs in the first six months from severe renal failure.

AIDS progresses and develops very quickly. with the terminal stage of HIV infection does not exceed 2-3 years. However, timely antiretroviral therapy can sometimes delay death for a long period of time.

Unfortunately, many HIV-infected people find out about their status in the final stages of the disease. What are the stages of the disease?

HIV infection is a very specific disease that can be found out many years after infection. For more than one year, the disease can pass in a latent stage, proceeding almost asymptomatically. However, in the early stages of HIV infection, the so-called acute stage occurs, the symptoms of which can become “bells” in order to be tested for HIV, especially if there was a recent risk of infection.

In modern Russian medicine, there are 5 main stages of HIV infection, which, in turn, are also subdivided into several types. The first stage is incubation. It begins from the moment the human immunodeficiency virus enters the body and can last from 3 weeks to 3 months, however, there have been cases when the incubation stage lasted a whole year. During this period, the virus actively multiplies in the body. It is impossible to determine HIV at this stage, since the disease is completely asymptomatic, and the immune system has not yet begun to produce antibodies to the virus, therefore, HIV tests in the body cannot yet be determined. The next stage is the stage of primary manifestations. It can take place in different ways: without symptoms (in this case, the only response to HIV is the production of antibodies), or acute HIV infection occurs, which can pass without or with secondary diseases. If the acute stage passes without secondary diseases, then, as a rule, it proceeds like a common cold - a slight fever, pharyngitis, swollen lymph nodes. If there are secondary diseases, then they are treated quickly enough, and arise as a result of low immunity. It is the acute stage that should become the first "bell" after which a person must be tested for HIV. At this stage, antibodies to HIV have already begun to be produced by the body, so tests should already detect the presence of the virus in the body.

After the acute stage, the subclinical stage begins, which can last up to twenty years, but usually it lasts for 6-7 years. It passes asymptomatically and only enlarged lymph nodes are a manifestation of the disease. The next stage is the stage of secondary diseases. With it, the level of lymphocytes in the blood is very low, so opportunistic diseases practically attack the body. The last stage is the so-called terminal, i.e. AIDS.

But it is the acute stage that is very important in determining HIV, because it is at this stage that you can pay attention to the symptoms. Of course, these symptoms are quite mediocre, and, in most cases, no one pays attention to them. However, if a person had a risk of infection with the virus, then it is just necessary to monitor their well-being, and if there are body aches, fever, a rash on the body and mucous membranes, diarrhea, vomiting, inflammation of the lymph nodes, then it is necessary to go to the hospital and take a test. In any case, you should inform your doctor about your guesses and assumptions so that he can already give precise instructions and recommend testing.

It is very important to monitor your health, to listen to the body's reactions, they are never accidental. If any processes occur in the body, you need to pay attention to them and go to the doctor.

Stage 1 - "Incubation stage" - the period from the moment of infection until the appearance of the body's reaction in the form of clinical manifestations of "acute infection" and / or the production of antibodies. Its duration usually ranges from 3 weeks to 3 months, but in isolated cases it can take up to a year. During this period, HIV is actively multiplying, but there are no clinical manifestations of the disease and antibodies to HIV have not yet been detected. Therefore, at this stage, the diagnosis of HIV infection, suspected on the basis of epidemiological data, cannot be confirmed by the traditional laboratory method (detection of antibodies to HIV). For this, it is necessary to use methods that allow detecting the human immunodeficiency virus or its fragments (antigens, nucleic acids) in the serum.

Stage 2 - The "Primary Manifestation Stage" is the body's primary response to the introduction and replication of HIV in the form of clinical manifestations and / or antibody production. This stage can have several flow options:

2A - "Asymptomatic", characterized by the absence of any clinical manifestations of HIV infection. The body's response to the introduction of HIV is manifested only by the production of antibodies (seroconversion);

2B - "Acute infection without secondary diseases", manifested by various clinical symptoms. The most frequently recorded fever, rashes on the skin and mucous membranes (urticarial, papular, petechial), swollen lymph nodes, pharyngitis. There may be an increase in the liver, spleen, diarrhea. Sometimes "aseptic meningitis" develops, which is manifested by meningeal syndrome. In this case, with lumbar puncture, unchanged cerebrospinal fluid is usually obtained, flowing out under increased pressure, occasionally a slight lymphocytosis is noted in it. Similar clinical symptoms can be observed in many infectious diseases, especially the so-called "childhood infections". Sometimes this variant of the course is called "mononucleosis-like" or "rubella-like" syndrome. In the blood of patients during this period, wide-plasma lymphocytes - mononuclear cells can be found, which further enhances the similarity of this variant of the course of HIV infection with infectious mononucleosis. Bright mononucleosis-like or rubella-like symptoms are detected in 15 - 30% of patients, the rest have 1 - 2 of the above symptoms in any combination. In some patients, lesions of an autoimmune nature may be noted. With this course of the stage of primary manifestations, a transient decrease in the level of CD4 lymphocytes is often recorded;

2B - "Acute infection with secondary diseases", characterized by a significant decrease in the level of CD4 lymphocytes. As a result, against the background of immunodeficiency, secondary diseases of various etiologies appear (candidiasis, herpes infection, etc.). Their manifestations, as a rule, are mild, short-term, respond well to therapy, but can be severe (candidal esophagitis, pneumocystis pneumonia), in rare cases, even fatal outcome is possible.

In general, the stage of primary manifestations, proceeding in the form of acute infection (2B and 2C), is recorded in 50 - 90% of patients with HIV infection. The onset of the stage of primary manifestations, proceeding in the form of an acute infection, is usually noted in the first 3 months after infection. It can outpace seroconversion, that is, the appearance of antibodies to HIV. Therefore, at the first clinical symptoms in the patient's serum, antibodies to HIV proteins and glycoproteins may not be detected.

The duration of clinical manifestations in the second stage can vary from several days to several months, but they are usually recorded within 2 to 3 weeks. Clinical symptoms of the stage of primary manifestations of HIV infection may recur.

In general, the duration of the stage of primary manifestations of HIV infection is one year from the onset of symptoms of acute infection or seroconversion.

In prognostic terms, the asymptomatic course of the stage of primary manifestations of HIV infection is more favorable. The harder and longer (more than 14 days) this stage lasts, the more likely it is that HIV infection will progress rapidly.

The stage of primary manifestations of HIV infection in the overwhelming majority of patients becomes subclinical, but some - bypassing it - immediately develop the stage of secondary diseases.

Stage 3 - "Subclinical stage", is characterized by a slow increase in immunodeficiency, which is associated with compensation of the immune response due to the modification and excessive reproduction of CD4 cells. The replication rate of HIV during this period slows down in comparison with the stage of primary manifestations.

The main clinical manifestation of the subclinical stage is "persistent generalized lymphadenopathy" (PGL). It is characterized by an increase in at least two lymph nodes in at least two unrelated groups (not counting the inguinal), in adults - up to a size of more than 1 cm in diameter, in children - more than 0.5 cm, persisting for at least 3 -x months. On examination, the lymph nodes are usually elastic, painless, not welded to the surrounding tissue, the skin over them is not changed.

The enlargement of lymph nodes at this stage may not meet the criteria for persistent generalized lymphadenopathy (PGL) or not be registered at all. On the other hand, such changes in the lymph nodes can be noted in the later stages of HIV infection. In some cases, they occur throughout the disease, but in the subclinical stage, enlarged lymph nodes are the only clinical manifestation.

The duration of the subclinical stage varies from 2 - 3 to 20 years or more, but on average it lasts 6 - 7 years.

Stage 4 - The "Secondary Disease Stage" is associated with depletion of the CD4 cell population due to ongoing HIV replication. As a result, against the background of significant immunodeficiency, infectious and / or oncological secondary diseases develop. Their presence determines the clinical picture of the stage of secondary diseases.

Depending on the severity of secondary diseases, stages 4A, 4B, 4C are distinguished.

Stage 4A usually develops 6 to 10 years after infection. It is characterized by bacterial, fungal and viral lesions of the mucous membranes and skin, inflammatory diseases of the upper respiratory tract.

Stage 4B most often occurs 7 to 10 years after infection. Skin lesions during this period are of a deeper nature and are prone to a protracted course. The lesions of the internal organs and the peripheral nervous system, localized Kaposi's sarcoma, begin to develop.

Stage 4B appears predominantly 10 to 12 years after infection. It is characterized by the development of severe, life-threatening secondary diseases, their generalized nature, and damage to the central nervous system.

Despite the fact that the transition of HIV infection to the stage of secondary diseases is associated with the depletion of the protective reserves of the macroorganism, this process is reversible (at least for some time). Clinical manifestations of secondary diseases may disappear spontaneously or as a result of ongoing therapy. Therefore, at this stage, there are phases of progression (in the absence of antiretroviral therapy or against the background of antiretroviral therapy) and remission (spontaneous, after previously conducted antiretroviral therapy or against the background of antiretroviral therapy).

Stage 5 - "Terminal stage", is manifested by the irreversible course of secondary diseases. As a result, the patient dies within a few months.

When making a diagnosis, the nosological unit according to ICD-10 is indicated - HIV infection, then the stage of HIV infection, phase, secondary disease. If, against the background of HIV infection, at least one of the secondary diseases has a degree of manifestation that meets the criteria for acquired immunodeficiency syndrome, AIDS is indicated after the phase of the disease.

Below is a list of conditions (28 in total) that indicate the development of AIDS in a patient (determined by WHO recommendations). It is used primarily for epidemiological surveillance of the spread of HIV in the world, since HIV cases are not registered in all countries.