D R . E L R O I


Tuesday, May 20, 2008

The Stages of HIV Infection

AIDS is the fourth stage of HIV infection. A person is said to have AIDS when he has HIV infection and subsequently develops one of a long list of conditions that usually only occur in people with a severe immune deficiency. A CD4 cell count below 200 per milliliter blood in the presence of HIV infection also constitutes an AIDS diagnosis.

The period between infection with HIV and the onset of AIDS averages 8-10 years. In some cases, it is longer, in others, shorter than this. People with AIDS often suffer infections of the lungs, brain, eyes and other organs, and frequently suffer debilitating weight loss, diarrhea and a type of cancer called Kaposi's sarcoma. Without antiretroviral treatment or ARV, most people with AIDS die within 2 years of developing infections or cancers that take advantage of their weakened immune systems.

The World Health Organization or WHO divides the course of the disease into four stages. Primary HIV infection is the first stage. From the time of infection with the virus until the antibodies are manufactured in the blood. A mild cold, night sweats, etc., could accompany this phase. This phase also covers the window period which is 3 months.

Asymptomatic stage is the second stage. The person is as healthy as can be, as his immune system is still strong enough like me. This stage can be prolonged for more than 20 or 25 years or sometimes even longer with the help of ARV. The person takes this lifetime medication to live a normal healthy lifestyle.

The third stage is the symptomatic HIV infection. Person has occasional mild mouth sores, skin infections or night sweats. The person receives treatment for the infections and they are completely healed. Months later, he may pick up another infection. These mild infections indicate a slight degree of immune suppression. It means the HI virus has already damaged the immune system to the point that it can no longer perform its normal functions.

The last stage is the progression from HIV to AIDS or AIDS stage; regular incidences of serious opportunistic infections such as TB, PCP or serious opportunistic lung infection, diarrhea and Kaposi's sarcoma which is a kind of skin cancer. There is a progressive deterioration in health, ultimately resulting in death. In this last phase you could say that the person has AIDS.

It is only in the last phase that a person's condition deteriorates to the extent that he will no longer be able to work. This phase lasts about 16 to 18 months. With some people this period is even shorter. The media have created the impression that the deterioration continues for years, with the person having to remain at home or in hospital. This actually only applies in the last few months of the fourth phase. For most of this period the person is healthy enough to continue working. It obviously varies from one person to the next. Some people are inclined to be chronically ill for longer, while others display the symptoms of AIDS for a long time while still being able to function normally.

There are also cases where a person positive to HIV has very low CD4 cell count and yet still looks healthy and very normal, while some suffers from different infections. I will discuss about testing, opportunistic infections, and treatments on my next posts.

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