Stages of HIV infectionThe U.S. Centers for Disease Control and Prevention (CDC) developed a staging system as early as 1993 that is still used today. The basis for this staging is the number of CD4 cells in the blood and the patient's individual symptoms. If the HIV infection progresses, the patient is reclassified. What is not taken into account in this staging is that under therapy, an improvement in both the CD4 cell count and the symptoms is possible. There is no provision for reclassification.
The acute HIV infection
After infection with HIV, acute flu-like symptoms appear after about two weeks. These vary in severity from patient to patient. In some patients this phase of the disease goes completely unnoticed. Typically, fever occurs, patient feels listless and has no appetite. Sometimes loses weight. Muscle and joint pain may occur, half of the patients develop a rash on the trunk and face two to three days after the onset of fever, ulcers in the mouth and inflammation of the throat are less common. The symptoms last about seven to ten days. They are often misinterpreted as symptoms of a cold, flu, or Pfeiffer's glandular fever.
Since no antibodies are detectable in the HIV test at this early stage of infection, it is also difficult for the doctor to diagnose an HIV infection. In this case it is important to point out a possible infection/risk situation yourself. After a risk contact, an infection can be detected with a modern HIV test that detects not only antibodies but also a specific antigen according to ca. 6 weeks exclude. If there is an urgent suspicion of an acute HIV infection, it is also possible to detect the viruses directly in the blood by means of HIV-PCR (polymerase chain reaction).
Symptom-free phase
After the acute infection is over, most infected persons feel healthy and have no further complaints. This phase can last for many years. However, the absence of symptoms does not mean that the HI virus is no longer present and does not cause any damage. On the contrary, it continues to multiply and destroy the CD4 cells. However, the immune system keeps HIV under control, so that a balance is established between virus replication and virus defense. How long this symptom-free phase lasts depends, among other things, on the state of health of the infected person.
Symptomatic phase
HIV disease continues to progress. Initial symptoms are usually not very typical. Do not necessarily suggest an HIV infection. These include
– Moderate fever> Chronic diarrhea lasting longer than one month – Shingles (herpes zoster) – Fungal infections of the oral cavity (thrush) – Swelling of the lymph nodes – Reduction of the blood platelets (thrombocytes) – Symptoms of the disease do not mean that the HI virus is no longer present and does not cause any damage
When these symptoms occur, therapy must be started.
AIDS-defining diseases
If HIV infection is not treated with antiretroviral drugs, AIDS-defining diseases usually develop after about eight to ten years. The full AIDS picture is now available (Acquired Immunodeficiency Syndrome). The immune system is so weakened that harmless pathogens can no longer be fought off. If HIV infection is diagnosed and treated in time, full-blown AIDS almost never occurs nowadays. However, about one in three HIV-infected persons only learns of his disease with the appearance of the full AIDS picture.