Symptoms

Symptoms

In its early stages, HIV infection has no symptoms or causes only a flu-like illness with many of the following symptoms: fever, sore throat, rash, nausea and vomiting, diarrhea, fatigue, swollen lymph nodes, muscle aches, headaches and joint pain. Although 50% to 90% of people experience symptoms within the first few weeks of contracting HIV infection, most people and doctors dismiss the illness as a routine cold or flu. In a small number of cases, this early stage of infection may progress to meningitis (inflammation of membranes covering the brain) or other severe flulike symptoms that require hospitalization.

As the number of CD4 cells drops below normal (800 to 1,200 cells per cubic millimeter of blood), the person may begin to develop swollen lymph nodes and skin problems, such as seborrheic dermatitis (dandruff), new or worsening psoriasis and minor infections. Ulcers can develop around the mouth.

Over the next few years, as CD4 cells continue to die, skin problems and mouth ulcers develop more often. Recurring herpes and varicella-zoster infections (shingles) can occur. Many people develop diarrhea, fever, unexplained weight loss, joint and muscle pain, and fatigue. Old tuberculosis infections may reactivate even before AIDS develops. (Tuberculosis is one of the most common AIDS-related infections in the developing world.)

Finally, with further decreases in the levels of CD4 cells, the person develops AIDS. In an HIV-infected person, some signs that AIDS has developed are:

• The CD4 count has decreased to 200 cells per cubic milliliter of blood or fewer.
• An infection has developed, causing certain types of pneumonia, diarrhea, eye infections or meningitis. Some of the germs that can cause these opportunistic infections include Candida fungus, cryptococcosis, cytomegalovirus, herpes simplex virus, Mycobacterium avium complex and Pneumocystis carinii. The person also can develop fungal infections specific to certain areas of the United States, such as histoplasmosis and coccidioidomycosis.
• A tumor has developed, including cervical cancer, Kaposi's sarcoma (cancer-causing round, reddish spots in the skin and mouth), certain types of non-Hodgkin's lymphoma or brain lymphoma.
• An AIDS-related brain illness has developed, including HIV encephalopathy (AIDS dementia) or progressive multifocal leukoencephalopathy.
• There is severe body wasting (HIV wasting syndrome).
• There is an AIDS-related lung illness, such as pulmonary lymphoid hyperplasia or lymphoid interstitial pneumonia (usually seen only in children).