AIDS occurs in patients who suffer from a severe and long unrecognized human immunodeficiency virus (HIV) infection (caused by either HIV-1 or HIV-2 virus) [1] [2] [3]. AIDS is almost never encountered in patients with an acute HIV infection, but rather develops after the period of latency and progressive decrease in CD4+T-cell function [4] [5]. One of the most important risk factors is the lack of treatment, mostly because of a missed (or unknown) diagnosis. The progressive nature of HIV infection symptoms and infections have been grouped into two diagnostic criteria devised by the Center for Disease Control (CDC) and the World Health Organization (WHO). As per CDC criteria, three distinct categories exist - A, B, and C, with A describing features of acute or asymptomatic HIV infection [2] [6]. On the other hand, categories B and C (similarly to clinical stages 2,3 and 4 of WHO criteria) include the appearance of AIDS-related conditions. Constitutional symptoms such as fever, fatigue, or diarrhea lasting for at least one month, peripheral neuropathy and numerous infections - Listeriosis, Bacillary angiomatosis, recurrent herpes zoster involving > 1 dermatome and pelvic inflammatory disease (PID) are initial signs of AIDS [1] [2] [3] [6] [7]. Candidiasis, however, is the most important group B feature of patients with suspected HIV or AIDS and can present in the oropharynx or the genitalia. Additional disorders that belong to the B category are immune thrombocytopenic purpura (ITP), cervical dysplasia (or cervical carcinoma in situ) and oral hairy leukoplakia. When patients present with profound weight loss and poor general condition due to "wasting syndrome" caused by HIV, they are adequately classified into category C and clinical stage 4, respectively, and signs of severe AIDS include [1] [2] [3] [6] [7]:

• Infections - Candidiasis (esophageal, pulmonary, or tracheal), pneumocystis jirovecii pneumonia (PCP), coccidiomycosis (either extrapulmonary or disseminated), extrapulmonary cryptococcosis, cytomegalovirus (CMV) infection of sites other than the spleen, lymph nodes or liver (such as pneumonia or retinitis), herpes simplex virus (HSV) infection of the respiratory system or the esophagus, histoplasmosis, intestinal isosporiasis, mycobacterial infections (both by tuberculous and by non-tuberculous mycobacteria, most notably M. avium), cerebral toxoplasmosis, recurrent pneumonias and severe infections by Salmonella spp.
• Malignancies - Lymphomas, Kaposi's sarcoma, and invasive cervical cancer.
• Other conditions - Progressive multifocal leukoencephalopathy (PML), HIV-related encephalopathy that can present with various neurological symptoms, including dementia (also known as the AIDS dementia complex).

• Generalized Lymphadenopathy

  Editorial Note Editorial Note: The report above documents the occurrence of cases of unexplained, persistent, generalized lymphadenopathy among homosexual males. [web.archive.org]

  Symptoms include generalized lymphadenopathy, fever, weight loss, and chronic diarrhea. [icd9data.com]

• Fever

  World English acquired immunodeficiency syndrome acquired immunodeficiency syndrome noun Medicine The disorder resulting from infection with human immunodeficiency virus (HIV), characterized by a reduction in the number of helper T lymphocytes with fever [oxforddictionaries.com]

  Pneumocystis carinii and fever improved immediately when ST mixture and highly active antiretroviral therapy (HAART) were performed. [ncbi.nlm.nih.gov]

  In some patients, generalized lymphadenopathy, fever, weight loss, dementia, or chronic diarrhea occurs much earlier in the course of the infection. [medical-dictionary.thefreedictionary.com]

  Symptoms of infection begin to appear, such as chronic fatigue, fever, significant weight loss, etc. These are signs that the organism is no longer able to properly protect itself. [fqsida.org]

• Weight Loss

  loss, lymphadenopathy, and the occurrence of opportunistic infections and malignant tumours; abbreviated AIDS. [oxforddictionaries.com]

  […] infections (for example, bacterial sinusitis) And/or Performance scale 2: symptomatic, normal activity Stage 3: Weight loss >10% body weight Unexplained chronic diarrhoea for longer than one month Unexplained prolonged fever (intermittent or constant [dx.doi.org]

  Weight loss Many opportunistic infections associated with AIDS cause serious illness. [ucsfhealth.org]

  Here, I report the case of a 31-year-old immigrant Burmese woman who exhibited epigastralgia, fever, weight loss and an epigastric mass. [ncbi.nlm.nih.gov]

  […] severe weight loss (>10% of presumed or measured body weight) Unexplained chronic diarrhea for >1 month Unexplained persistent fever for >1 month (>37.6°C, intermittent or constant) Persistent oral candidiasis (thrush) Oral hairy leukoplakia Pulmonary [web.archive.org]

• Fatigue

  Fatigue was defined by patient self-report. The outcomes were the prevalence of fatigue and the potential risk factors of fatigue. [ncbi.nlm.nih.gov]

  Symptoms of infection begin to appear, such as chronic fatigue, fever, significant weight loss, etc. These are signs that the organism is no longer able to properly protect itself. [fqsida.org]

  Mycobacterium Avium Complex — This is a bacterial infection that can cause persistent fever, night sweats, fatigue, weight loss, anemia, abdominal pain, dizziness, diarrhea and weakness. [ucsfhealth.org]

  Thalassemia can cause anemia, leaving you fatigued. If you have mild thalassemia, you might not need treatment. But more severe forms might require regular blood transfusions. [mayoclinic.org]

• Candidiasis

  Examples include, but are not limited to, the following: Bacillary angiomatosis Oropharyngeal candidiasis (thrush) Vulvovaginal candidiasis, persistent or resistant Pelvic inflammatory disease (PID) Cervical dysplasia (moderate or severe)/cervical carcinoma [web.archive.org]

  Disseminated cryptococcosis and recurrent oral candidiasis was presented in a-heterosexual AIDS patient. [ncbi.nlm.nih.gov]

  On admission he was found to have P. carinii pneumonia, oral candidiasis, and CMV retinitis. A complement-fixation CMV titer in April 1981 was 128. [doi.org]

• Anemia

  In univariate analysis, the significant differences in demographic characteristics between patients with and without fatigue were: gender [OR = 2.29; 95% CI (1.05-4.98)], education level [OR = 0.40; 95% CI (0.18-0.85)], anemia [OR = 3.80; 95% CI (1.27 [ncbi.nlm.nih.gov]

  It may cause anemia in their children. Anemia is low numbers of red blood cells or low hemoglobin level. Hemoglobin is the part of red blood cells. It carries oxygen to organs, tissues, and cells. [stanfordchildrens.org]

  During pregnancy, the microcytic anemia can be mistaken for anemia of pregnancy. The individual with α thalassemia trait will experience no significant health problems except a possible slight anemia which cannot be treated with iron. [thalassemia.com]

• Cough

  This is the case of a patient with multiple secondary sexually transmitted infectious diseases, lymphadenopathy, B-cell lymphoma, a productive cough, a clinical picture suggestive of pulmonary tuberculosis, eosinophilia, and a new-onset acquired immunodeficiency [ncbi.nlm.nih.gov]

  This infection causes a long-term cough that may include coughing or spitting up blood. You may have fever, weight loss, or night sweats. Other signs depend upon the site of the infection. [drugs.com]

  TB is transmitted when a person with active TB coughs or sneezes, releasing microscopic particles into the air. If inhaled, these particles may transmit the condition. [ucsfhealth.org]

• Chronic Cough

  Signs of chronic ENT disease, such as scarred eardrums, encrusted nostrils and postnasal drip may be evident. There may be a chronic cough with crepitations in both lungs. Hepatomegaly and splenomegaly may be detected in the abdomen. [patient.info]

• Diarrhea

  Keywords: non-human primate, chronic diarrhea, aids, hiv, siv Abstract: Diarrhea is the pathophysiological reaction of hosts gastrointestinal tract to a variety of external stimuli. [doi.org]

  Diarrhea is the pathophysiological reaction of host's gastrointestinal tract to a variety of external stimuli. Classified as a clinical syndrome, diarrhea is the leading cause of mortality and morbidity worldwide. [ncbi.nlm.nih.gov]

  […] pneumonia (PCP) Progressive multifocal leukoencephalopathy (PML) Salmonella septicemia, recurrent (nontyphoid) Toxoplasmosis of brain Wasting syndrome caused by HIV (involuntary weight loss >10% of baseline body weight) associated with either chronic diarrhea [web.archive.org]

• Chronic Diarrhea

  Keywords: non-human primate, chronic diarrhea, aids, hiv, siv Abstract: Diarrhea is the pathophysiological reaction of hosts gastrointestinal tract to a variety of external stimuli. [doi.org]

  Because of its impact on the host immune system, acquired immune deficiency syndrome (AIDS) is currently the major cause of chronic diarrhea in many parts of the world. [ncbi.nlm.nih.gov]

  Symptoms include generalized lymphadenopathy, fever, weight loss, and chronic diarrhea. [icd9data.com]

  diarrhea (two or more loose stools per day for ≥1 month) or chronic weakness and documented fever for ≥1 month WHO Clinical Staging of HIV/AIDS and Case Definition The clinical staging and case definition of HIV for resource-constrained settings were [web.archive.org]

  Other common symptoms include chronic diarrhea and nerve problems. It is most likely to occur when a person’s CD4+ T cell count falls below 100 cells per cubic millimeter of blood. [ucsfhealth.org]

• Failure to Thrive

  The clinical manifestations were failure to thrive; 9 children, persistent gastroenteritis; 8, recurrent fever; 5, bacterial infections; 5, hepatosplenomegaly; 5, candidiasis; 1, scabies; 1, skin rash; 2, tuberculous (TB) meningitis; 1 and paraplegia; [ncbi.nlm.nih.gov]

  The predominant clinical findings included failure to thrive, persistent infection of the oral mucosa by Candida albicans, chronic pulmonary infiltrates, hepatosplenomegaly, lymphadenopathy, and diarrhea. [nejm.org]

  Testing can be done within the first few months, but it is also important to recognize the early signs: recurrent infections and failure to thrive. [healthline.com]

  As the disease progresses, characteristics are a general failure to thrive, anergy, and any of a variety of recurring infections, most commonly Pneumocystis pneumonia, tuberculosis, meningitis, and encephalitis caused by aspergillosis, candidiasis, cryptococcosis [medical-dictionary.thefreedictionary.com]

  Common gastrointestinal symptoms include diarrhoea, malabsorption and failure to thrive or losing weight. [patient.info]

• Loss of Appetite

  Several symptoms, such as weight loss and loss of appetite, were more common in our subjects with PHI. [aidsonline.com]

  Other symptoms include stomach cramps, nausea, fatigue, weight loss, appetite loss, vomiting and dehydration. This infection is difficult to treat and there is no definitive effective treatment. Symptom control and treatment of HIV are necessary. [ucsfhealth.org]

  Symptoms of ARC may include loss of appetite, weight loss, fever, night sweats, skin rashes, diarrhea, tiredness, lack of resistance to infection or swollen lymph nodes. Note: Not everyone who has been infected with HIV develops AIDS. [healthcentral.com]

  […] of appetite, leading to a disproportionate loss of strength in different muscles in the body The CD4 lymphocyte count predicts the type of opportunistic infections and cancers an HIV-infected individual can develop as the count decreases Sometimes, an [dovemed.com]

• Perianal Ulcer

  Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med 1981;305:1439-44. Marmor M, Friedman-Kien AE, Laubenstein L., et al. [cdc.gov]

  Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. N Engl J Med. 1981;305(24):1439–44. PubMed Google Scholar 14. [springerlink.com]

  ulcerative herpes simplex lesions. [retrovirology.com]

• Lesion of the Tongue

  The signs and symptoms of some of these infections may include: Sweats Chills Recurring fever Chronic diarrhea Swollen lymph glands Persistent white spots or unusual lesions on your tongue or in your mouth Persistent, unexplained fatigue Weakness Weight [mayoclinic.org]

• Social Isolation

  This includes having regular dental checks and their own accommodation. [ 19 ] There may be an element of social isolation and psychological issues may need to be addressed. [patient.info]

  Socially isolate yourself from that source. And stop reading political journalists to learn about a health issue. [theamericanconservative.com]

  Children orphaned due to AIDS-related deaths of parents or caregivers face an unpredictable future that is often compounded by the same stigma, discrimination, and social isolation faced by their parents/caregivers (12). [ifsw.org]

  Direct mechanisms are those that increase the likelihood of a person coming into contact with someone who is HIV positive, for example, through residential segregation and the social isolation of marginalized populations. [epirev.oxfordjournals.org]

  Generally, frequent or long‐term absence from work leads to job loss and may result in depression, financial insecurity, and social isolation ( Henderson 2005 ; Linn 1985 ). [doi.org]

• Addictive Behavior

  Spontaneous cognition and HIV risk behavior. Psychology of Addictive Behaviors, 20 (2), 196–206. PubMed Google Scholar Stuss, D. T., & Knight, R. T. (2002). Principles of frontal lobe function. New York: Oxford University Press. [doi.org]

• Peripheral Neuropathy

  Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. [doi.org]

  Abstract Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. [ncbi.nlm.nih.gov]

  Constitutional symptoms such as fever, fatigue, or diarrhea lasting for at least one month, peripheral neuropathy and numerous infections - Listeriosis, Bacillary angiomatosis, recurrent herpes zoster involving > 1 dermatome and pelvic inflammatory disease [symptoma.com]

• Sexual Dysfunction

  ''And we never find out about sexual dysfunction or about a grandparent who is afraid to touch his grandchild or about a patient who has to sit alone at family gatherings because everyone is afraid he'll give them AIDS.'' [nytimes.com]

Because many disorders are a part of the clinical presentation of AIDS, physicians must maintain a high index of suspicion when any of the mentioned illnesses or infections appear together with a poor general condition. For this reason, a comprehensive workup is necessary to rule out HIV infection and AIDS as a possible cause [2]. Firstly, a detailed patient history must include assessment of potential risk factors such as unprotected sexual intercourse, particularly male homosexual (as the vast majority of patients in the developed world are males belonging to the men having sex with men - MSM population), contact with blood products (through intravenous drug use) or a positive family history in the setting of vertical transmission [2] [6] [7]. Moreover, the appearance of any of the infections (or their respective signs and symptoms) in recent months should be noted, and a detailed and complete physical examination may confirm cutaneous, pulmonary, or general manifestations of AIDS and warrant a laboratory investigation to diagnose the clinical entity. A neurological exam (including the mini-mental status examination) must be carried out in all patients suspected to have severe HIV infection, in order to assess the extent of neurological involvement and detect AIDS-related dementia. In addition to a complete blood count (CBC), which will show lymphopenia in virtually all patients, an extensive biochemical panel is necessary to evaluate organ status - lipid profile, liver and kidney function, and a full electrolyte panel [2] [3] [7]. If the diagnosis of HIV is not already known, testing for HIV antibodies is the first step in confirming this infection, followed by a CD4+T-cell count and isolation of viral RNA through polymerase chain reaction (PCR) analysis. Classification of patients harboring an HIV infection, supplementary to clinical criteria, is based on the CD4+T-cell count as well, and a number of < 200/µL is diagnostic for AIDS [2]. Additional recommended procedures include syphilis testing with the Venereal disease research laboratory test (VDRL) and rapid plasma reagin (RPR) tests, detection of anti-toxoplasma antibodies, purified protein derivative (PPD) test for tuberculosis, and determine possible coinfection by hepatitis viruses (A, B, or C) [3] [6] [7].

• Anergy

  Moreover, the findings of anergy and depressed T-lymphocyte helper-to-suppressor ratios in some of the patients with lymphadenopathy suggest cellular immune dysfunction. Patients with KS/OI have had severe abnormalities of cellular immunity (5,6). [web.archive.org]

  As the disease progresses, characteristics are a general failure to thrive, anergy, and any of a variety of recurring infections, most commonly Pneumocystis pneumonia, tuberculosis, meningitis, and encephalitis caused by aspergillosis, candidiasis, cryptococcosis [medical-dictionary.thefreedictionary.com]

• Leukopenia

  Approximately 2 years after the onset of urticaria pigmentosa, this patient developed septicemia and ascites along with hepatosplenomegaly, liver damage, chronic cholecystitis, leukopenia, thrombocytopenia and relative eosinophilia. [content.sciendo.com]

  Other features of his illness included leukopenia and mucosal candidiasis. His pneumonia responded to a course of intravenous TMP/SMX, but, as of the latest reports, he continues to have a fever each day. [doi.org]

  Other features of his illness included leukopenia and mucosal candidiasis. His pneumonia responded to a course of intravenous TMP/.SMX, but, as of the latest reports, he continues to have a fever each day. [web.archive.org]

• Lymphopenia

  Other researchers have documented that individuals with severe COVID-19 may exhibit lymphopenia, or an atypically low number of lymphocytes in the blood. [forbes.com]

  Lymphopenia was not common, as it is in adult patients. Infectious agents responsible for opportunistic infections in this series included Pneumocystis carinii, herpesviruses, particularly cytomegalovirus, and C. albicans. [nejm.org]

  All had lymphopenia, and the two patients who were specifically tested have had in vitro laboratory evidence of cellular immune deficiency. The case reports follow. [cdc.gov]

  In addition to a complete blood count (CBC), which will show lymphopenia in virtually all patients, an extensive biochemical panel is necessary to evaluate organ status - lipid profile, liver and kidney function, and a full electrolyte panel. [symptoma.com]

• Hyponatremia

  Hyponatremia and MAI bacteremia were found in 58% of CMVE cases. Polymerase chain reaction (PCR) of CSF samples identified CMV genome in 33% of CMVE cases. [neurology.org]

• Abnormal Renal Function

  The dose must be adjusted for abnormal renal function. Multiple randomized clinical trials indicate that TMP-SMX is as effective as parenteral pentamidine and more effective than other regimens. [cdc.gov]

• Hemoglobin Decreased

  Introduction Thalassemia is a general term for a group of congenital, genetic disorders characterized by low levels of hemoglobin, decreased red blood cell production, and anemia. [rarediseases.org]

[…] to be in need of treatment by more than 10 million. [web.archive.org]

After adjusting for other factors, a shorter time of treatment with TCM, male sex, older age, lower CD4 + T-cell counts, and long-term treatment with cART were risk factors of mortality. [ncbi.nlm.nih.gov]

The second 90 Among people who knew their status, four out of five (79%) were accessing treatment. The third 90 And among people accessing treatment, four out of five (81%) were virally suppressed. [avert.org]

When patients with penicilliosis/AIDS were diagnosed early and treated with standardized antifungal therapy and combined antiretroviral therapy, their prognosis improved. [ncbi.nlm.nih.gov]

Critical issues surrounding the diagnosis, screening of blood products, treatment of complicating infections and cancers, and prognosis for immunologic recovery in affected persons are unresolved. [annals.org]

Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]

If the target cell of AIDS is the mature T cell as suspected, the methods used in these studies may prove useful for the long-term growth of these cells and for the identification of antigens specific for the etiological agent of AIDS. [ncbi.nlm.nih.gov]

A second hospitalization, beginning in June 1982, was complicated by Salmonella sepsis, perianal herpes simplex virus infection, encephalitis of unknown etiology, and disseminated cytomegalovirus infection. He died in August 1982. [cdc.gov]

A historical framework for social epidemiology. In: Berkman LF, Kawachi I, eds. Social epidemiology. New York, NY: Oxford University Press, 2000:3–12. 2. Krieger N. A glossary for social epidemiology. [epirev.oxfordjournals.org]

European Centre for the Epidemiological Monitoring of AIDS. 1993 revision of the European AIDS surveillance case definition. AIDS Surveillance in Europe, Quarterly Report 1993; No. 37: 23-28 2. [web.archive.org]

The hypothesis that HIV causes AIDS is examined in terms of Koch's postulates and epidemiological, biochemical, genetic, and evolutionary conditions of viral pathology. [ncbi.nlm.nih.gov]

During submission, authors are given the option to submit papers to one of the following tracks: Basic Science, Clinical Science, Translational Research, Epidemiology, Implementation Science, Prevention Research, and Critical Review. [journals.lww.com]

Currently suggested pathophysiological mechanisms of the disease are mostly derived from stroke cases. Although rare, cerebral toxoplasmosis may strengthen the pathophysiologic mechanism of disease. [ncbi.nlm.nih.gov]

Keywords: non-human primate, chronic diarrhea, aids, hiv, siv Abstract: Diarrhea is the pathophysiological reaction of hosts gastrointestinal tract to a variety of external stimuli. [doi.org]

AIDS Pathophysiology AIDS Transmission AIDS Treatment AIDS Prognosis History of AIDS This article is licensed under the Creative Commons Attribution-ShareAlike License. [web.archive.org]

Sincerely, /Eugene McCray/ Eugene McCray, MD Director Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention www.cdc.gov/hiv /Jonathan Mermin/ Jonathan H. [cdc.gov]

Case Management: Guidance HIV Prevention Through Early Detection and Treatment of Other Sexually Transmitted Diseases HIV Prevention Bulletin: Medical Advice for Persons Who Inject Illicit Drugs Guidelines for Effective School Health Education to Prevent [web.archive.org]

Prevention of sexual transmission has been more difficult. Perhaps the greatest challenge in terms of prevention has been in the global community of MSM in which HIV remains endemic at high prevalence. [ncbi.nlm.nih.gov]

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