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. [cdc.gov]

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

• Fever

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

  You may have diarrhea, fever, weight loss, night sweats, or feel tired. Non-Hodgkin's lymphoma (lim-fo-muh) is a cancer that may effect AIDS patients. [drugs.com]

• Weight Loss

  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]

  […] 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]

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

  They are also prone to wasting syndrome (involuntary weight loss), and memory impairment. [practo.com]

• 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]

  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]

• Candidiasis

  Infectious diseases comprised of TB; 4 cases, cytomegalovirus infection (CMV) 4; bacterial pneumonia and meningitis; 7, and esophageal candidiasis in 2 cases. [ncbi.nlm.nih.gov]

  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]

  ((S))These infections include pneumonia, meningitis, or encephalitis due to one or more of the following: aspergillosis, candidiasis, cryptococcosis, cytomegalovirus, nocardiosis, strongyloidosis, toxoplasmosis, zygomycosis, or atypical mycobacteriosis [cdc.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]

• 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]

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

  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]

• 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]

  […] and loss of appetite, caused by HIV itself Common with CD4 count below 50/mm 3 : Cytomegalovirus infection -- a viral infection that can affect almost any organ system, especially the large bowel and the eyes Mycobacterium avium -- a blood infection [web.archive.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]

• 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]

• 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]

• 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). [cdc.gov]

  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]

• Lymphopenia

  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]

  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]

• 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. [n.neurology.org]

• 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]

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]

In Africa antiretroviral treatment coverage has increased significantly. This has partly been due to the Treatment 2015 initiative which aims to ensure that the world reaches its 2015 HIV treatment target of 15 million. [patient.info]

The clinical stage of the lymphoma was IVB and the international prognosis index was categorized as high. [ncbi.nlm.nih.gov]

Fear and uncertainty in patient care and prognosis as well as loss of confidentiality are among the stresses on gay men with AIDS. [annals.org]

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]

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]

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

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]

This study is an observational and retrospective study aimed at the characterising IFI incidence and describing the epidemiology, clinical diagnostic and therapeutic features and denouement in HIV/AIDS patients. [ncbi.nlm.nih.gov]

Abstract In the absence of direct epidemiological evidence, molecular evolutionary studies of primate lentiviruses provide the most definitive information about the origins of human immunodeficiency virus (HIV)–1 and HIV–2. [doi.org]

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]

[…] important strand of AIDS prevention programmes. [patient.info]

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]

It also disseminates federally approved HIV treatment and prevention guidelines. [curlie.org]

1. Campbell-Yesufu OT, Gandhi RT. Update on Human Immunodeficiency Virus (HIV)-2 Infection. Clin Infect Dis. 2011;52(6):780-787.
2. Mandell GL, Bennett JE, Dolin R. Mandel, Douglas and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pennsylvania: Churchill Livingstone; 2015.
3. Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.
4. Ortblad KF, Lozano R, Murray CJL. The burden of HIV: insights from the Global Burden of Disease Study 2010. AIDS (London, England). 2013;27(13):2003-2017.
5. GBD 2015 HIV Collaborators. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. Lancet HIV. 2016 Aug; 3(8):e361–e387.
6. Centers for Disease Control and Prevention (CDC). Revised surveillance case definition for HIV infection--United States, 2014. MMWR Recomm Rep. 2014;63(RR-03):1-10.
7. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012.