How high is the risk of infection? | The HIV infection

How high is the risk of infection?

The HIV disease progresses in several stages. For this reason, the symptoms differ in the respective stages and make it possible to assess the course of the disease. Symptoms in the first stage: This is an acute HIV infection.

The symptoms are mostly unspecific and resemble a flu. Fever, fatigue, skin rashes, abdominal pain, diarrhea and swelling of the lymph nodes may occur. In this phase, the virus replication is particularly high and thus the risk of infection is also high.

After one to two weeks the symptoms subside and a symptom-free latency phase follows. The immune system can fight the virus to some extent. Symptoms in the second stage: The immune system is now weakened and can no longer fight the pathogen efficiently.

Consequently, the virus replication increases again. Fever (>38.5), weight loss and night sweats may occur. The lymph nodes may swell and fatigue may develop.

Chronic diarrhoea, i.e. diarrhoea that persists for more than a month, can also be the symptom of a progressive HIV infection. Besides these unspecific symptoms, individual organs can also be affected. The heart or the nerves (so-called HIV-associated peripheral polyneuropathy) can be affected.

Furthermore, a reduction of white blood cells (so-called neutropenia) occurs. This leads to a weakening of the immune system, which in turn promotes infections. This can lead to a fungal infection in the nasopharynx or genital area.

Symptoms in the third stage: The third stage is no longer called HIV infection but AIDS disease. In this stage, the infection has progressed so far that diseases that define AIDS occur. These are diseases such as Pneumocystis-jirovecii pneumonia, fungal infections of the esophagus, cytomegalovirus infections, cerebral toxoplasmosis or HIV encephalitis.

Cancers such as Kaposi’s sarcoma or non-Hodgkin’s lymphoma may also occur. The skin rash is usually a symptom of the early stage. It usually occurs in the trunk – i.e. mainly in the chest, abdomen and back.

The rash is characterized by redness and small, blotchy nodules. After the acute infection has subsided, the rash usually disappears again. The rash may reappear in the further course of the infection.

A very specific rash can occur, especially due to a reactivation of the Varicella Zoster Virus. This virus causes chickenpox in healthy patients and persists for life in ganglion cells. Due to a weakened immune system, this virus can now replicate again and cause shingles (lat.

Herpes Zoster). This leads to a painful skin rash, which is localized on one side of the body only and occurs in a special segment. Shingles occurs in the second stage of HIV infection and is an indication of increasing immunosuppression.

Lymph node swelling is a non-specific symptom, as the lymph nodes are a filter station and produce part of the lymphocytes. Lymphocytes belong to the white blood cells and are important for the immune defense. Various diseases can trigger lymphadenopathy, i.e. swelling of the lymph nodes – in most cases these are harmless diseases.

An acute HIV infection also activates the immune system and leads to increased lymphocyte production. This results in lymphadenopathy. The lymph nodes may become swollen again and enlarge again as the disease progresses.

In the second stage of HIV infection, generalized lymph node swelling usually occurs and does not subside. However, the lymph nodes may swell only locally. The immune deficiency can cause further infections, which only lead to local swelling.

An example of this is a reactivation of tuberculosis – it usually only affects the lymph nodes in the neck area. In addition to infections, cancers can also lead to swelling of the lymph nodes and should therefore be clarified by a doctor, especially if the HIV infection has existed for a long time. If the HIV infection has reached the AIDS stage, non-Hodgkin lymphomas (malignant tumor of the lymph node) are more frequent.

In the course of an HIV infection, changes can occur on the tongue. Possible are white coatings that can be wiped off. The cause of this is a fungal infection, candidiasis.

The fungus is found on the oral mucosa of every person. However, it is kept in check by an intact immune system. With an immunodeficiency it comes to an increased reproduction of the fungus.In the advanced stages, fungal infection of the esophagus can also occur, which is an AIDS-defining disease.

Furthermore, oral hair leukoplakia can also occur on the tongue. This disease is caused by the reactivation of the Epstein-Barr virus. White deposits develop on the tongue that cannot be removed.

Mostly the changes occur at the lateral edges of the tongue. Coughing is a very unspecific disease symptom and can be triggered by numerous diseases. Coughing can also occur during an HIV infection.

Mostly this cough is very persistent and without any recognizable causes. In addition, pneumonia (so-called Pneumocystis-jirovecii-Pneumonia) can develop in the advanced stage of HIV infection. In this case additional symptoms such as shortness of breath occur.

Basically, a cough without a recognizable cause and a longer existence should be clarified by a physician. Serious diseases, such as HIV infection, could be hidden behind it. Diarrhea is a symptom that often occurs with HIV infection.

It is a relatively unspecific symptom that can also occur with other diseases. Diarrhea can occur during an acute infection and disappears after one to two weeks. The immune system can keep the HIV virus in check for a certain period of time and after the acute phase follows a latency phase which is asymptomatic.

However, there is an increasing immune deficiency, which manifests itself through various diseases or symptoms. In the second stage there is usually chronic diarrhea, which cannot be explained by any other disease. Kaposi’s sarcoma is an AIDS-defining disease – it only occurs in the advanced stages of HIV infection.

The cancer is caused by the human herpes virus 8 (HHV-8). Pink-brown spots or nodules appear on the skin, mucous membrane and intestines. The most common location of sarcoma is on the skin of the arms and legs.

It usually does not cause any other symptoms – there is no pain or itching. In some cases, Kaposi’s sarcoma can also affect lymph nodes and lead to fluid accumulation (so-called lymphedema). The therapy consists of the treatment of HIV infection.

When the immune system improves, Kaposi’s sarcoma disappears again. If HIV treatment has not yet been initiated, this is recommended. If drug therapy is being used, it should be changed.