Viral Stages
What is the 'primary' or 'acute' infection stage of HIV?
The 'primary' or 'acute' infection stage of HIV is in the early weeks, and why people make a point about it is because that's when there is a dramatic viremia, which means a lot of virus in the blood stream, a lot of virus free in the plasma, a lot of infected cells. It just peaks within a few weeks' time, way up. Then it comes down a bit and comes to sort of a set point, where it varies for the individual. It comes down in part because of our immune response and probably in part because it is starting to run out of target cells. Probably both factors contribute. But the acute phase is also symptomatic, generally speaking, with fatigue, fever, chills, like a lot of acute viral infections. Then it settles down and there's very few, if any, symptoms at all for a long time.
What is the 'asymptomatic' stage of HIV?
After those early weeks of infection, people settle down with a basal set point of how much it varies up and down - mainly there's a set point for individuals. That period goes for years until clinical AIDs begins to appear, but it doesn't mean the virus has been altogether asleep.
What are the clinical stages of HIV?
What is the typical progression of HIV to AIDS?
You can define, scientifically, a viremic period of acute infection, generally fever, chills, sweats etc. Sometimes an opportunistic infection if it's bad, so it looks like lay dates. Then you do a CD4 count and you find, "Hey, it's 700 he's still reasonably OK ... the CD4 may have dropped some but then his immune system comes over and goes back up." Because it actually does dip and come back up, it dips a little. And then you go into this lull where the virus is bouncing around and the person feels fine. Then all of a sudden T-cells are dropping significantly, an unlucky person may have more in the brain than not. An unlucky person-- who is not treated now, no treatment, we don't know, he doesn't know he's infected-- he may get a tumor before he should have which will bring him to a doctor's office. Or in the area of no therapy it's just going to wait until some infection occurs and the guy goes to the doctor and says, "I've been getting a lot of strange infections." That's coming in too late, when you start seeing the signs of frank AIDS, that's late.
What are 'opportunistic infections'?
Opportunistic infections are illnesses, diseases caused by a microorganism, or microbe, which under most normal circumstances would not cause a disease. But in a person who has an immune disorder of one kind or another by one cause or another, such microbes cause disease in that person. Immune defiency is not unique to HIV. What is unique is that it is a new epidemic, raging. But in many respects its like a manifestation of essential wrong. Like cough is a sign and symptom of something essentially wrong to the lung. Immune disorder getting opportunistic infections are manifestations of something essentially wrong, namely the heart of the immune system.
What are 'AIDS-defining' diseases?
What we talked about, opportunistic infections and certain kinds of cancers like Kaposi's Sarcoma, this tumor that appears often visible on the skin, with red, purple legions, they are aggressive sometimes but also exist internally, where you don't see it. Lymphomas occur with increased frequency, for example another tumor, and many fungal infections, for instance. And the mycobacterium, avium, normally doesn't cause a problem, causing a lung problem, is another example.
