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HIV Infection Phases and Diagnosis

Aug 17, 2025

Overview

This lecture discusses the three phases of HIV infection, the progression to AIDS, common opportunistic infections, and diagnostic methods for HIV.

Phases of HIV Infection

  • Phase 1: Asymptomatic or chronic swollen lymph nodes (chronic lymphadenopathy) after primary infection.
  • Phase 2: Persistent health decline with increased vulnerability to infections due to a weakening immune system.
  • Phase 3: HIV infection progresses to AIDS once CD4 T cell count drops below 200 cells/μL or 14% of normal.

Acute HIV Syndrome and Immune Response

  • After infection, acute HIV syndrome causes a rapid drop in CD4 T cell count and spike in viral load.
  • Seroconversion (full antibody response) takes up to three months.
  • Once antibodies develop, viral load drops and CD4 T cell count partially recovers, then steadily declines over years.

Constitutional Symptoms and AIDS

  • Near end of Phase 2, "constitutional symptoms" appear: fever, night sweats, chills, and weight loss.
  • AIDS is diagnosed when CD4 T cells fall below 200/μL; opportunistic diseases begin to occur.

Opportunistic Infections in AIDS

  • Toxoplasma gondii can cause encephalitis in immunocompromised individuals.
  • Cytomegalovirus (CMV) may cause encephalitis, blindness, or death.
  • Tuberculosis (Mycobacterium tuberculosis) is more severe in HIV/AIDS patients.
  • Pneumocystis pneumonia, yeast infections, and Kaposi's sarcoma are common in AIDS.
  • AIDS patients die from infections due to complete loss of immune function.

Diagnosis of HIV

  • Initial screening uses ELISA to detect HIV antibodies (may take months for seroconversion).
  • Confirmation is done with Western blot or the AB tema (RNA test) to detect the virus directly.

Key Terms & Definitions

  • HIV (Human Immunodeficiency Virus) — Virus that attacks the immune system, especially CD4 T cells.
  • AIDS (Acquired Immunodeficiency Syndrome) — Final stage of HIV infection marked by severe immune deficiency (CD4 < 200/μL).
  • CD4 T Cells — White blood cells crucial for immune defense.
  • Seroconversion — Development of detectable antibodies to HIV.
  • Opportunistic Infection — Illnesses that occur more frequently in people with weakened immune systems.
  • ELISA — Blood test used to detect HIV antibodies.
  • Western Blot/AB tema — Tests to confirm HIV infection by detecting the virus.

Action Items / Next Steps

  • Review the list of opportunistic infections associated with AIDS.
  • Study the diagnostic steps for detecting and confirming HIV infection.