Pathophysiology of HIV

Pathophysiology of HIV 150 150 Tony Guo

Pathophysiology of HIV

  • HIV is a ribonucleic acid virus
    • Called retroviruses because they replicate in a “backward” manner going from RNA to DNA
    • CD4+T cell is the target cell for HIV
      • Type of lymphocyte
      • HIV binds to the cell through fusion
  • Immune problems start when CD4+ T cell counts drop to < 500 cells/μL
    • Severe problems develop when < 200 CD4+ T cells/μL
    • Normal range is 800 to 1200 cells/μL
  • Insufficient immune response allows for opportunistic diseases

Clinical Manifestations and complications

  • Acute Infection
    • Flulike symptoms
    • Fever, swollen lymph nodes, sore throat, headache, malaise, nausea, muscle and joint pain, diarrhea, or a diffuse rash
    • Occurs about 2 to 4 weeks after infection
    • Highly infectious
  • Asymptomatic Infection
    • Left untreated, a diagnosis of AIDS is made about 10 years after initial HIV infection
    • Symptoms are generally absent or vague
    • High risk behaviors may continue
  • Symptomatic Infection
    • CD4+ T cells decline closer to 200 cells/μL
    • Symptoms become worse
    • HIV advances to a more active stage
    • Oral thrush
      • One of the more common infections associated with symptomatic infection is oropharyngeal candidiasis (thrush).
      • Candida organisms rarely cause problems in healthy adults, but are more common in HIV-infected people.
    • Shingles
    • Persistent vaginal candidal infections
    • Herpes
    • Bacterial infections
    • Kaposi Sarcoma
      • Malignant vascular lesions such as Kaposi sarcoma lesions can appear anywhere on the skin surface or on internal organs.
      • Kaposi sarcoma is caused by human herpes virus VIII.
      • Lesions vary in size from pinpoint to very large and may appear in a variety of shades.
    • Oral hairy leukoplakia
      • Epstein-Barr virus infection that causes painless, white, raised lesions on the lateral aspect of the tongue, can occur at this phase of the infection and is another indicator of disease progression

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