Stages of HIV Infection: Difference between revisions

No edit summary
(Updated references, added to text, added links)
Line 5: Line 5:
</div>  
</div>  
== Introduction ==
== Introduction ==
Human Immunodeficiency Virus (HIV) is a virus that attacks the human immune system (especially the CD4 and T cells) and when left untreated, leads to Acquired Immune Deficiency Syndrome (AIDS). Immunosuppression (the reduced ability to fight infections and other diseases) is determined by laboratory measurements of CD4+ T cells and plasma HIV viral load<ref>Simon V, Ho DD, Karim QA. [https://doi.org/10.1016/S0140-6736(06)69157-5 HIV/AIDS epidemiology, pathogenesis, prevention, and treatment.] The Lancet. 2006 Aug 5;368(9534):489-504.</ref>. As at the end of 2020, it was estimated that 37.7 million people are living with HIV, with two thirds of that population in the African region<ref>World Health Organisation. HIV/AIDS. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids (Acessed 10 December, 2021).</ref>.  
[[Human Immunodeficiency Virus (HIV)]] is a [[Viral Infections|virus]] that attacks the human [[Immune System|immune system]] (especially the CD4 and T cells) and when left untreated, leads to [[Acquired Immune Deficiency Syndrome (AIDS)]]. [[Immunocompromised Client|Immunosuppression]] (the reduced ability to fight infections and other diseases) is determined by laboratory measurements of CD4+ T cells and plasma HIV viral load<ref>Simon V, Ho DD, Karim QA. [https://doi.org/10.1016/S0140-6736(06)69157-5 HIV/AIDS epidemiology, pathogenesis, prevention, and treatment.] The Lancet. 2006 Aug 5;368(9534):489-504.</ref>. As at the end of 2021, it was estimated that 38.4 million people are living with HIV, with two thirds of that population in the African region<ref>World Health Organisation. HIV/AIDS. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids (Last accessed 06/12/2022).</ref>.  


== Modes of Infection/ How does Infection Occur in the Body? ==
== Modes of Infection/ How does Infection Occur in the Body? ==
Infection occurs when a one comes in contact with body fluids of infected persons.  
[[Infection Prevention and Control|Infection]] occurs when one comes into contact with body fluids of infected persons.  


== Stages of HIV Infection  ==
== Stages of HIV Infection  ==
The World Health Organisation (WHO) categorises patients with HIV into four clinical stages and this categorisation results from the patient displaying at least one clinical condition in the stage's criteria<ref name=":0" />. The clinical phases seen in the course of the HIV infection is directly linked to the progression of the infection<ref name=":0">Weiner JL, Kovarik CL. [https://journalofethics.ama-assn.org/article/who-clinical-staging-system-hivaids/2010 The WHO Clinical Staging System for HIV/AIDS.] Virtual Mentor 2010; 12 (3): 202-206</ref>. The four stages include:
In low resource settings there is not always the possibility to measure immunosuppression via laboratory testing, so the World Health Organisation (WHO) developed a staging system based on a patients clinical features. There is 4 progressive stages and categorisation results from the patient displaying at least one clinical condition in the stage's criteria. The clinical phases are linked to the progression of the infection and laboratory markers.<ref name=":0">Weiner JL, Kovarik CL. [https://journalofethics.ama-assn.org/article/who-clinical-staging-system-hivaids/2010-03 The WHO Clinical Staging System for HIV/AIDS.] Virtual Mentor 2010; 12 (3): 202-206</ref>


'''Stage One:''' Patients in this category are usually asymptomatic. Only characterised by flu-like symptoms and CD4 counts stay above 500 cells per microliter.  
The four stages are:<ref>World Health Organisation. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. [Internet] 2nd edition. Geneva; 2016. Available from: https://www.ncbi.nlm.nih.gov/books/NBK374293/#_NBK374293_pubdet_ (Last accessed 06/12/2022)</ref><ref name=":0" />


'''Stage Two:''' Also known as a mildly symptomatic stage. It is characterised by an unexplained weight loss of less than 10% of total body weight; recurrent respiratory infections such as: sinusitis, bronchitis, otitis media, and pharyngitis; an array of dermatological conditions including: recurrent oral ulceration,  papular pruritus eruptions and fungal nail infections <ref name=":0" />.
'''Stage One:''' Patients in this category are usually asymptomatic, or have swelling of [[Lymphatic System|lymph nodes]] for more than 6 months.  


'''Stage Three:''' Also known as the moderately symptomatic stage of the infection. The following characterises this stage: weight loss of greater than 10% of the total body weight, unexplained diarrhoea occurring for more than one month, pulmonary tuberculosis; bacterial infections like: pneumonia, pyelonephritis, empyema, pyomyositis, meningitis and bacteremia; mucocutaneous conditions such as:recurrent oral candida sisgingivitis or periodontics<ref name=":0" />.  
'''Stage Two:''' Also known as a mildly symptomatic stage. It is characterised by an unexplained [[Malnutrition|weight loss]] of less than 10% of total body weight; recurrent [[Respiratory Disorders|respiratory]] infections such as: sinusitis, bronchitis, otitis media, and pharyngitis; an array of [[Dermatological Disorders|dermatological]] conditions including: recurrent oral ulcerationpapular pruritus eruptions and fungal nail infections.


'''Stage Four:''' At this stage, a clinical diagnosis of Acquired Immune Deficiency Syndrome (AIDS) is made when the following clinical findings are made: HIV wasting syndrome, pneumocystis pneumonia, recurrent severe or radiological bacterial pneumonia, extrapulmonary tuberculosis, HIV encephalopathy, CNS toxoplasmosis, oesophageal candidiasis and Kaposi's sarcoma<ref name=":0" />. CD4 count here drops below 200 cells per microliter.
'''Stage Three:''' Also known as the moderately symptomatic stage of the infection. The following characterises this stage: weight loss of greater than 10% of the total body weight, unexplained diarrhoea occurring for more than one month, pulmonary [[tuberculosis]]; bacterial infections like: [[pneumonia]], pyelonephritis, empyema, pyomyositis, [[meningitis]] and bacteremia; mucocutaneous conditions such as:recurrent oral candida sis,  gingivitis or periodontics.
 
'''Stage Four:''' At this stage, a clinical diagnosis of Acquired Immune Deficiency Syndrome (AIDS) is made when the following clinical findings are made: HIV wasting syndrome, pneumocystis pneumonia, recurrent severe or radiological bacterial pneumonia, extrapulmonary tuberculosis, HIV encephalopathy, CNS toxoplasmosis, oesophageal candidiasis and Kaposi's sarcoma.


== Resources  ==
== Resources  ==
*bulleted list
*[https://www.eltonjohnaidsfoundation.org/hiv-aids-resources/ Elton John AIDS Foundation HIV/AIDS resources]
*x
or
 
#numbered list
#x
 
== References  ==
== References  ==


<references />
<references />
[[Category:Human Immunodeficiency Virus (HIV)]]
[[Category:Human Immunodeficiency Virus (HIV)]]

Revision as of 18:05, 6 December 2022

Original Editor - Cindy John-Chu

Top Contributors - Cindy John-Chu, Kim Jackson and Chloe Waller  

Introduction[edit | edit source]

Human Immunodeficiency Virus (HIV) is a virus that attacks the human immune system (especially the CD4 and T cells) and when left untreated, leads to Acquired Immune Deficiency Syndrome (AIDS). Immunosuppression (the reduced ability to fight infections and other diseases) is determined by laboratory measurements of CD4+ T cells and plasma HIV viral load[1]. As at the end of 2021, it was estimated that 38.4 million people are living with HIV, with two thirds of that population in the African region[2].

Modes of Infection/ How does Infection Occur in the Body?[edit | edit source]

Infection occurs when one comes into contact with body fluids of infected persons.

Stages of HIV Infection[edit | edit source]

In low resource settings there is not always the possibility to measure immunosuppression via laboratory testing, so the World Health Organisation (WHO) developed a staging system based on a patients clinical features. There is 4 progressive stages and categorisation results from the patient displaying at least one clinical condition in the stage's criteria. The clinical phases are linked to the progression of the infection and laboratory markers.[3]

The four stages are:[4][3]

Stage One: Patients in this category are usually asymptomatic, or have swelling of lymph nodes for more than 6 months.

Stage Two: Also known as a mildly symptomatic stage. It is characterised by an unexplained weight loss of less than 10% of total body weight; recurrent respiratory infections such as: sinusitis, bronchitis, otitis media, and pharyngitis; an array of dermatological conditions including: recurrent oral ulceration, papular pruritus eruptions and fungal nail infections.

Stage Three: Also known as the moderately symptomatic stage of the infection. The following characterises this stage: weight loss of greater than 10% of the total body weight, unexplained diarrhoea occurring for more than one month, pulmonary tuberculosis; bacterial infections like: pneumonia, pyelonephritis, empyema, pyomyositis, meningitis and bacteremia; mucocutaneous conditions such as:recurrent oral candida sis, gingivitis or periodontics.

Stage Four: At this stage, a clinical diagnosis of Acquired Immune Deficiency Syndrome (AIDS) is made when the following clinical findings are made: HIV wasting syndrome, pneumocystis pneumonia, recurrent severe or radiological bacterial pneumonia, extrapulmonary tuberculosis, HIV encephalopathy, CNS toxoplasmosis, oesophageal candidiasis and Kaposi's sarcoma.

Resources[edit | edit source]

References[edit | edit source]

  1. Simon V, Ho DD, Karim QA. HIV/AIDS epidemiology, pathogenesis, prevention, and treatment. The Lancet. 2006 Aug 5;368(9534):489-504.
  2. World Health Organisation. HIV/AIDS. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids (Last accessed 06/12/2022).
  3. 3.0 3.1 Weiner JL, Kovarik CL. The WHO Clinical Staging System for HIV/AIDS. Virtual Mentor 2010; 12 (3): 202-206
  4. World Health Organisation. Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. [Internet] 2nd edition. Geneva; 2016. Available from: https://www.ncbi.nlm.nih.gov/books/NBK374293/#_NBK374293_pubdet_ (Last accessed 06/12/2022)