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The duration of clinical manifestations of acute HIV infection varies from several days to several months, but is usually 2-3 weeks. An exception is lymph node enlargement, which may persist throughout the disease.
Clinical manifestations of acute HIV infection may recur. In the vast majority of patients, the stage of primary manifestations of HIV infection passes into the subclinical stage, but in some cases it can pass into the stage of secondary diseases. Stage 3 - subclinical - is characterized by a slow progression of immunodeficiency, compensated by a modification of the immune response and excessive reproduction of CD4. Antibodies to HIV are found in the blood; the rate of virus replication, in comparison with the stage of primary manifestations, slows down. The only clinical manifestation of the disease is lymph node enlargement, which is usually generalized (persistent generalized lymphadenopathy, PGL), but may be absent. There may be (more often in children) such laboratory changes as anemia, thrombocytopenia, including those leading to clinical manifestations of impaired hemostasis. The duration of the subclinical stage can vary from 2–3 to 20 years or more, with an average of 6–7 years. During this Buy Meclizine (Meclizine Hydrochloride) 25mg online - Motion Sickness period, there is a gradual decrease in the number of CD4 with an average rate of 50-70 µl -1 per year. HIV replication continues, which is accompanied by the death of CD4 and the depletion of their population. This leads to the development of secondary (opportunistic) infectious and / or oncological diseases against the background of immunodeficiency. Clinical manifestations of opportunistic diseases, along with PGL, which persists in most patients with HIV infection, determine the clinical picture of the stage of secondary diseases.
Depending on the severity of secondary diseases, there are: Stage 4A (usually develops 6-7 years after infection).
It is characterized by bacterial, fungal and viral lesions of the mucous membranes and skin, inflammatory diseases of the upper respiratory tract.
Typically, stage 4A develops in patients with a CD4 count of about 350 µl -1 . Stage 4B (usually 7-10 years after infection) - skin lesions are deeper and tend to be protracted. In addition, localized Kaposi's sarcoma, mild constitutional symptoms (weight loss, fever), and damage to the peripheral nervous system may be noted.
A sign of the transition of HIV infection to stage 4B may be tuberculosis, limited to one anatomical region. For example, it can be pulmonary tuberculosis, including with damage to the bronchial lymph nodes, or extrapulmonary tuberculosis, but with damage to one organ. Typically, stage 4B develops in patients with a CD4 count of 200–350 µl -1 .
Stage 4B (usually 10–12 years after infection) is characterized by the development of severe, life-threatening secondary (opportunistic) diseases, their generalized nature, and damage to the central nervous system.
Typically, stage 4B develops in patients with a CD4 count 1 mo; Cytomegalovirus infection (with damage to organs other than the liver, spleen, lymph nodes) in a patient older than one month; Cytomegalovirus retinitis with loss of vision; HIV-associated encephalopathy (HIV encephalitis); Herpes simplex infection: chronic ulcers that last longer 1 month, or bronchitis, pneumonia, esophagitis in a patient older than one month; Histoplasmosis disseminated or extrapulmonary; Intestinal isosporosis (with diarrhea lasting more than 1 month); Kaposi's sarcoma; Interstitial lymphoid pneumonia in a child under the age of 13; Burkitt's lymphoma (or other B-cell non-Hodgkin's lymphoma); immunoblastic lymphoma; Lymphoma of the brain primary; Mycobacteriosis caused by M.