HIV: Symptoms & Diagnosis

Instructor: Ian Lord

Ian has an MBA and is a real estate investor, former health professions educator, and Air Force veteran.

In this lesson, we'll review the symptoms and diagnosis of human immunodeficiency virus infections, more commonly known as HIV. We'll also briefly discuss risk factors and testing in a patient education centered approach.

What is HIV?

John is a sexually active IV drug user who lately has become concerned with his risks for contracting HIV following an annual physical. As part of his patient education, it's helpful to understand exactly what HIV is and its symptoms. Let's observe how his healthcare provider defines these items for John.

HIV, or Human Immunodeficiency Virus, is a blood-borne disease caused by becoming infected with the HIV-1 or HIV-2 retroviruses. HIV 1 is more prevalent. These retroviruses kill or damage the cells of the immune system known as CD4 T-cells. It can be contracted by sexual activity or through shared needles as commonly seen with IV drug use, both of which are significant risk factors for John. HIV can also be transmitted from mother to child during pregnancy, childbirth, or breastfeeding.

Symptoms

So what kind of signs and symptoms should alert John that he might have contracted HIV? Unlike many other diseases, HIV itself does not have any specific presenting symptoms. Remember that HIV causes the decline of the number T-cell antibodies that help the body fight off infections. Any symptoms that appear are caused by the underlying medical problem that the body's immune system can no longer prevent.

In many cases, especially early on after acquiring the disease, John could be asymptomatic, which means there are no signs of illness. While he might not have symptoms, he still has the disease and can pass it on to others. As the body's T-cells decrease, opportunistic infections begin to cause illness. An opportunistic infection is an illness that frequently occurs and with greater severity in people with a weakened immune system. A person with a healthy immune system might not get sick at all, or at least not have very severe symptoms. Examples of symptoms from these infections include flu-like illnesses, fever, rashes, and enlarged lymph nodes.

HIV patients may have AIDS like symptoms, such as chronic diarrhea, weight loss, or even dementia. Eventually, HIV can progress to AIDS, or Acquired Immunodeficiency Syndrome when the immune system has severely lost its ability to fight off infections. In this later progression of HIV, John could develop repeat severe illnesses of a life threatening nature.

Diagnosis

How would John know for sure if he has contracted HIV? His recent history of multiple sexual partners and drug use put him at risk, but does simply getting a cold mean he has the disease? Fortunately, HIV can be easily detected by a blood test. His healthcare provider can draw a sample during a routine exam or at a separate testing appointment. Healthcare providers recommend annual screening for people with high risk behaviors such as John, as well as people whose jobs put them at higher risk of exposure such as police and healthcare workers.

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