HIV phase. Stages of development of AIDS. Treatment of pulmonary manifestations

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In order to properly and effectively treat the most common infectious diseases, it is necessary to know the phases of the course of diseases in the human body. The development of the disease depends on many factors:

How did the pathogen enter the body?
What a Patent Agent Needs to Survive.
The possibility of further spread of the microorganism in nature.

Knowing how the body reacts to foreign cells in the body, and what changes occur, one can not only effectively treat the disease and successfully prevent complications, but also provide for the further spread of the infectious process among the population.

Development of HIV infection

The causative agent is found in any cells. At the first contact of the body with an infectious agent, our immunity tries to fight foreign proteins, which are represented by immunodeficiency viruses. Therefore, the development of HIV does not begin immediately after the pathogen enters the body. In the scientific works of scientists, many cases of the destruction of a large amount of the pathogen by human immunity cells are described, but this is not enough to finally defeat the AIDS disease. The development of this disease is possible even with a minimal infectious dose of viral particles. In the first 24-48 hours after contact with the causative agent of HIV, emergency prophylaxis can be carried out and a fatal disease can be avoided.

How does developing HIV affect the body? Once the virus has entered the blood or mucous membranes, it is able to infect a large number of a wide variety of cells. Since the function of the immune system turns on very quickly, often the first obstacle to the spread of HIV is T-helper lymphocytes. It is this type of structures that in the first days of the disease undergoes great changes both quantitatively and qualitatively. To a lesser extent, other cells that are responsible for the immune status of a person are also affected. These include monocytes, macrophage cells, structures of lymphatic vessels, and others.

Recent studies have shown that HIV in the first days of its spread in the human body penetrates the brain and disrupts some functions of higher nervous activity. This leads to increased sexual activity, and as a result, further spread of infection among the population.

The first weeks of HIV in the body

With the help of specific receptors, which are equipped with human immunodeficiency viruses, the target cell is captured, causing splitting of the membrane and penetration of the pathogen into the structure. There, under the action of enzymes, the genetic code of the pathogen is inserted into the target DNA, causing the production of daughter viruses - virions - and the gradual destruction of the donor cell.

During the day, more than a billion new particles can be formed in this way, which further spread in the body and infect other structures by a similar mechanism.

It should be noted that there are cases when the virus only at the stage of introduction into the cell is already subjected to a powerful attack by the immune system and dies under its action. This option is possible in 1 out of 300 cases of human infection with this disease. In this case, further progression of HIV infection in the human body is impossible.

There is another option for the development of HIV in the body. In this case, the virus remains in the cell of the human body for a very long time. With any changes in the immune system, the development of HIV in the body continues with greater aggressiveness.

What happens to a person with HIV?

The development of pathology begins from the moment the virus enters the body and the reproduction of pathogenic cells, which lead to a decrease in the protective function. The reason for this phenomenon is not only the immunotropic effect of the pathogen, but also other factors. One of these are antibodies that are produced against a retrovirus. The body genetically remembers that the pathogen is located in certain cells and directs the action of immunity to damage its own structures that contain pathogenic material. Thus, any cells that ever have the HIV virus in their genome die under the influence of their own immune system.

Progressive HIV infection gradually leads to a catastrophic decrease in the quality and quantity of protective structures and the destruction of other elements that are no less important for the human body.

How does HIV develop in the first month? Over time, the infection changes the DNA of human cells and programs them for a planned death, which in this case occurs much earlier than the right time. Gradually, all structures are programmed for early apoptosis, which leads to a significant reduction in lifespan. This initial stage of the disease can last from a month to 3-5 years, depending on individual characteristics.

Stages of development of HIV (AIDS) in humans

The first stage of the development of AIDS disease begins from the moment the virus enters the body and lasts until the onset of clinical symptoms of the disease. This phase is called "latent" and can last up to 6 months or more. During this time, the virus infects a large number of body cells. The patient's blood contains a high number of viral particles, and the patient is considered dangerous in terms of the spread of infection.

The development of AIDS in the second stage, which is called the "stage of primary manifestations", is the activation of the human immune system against the virus. How much HIV develops at this stage of its life in the body depends on the patient's state of health, his immune system and social activity.

The second stage can be divided into 3 main stages:

An acute febrile phase, accompanied by an increase in body temperature for a long time without objective reasons.
The asymptomatic period, which is characterized by immune manifestations to HIV and the ability to detect antibodies in the blood.
The phase of persistent lymphadenopathy suggests that the disease develops and the human immune system is no longer able to fight it. Medical care at this stage will only help alleviate the condition, while treatment at earlier stages can effectively delay the peak of the disease. In this phase, the cells of the lymph nodes accumulate viruses in themselves, which leads to an increase in all structures in the body and their soreness.

Stage of secondary diseases: Depending on what happens, HIV can quickly move from one stage of its development to another. For example, the latent stage may take only a few days, while the asymptomatic stage may last for several months. Stage 3 is divided into phases:

3A - there are minor changes in the operation of all systems;
3B - characterized by more pronounced changes in the structure of organs, the addition of a significant number of secondary infections and a critical weakening of the immune system.

Ultimately, all stages of HIV lead to the last fourth stage, which is characterized by significant damage to the central nervous system, inflammatory processes in almost all organs.

Due to the lack of immune protection to fight infection, the body produces a large number of blast cells that do not have time to mature to the desired state and turn into a tumor. Thus, we can say that the criterion for the last stage of the development of HIV disease (AIDS) are oncological pathologies.

How fast does HIV develop?

All stages of development of HIV infection can pass in 300-400 days, and may not end with the fourth stage throughout the life of the patient. Such a big difference depends on how the HIV infection develops in a particular person, whether the patient is taking medications and how well the therapy is prescribed.

With AIDS, a rapid restructuring of the body occurs, therefore, the faster and better specific assistance is provided, the slower the deadly infection will progress in the patient's body.

AIDS (acquired immunodeficiency syndrome) is a late manifestation of infection of the body with the human immunodeficiency virus (HIV). AIDS is not a disease, but a complex reaction of the body to a developing infection; you cannot get AIDS, only HIV infection. According to doctors at Oxford University, the development of the syndrome indicates an overly acute reaction to HIV: groups of people with a significant amount of viral particles in the blood, who have not undergone antiretroviral therapy and do not have symptoms of AIDS, have been identified. The causes of AIDS, its development in HIV-infected people, methods of therapy are still under study. Today, there is scientifically confirmed information about the methods of infection, the stages of development of the syndrome and methods of prevention.

What is HIV?

The human immunodeficiency virus was isolated from a patient's lymphocytes in 1983 by a group of scientists led by Luc Montagnier. At the same time, a similar virus was obtained in a US laboratory. In 1987, the disease was named "HIV infection".

There are two serotypes of the virus: HIV-1 and HIV-2. The first type plays the most significant role in the infectious pandemic, including in Russia. HIV infection is a systemic disease of the body, provoking a gradual decline in the general immunity of a person. With a decrease in immunity, the body cannot resist the effects of numerous pathogenic microorganisms and fight the development of malignant neoplasms.

The main diseases that occur in the body of an infected person can also affect healthy people, however, as a rule, the dynamics of their development is much more restrained. Some diseases (the so-called opportunistic ones) occur exclusively with immunodeficiency against the background of HIV infection, since normally they are inhibited by immunity.

Why is HIV infection incurable?

The causative agent of HIV infection after penetration into the human body cannot yet be destroyed. Also, despite numerous studies and programs, an effective HIV vaccine has not yet been created.

This phenomenon is associated with the high ability of the virus to genetic variability: the microorganism changes at the same moment when the immune system begins to produce antibodies. Moreover, if a virus infected with one strain of the virus is re-infected with a virus with an altered genotype, two strains "perform" recombination, the exchange of gene regions, which leads to the appearance of superinfection. The third reason for the resistance of the virus to the effects of drugs is the ability to "hide" in the intracellular space, turning into a latent form.

Causes of AIDS

It is possible to get sick with AIDS only when infected with HIV and the corresponding reaction of the body to the pathogen. Despite the prevailing opinion that only a drug addict or a homosexual can get AIDS, this has long ceased to correspond to the real situation. HIV infection no longer serves as a marker exclusively for the use of narcotic drugs, the presence of promiscuous hetero- and homosexual relationships: the prevalence of the virus is detected among various social strata of the population, age groups, regardless of sexual preferences and addictions.

According to the World Health Organization, about 80% of new HIV infections were detected in Eastern Europe, 18% in Western European countries, 3% in Central Europe. Russia accounts for 81% of the Eastern European countries and 64% of all cases reported in the European Region.

At the same time, the ways of infection differ on a territorial basis: in Europe, homosexual sexual contacts occupy the first place (42%) with a slight lead over heterosexual ones (32%), infection among drug addicts does not exceed 4%.

Russia today is the only country in the world where infection among drug addicts accounts for more than half of the common causes of the spread of HIV infection (51%). In second place are heterosexual contacts (47%), and only 1.5% is infection among homosexual persons.

It is worth noting that in Russia it is not accurate enough: according to experts, every 100th, that is, 1% of the population, is a carrier of HIV infection in our country, not counting illegal migrants. Experts warn that in a country with so many infected, where only one in three patients receive free antiretroviral therapy, a large-scale epidemic could begin by 2021.

Ways of transmission of infection

In world statistics, HIV infection is in the first place through sexual contact with an infected person, and during any type of sexual contact. If the carrier of the infection follows the rules of specific therapy, the probability of infection is 1%.

Traumatic sexual contacts, in which the formation of cracks on the mucous surfaces, as well as the presence of erosion, damage to the internal and external integuments with existing diseases, increase the likelihood of virus penetration. In women, the virus is present in the blood, vaginal secretions, in men - in the blood and semen. Infection when particles of blood or other biological fluid containing an infectious agent enter the body of a healthy person also occurs during invasive procedures, most often associated with the use of reusable syringes without appropriate processing. Infection is also likely during medical, dental manipulations, visits to nail salons, tattoo studios and other places where the instrument may come into contact with an injured surface intentionally or accidentally. Before the introduction of control of donor fluids (blood, plasma) and organs, there were cases of infection from the donor to the recipient.

The vertical route of infection is the transmission of infection from mother to child during gestation, during childbirth or during breastfeeding.

There are no other ways of infection that are not associated with contact with blood, vaginal secretions or seminal fluid. The infection does not spread when using the same dishes, hygiene items, visiting swimming pools, bathrooms and toilets, it is not transmitted through blood-sucking insects, etc. The human immunodeficiency virus is extremely unstable in the external environment and quickly dies outside the body.

Symptoms of AIDS (Acquired Human Immunodeficiency Syndrome)

The disease, AIDS syndrome develops as a late complication of HIV infection. Immediately after infection, during the incubation period (on average 3 weeks - 3 months), no symptoms and manifestations are observed, although antibodies to the causative agent of the disease are already beginning to be produced.
The stage of primary manifestations, which replaces the incubation period, can also be asymptomatic or manifest as an acute HIV infection, which depends on the general health of the person and the state of his immune system.

The clinical picture of the manifestation of the disease is quite extensive. The first symptoms may include:

feverish state;
rash on the skin and mucous membranes;
enlargement and / or soreness of the lymph nodes;
catarrhal manifestations, cough, rhinitis, pharyngitis;
weight loss;
persistent or recurrent diarrhea;
enlargement of the liver and spleen in size.

Similar symptoms, including all of the above manifestations, are observed only in 15-30% of patients, in other cases there are 1-2 symptoms in different combinations.
Then comes the latent asymptomatic stage, the duration of which is from 2-3 to 20 years (average 6-7 years). At this stage, there is a significant decrease in the number of lymphocytes in the blood. A drop in the level of lymphocytes, indicating the onset of severe immune deficiency, can lead to the stage of secondary diseases. Among the most frequently encountered are:

sore throats;
pneumonia;
tuberculosis;
herpes;
fungal infections;
intestinal infections;
oncological diseases;
infections caused by protozoa and others.

The next stage, terminal, is characterized by acquired immunodeficiency syndrome or AIDS. At this stage of AIDS, severe symptoms lead to the destruction of vital body systems. This stage is lethal despite active antiviral therapy.
Modern drugs make it possible to prolong the stages of infection and more effectively fight opportunistic and general infections that lead to the death of patients.

AIDS and HIV - diagnostic methods

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Diagnosis is never based on symptoms of AIDS or other stages of HIV infection. However, the disease can be suspected by the following diagnostic features:

treatment-resistant diarrhea for 2 or more months;
prolonged unmotivated fever;
skin rash in various variations;
development of Kaposi's sarcoma at a young age;
weight loss of more than 10%, for no apparent reason.

Confirmation of the diagnosis is made using two tests: a screening test (the most common test is enzyme immunoassay) and a confirmatory test that assesses the presence of the virus and viral load.

Treatment and prevention of the disease

The basis of therapy is the control of viral reproduction and the treatment of concomitant diseases. By following the prescriptions of specialists and taking modern drugs, it is possible to contain the development of HIV infection.

Treatment should begin immediately after diagnosis. In Russia, centers for the treatment and prevention of HIV infection have been established, where drugs are prescribed and dispensed for HIV-infected people. Complementary treatment is aimed at combating cancer and opportunistic infections resulting from reduced immunity and stimulating the immune system.

Preventive measures consist of observing safety measures during sexual intercourse, medical and cosmetic procedures, regular blood tests for infection, and following the appointments of specialists.

After the human immunodeficiency virus enters the body, the disease goes through several successive stages. There are 4 independent stages of HIV infection, each of which has its own distinctive features.

Today we will consider how the fourth stage of this disease manifests itself in the body of an infected person.

Characteristics of stage 4 HIV disease

The reaction of each organism to the penetration of the virus is individual. The stage of secondary diseases, which is the fourth in a row, can occur both a few years after the primary manifestations, and a couple of months from the onset of clinical symptoms. It depends on the internal reserves of the human body, which determine the duration of the latent (or asymptomatic) phase - stage 3.

The main sign of the progression phase of HIV infection, that is, the rapid transition to persistent immunodeficiency, is a significant decrease in the level of CD4 cells in the blood of an infected person.

According to the clinical classification of the development of HIV infection, developed by WHO in 2002, stage 4 is characterized by the following manifestations:

cachexia - a decrease in body weight of at least 10% of the initial weight;

lung lesions: tuberculosis, pneumocystis pneumonia, cryptococcosis;

repeated or persistent febrile conditions with a temperature of 37.5 ° C for a month;

diarrhea lasting more than a month and accompanying cryptosporidosis;

viral or bacterial lesions of the skin and mucous membranes: herpes, fungal infections, cytomegalovirus infection, salmonella septicemia;

candidiasis of various internal organs: lungs, pharynx, esophagus, trachea, bronchi;

patients develop various oncological diseases, among which Kaposi's sarcoma occupies a special place;

diseases associated with the persistence of the herpes virus in the body: herpes zoster in a localized or generalized form;

an increase in the size of lipoproliferative organs: the spleen and lymph nodes;

encephalopathy;

a decrease in the level of functionality to level 4: the patient spends more than half of his daytime in bed.

According to the classification of V.I. Pokrovsky, there are 3 phases of the 4th stage of HIV, preceding the onset of AIDS (acquired immunodeficiency syndrome) - a, b and c. This division is based on differences in the clinical manifestations of the disease, as well as on the level of CD4 cells. Consider the characteristics of each of them.

At this stage, the level of CD4 cells does not fall below 500 per mm3. Phase 4a occurs approximately 8-10 years after infection. This phase is still easily amenable to medical correction with antiviral drugs and symptomatic treatment.

With HIV infection in stage 4a, various infectious infections are characteristic:

In this case, the mucous membranes of the mouth and skin, the organs of the genitourinary system and the respiratory tract are affected.

The fourth phase A is sometimes characterized by the occurrence of a period of remission - the absence of a transition to an immune deficiency. This process can occur spontaneously and slow down the development of the disease for many years.

With the development of this phase of the disease, the CD4 level begins to decrease, but does not pass the threshold of 200 cells per mm3. The onset of the 4b period occurs approximately 9-12 years after the immunodeficiency virus enters the human body.

If a person is diagnosed with the 4b phase of HIV, this means that the disease is progressing, and the adaptive abilities of the body are reduced. At this stage, the patient's working capacity is usually greatly reduced, and he is forced to switch to light work and receive disability.

This period is characterized by a decrease in the concentration of CD4 in human blood below 200 per mm3. Phase 4b develops 15 years after infection. However, often, people do not even live up to it. This is due not to the spread of the virus in the body itself, but to the intensive development of opportunistic diseases - generalized viral, fungal, bacterial or protozoal infections.

The onset of this phase of the disease indicates that the immunodeficiency virus has adapted to the effects of drugs used for treatment. Therefore, in order to slow down the transition from stage 4 of HIV infection to AIDS, it is necessary to change medications.

Basic actions during stage 4 of the disease

The stage of occurrence of secondary opportunistic diseases requires constant monitoring at the Center for the Prevention and Control of AIDS. In this institution, HIV-infected people are provided with the following assistance measures:

the appointment of drug therapy;

dispensary observation;

assessment of the patient's need for inpatient treatment;

psychocorrection and psychotherapy with the participation of qualified specialists.

Unfortunately, at the moment, no treatment has been developed to destroy the virus in the human body. However, there are tools that can greatly alleviate the patient's condition and improve the quality of his life. For this purpose, antiretroviral drugs are used in various individually selected combinations.

At stage 4c, treatment is given on an ongoing basis. It is possible to use the following groups of drugs:

nucleoside transcriptase inhibitors - Didanosine, Abacovir;
non-nucleoside inhibitors - Nevirapine, Delavirdine;
inhibitors of viral fragments - Indinavir, Ritonavir.

Of particular note is the possibility of pregnancy in women with stage 4 HIV. It has been proven that the conception of a child does not aggravate or accelerate the development of the disease and its transition to the terminal stage. However, at this stage of the development of the disease, the risk of transmission of infection in utero to a child is almost 100%. And also at stage 4, a woman needs mandatory treatment with antiviral drugs that negatively affect the fetus. Therefore, if possible, it is better not to plan pregnancy at the fourth stage of HIV infection.

How long do HIV-infected adults live?

Stage 4 of HIV can come on rapidly or only after a few decades, and it is impossible to say for sure how many people live with it. For each person, the process of suppression of the immune system proceeds individually and has a different duration.

Life expectancy may depend on the following factors:

the presence of bad habits;
infection with infectious diseases, sexually transmitted diseases;
compliance with medical recommendations for treatment, diet and lifestyle.

On average, it takes about 15 years from the initial signs of HIV infection to the development of AIDS in a patient. However, for some people, this process takes several months.

The main cause of death in patients in the fourth stage is CNS damage. There is an inhibition of the vital activity of the nerve cells of the brain and dementia occurs, from which a person dies. And also the causes of death are often oncological and severe infectious diseases.

With timely antiretroviral therapy, an infected person has a chance to prolong his life. To do this, you must follow all the doctor's recommendations and monitor the level of viral load in blood tests.

Clinical picture of HIV at 4 stages of development

The fourth stage of HIV is the penultimate one. It is during this period that oncological and infectious diseases begin to develop, which lead to the death of a person. Stage 4 HIV infection is accompanied by serious ailments, which are difficult to cure due to the lack of immunity.

The stage of secondary diseases is associated with a decrease in CD4, that is, an increase in viral load. The result of this indicator is the body's inability to resist viruses. This process is easily reversed with antiviral therapy, which helps to reduce the viral load for a long time and slow down the stages of HIV development. If you seek help in a timely manner and start taking medications, you can slow down the development of immunodeficiency. This is possible only with complete or partial elimination of concomitant diseases, since the patient's immunity is not able to cope with ailments on its own.

Clinical forms of HIV infection

HIV AIDS 4 periods, divided into several phases. For the correct diagnosis, it is necessary to donate blood for viral load. This stage is determined not only by symptoms, but also by taking into account the number of CD4 cells.

HIV 4A - occurs 8-10 years after infection. It is accompanied by fungal, viral, bacterial lesions of the skin and mucous membranes, as well as inflammatory diseases of the genital organs and respiratory tract, often with severe and moderate pneumonia. People who have reached stage 4a of HIV live for a long time, as it has a reversible process and is easily treatable.

HIV 4B - achieved 9-12 years after infection with a retrovirus. At this stage, dermatitis and diseases of the mucous membranes develop. Irreversible weight loss can reach 15%, which is associated with prolonged diarrhea and an increase in body temperature up to 38-39 degrees. These symptoms can last from three weeks to two months. Often, HIV (stage 4b) is accompanied by tuberculosis and sexually transmitted diseases such as syphilis and genital herpes. Women also tend to exacerbate vaginitis and thrush. There are many cases where it was possible to slow down or stop the development of the disease during this period and increase the life span of a patient with stage 4b HIV.

HIV 4B - few infected people reach this stage, mostly it occurs no earlier than 15 years after infection. How long stage 4 HIV patients live is a moot point, since it is this group of people who die not from the disease itself or secondary manifestations of AIDS, but from brain damage. This is due to the fact that with HIV (stage 4c), nerve cells and the brain are primarily affected, which can also lead to partial or complete paralysis.

The forms indicated above may manifest themselves in different ways. Some begin with mild symptoms and develop gradually. In such cases, it is possible to recognize the onset of the fourth stage of HIV in time and start treatment in a timely manner. Minor symptoms, such as a severe cough accompanied by chest pain or bloody discharge, may indicate the onset of stage 4 HIV infection.

HIV stage 4b, what does it mean? With the development of AIDS, the virus is gradually rehabilitated in the blood and finds ways to avoid being hit by the therapy being taken. Every year the development of a certain stage becomes faster by 0.5 - 3% of the results of the previous year. In connection with these data, scientists say that it is necessary to separate antiviral drugs, not only referring to the stage of immunodeficiency, but also taking into account what therapy the patient took at the previous stages of the disease. This approach will prevent the virus from producing cells that protect it from the medications it takes.

If the retrovirus is in a "sleeping" state, the fourth stage may not occur at all. A “sleeping state” is when the virus does not develop inside a person, that is, the body itself has found a way to interact with the pathogen. This condition may not be initial, but may occur at any stage of immunodeficiency, except for the last one. This means that a person with stage 4 HIV infection in the progression phase can live for a long time.

In most people with a mild course of the disease, smoothly moving into a new stage, additional symptoms may appear, and they cannot be left unattended. These signs include:

headache, especially in the morning;
frequent dizziness;
nausea or diarrhea immediately after eating;
heavy sweating at night;
unreasonable anxiety and insomnia.

All these signs are important to correctly identify in order to prevent an erroneous diagnosis.

Changes in the structure of the skin and mucous membranes are the most obvious and severe sign of HIV infection at the stage of secondary diseases. Damage to the skin may indicate the presence or exacerbation of severe oncological diseases, which complicates the treatment. Also sometimes there are small ulcers on the palms, feet and armpits. They often abscess, bleed and fester. This is just a temporary phenomenon that disappears after an exacerbation or with the start of therapy. Such a period is always accompanied by a high fever and illnesses such as pneumonia, influenza or bronchitis. At stage 4 HIV, these diseases can be fatal.

With the onset of the fourth stage of HIV, a disease such as anemia manifests itself. A decrease in hemoglobin in the blood leads to heart failure, frequent fainting, loss of appetite and, consequently, serious weight loss.

Depression is one of the common conditions in AIDS, it is not only the cause of weight loss, but also a symptom of other diseases. Against the background of depression, an infected person may develop diseases of the heart and nervous system. Very often, patients bring themselves to this state. The reason for this is self-pity and the inability of the doctor to positively set up the patient.

The fourth stage of HIV infection can last for years with the start of timely treatment. Do not be afraid of it, this process can not only be slowed down, but also reversed. Signs of the fourth stage of HIV should never be ignored. If they are identified, you should immediately contact the AIDS center. There, tests for viral load are taken, and only after that a diagnosis is made and treatment is prescribed.

Pregnancy at the fourth stage of HIV development

Although pregnancy does not affect the development of immunodeficiency, it is still not worth having children at this stage, as the risk of infection of the child and the development of secondary diseases in the mother increases. After childbirth, therapy may not have the desired effect. Such a consequence can not only fail in treatment, but also cause resistance to antiviral drugs in the virus. This may be due to taking therapy during pregnancy, since at this time it is aimed primarily at protecting the fetus from the virus and the mother's body is especially vulnerable. If the therapy has given the desired result, the development of the disease has slowed down and there are no other contraindications to bearing the fetus, pregnancy is still possible with HIV at stage 4A.

It is worth paying attention to the symptoms and signs that the body gives, especially for changes in body temperature and modifications of the skin. With the timely intake of drugs, you can significantly slow down the progression of the disease. Let it be impossible to get rid of it, but you can stop development and live for many years, despite the presence of a retrovirus in the body.

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Stages of development of AIDS

Unfortunately, so far there are no drugs that can defeat the disease, and the measures taken are aimed at slowing down the development. Only the early start of effective treatment gives a chance for a significant prolongation of life. AIDS has no analogues in medical practice in terms of its variety of clinical manifestations, but the general trends in its development are amenable to analysis.

At its core, HIV infection is a progressive disease caused by the human immunodeficiency virus (HIV). During the vital activity of the infection, the human immune system is suppressed with the development of acquired immune deficiency syndrome (AIDS), which ultimately leads to a complete inhibition of the body's ability to resist any infections. Any secondary opportunistic diseases become fatal for a person, although they do not pose any danger to a normal organism.

In essence, AIDS is the last stage of the development of HIV infection, and, unfortunately, this stage of the disease occurs in any infected patient within 5-16 years after infection, depending on the measures taken. How long do sick people live? Statistics show that at the stage of advanced AIDS, life expectancy averages 9-10 months, however, with effective therapy in the early stages, the patient's life can be maintained for 50-70 years.

The mechanism of the pathogenesis of HIV infection has not yet been elucidated, but a number of features of the progression of the disease can be analyzed and have their own patterns. During the course of the disease, staging is quite clearly traced, and the scheme for changing stages lends itself to certain rules. In Russia, it is customary to distinguish 5 stages of HIV development: incubation, primary manifestations, subclinical phase, period of secondary diseases, terminal stage. If we talk about AIDS as a separate type of HIV infection, then it is finally formed at the last 2 stages.

Predecessor stages

Incubation stage, i.e. the period from infection to the first manifestations of symptoms of the disease can last from 20 days to 3 months. At this stage, a person does not feel any changes, moreover, it is still difficult to detect antibodies. The duration of the asymptomatic development of the disease depends on the type of virus, age, characteristics of the organism, and the etiology of the disease. So the HIV-1 strain develops much faster than HIV-2.

The second stage of HIV is characterized by the primary manifestations of infection. It is divided into several stages:

asymptomatic course;
acute manifestation without secondary pathologies;
acute infection that provokes secondary diseases.

The asymptomatic stage can last from 1-2 months to 2-3 years: at this time, a sick person does not feel obvious signs, but unlike the 1st stage, he becomes an infectious carrier of HIV, and antibodies are found in his blood.

The primary manifestations are manifested in the form of an acute febrile phase with the following symptoms: fever, general weakness, increased sweating at night, nausea, diarrhea, loss of appetite, pain in the head and throat, enlarged lymph nodes, rash in the form of spots and papules, skin peeling, signs of herpes and dermatitis. Further development of the disease leads to the appearance of an acute infection (stage 2B), which provokes secondary diseases. Of these secondary manifestations, the most common are: bacterial pneumonia, tonsillitis, candidiasis, various types of herpes.

It should be noted that in the second stage, primary and secondary manifestations are still amenable to effective treatment, which significantly increases the life expectancy of an infected person.

Stage 3 (subclinical development) is considered the immediate precursor to AIDS ("pre-AIDS"). During this period, there is a gradual formation of immune deficiency. Explicit symptoms of the disease at the 3rd stage subside, and the main manifestation is enlarged lymph nodes. However, such reassurance is deceptive, because. the level of CD4-lymphocytes decreases, which leads to immunodeficiency. The stage can last from 2 to 15 years, but most often lasts 5-6.5 years.

AIDS itself develops starting from the 4th stage - the period of secondary pathologies. Conventionally, this period is divided into several stages. Stage 4A is characterized by a loss of body weight of up to 8-10% and pronounced signs of secondary diseases: violations of the skin and mucous membranes of a fungal, bacterial and viral nature; recurrent pharyngitis, sinusitis, herpes zoster.

The last 5th stage is the terminal stage or advanced AIDS. This stage is not in vain called the dying stage of HIV infection, because. it is characterized by irreversible processes of a generalized nature, the treatment of which is no longer possible. During this period, treatment is aimed at pain relief and alleviating the suffering of a dying person. At this stage, a person can live for several more years (on average 12-20 months), but it is already impossible to stop the disease. The probability of death is 100%.

In the terminal stage, generalization of diseases and pathologies occurs, tumor processes and various secondary diseases develop: tuberculosis, salmonellosis, encephalitis, meningitis, toxoplasmosis, histoplasmosis, pneumocystis pneumonia and a number of other pathologies. The body completely loses its immunity to any infectious lesions.

AIDS is a terrible disease for which there is currently no cure. It is possible to prolong the life of a sick person only with active antiviral therapy in the initial stages. With the transition of the disease to the final stage, it is no longer possible to help a person.

HIV infection stage 3

Stage 3 HIV infection is an intermediate stage between the time when the disease is still in principle curable and AIDS. The considered period of time is the most dangerous for the body. The pronounced symptoms of infection, observed in stages 1 and 2, go into a latent state, but the disease itself does not disappear, progressing and causing new pathologies in the body.

On average, the duration of stage 3 does not exceed 6-7 years, but in some patients the disease can be asymptomatic for at least 20 years.

Characteristics

Subclinical stage 3 HIV in most patients manifests itself as follows:

Lymph nodes are enlarged;
The immune system is weakened, the virus spreads throughout the body, provoking the development of dangerous diseases;
Regular decrease in the number of CD4-lymphocytes.

Unfortunately, these characteristic signs are not enough for the patient to see a doctor. Most often, an increase in lymph nodes is attributed to other less dangerous diseases, the infection of which is weakened by HIV infection of the body, occurs approximately in this period.

Many specialists pay close attention to these symptoms only when three or more groups of enlarged lymph nodes located in different places are found in a patient. In this case, the patient is invited to undergo appropriate diagnostics, during which the latent stage of HIV is detected.

A patient who does not observe signs of HIV in himself often does not think about the danger that this infectious disease and he himself, as its carrier, pose to others. He leads a normal life, not knowing that he is a potential spreader of the disease. The duration of the latent stage depends on the strength of the immune system and the strength of the body.

Being interested in how long HIV patients live, one should pay special attention to the fact that the third stage of the disease is considered fatal, but at the same time, it is still not possible to exclude a lethal outcome.

Death can occur due to pulmonary tuberculosis, the development of disseminated herpes zoster, and even pneumonia. In the third stage of HIV, a progressive decrease in body weight is often observed, on average, the patient loses up to 10% of his usual weight. Such a significant weight loss is most often due to prolonged diarrhea, the causes of which remain unexplained for more than 1 month.

Patients may experience discomfort in the oral cavity due to developed candidiasis. A direct consequence of infection is leukoplakia, peripheral neuropathy, a localized form of Kaposi's sarcoma, bacterial sinusitis, pyomyositis.

The disease may not progress for 12 or more years, which means that the person will be completely healthy outwardly. A strong body, supported by the necessary drug therapy, is able to fight infection for a long time. In medical practice, there are cases when a patient lives without knowing about his diagnosis until his death, which occurs due to natural causes and has nothing to do with the disease itself.

Latent stage of HIV in children

Infection of a child with HIV infection most often occurs in the womb, or in the process of transfusing the blood of a sick person to him. At the latent stage, the disease is relatively short-lived - several months and even weeks after infection. At the same time, the signs of HIV in a child are more pronounced - the entire skin, or its individual sections, mucous membranes is affected.

Maintaining the life and health of an HIV-infected child is extremely difficult. If the disease was not detected at the 1st, 2nd and 3rd stages, there is practically no chance of recovery. Having passed all three stages of infection, the body stops fighting, the child is diagnosed with AIDS.

The third stage of the disease is also known as persistent generalized lymphadenopathy. For the most accurate determination of the main causes of the disease, its signs and consequences, the division of the considered period of time into separate phases is used:

A person loses weight, but the weight lost by him is less than 10% of the total body weight. This phase is characterized by damage to the skin and mucous membranes by a pathogenic fungus, viruses and bacteria. As a result of the activity of pathogens, herpes zoster, pharyngitis, sinusitis develop;
The patient loses weight rapidly. Body weight is reduced by more than 10% of the original weight. There is prolonged diarrhea. Loose stools disturb the infected for 1 month, while the reason for this behavior of the stomach remains unclear. If the body is weakened by other diseases, then the presence of HIV infection in the body can serve as an impetus for serious damage to internal organs, skin and mucous membranes. In severe cases, a malignant tumor is diagnosed - Kaposi's sarcoma;
In patients, pneumonia begins, the Candida fungus affects the internal organs, and above all, the esophagus, intestines. An extrapulmonary form of tuberculosis may develop, the central nervous system is affected, viruses, fungi and bacteria provoke the appearance of pustules on the skin, ulcers and tumors. The result of this phase is the diagnosis of AIDS in a patient.

Unfortunately, the presented description of the development of the third stage of the disease is not always true. In most cases, the disease is asymptomatic, these signs are not taken seriously enough. During the transition to the latent stage, the immune system still copes with the disease on its own and therefore the person does not feel serious changes.

Naturally, the immune system is not capable of suppressing the virus, but it can contain its harmful effects for 10-15 years.

Diagnosis, treatment, prevention

Diagnosis is made by taking blood from a vein to detect antibodies to the virus. A positive test result is a reason for an immune system blot. The disease is incurable, but if it is detected in the latent stage, it is likely that the patient will be able to lead a full life and even live to old age.

Treatment of HIV infection at the latent stage is carried out in three directions:

Etiotropic therapy. Drugs are used that act on the causative agent of the disease. For this purpose, the following are used: Acyclovir, Riboverin, Suramin, Azidomitin, Interferon;
pathogenic therapy. A group of drugs that affect the immune system, stimulate its work and prevent the further development of the disease are used. In order to correct immunity, thymomimetics are used - Timalin, Thymosin, T-activin and Timomulin;
Getting rid of opportunistic conditions. The patient is prescribed a large number of antibiotics and immunoglobulins. So, pneumocystis pneumonia is treated with Biseptol and 1-difluoromtilornithine, Acyclovir, Zavirax and Virolex are used to treat herpes. Ulcers and erosions on the skin are treated with Amphoterricin B, Kaposi's sarcoma is treated with Vincristine, Epidodovillotoxin.

The drugs and medicines noted above can quite cope with some forms of manifestation of HIV at the latent stage, but they cannot completely cure the disease. As mentioned above, their use in the specified period of time allows you to slow down the development of the disease, but the infection will still remain in the body and continue its pathological effects on it.

Timely detection of an HIV-infected person allows not only to prevent the further spread of the disease, but also to increase his life expectancy.

There is no need to wait for the next medical examination or hospital admission to take an HIV test. You should consult a doctor if you have the following symptoms:

Enlarged lymph nodes;
Sudden weight loss;
Constant feeling of fatigue, weakness.

In addition, there is loss of ability to work, insomnia, apathy, lack of appetite. The latent stage may be accompanied by fever and disorders of the digestive system, in particular, diarrhea. The nature of these conditions cannot be revealed for a long period of time, as a result, the prodromal period, when effective help can still be provided to the patient, ends, and HIV passes into the fourth (thermal) stage of development, or AIDS, as mentioned above.

If the disease is detected at the third stage preceding AIDS, one should not despair. According to scientists, patients who managed to reach this particular period in the development of the disease and at the same time not experience a clear feeling of discomfort may well continue to lead their usual way of life. They will not be able to recover from the virus, but it is quite realistic to prevent the disease from spreading throughout the body and leading to death.

With the help of the drugs described above, it is possible to stop the development of the disease for 5, 10, 20 or more years. If you follow the recommendations of a doctor with a diagnosis of HIV, you can live almost your whole life, of which there are a great many examples.

HIV infection stage 4 how long to live

Phase 4B (moderately pronounced, "intermediate" signs) in terms of clinical manifestations of the disease is close to the concept of SAH. There are some general symptoms or signs of AIDS without the generalization of opportunistic infections or tumors that occur in the later stages of the disease. That is, in this period of the disease, we are talking about more serious lesions than in phase 4A, and not fatal, compared with phase 4B. Characteristic: unexplained prolonged fever of intermittent or persistent type for more than 1 month, unexplained chronic diarrhea for more than 1 month, weight loss of more than 10% of body weight. There are deeper changes in the skin and mucous membranes that tend to spread and recur (herpes zoster, hairy leukoplakia, necrotizing gingivitis and periodontitis, bacillary angiomatosis, localized Kaposi's sarcoma).

In this phase of HIV infection, bacterial, fungal, viral, protozoal lesions of internal organs can be observed, but without dissemination of the infectious process. Among them, bacterial or fungal lesions of the lungs most often develop. causative agents bacterial pneumonia HIV-infected patients most often have Streptococcus pneumoniae and Haemophilus influenzae. In addition, pneumonia can be caused by staphylococci, nocardia, legionella, mycoplasmas, rhodococci, group B streptococci, Klebsiella, Proteus, Escherichia, Pseudomonas aeruginosa, and some anaerobic bacteria. Often there are microbial, viral-microbial and microbial-protozoal associations. The symptomatology of bacterial pneumonia in HIV-infected patients is quite typical and practically does not differ from the clinical manifestations of pneumonia in people not infected with HIV: general intoxication syndrome, fever, cough with sputum, moist rales, compaction in the lungs, the corresponding x-ray picture, etc. d. It occupies a special place pulmonary tuberculosis, which in itself remains a very important issue, especially for Russia. It is believed that the presence of HIV in previously ill with tuberculosis in 30% of cases leads to a relapse of tuberculosis. Fungal lesions(candidiasis, cryptococcosis, less often - aspergillosis, sporotrichosis, mucormycosis, endemic mycoses - histoplasmosis, coccidioidomycosis, blastomycosis, penicilliosis) in HIV-infected patients are also quite common. The entry gates of infection are most often the lungs. The fungi that have penetrated here create the primary focus of infection. At the same time, the activation of latent infection occurs as immunodeficiency develops.

Pathogenesis idiopathic thrombocytopenic purpura, probably due to direct HIV damage to megakaryocytes containing CD4 receptors (the latter are absent on platelets). In addition to this mechanism, thrombocytopenia in HIV-infected individuals may be associated with autoimmune aggression. Against the background of progressive immunosuppression, a tendency to anemia is determined. Leukopenia is due mainly to lymphopenia and only to a small extent neutropenia. The virus is actively multiplying, signs of immunodeficiency are growing. Revealed a decrease in the number of CD4-lymphocytes to 200-300/µl.

Phase 4B disease (expressed, late signs) corresponds to the stage of advanced AIDS. As a rule, it develops when the duration of the infectious process is more than 5 years. The growing failure of the immune system leads to the development of two main clinical manifestations of AIDS - opportunistic infections and neoplasms, which take on a generalized disseminated character and are deadly. In addition, it must be remembered that any pathogenic microorganisms cause unusually severe clinical conditions.

Among bacterial infections Tuberculosis (both pulmonary and extrapulmonary), atypical mycobacteriosis, recurrent pneumonia and generalized salmonellosis are of the greatest relevance. Among fungal infections First of all, it is necessary to isolate the fungi of the genus Candida, which are ubiquitous and in patients with HIV infection can cause damage to any organ, from the skin to severe manifestations of esophagitis or candidemia. The most important ubiquitous opportunistic fungal infections include cryptococcosis (extrapulmonary), manifested, as a rule, by meningitis or meningoencephalitis and dissemination up to sepsis. Among viral lesions most often manifest infections caused by the herpesvirus family (herpes simplex viruses types 1 and 2, Varicella Zoster, cytomegalovirus), as well as progressive multifocal leukoencephalopathy (one of the papovaviruses is the JC (Jakob-Creutzfelt) polyoma virus). The main among protozoan opportunistic invasions with HIV infection are pneumocystosis, toxoplasmosis, cryptosporidiosis, isosporiasis. In recent years, microsporidiosis, cyclosporosis, blastocystosis, and acanthamoebiasis have been increasingly diagnosed in AIDS patients. It should be noted that the etiology of developing opportunistic infections that complicate HIV infection at the stage of secondary diseases can be very different in general and is largely determined by the living, climatic and natural conditions in which a sick person lives. to the most significant neoplasms that occur with HIV infection against a background of deep immunodeficiency include Kaposi's sarcoma and non-Hodgkin's lymphomas (with more frequent localization in the central nervous system). In HIV-infected women at the stage of advanced AIDS, malignant cervical carcinoma associated with human papillomavirus type 16, 18, or 31 is often found.

The diagnosis of advanced AIDS can be made if there are pronounced signs HIV cachexia (wasting syndrome due to HIV). This syndrome is interpreted as a significant involuntary loss of body weight of more than 10% of the original in the presence of chronic diarrhea (loose stools at least 2 times a day for more than 1 month) and unexplained intermittent or constant fever for more than 1 month, as well as chronic weaknesses. At the same time, there should be no concomitant diseases or conditions (except for HIV infection) that could explain this symptom complex. Currently, it is generally accepted that this type of enteropathy occurs as a result of the direct action of HIV not only on the cells of the intestinal immune system (CD4-lymphocytes, macrophages), but also on serotonin-producing chromaffin cells. Histological examination of biopsy specimens of the jejunum revealed villous atrophy, crypt hyperplasia, and an increase in the content of intraepithelial lymphocytes.

Particularly worth stopping at HIV encephalopathy (AIDS-dement complex), the initial manifestations of which are sometimes recorded already in phases 4A and 4B. The AIDS-dementia complex is based on subacute encephalitis caused by HIV. The diagnosis of AIDS dementia is based on the following criteria: cognitive, behavioral, and motor impairments that progress over weeks or months; the absence of concomitant diseases or conditions (other than HIV infection) that may cause these changes; the absence of opportunistic infections or brain tumors excluded by clinical instrumental and laboratory tests, including by examining the cerebrospinal fluid. Progressive vacuolar myelopathy is also the result of direct HIV spinal cord injury. In a significant proportion of cases, it is combined with dementia, but it can develop in isolation or predominate in the clinical picture of HIV infection. Peripheral neuropathies (distal symmetric polyneuropathy, inflammatory demyelinating polyneuropathy) and muscle damage due to direct exposure to HIV also occur frequently at this stage of the disease.

Quite often, during the period of advanced AIDS, thrombocytopenia, anemia, and neutropenia are expressed. Deep immunosuppression is determined, in which the number of CD4-lymphocytes decreases to less than 200/µl. Comes with time terminal stage , especially when CD4 cells decrease to 50/µl, when the disease progresses steadily even against the background of adequate therapy, which ultimately leads to the death of the patient.

Long-term clinical observation of patients with HIV infection has shown that after the appearance of secondary diseases, they may experience long periods of remission. That is why, in the stage of secondary diseases, the phases of progression (in the presence of clinical manifestations of secondary diseases) and remission (when their clinical manifestations are absent) should be distinguished. In addition, from a prognostic point of view and in relation to patient management, it is fundamentally important whether progression (remission) occurs spontaneously or against the background of antiretroviral therapy, and whether the patient has previously received treatment or is currently receiving it.

However, it should be noted that the detailed classification given here is not free from some shortcomings. Chief among them is the lack of rigid attachment to the results of laboratory studies of the state of the immune system. That is why in 1993 the Center for Disease Control (CDC, USA) adopted a classification that provides for the relationship of clinical and immunological (CD4-cell level) signs of HIV infection. It includes 3 clinical categories (A, B, C) and 3 categories of T-helper content (more than 500/µl, 200-499/µl, less than 200/µl). Clinical category A includes acute HIV infection, asymptomatic HIV infection, and persistent generalized lymphadenopathy (PGL). The most important category B syndromes are: bacillary angiomatosis; oropharyngeal and / or vaginal candidiasis that persists for more than 1 month or is difficult to treat; severe cervical dysplasia (carcinoma); fever over 38.5 0 C or diarrhea for more than 1 month; hairy leukoplakia; recurrent or disseminated herpes zoster; idiopathic thrombocytopenic purpura; listeriosis; pulmonary tuberculosis; pelvic inflammatory disease; peripheral neuropathy. Category C practically corresponds to the phase of advanced AIDS according to the classification of V.I. Pokrovsky. According to the CDC classification, the diagnosis of AIDS is established for all persons with clinical category C (regardless of the content of CD4 cells), as well as patients with a CD4 cell level below 200/μL, even if they have clinical categories A or B and no category C.

Clinical signs of HIV in the terminal stage

"Plague of the twenty-first century" - this is the name of this disease. Today, almost 5% of the world's population is infected with HIV. Pathology in the early stages is not visually noticeable, which cannot be said about the final stage of the development of HIV infection. It has long been proven that people do not die from the immunodeficiency virus, death occurs from diseases that develop against the background of AIDS.

A person who is in the last stage of HIV usually stays in a rehabilitation center under the supervision of infectious disease doctors. The signs of the last stage of AIDS are very visible. The patient has absolutely no immunity, no strength to fight the disease. He is usually very thin and has many black spots and bruises on his body. The latter are formed from any touch, this is due to a violation of blood counts. The skin thus loses the possibility of regeneration.

The terminal stage of HIV (AIDS) can last from a week to three years. There is practically no chance of recovery for the patient. This period is irreversible. The condition may improve for a while, but these are only visible positive changes. The patient's skin color slightly normalizes and appetite appears, but after a while AIDS still wins. People with the last stage of AIDS live no more than three years, provided that they stay in a hospital under round-the-clock supervision and constantly take antiretroviral drugs and drugs that help to cope with concomitant ailments. If the patient does not go to the AIDS center and the last stage of HIV passes at home, then his life is significantly reduced. The countdown can go on for months or even weeks, it depends on how much the disease has developed and what concomitant diseases the person has.

At any of the five stages of HIV infection, lymph nodes can become inflamed. In the last period, this symptom is especially dangerous, since the skin cells are so damaged that they are unable to withstand such swelling. Tissue ruptures and purulent discharge are clear signs of stage five HIV. In such cases, you should be especially careful when in contact with an infected person. Patients with AIDS, even at the last stage, cannot infect others by household means, but since they have frequent bleeding, there is a risk of infection transmission upon contact with biological fluid.

End-stage AIDS has a number of symptoms that can be confused with other illnesses such as tuberculosis, severe pneumonia, skin cancer, or severe psoriasis. It also becomes difficult for a person to breathe, often coughing is accompanied by the release of mucus with blood. This indicates damage to the lungs and respiratory tract. Sometimes a similar sign can be a symptom of internal bleeding. The whole body is often covered with red spots. At the site of their formation, the skin peels off, it is this phenomenon that is similar to psoriasis.

In the 5th period of immunodeficiency, a person often loses the ability to think logically. It is associated with brain damage. The reasons for this are different. Someone wins self-pity and hatred of others, it is proved that such people are especially susceptible to physical changes. In other patients, an abscess of tumors begins, which often occur against the background of immunodeficiency, it affects the brain. It is useless to deal with such consequences.

I would like to note that the terminal stage of HIV infection (AIDS) occurs long after infection. That is, the patient has at least tens of years before the onset of the fifth period of the disease. Of course, this is all individual and depends on the presence of concomitant diseases, therapy and the stage at which HIV was recognized.

In the last stage, the symptoms of HIV are always pronounced. In comparison with the third period, the patient's complexion is markedly different. Analyzing photos of people with AIDS in different phases, you can notice a gradual darkening of the skin. This sign is not natural, it does not look like a tan. The skin takes on a blue-black hue. The area around the eyes and lips is especially affected.

If the face becomes almost uniformly dark, spots appear on the body, as a rule, their color varies from blue to black. They cover almost the entire body of the patient. The skin lesion begins with the legs, which does not allow time to notice the onset of the last stage of HIV (AIDS). If you look closely, then each such spot has very small sores, which later begin to fester or bleed.

A common occurrence in immunodeficiency is the presence of serious concomitant diseases, such as syphilis. In this combination, the patient's nose and Adam's apple are depressed. Such people die quite quickly, because it is difficult for an already weakened immune system to fight diseases and restore bones, which leads to complete depletion of the body.

Can people in the last stage of HIV be helped? Therapy can only sustain life. The final stage of development of HIV infection is irreversible. With the timely adoption of therapy, one can only delay the inevitable death. A patient who is hospitalized at the AIDS Center receives not only antiviral therapy, but also drugs for concomitant diseases that have developed against the background of immunodeficiency, as well as painkillers.

Another symptom of the last stage of AIDS is eye changes. Severe redness or blueness of the protein coat is combined with damage to the mucous membranes. The optic nerve may be damaged, as a result of such a change, there is a partial or complete loss of vision in the patient.

Due to the fact that AIDS is a disease directly related to immunity, the patient at this stage suffers from any even the most insignificant infection, which then develops into serious ailments. In the fifth period of immunodeficiency, even a common cold cannot be treated.

Cells lose their ability to recover, that is, the skin, when cut, does not regenerate, does not heal. Damage, abrasions and scratches begin to fester. Blood from them, as a rule, is not strongly allocated. The patient with skin lesions feels aching pain, which does not go away on its own over time.

AIDS patients are prescribed sessions of physiotherapy and chemotherapy, which leads to some improvement in the condition, but carries with it a number of consequences. There is hair loss and complete baldness. Such a result can be not only the result of procedures, but also a consequence of the disease itself.

It can be noted that the life span of a patient in the last stage of AIDS cannot be accurately named. If the patient is on home treatment and does not go to the hospital for help, the duration of his life can be measured in weeks or months. All this time he will feel pain and other symptoms of concomitant diseases. When contacting a specialized center for the fight against AIDS, you can extend life up to three years. If the patient refuses hospitalization, it is necessary to explain to him the consequences of the decision made and to insist on seeking help. Upon admission to the AIDS Center hospital, it is worth reporting the duration of symptoms, the latest result of viral load tests and concomitant diseases. The hospital will conduct research to clarify the diagnosis.

It is worth remembering that the last stage can be delayed only if you contact an infectious disease specialist in a timely manner, strictly following all his instructions and taking free therapy to combat the retrovirus. An infected person can lead a normal life, have a family and children, get an education and work in any field of activity, but all this is real only when antiretroviral therapy is carried out.

general information

Predecessor stages

The second stage of HIV is characterized by the primary manifestations of infection. It is divided into several stages:

asymptomatic course;
acute manifestation without secondary pathologies;
acute infection that provokes secondary diseases.

The asymptomatic stage can last from 1-2 months to 2-3 years: at this time, a sick person does not feel obvious signs, but unlike the 1st stage, he becomes an infectious carrier of HIV, and antibodies are found in his blood.

Progression

HIV infection is a long-term chronic infectious disease caused by the human immunodeficiency virus, characterized by the gradual destruction of the entire immune system of the patient and the onset of immunodeficiency, which contributes to the occurrence of any opportunistic infections and tumors. Its spread began more than 20 years ago, now it has the character of a pandemic, the incidence is steadily growing throughout the planet.

If earlier HIV was registered only in the countries of West and South Africa, now its center has moved to the countries of Eastern Europe, or rather, the CIS. The share of Russia in this case is 80% of cases, 15% fall on Ukraine, Belarus, Kazakhstan, Moldova and Tajikistan. The UN structure, which is engaged in the prevention of HIV infection worldwide, stated in July 2016 that the most significant incidence was noted from the CIS countries in Russia, at present it is 824 thousand people, the first such patient was registered back in the USSR in 1987 These rates are associated with high levels of injecting drug use.

Exciter characteristic

HIV belongs to the family of retroviruses, a genus of lentiviruses, which are called slow, so the symptoms of the disease appear after a very long time. There are thousands of protein molecules on the surface of the virus, but gp120 and gp41 molecules cause AIDS, with the help of which it attacks the protective components of the immune system, namely lymphocytes.

It dies in the air in a few seconds, at 56 ° C it is destroyed in half an hour, at 80 ° C - after 10 minutes, it is destroyed by contact with antiseptics: peroxide, hydrochloric acid, chlorine, alcohol. From boiling perishes instantly. Can be viable in the dried state for about 2 weeks, survives only in liquid media, especially in the blood.

Pathogenesis

The human immune system consists of 4 types of cells, the main of which are lymphocytes - they provide protection to the body. To do this, they recognize foreign elements that have entered the body and begin to develop special antibodies to it - protein molecules that perform the function of protection. Those types of blood elements that are designed to protect us are called lymphocytes and there are 2 classes, one of which got its name from the place of its production, i.e. thymus, or thymus, - T-lymphocyte. It has 3 additional subspecies: the main ones are T-killers that destroy any foreign cells; the following - T-helpers - contribute to the formation and existence of immunity; the latter are T-suppressors, or regulatory cells, they control the strength and duration of the body's immune response.

The human immunodeficiency virus has a complex structure, on its surface it contains outgrowths rounded in the form of tires, the so-called petals, which fit into the recesses of the lymphocytes of the human immune system like puzzles or a key to a lock. This refers to those types of lymphocytes that contain CD4+ receptors on their surface (T-helpers, macrophages designed to capture and digest foreign agents, and dendritic cells). The pathogen opens them and then destroys the ability of lymphocytes to recognize foreign agents.

The envelope covering the virus is completely combined with the cell membrane of the lymphocyte. Merging with it, the virus first penetrates into the plasma of the lymphocyte cell, and then into its most valuable component - the nucleus. Here, without much difficulty, the aggressor is built into the very gene apparatus of the nucleus, i.e. begins to reproduce cells of its own kind from materials, the process of HIV development is started. Quite often, a virus can hide, but its transmission continues during cell division, it spreads, its gene apparatus is already present in all daughter cells.

At first, the infected organism fights and compensates for the lack and massive death of its protective cells by producing new ones. But over time, this is not enough, and then the patient's immune system begins to irreversibly collapse. Macrophages, T-helpers die and cannot protect the body, it is completely defenseless against any, even the most frivolous disease.

And at this time, the defeat and destruction of all new lymphocytes continues, their number decreases at such a catastrophic rate that very soon the number of T-helpers in 1 cu. mm of blood first drops to a thousand from the initial units of 2-3 million, and then it becomes less than 400 units. And if a healthy lymphocyte can produce up to a thousand immune protective bodies, then the patient will not produce even ten. When the number of CD4+ T-lymphocytes becomes less than 200 per 1 µl of blood, cellular immunity no longer works. HIV is considered the most deadly and “intelligent” virus: it is not he who kills, but the joining diseases.

Ways of infection

The most common route is blood contact, through blood when using a common syringe by drug addicts, during blood transfusions, non-sterile medical procedures in tattoo and piercing parlors, during organ transplantation, endoscopic and dental procedures, manicure, using someone else's toothbrush, razor, if they have even the smallest amount of blood. The sexual route of transmission is relevant for unprotected sex, especially among homosexuals, because the mucous membrane of the rectum is damaged. Oral sex is contagious in 0.04% of cases, proving to be more dangerous for the partner who comes into contact with the genitals than for the other who gets only saliva. Biological fluids contain little virus, they become possible sources of infection only if they contain blood impurities.

The possibility of infection occurs when there is a so-called entrance gate for HIV penetration, it can even be small abrasions, microcracks, scratches or wounds, damaged mucous membranes during any manipulations by dentists, gynecologists, surgeons, and stomatitis, periodontal disease, erosion are themselves dangerous in terms of infections. The virus can also be transmitted from a sick mother during pregnancy to her fetus or during childbirth (vertical route), but there are many cases of a healthy child born to such mothers. The virus is not transmitted by contact-household way (through saliva, sweat, urine). The source of infection is the patient and the carrier, the risk group for developing HIV includes: those involved in prostitution, drug addicts, people without a fixed place of residence, etc. Whole skin serves as a reliable barrier against the penetration of the virus, so infection does not happen from hugs, kisses, they do not get infected in baths, swimming pools, from animals, from mosquito bites.

Classification

There are 2 types of the virus - HIV-1 and HIV-2. The latter is less common, found only in West Africa, HIV-1 is the culprit of the pandemic in the world, it does not have a reservoir in nature. There are the following stages of HIV infection:

Incubation.
Primary manifestations (lasts up to 6 years).
Latent stage of HIV infection.
Stage of secondary diseases (lasts from 2 to 8 years).
Terminal - AIDS.

The stage of primary manifestations may be asymptomatic or combined with secondary diseases. Classification of HIV infection and stages of development are important for the development of treatment for the patient.

primary stage

Any infection begins with an incubation period, here it averages from 20 to 100 days, sometimes up to 1-10 years. At this stage, the virus enters the human body, and the production of antibodies begins, the infection does not manifest itself, the person does not feel anything, but becomes a contagious carrier of the infection. The level of antibodies is very low, and it is not yet possible to detect HIV in the laboratory. Then comes the first stage of HIV infection, its course goes through several phases.

At first, the acute, febrile phase lasts up to 3 weeks, the symptoms resemble a cold: the temperature rises to 38-39 ° C, appetite decreases, among the early symptoms are swelling, but painlessness of the cervical lymph nodes, enlarged tonsils, headache, fatigue, malaise, pharyngitis, cough , myalgia, runny nose, sore throat when swallowing, in the joints, eye sockets, night sweats, in 85% of cases stomatitis and weight loss, in men there is still an additional unclear small-pointed rash similar to rubella, diarrhea, vomiting, stomach cramps, enlarged liver and spleen , apathy. As you can see, the symptoms are nonspecific, a person perceives them only as a cold or poisoning and does not go to the doctor.

This picture lasts 2-4 weeks, the fever can last up to a month, conventional medicines do not knock it down, everything goes away without treatment. This stage is very contagious, viruses multiply especially intensively. If the symptoms of a cold do not go away within a few months, the person has lost weight, causeless diarrhea is observed, you need to be tested for infection. The stage independently passes into the next phase, latent - asymptomatic course, this is a period of stabilization, which sometimes lasts 3-4 months, more often 5-10 years.

There are no external symptoms, antibodies are produced, the process develops. It can already be detected by a blood test. Then, closer to the secondary stage, three or more groups of lymph nodes increase for no reason for more than 2 months: cervical, axillary, occipital, but the state of health does not worsen. This phase lasts up to 6 years and is called generalized lymphadenopathy. The phases are generally delimited conditionally, the latent stage can already begin with an increase in lymph nodes.

Sometimes the primary, initial stage of HIV development proceeds without symptoms at all, with it a mobile balance is established: the reproduction of the virus itself and the opposition of immunity are equal for some time. The reproduction of the virus does not stop, CD4+ cells (helpers) are destroyed, there is a VL expressed at different levels - the so-called. viral load is the free circulation of the virus in the blood. The annual drop in the number of CD4+ cells is 50 million cells per 1 liter.

The average life expectancy of a patient is now estimated at 12 years, plus or minus 3 years.

It happens that some of the infected homosexuals live for 20 years without health problems, but this is rare. HAART (highly active antiretroviral therapy) allows you to extend the first stage for decades.

Development of HIV infection

The first weeks of HIV in the body

What happens to a person with HIV?

Stages of development of HIV (AIDS) in humans

How fast does HIV develop?

What is HIV?

Why is HIV infection incurable?

Causes of AIDS

Ways of transmission of infection

Symptoms of AIDS (Acquired Human Immunodeficiency Syndrome)

AIDS and HIV - diagnostic methods

Treatment and prevention of the disease

Characteristics of stage 4 HIV disease

Basic actions during stage 4 of the disease

How long do HIV-infected adults live?

Clinical picture of HIV at 4 stages of development

Clinical forms of HIV infection

Pregnancy at the fourth stage of HIV development

Stages of development of AIDS

Predecessor stages

HIV infection stage 3

Characteristics

Latent stage of HIV in children

Diagnosis, treatment, prevention

HIV infection stage 4 how long to live

Clinical signs of HIV in the terminal stage

general information

Predecessor stages

Progression

Exciter characteristic

Pathogenesis

Ways of infection

Classification

primary stage

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