HIV Infection: Symptoms & Therapies

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Questions and Answers

What is a common initial symptom of an acute HIV infection?

Severe weight loss

Chronic diarrhea

Fever and sore throat (correct)

Persistent generalized lymphadenopathy

What percentage of patients experience an asymptomatic period after initial HIV infection?

70-90%

Varies widely (correct)

30-50%

50-70%

What condition is characterized by the enlargement of two or more lymph nodes without another illness accounting for it?

Chronic fatigue syndrome

Persistent generalized lymphadenopathy (correct)

Acute lymphocytic leukemia

Generalized edema

Which symptoms may indicate the progression from asymptomatic HIV to AIDS?

Malaise, fever, and night sweats Signup and view all the answers

What is one of the characteristic manifestations of AIDS?

Neurologic manifestations or opportunistic infections Signup and view all the answers

How long does the advanced stage of HIV typically develop after initial infection?

10 to 15 years Signup and view all the answers

Which of the following is NOT commonly associated with acute HIV manifestations?

Skin dryness Signup and view all the answers

What staging systems can classify HIV/AIDS?

WHO and CDC systems Signup and view all the answers

What is the preferred treatment for oral thrush?

Fluconazole Signup and view all the answers

Which infection is associated with inhaling a fungus that can affect the lungs and other organs?

Histoplasmosis Signup and view all the answers

What symptoms are indicative of Mycobacterium avium complex in patients with HIV?

Night sweats and diarrhea Signup and view all the answers

What is a common prophylactic treatment for tuberculosis (TB) in HIV-positive patients?

Isoniazid Signup and view all the answers

What characterizes oral hairy leukoplakia in patients with weakened immune systems?

White lesions on the tongue Signup and view all the answers

Which symptom is NOT typically associated with AIDS dementia complex?

Headaches Signup and view all the answers

In managing persistent skin dryness for HIV patients, which practice is recommended?

Use moisturizers Signup and view all the answers

What dietary measure can help mitigate diarrhea in patients?

Consuming bananas and rice Signup and view all the answers

Which treatment is suggested for the management of peripheral neuropathy in HIV patients?

Gabapentin Signup and view all the answers

What is the treatment for vaginal candidiasis?

Miconazole Signup and view all the answers

Which of the following is an AIDS-defining condition according to the CDC?

Histoplasmosis Signup and view all the answers

What type of ulcerations are considered painful and related to immune suppression?

Aphthous ulcers Signup and view all the answers

Which medication is commonly used for treating esophageal candidiasis?

Fluconazole Signup and view all the answers

What is a defining characteristic of HIV wasting syndrome?

Weight loss of at least 10% Signup and view all the answers

Which condition is commonly associated with Clinical Stage 3 of HIV Infection?

Unexplained severe weight loss Signup and view all the answers

What is the significance of a CD4+ T-lymphocyte count below 200?

It signifies the onset of opportunistic infections. Signup and view all the answers

What type of treatment can be effective for HIV wasting syndrome?

Liquid nutritional supplements and exercise Signup and view all the answers

Which of the following is NOT a characteristic of Clinical Stage 2 of HIV Infection?

Severe persistent oral candidiasis Signup and view all the answers

What is a common initial symptom of Pneumocystis jiroveci pneumonia (PJP) in AIDS patients?

Nonproductive cough Signup and view all the answers

What indicates a risk of developing opportunistic infections in an HIV patient?

Lower CD4 cell count Signup and view all the answers

Which of the following conditions is not associated with Clinical Stage 4 of HIV Infection?

Moderate unexplained weight loss Signup and view all the answers

What does recurrent oral ulceration indicate in an HIV infection context?

Stage 2 HIV infection Signup and view all the answers

Which complication is most associated with a CD4+ T-lymphocyte count falling below 200?

Opportunistic infections Signup and view all the answers

What symptom is typically noted in patients with HIV during Clinical Stage 1?

Persistent generalized lymphadenopathy Signup and view all the answers

Which of the following is a common cause of death in patients with AIDS?

Pneumocystis jiroveci pneumonia (PJP) Signup and view all the answers

What is the typical clinical manifestation of Chronic herpes simplex infection in HIV patients?

Orolabial lesions for more than 1 month Signup and view all the answers

What is the hallmark of Clinical Stage 4 of HIV infection?

AIDS-defining conditions Signup and view all the answers

What is a common manifestation of oral candidiasis in patients with AIDS?

Difficulty swallowing as well as substernal pain Signup and view all the answers

Which organism is commonly associated with disseminated disease in AIDS patients?

Mycobacterium avium complex Signup and view all the answers

What type of cancer is most commonly associated with AIDS?

Kaposi sarcoma Signup and view all the answers

What is a primary complication of Mycobacterium avium complex in AIDS patients?

Wasting syndrome Signup and view all the answers

Which of the following infections is commonly associated with changes in mental status in AIDS patients?

Crytococcus neoformans infection Signup and view all the answers

What distinguishes the cervical cancer risk among women with HIV compared to the general population?

Increased mortality from cervical cancer Signup and view all the answers

What skin condition is primarily associated with Kaposi sarcoma in AIDS patients?

Vascular macules and papules Signup and view all the answers

Which opportunistic infection is characterized by white, friable plaques in the mouth of AIDS patients?

Candidiasis Signup and view all the answers

What symptom is commonly related to non-Hodgkin lymphoma in AIDS patients?

Headache and mental status changes Signup and view all the answers

What type of infection can lead to prolonged diarrhea in AIDS patients?

Cryptosporidium Signup and view all the answers

In terms of disease progression related to AIDS, how is tuberculosis stratified?

It can arise from reactivation of a previous infection. Signup and view all the answers

How frequently should women with HIV infection have a Pap test according to recommendations?

Every 6 months Signup and view all the answers

What is one of the most common respiratory complications associated with AIDS?

Pneumonia due to opportunistic infections Signup and view all the answers

What type of disease progression is often seen with Mycobacterium avium complex in AIDS?

Rapid and severe Signup and view all the answers

What is the common effect of herpesvirus infections in patients with AIDS?

They often become chronic and severe. Signup and view all the answers

What defines stage 3 HIV, or AIDS?

T-lymphocyte counts below 200 Signup and view all the answers

Which of the following is the most common cause of changes in mental status for patients with HIV infection?

AIDS dementia complex Signup and view all the answers

What is the typical manifestation of AIDS dementia complex?

Fluctuating memory loss Signup and view all the answers

How does the severity of lymphadenopathy relate to HIV infection?

It worsens as CD4 count decreases. Signup and view all the answers

What is the most common form of peripheral neuropathy in HIV-infected patients?

Distal symmetric polyneuropathy (DSP) Signup and view all the answers

What distinguishes night sweats from regular perspiration?

They happen exclusively during sleep. Signup and view all the answers

What is the primary treatment for Kaposi sarcoma in patients with AIDS?

Chemotherapy or radiation therapy Signup and view all the answers

Which opportunistic infection is known to affect the eyes in AIDS patients?

Cytomegalovirus (CMV) Signup and view all the answers

What treatment option is often used for mild lymphadenopathy in early HIV infection?

NSAIDs to relieve swelling Signup and view all the answers

Which symptom is typically one of the first signs of an HIV infection?

Flulike symptoms Signup and view all the answers

What symptom is least likely to occur without the presence of other symptoms during HIV infection?

Night sweats Signup and view all the answers

Which of the following is a typical manifestation associated with distal symmetric polyneuropathy?

Aching or burning sensations in lower extremities Signup and view all the answers

How can the CNS complications in AIDS patients be categorized after the introduction of ART?

Decreased significantly Signup and view all the answers

What is a common CNS complication in patients with AIDS?

Cryptococcal meningitis Signup and view all the answers

Study Notes

HIV Infection: Clinical Manifestations & Therapies

Early Symptoms:
Flu-like symptoms (fever, chills, headache, sore throat, cough, congestion, muscle aches) appear within days to weeks of infection.
Patients often mistake these symptoms for common viral illnesses.
Lymphadenopathy:
Lymph node swelling (lymphadenopathy) is common and often generalized, occurring in neck, under jaw, armpits and groin.
Severity is linked to immunosuppression level.
General Malaise & Fatigue:
Feelings of weakness, discomfort, lack of energy, extreme tiredness, not alleviated by rest.
Underlying cause is needed for treatment.
Night Sweats:
Profuse sweating, often during sleep and without exercise.
May accompany other symptoms like fever, weight loss, and diarrhea.
Fever:
Temperature above 38°C (100.4°F) can appear 2-4 weeks after exposure.
Rest and hydration are key management strategies.
Opportunistic Infections:
Kaposi sarcoma (KS): Most common HIV-related cancer, presents as skin lesions (red/purple), but can affect organs. Treatment might include chemotherapy, radiation, or interferon.
Cytomegalovirus (CMV): Can infect eyes, brain, throat, GI tract, or spinal cord in immunocompromised patients. Treatment or prevention involves antiviral medication. Some strains are resistant to ganciclovir.
Candidiasis: Common fungal infection affecting mouth, vagina, esophagus, or skin. Symptoms include white bumps, dry mouth, difficulty swallowing, alteration in taste. Treated with antifungal medications (e.g., fluconazole).
Aspergillosis: Fungal infection from soil/plant exposure. Symptoms include cough, chest pain, shortness of breath, facial pain, fever, and night sweats. Treated with antifungal medications (e.g., amphotericin B or itraconazole).
Histoplasmosis: Fungal infection from inhaling fungus in soil/plant life. Symptoms include fever, skin lesions, breathing problems, weight loss, and liver enlargement. Treated with itraconazole and long-term maintenance.
Mycobacterium avium complex (MAC): Infection affects many organs. Symptoms include chills, fever, weakness, night sweats, abdominal pain, diarrhea, and weight loss. Treated with antibiotics, e.g., clarithromycin, azithromycin, or rifabutin.
Tuberculosis (TB): Infection from contact with TB patients. Symptoms are widespread pulmonary and extrapulmonary. Prevents by isoniazid prophylaxis and treated with multiple drugs (isoniazid, rifampin, pyrazinamide, ethambutol).
Oral hairy leukoplakia (OHL) : Indication of severe immune damage. Appearance includes white lesions on the tongue edges, caused by Epstein-Barr virus. Treated with famciclovir.
Neurologic Disorders:
AIDS dementia complex (ADC): HIV infection of the brain causing cognitive, motor, and behavioral dysfunction (memory loss, confusion, reduced motor skills, apathy). Treated with antivirals for HIV, and possibly antidepressants or antipsychotics.
Peripheral neuropathy (DSP): Severe burning pain in legs/feet. Distal symmetric polyneuropathy is most common. Treated with medications like gabapentin or pregabalin. other neuropathies may be drug or toxin induced.
CNS opportunistic infections: Toxoplasmosis (encephalitis, mass lesion), Cryptococcal meningitis, and cytomegalovirus infection can also cause CNS issues.
Gastroesophageal Disorders:
Diarrhea: May be due to infection, intolerance, pancreatic problems, medication, or stress. Treated by eliminating trigger foods and potentially anti-diarrheal medication.
Malabsorption: Reduces nutrient and medication absorption. Causes weight loss and fatigue. Treated with vitamin supplements, increased calories, or IV nutrition.
Integumentary Disorders:
Dry skin: Flaking, roughness, redness, cracking. Treated with moisturizers and topical creams
Skin rash: Red, scaly, itchy areas. Treated with prescription topical corticosteroids.
Other Manifestations:
Inflammation/ulceration: Gum disease (inflammation), mouth sores. Prevention and treatment include good oral hygiene, avoiding specific foods, or prescription treatment.
Weight loss (HIV wasting syndrome): Progressive involuntary weight loss. Characterized by at least 10% weight loss, presence of diarrhea or chronic weakness, fever, duration of condition for a minimum of 30 days and NOT due to other causes. Treatment includes antiretroviral therapy (ART), diet adjustments, exercise, and supplements.

HIV Infection Stages (Simplified)

Clinical Stage 1 (Acute): Asymptomatic or persistent lymphadenopathy. High transmission risk.
Clinical Stage 2 (Chronic/Latency): Virus present, few symptoms. CD4+ T-lymphocyte count/percentage still within range.
Clinical Stage 3 (AIDS): Presence of AIDS-defining condition or significant drop in CD4+ T-lymphocyte count/percentage.
Clinical Stage 4: HIV wasting syndrome or opportunistic infections (e.g., PJP, CMV, Tuberculosis).

Opportunistic Infections in AIDS

Opportunistic infections are highly prevalent in AIDS. The risk correlates with declining CD4+ T-lymphocyte counts.
Pneumocystis jiroveci pneumonia (PJP): Common opportunistic infection, leading cause of death. Presents with symptoms like fever, coughing and breathing issues.
Tuberculosis: Occurs due to active primary infection or reactivation.
Candidiasis: Oral, esophageal, or vaginal infection.
Other opportunistic infections: CMV, Toxoplasmosis, cryptococcus infection, Herpes infections, and more affect patients with severely compromised immune systems.

Secondary Cancers in AIDS

Kaposi's sarcoma (KS): Common cancer related to HIV. Appears on skin and internal organs, related to human herpesvirus-8 (HHV8).
Lymphomas (non-Hodgkin and primary brain): More frequent in HIV infection. Can originate in the CNS, bone marrow, GI tract, liver, and skin.
Cervical cancer: Higher incidence in HIV-positive women, usually associated with severe pre-existing cervical dysplasia.

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Description

Test your knowledge on the clinical manifestations and therapies associated with HIV infection. This quiz covers early symptoms, lymphadenopathy, general malaise, and opportunistic infections. Understand the nuances of recognizing and treating the various symptoms of HIV.