Download How HIV Progresses to AIDS

How HIV Progresses to AIDS
If you're HIV positive, you can live for years
without the virus progressing to AIDS — if you
follow your HIV treatment plan.
By Elizabeth Connor
Medically reviewed by Lindsey Marcellin, MD, MPH
Print
Email
Once a person has been infected with the human immunodeficiency
virus (HIV), the progress of the disease is influenced by factors both
within and outside of the patient’s control. An effective form of HIV
treatment, called highly active antiretroviral therapy (HAART), was
introduced in 1996 and forever changed HIV disease from an
almost certainly fatal condition to a difficult but long-term chronic
illness.
Within a month or two after a person is exposed to HIV, he or she
may come down with an illness that resembles the flu. Common
symptoms of this illness include fever, headache, fatigue, and
swelling of the lymph nodes in the neck and groin. Although the flulike symptoms go away, a person in the early stages of HIV is still
very infectious.
After the initial illness, a person may not experience any HIV
symptoms for a long time, perhaps 8 to 10 years. However, 5 to 15
percent of people with HIV get sick more quickly than this, and a
similar percentage remain symptom-free for longer than 10 years.
Staging HIV
The outward symptoms of HIV disease can look very different from
one person to the next, so doctors use precise clinical tests to
categorize HIV in one of three stages. The final stage of infection is
acquired immune deficiency syndrome, or AIDS.

Stage 1: In stage 1, a person does not have any of the diseases
associated with severe HIV infection (called an AIDS-defining
disease) and a relatively high level of the immune cells that fight
infection (called CD4+ T-cells, or simply CD4 cells).

Stage 2: In stage 2, there is still no AIDS-defining disease, but the
level of CD4 cells has fallen dramatically.

Stage 3: In the final stage, AIDS, a person has at least one of the
AIDS-defining diseases and a very low level of CD4 cells.
Signature HIV Symptoms
As HIV disease progresses and the CD4 count drops, but before
the definition of AIDS is met, many people with HIV infection
experience the following symptoms:

Sweats

Fevers

Swollen lymph nodes
When the CD4 count gets very low, the immune system can no
longer protect the body against common infectious agents in the
environment that would not normally cause illness. Certain cancers
may also appear in HIV patients because of the body’s dramatically
lowered immunity. When one of these conditions is diagnosed in
someone with a CD4 count less than 200, it is said to be an AIDSdefining disease — therefore, the person now meets the U.S.
Centers for Disease Control and Prevention’s (CDC’s) definition of
having AIDS. The most common aids-defining diseases include:

Severe herpes simplex virus infections

Pneumocystis carinii pneumonia

Cytomegalovirus infection of the eye

Active tuberculosis

Yeast infection of the esophagus

Severe shingles outbreaks

Encephalopathy (brain inflammation)

Wasting syndrome

Cancer of the lymph glands

Kaposi’s sarcoma
A person with AIDS has a very weak immune system and frequently
will come down with more than one serious, debilitating illness at a
time.
Personal Characteristics Can Increase HIV Risk
The rate at which HIV progresses is different for each person, and
can be influenced by many factors. Here are some facts:

Older people infected with HIV are likely to become sick more
quickly than those who are younger.

How a person becomes infected with HIV can influence how quickly
their HIV progresses. In one study, HIV progressed to AIDS most
quickly among men who have sex with men. These men had a high
rate of Kaposi’s sarcoma, a type of cancer that is rare among
people without HIV. Injection drug users also often progress to
AIDS faster than those who do not inject drugs.

Both men and women with multiple sex partners progress faster
from HIV to AIDS.

A person’s immune system and genetics can affect whether they
become infected with HIV after exposure and also how fast the HIV
progresses.
Not everyone infected with HIV will necessarily progress to AIDS. In
a study of the deaths of almost 500 HIV-positive people, only about
10 percent died from a disease strongly linked to AIDS. Frequently,
the cause of death was a debilitating disease with a weaker
association with HIV or a factor not related to HIV at all.
Between 1995 and 1996, the estimated remaining lifetime for a 25year-old person with HIV was eight years. For the same person
diagnosed between 2000 and 2005, the expected remaining time of
life was about four times that, approximately 33 years. Many factors
play a part in these dramatic gains in life span, particularly improved
therapies and long-term behavior changes among people living with
HIV