Clinical manifestations of AIDS
(A) Adult AIDS
1, acute infection (the equivalent of CDC Classification group Ⅰ): non-specific symptoms, after exposure to the onset of HIV is about 1 ~ 6 weeks, the main clinical manifestations are fever, sweating, fatigue, myalgia, anorexia, nausea, diarrhea and non-exudative pharyngitis, headache, photophobia and meningeal irritation. 1 / 4 to 1 / 2 persons torso rash (maculopapular rash, rose rash or hives). Small number of people, there may be encephalitis, peripheral neuritis and acute polyneuritis. Physical examination may have neck, axillary, occipital lymph nodes occasionally liver, splenomegaly, individual Dan mouth ulcers or esophageal Candida infection.
Laboratory examination: total lymphocyte count decline accelerated ESR, serum addicted to different agglutination-negative, aminotransferase and alkaline phosphatase increased, CD4 / / CD8 ratio of "a few weeks after emergence CD4 / / CD8 ratio of" 1. Peripheral blood smear can be seen atypical lymphocytes. HIV2 weeks after infection, p24 antigen in serum and cerebrospinal fluid can be positive, and for several weeks to several months. Negative for anti-HIV antibodies can last up to 2 ~ 3 months, this period is called window period.
2, early (the equivalent of CDC Classification, Group II): Multi-non-specific symptoms, but in some cases there can be no other reason, persistent lymphadenopathy, painless, often symmetrical, to neck, pillow, and axillary more common , lymph node diameter> 1cm, lymph node puncture or biopsy of follicular hyperplasia.
3, medium-term (equivalent to CDC Classification, and section III Group IV Group A, B subtype, or AIDS-related syndrome): In addition to a persistent generalized lymphadenopathy, there are non-specific systemic symptoms, thrush, mouth Dan hairy leukoplakia and thrombocytopenia purpura.
(1) non-specific systemic symptoms: easy fatigue, slight fever, night sweats and intermittent diarrhea. Pneumocystis carinii pneumonia in patients with early stage may be only the symptoms without respiratory symptoms.
(2) Thrush: in particular, CD4 cells dropped to <200 ~ 300/mm3 Dan when I increased the incidence of Candida infection.
(3) port Dan Gross leukoplakia: not easy to scrape off white spot, loose-leaf paper review the organization can be found in EB virus EB virus may be the tongue and buccal keratinized epithelial cells replication.
(4) thrombocytopenia purpura: About 5% ~ 15% HIV antibody positive have persistent thrombocytopenia, a general reduction of "50000 / mm3 ~ 10 Wan / mm3 may have bleeding, often hepatosplenomegaly, anemia can be simultaneously .
4, late (equivalent to CDC Classification IV Group C, D, E subtype, that is, AIDS period): helper T cells decreased significantly, it usually involves a variety of opportunistic infections and tumors, a variety of clinical symptoms may appear, the kinds of opportunistic infections and diseases of different pathogens, clinical manifestations vary (the United States 65% of AIDS patients with pneumocystis carinii pneumonia occurred; 3% of AIDS patients by fiberoptic endoscopy esophageal Candida infection was found. 20% ~ 40% have peripheral neuropathy symptoms of the disease can appear in various issues). Can also be associated with wasting syndrome and dementia. The most commonly available are:
(1) opportunistic infections: There are Gram-positive or Gram-negative bacteria, Mycobacterium tuberculosis and bird type. Virus (HBV, HSV). Fungal infections, cryptococcosis, candidiasis, and histoplasmosis infections. Protozoa are pneumocystis carinii pneumonia, toxoplasmosis, and cryptosporidiosis and so on.
(2) malignant tumor: Kaposi sarcoma, lymphoma, and so on.
(3), dementia and wasting syndrome: can be violated due to destruction of brain cells affected by HIV. Wasting syndrome showed significant weight loss.
AIDS, late clinical manifestations, pathogenic infection or disease due to the location were different. Diagnosis primarily based on clinical symptoms, signs and related experiments and related auxiliary examination determined.
(B) the unique abilities of children with AIDS
Pediatric AIDS, 70% ~ 75% from mother to child vertical transmission (intrauterine, birth canal, and breast-feeding), 20% from blood transfusion and blood products, the rest from other channels, including sexual abuse, the incubation period shorter than adults.
1, growth, developmental abnormalities: about 65% to 75%, the sooner the performance of the more serious infections. Fetal infection during early pregnancy can occur craniofacial malformations (small head, his forehead was square, collapsed bridge of the nose, eyes and small crack), growth retardation.
2, nervous system damage: is often associated with nervous system damage, such as HIV encephalopathy, central nervous system opportunistic infections than adult rare.
3, chronic diarrhea, failure and malnutrition: diarrhea repeated attack, probably due to a direct HIV effects on gastrointestinal mucosa, or opportunistic infections.
4, lung disease: more common is pneumocystis carinii pneumonia and chronic lymphoid interstitial pneumonia is the leading cause of death among children with AIDS.
5, skin and mucous membrane lesions: 75% of pediatric AIDS can occur in patients with recurrent herpetic Dan inflammation and Candida pharyngitis, 20% of Candida can occur in children with esophagitis.
6, lymph nodes and parotid gland enlargement: multi-site lymph nodes, no tenderness, and sustainable for several months to several years in diameter> 2cm, met with children at the 74% AIDS. Symmetry parotid gland enlargement, seen in 20% of the children, often have elevated serum amylase.
7, malignant tumors: Kaposi sarcoma, a rare, lymphoma more common.
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