AIDS is a very special malignant infectious disease. After AIDS, it is dangerous. At present, the mortality rate is 100%. AIDS is a disease that is caused by HIV infecting the human immune system and central nervous system. It involves all tissues and organs of the body. Its clinical manifestations vary widely. Its perplexing characteristics are its immune deficiency, especially the cellular immune function, which is caused by various opportunistic infections and malignant tumors of the lymphatic system.
From infection to onset, the disease can be divided into four phases: acute infection period, incubation period, pre AIDS period and typical AIDS stage. Not every infected person will have phase IV manifestations completely, but patients at each disease stage can be seen clinically. The different clinical manifestations in the four periods are a gradual and coherent course of development.
1,Acute infection period: the window period is also at this time. The response of HIV to the stimulation of the body. The patient has fever, rash, enlarged lymph nodes, fatigue, sweating, nausea, vomiting, diarrhea, pharyngitis, etc. Some also have acute aseptic meningitis, showing headache, neurological symptoms and meningeal irritation. At the end of the blood test, the total number of leukocytes is normal, or lymphocytes are reduced and monocytes are increased. During the acute infection period, the symptoms are often mild and easy to be ignored. When the fever and other body discomfort occurs 5 weeks or so, the serum HIV antibody can show positive reaction. Since then, the clinical HIV antibody positive can be positive. Since then, there has been a relatively healthy and asymptomatic incubation period with different lengths in clinic.
2,Incubation period: the infected person may not have any clinical symptoms, but the incubation period is not a stationary period, let alone a safe period. The virus continues to reproduce and has a strong destructive effect. The incubation period refers to the time from the onset of HIV infection to the onset of AIDS clinical symptoms and signs. The average incubation period of AIDS is now thought to be 2~10. This is very difficult for early detection of patients and prevention.
3,Pre AIDS: AIDS related symptoms and signs begin to develop after the incubation period, until it develops into a typical period of AIDS. During this period, there were many names, including “AIDS related syndrome“, “lymphatic disease related syndrome”, “persistent generalized lymphatic disease”, “pre AIDS syndrome” and so on. At this point, the patient has acquired the most basic feature of AIDS, that is, cellular immunodeficiency, only a mild symptom.
The main clinical manifestations are:
(1) Lymphadenopathy is one of the most important clinical manifestations at this stage. It is mainly superficial lymphadenopathy. The most common sites were head and neck, armpit, groin, posterior neck, anterior ear, posterior ear, femoral lymph node, submaxillary and so on. Generally, there are at least two or more parts, some as many as a dozen. Swollen lymph nodes do not respond to general treatment and often continue to swell for more than half a year. About 30% of patients have only superficial lymphadenopathy without other systemic symptoms.
(2) Patients with systemic symptoms often have systemic discomfort, muscle pain and other symptoms of viral diseases. About 50% of patients have fatigue, weakness and periodic low fever, which often lasts for several months. Night sweats, more than 5 times in a month. About 1 / 3 of the patients lost more than 10% of their weight. This weight loss can not be explained by fever alone. Supplementing enough calories can not control this weight loss. Some patients have headache, depression and anxiety, and some have sensory nerve endings, which may be related to the virus invading the nervous system. Some can have reactive mental disorders. Splenomegaly can occur in 3 / 4 of patients.
(3) In addition to the above superficial lymphadenopathy and systemic symptoms, patients often have various special or recurrent non fatal infections. Repeated infection will accelerate the development of the disease and make the disease enter the typical AIDS period. About half of the patients have severe tinea pedis, usually unilateral, and lack of effective response to local treatment. Patients with axillary and inguinal areas often have staphylococcal infection, bullous pustules, and patients with perianal, genital, weight-bearing areas and oral mucosa often have condyloma acuminatum and verruca vulgaris virus infection. The incidence of oral herpes simplex and chest herpes zoster was also significantly higher than that of normal people. Oral Candida albicans is also quite common, mainly manifested in oral mucosal erosion, congestion and cheese like covering.
Other common infections are non streptococcal pharyngitis, acute and chronic sinusitis and intestinal parasitic infection. Many patients have increased defecation times, thinning and mucus. It may be related to proctitis and the invasion of various pathogenic microorganisms to the intestine. In addition, oral hairy leukoplakia and hairy leukoplakia are important clues for early diagnosis of AIDS.
4, some typical AIDS scholars call it fatal AIDS, the final stage of HIV infection. This issue has three basic characteristics:
(1) Severe cellular immune deficiency, especially T4 cells.
(2) Various fatal opportunistic infections occur, especially Pneumocystis carinii pneumonia (PCP).
(3) Various malignant tumors occur, especially Kaposi’s sarcoma (KS).
PCP and KS can occur alone or simultaneously. PCP accounts for 64% of AIDS patients. 60% of them had PCP at the same time, and died rapidly when PCP and KS occurred at the same time. In recent years, due to the serious epidemic of tuberculosis, concurrent tuberculosis has become an important cause of AIDS deaths. In the final stage of AIDS, the immune function collapses completely, and all kinds of serious syndromic symptoms appear until death.