The Symptoms of HIV

ACUTE: The initial infection, with a brief flulike illness similar to mononucleosis Included in the symptoms mayu be nausea, swollen lymph glands, a sore throat, and a fever. These symptams are obviously not unique to HIV at this early time. The inflammation of the brain, called encelaphalopathy, can lead to headaches and fevers, sometimes associated with a loss of memory and a changes in personality (dementia). This acute stage usually lasts a few days to a few weeks, and a significant number of people display no symptoms. CHRONIC (SYMPTOMATIC): Following the acute phase the infected person will usually feel well, but will become seropositve (display antibodies) to the HIV infection. It is possible for the infection to be completely silent (latent) for a number of months, but it usually enters a persistent or chronic mode of 2-12 years in an adult, where the T-4 cells are gradually being depleted but few other symptoms are noticeabie. Slowly but surely, the immune system slowly loses the battle. As the T4 cells continue to decline, a number of HIV disease symptoms gradually appear. They inciude chronic lympnadenopathy (swollen lymph glands), wasting syndrome (sudden weight loss and night sweats, unexplaned fever), and some neurological symptoms such as dementia (impared mental function). The difference now is that these symptoms no longer go away, but continue to worsen. This stage of the disease just preceding the appearance of opportunistic infections, goes by various names including Pre-AIDS, AIDS Related Complex (ARC), PGL (Persistent Generalized Lymphadenopathy) or LAS (Lympnadenopathy Syndrome) CRISIS: The immune system is getting beat. It lowers down to 200-300 T cells per microliter of blood, and the infected person will begin to experience persistent fungal and viral infections that will not heal. These include Herpes infections, Thrush, Hairy Leukoplakia, and Shingles. Then even more serious opportunistic infections develop as the immune system falters and the T cell count drops even further. The infected person now has full blown AIDS. It will be just a few years or even months before an opportunistic infection will end the person's life. Drug Therapy Listed below are some of the experimental and marketed drugs used in the fight against HIV. 1. Blocks virus from attaching to T-4 Cells -Alpha Interferon -Peptide T -CD4 IgG -CD$-PE40 2. Blocks virus from penetrating membrane 3. Inhibits the virus from uncoding 4. Inhibits reverse transcriptase -Azidothymadine -ddC -ddI -d4t 5. Blocks virus from integrating -Anti B2 Microglubin 6. Prevents virus from making proteins -Ribozymes; GP17 specific -Antisense Oligonucleotides 7. Inhibits Protein Modifications -Peptide I 8. Inhibits viral assembly -3DZA 9. Prevents new virons from exiting Vaccines Our primary human-aided control of a viral infection is, of course, the stimulation of the immune system by vaccination (immunization) to create an immune memory sufficient to prevent a natural infection. This technology has been markedly successful with many viral diseases, both animal and human. The prime example is Smallpox. We have already covered in previous chapters the reasons why the development of a true preventive vaccine is problematic for HIV; and why a therapeutic vaccine to slow the progress of this disease is an open question. Still, much research is being carried out, and a number of therapeutic vaccines (more than 60) are being prepared for the safety trials that precede the trials for efficacy. Now under current testing are vaccines made of: Live attenuated HIV Natural viral products Passive immunization products Mass produced recombinant DNA proteins from HIV Synthetic peptides of HIV Anti-idiotype (mirror image) antigens Whole HIV Live recombinant virus Domain specific monoclonal antibodies The current attempts to develop a vaccine are impressive in number and in variety, but none have even passed safety trials. Even if one of the vaccines were shown to be successful in therapeutic management of the HIV infection, having it approved and available for general use in the health-care community is a minimum 5 years away. And a fully preventive vaccine? If possible (and some believe that to be unlikely) it would take a longer time. If a new preventive vaccine were announced today, it would be at least 6-8 years before it were fully tested for safety and efficacy and manufactured for general use.