AIDS

AIDS (acquired immune deficiency syndrome) is the final stage of HIV infection. HIV (human immunodeficiency virus) is a viral infection that slowly weakens your immune system. The virus kills a type of white blood cell called CD4. The loss of CD4 cells weakens your immune system. Over time, a weak immune system makes it difficult for you to fight infections. This can also lead to certain cancers and heart disease. A normal CD4 count ranges from 500 to 2000. You have HIV when your CD4 count ranges from 200 to 500. You have AIDS when your CD4 count is less than 200 or you have one of the infections or cancers caused by AIDS. AIDS means your immune system cannot fight off infections and disease. This can become life-threatening.

What are the signs and symptoms of AIDS?

The following signs and symptoms are common when you have AIDS or infections or cancer caused by AIDS:

• Extreme tiredness
• Chronic diarrhea
• Weight loss
• White spots, sores, or hairy patches inside your mouth
• Trouble breathing
• Coughing up blood
• Fever that lasts longer than 1 month, and night sweats
• Rash, blisters, bruises, or other skin changes
• Hair loss or vision loss
• Confusion and memory loss

How is AIDS diagnosed?

Your healthcare provider will ask about your signs and symptoms. He will check your height and weight and examine your skin, mouth, and eyes. He may ask questions about your sexual history and if you have ever used illegal drugs. He will ask these questions to find out how you became infected with HIV and who else may be at risk.

• Tell your healthcare provider about any illness or infections you have had, including sexually transmitted infections (STIs). Tell him when your HIV was diagnosed and if you have used medicines to treat HIV. He will ask if you have ever been hospitalized for an HIV-related infection or illness. Tell him your most recent CD4 count and viral load, and your lowest CD4 count. These answers can help your healthcare provider understand your illness and help him plan treatment.
• HIV screening tests may include testing your blood or saliva for HIV antibodies. These are substances your body creates after it has been infected with HIV.
• Other blood tests may be used to find your CD4 cell count. Your viral load will also be checked. This is the amount of HIV in your blood at any given time. Your healthcare provider will test your blood for infections and cancer.

What illnesses might I develop because I have AIDS?

As your CD4 count drops, you are at risk for many types of cancer and opportunistic infections. These are illnesses that develop because your immune system cannot fight the bacteria or viruses that cause them. Infections that are common when your CD4 count drops below 200 are Pneumocystis pneumonia (PCP), toxoplasmosis, and histoplasmosis. You may develop other infections such as cytomegalovirus, cryptococcal meningitis, or Mycobacterium avium complex (MAC). You may develop cancers such as Kaposi sarcoma or central nervous system lymphoma.

How is AIDS treated?

There is no cure for HIV or AIDS. The goals are to manage your pain, treat your symptoms, extend your life, and improve your quality of life. Treatment is based on how long you have had HIV or AIDS, your age, and your current health. You may need any of the following:

• Antiretroviral medicines slow the progression of HIV. They are given in different combinations called highly active antiretroviral therapy (HAART). Your healthcare provider will decide what kind of HAART you need and when to begin this treatment. You may need to make HAART changes if you have severe side effects, or if you develop resistance to a medicine.
• Antidepressants may be given to improve your mood. Rarely, antidepressants can make your symptoms worse. Do not stop taking this medicine unless directed. It may take 4 to 6 weeks for antidepressants to help you feel better.
• Antimicrobial medicines are given to kill infections caused by bacteria, viruses, or a fungus.
• Medicines may be given to calm your stomach and prevent vomiting. You may receive a different medicine to help relieve diarrhea.
• Appetite stimulants may help increase your energy level and appetite.
• Pain medicine may be given. Ask your healthcare provider how to take this medicine safely.
• Muscle relaxers help decrease pain and muscle spasms.
• Cancer treatments will be planned by you and your healthcare provider.

What can I do to care for myself at home?

• Eat small amounts often. If you do not feel hungry, eat small amounts often instead of large meals. You need to eat enough calories to prevent weight loss caused by AIDS. You also need to eat protein and iron to prevent anemia, and calcium to prevent bone loss. Never eat raw eggs, unpasteurized foods, undercooked meat, or anything else that could lead to food poisoning.
• Take supplements as directed. Ask your healthcare provider if you should take calcium and vitamin D pills to prevent the loss of bone density. You may also need multivitamins.
• Care for your mouth. Use a toothbrush with soft bristles. If you have mouth sores or pain when you swallow, rinse your mouth with salt water. Mix ½ teaspoon of salt in a glass of water to make salt water. Do this after meals and before you go to sleep. If your mouth is dry, sip drinks often or suck on pieces of fruit. Avoid citrus fruits such as oranges and grapefruits. Citrus can hurt your mouth sores.
• Treat diarrhea. Apply petroleum jelly to your anal area after bowel movements. Wash the area 3 times each day with soap and water. Do not have caffeine, dairy, or spicy foods. Diarrhea can sometimes lead to dehydration. Drink small amounts of fluid throughout the day, or drink oral rehydration solution (ORS) to prevent dehydration.
• Breathe more comfortably. Sit upright or in a position that allows you to breathe comfortably. Use extra pillows to support your back. Open windows for fresh air. Sip water often if you have a chronic cough.
• Do not smoke. If you smoke, ask for information on how to stop. HIV and medicines to treat HIV can increase your risk for heart disease. Nicotine increases your risk for heart disease even higher. Do not use e-cigarettes or smokeless tobacco products in place of cigarettes. They still contain nicotine.
• Care for your mental health. Dementia (loss of memory and brain function) can sometimes occur with AIDS. To manage dementia, keep things in the same place and follow a pattern for each day's activities. Stay in familiar places and avoid noise whenever possible.
• Make end-of-life decisions. Ask your healthcare provider for more information about advanced medical directives. These documents help you decide and write down your choices for end-of-life care. It is best to complete them early in your illness, when you can think clearly about your wishes. You may want to learn more about hospice care. Hospice is a program that will help make you comfortable in the last 6 months of your life.

What can I do to prevent the spread of HIV?

Tell your sex partners of your HIV status. Do not have sex without a latex condom. If you inject drugs, do not share needles or syringes. Use a needle exchange program to obtain clean needles. Ask your healthcare provider for information if you need help to stop injecting drugs.

Where can I find support and more information?

• AIDS Info
  P.O. Box 6303
  Rockville , MD 20849-6303
  Phone: 1- 800 - 448-0440
  Web Address: http://www.aidsinfo.nih.gov

• The National Association of People With AIDS
  8401 Colesville Rd, Ste 505
  Silver Spring , MD 20910
  Phone: 1- 240 - 247-0880
  Phone: 1- 866 - 846-9366
  Web Address: http://www.napwa.org

When should I seek immediate care?

• You have a fever with night sweats or vomiting.
• You have trouble breathing.
• You are coughing up blood, or you have bloody bowel movements.
• You have a headache and a stiff neck.
• You have new vision problems.
• You are confused and notice changes in the way you think.
• You have a seizure.

When should I contact my healthcare provider?

• You are having side effects from your medicines that make you want to stop taking them.
• You are very tired or have lost weight.
• You have ongoing nausea, vomiting, and diarrhea.
• You have raw, painful skin or open sores around your rectum.
• You see white spots, sores, or hairy patches inside your mouth.
• You have white vaginal discharge and vaginal pain or swelling.
• You have a rash, blisters, bruises, or other skin changes.
• You have a cough that will not go away, or swollen lumps in your neck or armpits (swollen lymph nodes).
• You have questions or concerns about your condition or care.