The Stages Of HIV/AIDS

    Most of us are used to thinking of disease in very simple terms: if you feel sick, you are sick; if you feel healthy, you are healthy. However, because HIV may begin causing subtle changes in the immune system long before an infected person feels sick, most doctors have adopted the term "HIV disease" to cover the entire HIV spectrum, from initial infection to full-blown AIDS (which is also called "advanced HIV disease").

    The HIV continuum described below is representative of the experience of many people with HIV. The time that it takes for each individual to go through these stages varies. For most people, however, the progression of HIV disease is fairly slow, taking several years from infection to the development of severe immune suppression.
Following exposure to the virus, HIV enters the bloodstream and begins to take up residence in the cells; this is when HIV infection occurs. People with HIV are considered to be infectious (able to transmit HIV to others) immediately after infection with the virus. A person with HIV is infectious at all times. Also, a person does not need to have symptoms or look sick to have HIV. In fact, people may look perfectly healthy for many years despite the fact that they have HIV in their bodies. The only way to find out if you are infected is by taking an HIV test.

STAGE 1:Primary HIV infection
 Is the first stage of HIV disease, typically lasting only a week or two, when the virus first establishes itself in the body. Some researchers use the term acute HIV infection to describe the period of time between when a person is first infected with HIV and when antibodies (proteins made by the immune system in response to infection) against the virus are produced by the body (usually 6 to 12 weeks) and can be detected by an HIV test.

STAGE 2: Seroconversion
This term refers to the time when an HIV positive person's immune system responds to the infection by producing antibodies to the virus. Most people develop antibodies within three months after infection, and some can take up to six months. If an antibody test is done before seroconversion is complete, it may give a "false negative" result because sufficient antibodies have not yet been developed by the body. A three-month window period between infection and production of antibodies is normal for most of the population. Very, very rarely (i.e., in only a few cases ever), a person may take six months to produce antibodies. To be certain of your HIV status, take an HIV antibody test three months or longer after you were exposed to the virus. For even greater certainty, get tested again six months after the exposure occurred.

STAGE 3: The Asymptomatic Stage
After the acute stage of HIV infection, people infected with HIV continue to look and feel completely well for long periods, usually for many years. During this time, the only indication that you are infected with HIV is that you will test positive on standard (antibody) HIV tests and you may have swollen lymph glands. This means that you look and feel healthy but can infect other people through unprotected sex or through needle sharing -- especially if you have not been tested and do not know that you are infected. Even though an infected person may appear perfectly healthy, HIV is still very active and is continuing to weaken the immune system during this stage. In some individuals, the virus appears to slowly damage the immune system over a number of years. In most people, however, a faster decline of the immune system occurs at some point, and the virus rapidly replicates. This damage can be seen in blood tests before any actual symptoms are experienced.

STAGE 4: Early- and Medium-Stage HIV Symptomatic Disease
When the immune system is compromised by HIV infection, many people begin to experience some mild HIV disease symptoms, such as skin rashes, fatigue, night sweats, slight weight loss, mouth ulcers, and fungal skin and nail infections. Most, though not all, will experience mild symptoms such as these before developing more serious illnesses. Although one's prognosis varies greatly depending on a number of factors, it is generally believed that it takes five to seven years for the first mild symptoms to appear. These symptoms mark the early and medium stages of HIV symptomatic disease. As the disease progresses, some individuals may become quite ill even if they have not yet been diagnosed with AIDS, the late stage of HIV disease. Typical problems include chronic oral or vaginal thrush (a fungal rash or spots), recurrent herpes blisters on the mouth (cold sores) or genitals, ongoing fevers, persistent diarrhea, and significant weight loss. These symptoms are not necessarily specific to HIV or the development of AIDS. However, they should be of concern to people who have tested positive for HIV. Usually, symptoms occur when the virus has already caused considerable damage to the immune system. For that reason, people with HIV should not wait until symptoms appear to get medical treatment. Also, people with high risk for HIV infection should not wait to for symptoms to appear before getting tested.

STAGE 5: Late-Stage HIV Disease (AIDS)
Receiving an AIDS diagnosis does not necessarily mean that the diagnosed person will die soon; some people have lived for many years after their diagnosis. This is even more the case today with the availability of highly active antiretroviral therapy (HAART), which has helped extend the lives of thousands of people living with HIV and AIDS. In addition, many opportunistic infections can be prevented or treated successfully. This has substantially increased the longevity and quality of life of people living with HIV/AIDS. Does everyone who has HIV eventually develop AIDS? We don't know for certain. Studies show that the majority of untreated people do eventually become ill from HIV. However, with regular medical care and other positive lifestyle factors, such as emotional support, many long-term survivors have been living with HIV/AIDS for upwards of two decades. As existing treatments are used earlier in the course of HIV disease and new treatments are developed, it has become possible to further postpone, and perhaps even prevent, illness.