Part 2: Presentations of HIV Disease

 Seroconversion Illness

   

Occurs in 40-90% of cases
Not always recognised    

 
Onset:                                1-4 weeks  

 
Duration:                        2-3 weeks  

 
Symptoms and signs:  

 
  • General:                           
 Fever (77%)
Enlarged lymph nodes (39%)
Lethargy (66%)
Aching joints (31%)  

 
  • Skin:                                 
 Non-itchy rash any part of body (56%)  
  • CNS:                                 
 Meningitis
Encephalitis    

 
  • Mouth/ Oesophagus:     
Pharyngitis (44%)
Ulceration (29%)  

 
  • GI Tract:                          
 Weight loss (24%)
Diarrhoea (23%)
Vomiting (12%)  

 

Symptomatic HIV Disease (Non-AIDS)  

 

Skin: 

 Psoriasis  
Viral infections:  Shingles >1 dermatome                                           
Recurrent severe Herpes Simplex
Facial Molluscum contagiosum  
Bacterial infections:  Folliculitis Abscesses                                                                            
Cellulitis      
Fungal infections:  Seborrhoeic dermatitis                                                               
Tinea  
Drug reactions  
CNS:                             Streptococcal/ H. inlfuenzae meningitis
Herpes simplex meningo-encephalitis  

 
Mouth:                         Oral Candida
Oral Hairy Leukoplakia
Warts
Severe gingivitis            

 
Chest:                           Streptococcal pneumonia
Haemophilus influenzae pneumonia

 
GI Tract:                   Gastro-enteritis:               Salmonella                                                                                
Campylobacter                                                                                
Shigella                                                                                

Amoebiasis  

 
Gynae:                        Pelvic inflammatory disease and pelvic abscess  

 
Blood/ Bone Marrow:        Malaria  

 

AIDS  

 

Skin:                            

 

 Kaposi’s sarcoma  

CNS:

   Meningitis:       Cryptococcal                                                                 
Tuberculous                                                                               
Lymphoma   

 
Encephalitis:  CMV                                                                                  
HIV (HIV dementia)                                                 
Progressive Multifocal Leucoencephalopathy   

 
Space occupying lesion:  Toxoplasma                                                                                  
Lymphoma                                                                                  
Tuberculosis                                                                                 
Cryptococcus  

 
Mouth/ Oesophagus:   KS
CMV
Herpes simplex
Candida  

 

 Chest:                             

 

Pneumocystis carinii Pneumonia (PCP)
Mycobacterium tuberculosis (TB)
KS

Fungi:   Cryptococcus                                                                                    
Histoplasma  
CVS:                                   Cardiomyopathy  

 

GI Tract:                          

Weight loss

Protozoa:   Cryptosporidium
Microsporidia
Lymphoma
CMV  

 
Gynae:                                  Cervical carcinoma  

 

Blood/ Bone Marrow:     

Mycobacterium avium-intracellulare (MAI)
Lymphoma
Leishmaniasis