issues for patients as HIV progresses

ISSUES FOR PATIENTS AS HIV PROGRESSES (monica)

There are many complications that can occur with HIV because it is a virus that attacks the immune system directly. Effects of HIV infection include:

Neurological disease – at early stages of the disease nervous tissue can become infected. As the disease progresses AIDS dementia complex can result as well as aseptic meningitis (infection has caused meninges to become inflamed) and sensory polyneuropathy (condition in which peripheral nerves lose sensory sensation), but these conditions are becoming less frequent with the introduction of highly active anti-retroviral therapy (HAART).

Eye disease – the most serious condition is cytomegalovirus retinitis, which is a common cause of eye disease and blindness. Usually unilateral to begin with but can then progress to the other eye. Can result in floaters, loss of visual acuity, field loss and scotomata (a defect of vision in a defined area of the visual field in one or both eyes. Common symptom is shimmering film appearing as island in visual field.), orbital pain and headache.

Haematological complications – anaemia, neutropenia (abnormal fall in number of neutrophils in the blood) and thrombocytopenia (reduction in number of platelets) are all common conditions that occur as HIV advances.

Gastrointestinal effects – weight loss and diarrhoea are extremely common, and wasting is a common feature of advanced HIV, which is attributed to the effects of HIV on metabolism.

Renal complications – nephrotic syndrome can occur as a result of HIV cytopathic effects on renal tubular epithelium.

Respiratory effects – upper airway and lung damage leads to an increase in upper and lower respiratory tract infections. Sinus mucosa functions abnormally and is frequently the site of chronic inflammation.

Cardiac complications – cardiomyopathy although rare associated with HIV, may lead to congestive cardiac failure. Lymphocytic and necrotic myocarditis may also occur.

Apart from all the conditions above a major complication that occurs as HIV progresses is AIDS (acquired immune deficiency syndrome), which often leads to opportunistic infections manifesting, as the immune system is very weak or not functioning at all. Also progression to AIDS usually results in death of the patient.

Sources: Kumar and Clark,
Mosby’s Dictionary