Acquired Immune Deficiency Syndrome

What is AIDS, and how does it differ from HIV?

AIDS is the final stage of HIV. HIV kills a type of white blood cell called CD4 cells, which weakens your immune system. Your immune system becomes too weak to fight infections. A weak immune system can also lead to certain cancers and heart disease. A normal CD4 count ranges from 500 to 2000. When you have HIV, 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.

How is AIDS diagnosed?

Your caregiver will ask about your signs and symptoms. He will check your height and weight and examine your skin, mouth, and eyes. Tell him about any illness or infections you have had, including sexually transmitted infections (STIs). Tell your caregiver when your HIV was diagnosed. Tell him 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. He may ask questions about your sexual history and if you have ever used street drugs. He will ask these questions to find out how you became infected with HIV and who else may be at risk. You may need any of the following tests:

  • HIV screening tests: Your caregiver may test your blood or saliva for HIV antibodies. These are substances your body creates after it has been infected with HIV.

  • Other AIDS tests: Your caregiver will use blood tests to find out your CD4 cell count. He will also test your viral load, which is the amount of HIV in your blood at any given time. Your caregiver 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 your body could fight off with a healthy immune system, but are very dangerous if you have HIV or AIDS. 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, crytococcal meningitis, or Mycobacterium avium complex (MAC). You may develop cancers such as Kaposi sarcoma or central nervous system lymphoma.

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 or spit

  • 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 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 medications: These medications slow the progression of HIV. They are given in different combinations called highly active antiretroviral therapy (HAART). Your caregiver 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: These 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: These are given to kill infections caused by bacteria, viruses, or a fungus.

  • Medicines for nausea and diarrhea: You may be given medicine to calm your stomach and prevent vomiting. You may receive a different medicine to help relieve diarrhea.

  • Appetite stimulants: You may be given medicines to help increase your energy level and appetite.

  • Pain medicine: You may need medicine to take away or decrease pain.

    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

  • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.

  • Cancer treatments: Together, you and your caregiver will decide how to treat your cancer.

How can I care for myself at home?

You or the person who helps care for you at home can do any of the following to increase your comfort:

  • Eat small amounts often: If you do not feel hungry, eat small amounts of your favorite foods 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: Ask your caregiver 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 a 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. Avoid caffeine, dairy, and 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 easier: 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.

  • 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.

What do I need to know about living with AIDS?

  • Make end-of-life decisions: Ask your caregiver 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.

  • Protect others from HIV: Inform your partners of your HIV status. Do not engage in sexual activity 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 caregiver 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 contact my caregiver?

Contact your caregiver if:

  • 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.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a fever with night sweats or vomiting.

  • You are coughing up blood, or you have bloody bowel movements.

  • You have trouble breathing.

  • You have new vision problems.

  • You have a headache and a stiff neck.

  • You are confused and notice changes in the way you think.

  • You have a seizure.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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