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Aids, Ambulatory Care
(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.
Common symptoms include the following:
- 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
Call 911 for:
- Trouble breathing
Seek immediate care for the following symptoms:
- Fever with night sweats or vomiting
- Coughing up blood, or you have bloody bowel movements
- Trouble breathing
- New vision problems
- Headache and a stiff neck
- Confusion and noticing changes in the way you think
Treatment for AIDS
may include 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.
- 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.
Prevent the spread of HIV
by telling 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.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
Care AgreementYou 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.
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