Reply #36: When speaking about disease progression,

[JackBeck]

in other words, how HIV progresses over time in a person who is untreated, there are certain stages that the disease goes through.

The first is transmission. Seems basic, but you can be exposed to HIV many times before transmission occurs. But once transmission occurs, about 4-5 days after, an increase in viral load happens, as well as a drop in the CD4/T-cells. Flu-like symptoms occur in some, but most people will not have this experience.

Eventually, once the immune system figures out a response to the HIV infections, antibodies are produced and the viral load drops dramatically and the CD4/T-cell go back up. This is called "seroconversion". Once seroconversion occurs, a person with HIV moves into an "asymptomatic" period, where they don't show any symptoms of an HIV infection. We don't know how long the "asymptomatic" period lasts and but we do know it's going to differ from person to person.

After the asymptomatic period comes the "symptomatic" stage. This is when those flu-like symptoms return, but this time they may be more persistent and don't go away. What also is going on in someone who is HIV+ and not on treatment, is that on average, they are losing 50-80 CD4/T-cells per years. CD4 cells are the generals of our immune system. They tell everyone else what to do. So losing CD4 cells is not a good thing. You increasingly become susceptible to diseases called "Opportunistic Infections".

Once the symptomatic phase comes to an end, an AIDS diagnosis is given. I've described what an AIDS diagnosis is in another thread. If you want me to go over this, I can. After an AIDS diagnosis, is Advanced AIDS (CD4 cells below 50) and then death. But remember, this is all disease progression in people who are not on treatment.


To quickly address you other question, HAART can be very toxic. But again, it differs from person to person. We all have our own, unique immune systems, as well as metabolisms, so the HIV meds are going to act differently on a case to case basis. With that said, every med has a side effect. Some meds hurt the liver, some cause lypodystrophy (fatty deposits on the back of the neck, a "buffalo hump" for ex.) Diarrhea, nightmares(more common with Sustiva), even a false positive for a marijuana test (which sucks if you are in a drug treatment program) are side effects.