April 6, 2009
If left untreated, HIV infection inevitably degrades the immune system, leading to the development of life-threatening infections -- AIDS -- about 10 years later. The time between initial HIV infection and the development of AIDS is commonly referred to as the symptom-free, or asymptomatic, period. The reason for this is that during that time life-threatening infections are uncommon. The idea of dividing the stages of HIV disease into these specific periods occurred early in the course of the AIDS pandemic, when the medical focus was on delaying the appearance of severe infections and the always-looming spectre of death.
In 1996, highly active antiretroviral therapy (HAART) became available in high-income countries. As a result, for the first time in the history of AIDS, HIV positive people were able to recover from and resist life-threatening infections. Today, the benefits of HAART are clearly prolonged and so immense that researchers increasingly expect that some HIV positive people may live near-normal life spans.
In total, 1,992 HIV positive people were surveyed. Their average profile was as follows:
The study team divided participants into three groups based on their CD4+ cell counts, as follows:
The survey asked questions about participants' health status, particularly about a wide range of symptoms covering physical and mental issues.
In general, after assessing the number of symptoms reported, there were no significant differences among the three groups of people. This suggests that even at modest or high CD4+ counts, HIV positive people experience symptoms of illness.
Participants who were taking anti-HIV drugs tended to report less-intense symptoms than people who were not taking HAART.
Commonly reported symptoms included the following:
For some participants, regardless of CD4+ counts, these symptoms were intense.
Some of the above-listed symptoms could occur as isolated problems or as part of many other health conditions, including but not limited to anxiety, depression and hormonal deficiencies. Although none of the study participants were experiencing life-threatening conditions, even those who had more than 350 CD4+ cells were experiencing symptoms of illness, perhaps unrelated to HIV.
The international study team suggests that doctors and nurses carefully interview their patients about health-related issues regardless of CD4+ counts. In doing so, health care professionals may uncover underlying conditions that are reducing their patients' quality of life, which would allow them to provide relief.