Skin of hiv infected. Treatment of acne in HIV infection. Seborrheic dermatitis in HIV

26. SKIN SIGNS OF HIV AND ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)

The human immunodeficiency virus (HIV) belongs to the family of retroviruses and has a tropism for CD4 lymphocytes (T-helpers), which leads to their death and reduced immunity.

Acquired Immune Deficiency Syndrome (AIDS) - last stage HIV infection, in which suppression of the immune system leads to the development of recurrent infectious diseases and malignant tumors.

Epidemiology. According to the World Health Organization, as of December 2005, there were 40.3 million HIV-infected people in the world, of which 4.9 million were detected in 2005. In the same year, 3.1 million patients died, of which 570,000 children up to 15 years old. In terms of the growth rate of newly registered cases of HIV infection, our country occupies one of the first places in the world. The official number of people living with HIV in Russia is 360,000, but the actual number of people living with HIV/AIDS in the Russian Federation is several times higher.

Etiology and pathogenesis. HIV belongs to the group of retroviruses and has a special tropism for T-helpers with CD4 receptors. 2 types of virus have been identified: HIV-1 (widespread throughout the world, as well as in our country) and HIV-2, isolated mainly from patients in West Africa.

Ways of transmission of HIV - sexual, through the blood, vertical. The main way is sexual with heterosexual and homosexual contacts.

Through the blood, transmission is possible when using common syringes (among drug addicts), when transfusing blood or its preparations, when transplanting organs and tissues from HIV-infected people. There are known cases of infection of patients with hemophilia when they are injected with drugs ( factor VIII and factor IX) from the blood of HIV carriers, as well as when transplanting a cadaveric cornea from a patient. With the vertical route, infection occurs in utero or during childbirth, as well as through breast milk. Other routes of transmission (airborne, blood-sucking insects) have not been registered.

Main risk groups for HIV/AIDS:

Injecting drug users;

Commercial sex workers of both sexes, including homosexuals;

Prisoners in prisons;

Migrants and displaced persons, as well as street and neglected children.

Stages of HIV infection.

1. From the moment of infection to the appearance of seropositivity. The infection is not accompanied by any clinical manifestations.

After incubation period lasting from 1 to 6 weeks, there may be short-term rises in temperature, muscle and joint pain, headaches, increased lymph nodes, asthenia. Skin manifestations are noted only in 10-50% of HIV-infected people in the form of macular or maculopapular rashes, mainly on the trunk. Usually they are not accompanied by itching and resolve spontaneously within 6-8 days. There are aphthous rashes in the oral cavity, pharyngitis, ulcers on the genitals. There are more than 500 CD4 lymphocytes in 1 mm 3.

2. Asymptomatic stage in carriers of HIV infection. After the acute reaction to the introduction of the virus subsides, an asymptomatic stage begins, sometimes lasting for years. HIV-infected people retain their ability to work and visibility full health, but they often have banal infections, including skin infections. A decrease in the number of CD4 to 400 in 1 mm 3 indicates the rapid progression of the disease.

3. Stage of clinical manifestations of AIDS. The interval between HIV infection and the development of AIDS is on average 8 years (from 1 to 18 years).

Along with common symptoms, skin manifestations are the most demonstrative and can serve as diagnostic and prognostic markers of HIV infection.

CD4 lymphocytes in patients at this stage are less than 400 in 1 mm 3.

General clinical manifestations of AIDS: weight loss of more than 10% of the original; diarrhea lasting more than 1 month; recurrent infections of the upper respiratory tract; pulmonary tuberculosis; unusual course of banal infections; opportunistic infections: pneumocystic pneumonia, cerebral toxoplasmosis, encephalitis of various etiologies, salmonella septicemia, cerebral toxoplasmosis, infection caused by cytomegalovirus.

Clinical manifestations of HIV infection on the skin

Fungal infections of the skin and mucous membranes

Candidiasis mucous membrane oral cavity or pharynx, caused by yeast-like fungi of the genus Candida occurs in 40% of HIV-infected people. White plaques on the mucous membrane of the cheeks, tongue and larynx are able to merge into foci with clear boundaries. The erythematous form of candidiasis indicates aggressive current illness. Often diagnosed persistent vulvovaginitis, manifested by a grayish-white crumbly coating, itching and burning. Onychia, paronychia and candidiasis of large folds are somewhat less common.

With severe immunodeficiency, candidiasis of the trachea, bronchi and lungs develops, which is included in the list of opportunistic infections.

Mycoses in HIV-infected people are widespread, severe, difficult to treat and often relapse. There are disseminated forms of mycoses, including versicolor, as well as lesions of the scalp in adults, which is rarely observed in individuals with a normal immune status. Diagnosis is based on clinical picture and finding mycelium at microscopic examination, as well as on the identification of the pathogen culture obtained during sowing.

Deep mycoses(cryptococcosis, sporotrichosis, chromomycosis, etc.) outside their endemic zones are opportunistic infections and indicate the rapid progression of AIDS.

Viral infections

Clinical manifestations herpes simplex occur in 5-20% of HIV-infected people, since immunodeficiency contributes to the activation of the virus, and herpes simplex virus (HSV-2) seropositivity is determined in 40-95% of infected individuals. Defeats can take not-

usually a large area and culminate in necrosis. Features of clinical manifestations, torpidity of the course, as well as relapses of the disease, suggest AIDS.

herpes zoster can serve as a marker of HIV infection, as it occurs in 70-90% of patients and is manifested by bullous and vesicular rashes (Fig. 102). Localization of lesions in the head and neck area indicates an aggressive course of HIV infection. The most severe complications are keratitis and blindness in herpetic eruptions in the eye area. Against the background of immunodeficiency, there are relapses of herpes zoster (in the same or another dermatome) and its chronic course.

Verrucous leukoplakia has plaque and warty varieties. For the latter, the etiological factor of which is considered Epstein-Barr virus, typically the appearance of tuberous or warty formations of milky white or white color with jagged edges on the oral mucosa. 80% of patients with signs of verrucous leukoplakia (“hairy tongue”) developed AIDS 7–31 months after diagnosis.

Chicken pox caused by the same virus varicella zoster, what is herpes zoster. Vesicular rashes immediately after their appearance resemble drops of water on the skin. In the center of the vesicles, umbilical-shaped impressions appear, and the vesicles themselves turn into pustules within 8-12 hours, and then into crusts. After they fall off after 1-3 weeks, pinkish, slightly sunken rounded depressions remain, sometimes atrophic scars. The first elements appear on the face and scalp, then the process gradually spreads to the trunk and limbs. The rash is most abundant between the shoulder blades, on the lateral surfaces of the body, in the popliteal and ulnar fossae. Mucous membranes are often affected: palate, pharynx, larynx, trachea. Rashes on the conjunctiva and vaginal mucosa are possible. Subjectively, patients note

Rice. 102.herpes zoster in an HIV-infected person

severe itching. The appearance of the disease in an adult, especially at risk, requires serological survey.

genital warts, caused by the human papillomavirus (usually types 6 and 11), are soft warty growths. Merging into larger foci, they resemble cauliflower or cockscomb. Most often localized on the inner sheet foreskin in men (Fig. 103) or at the entrance to the vagina in women. As immunodeficiency increases, condylomas grow strongly and can form very extensive conglomerates.

Herpes virus type 6 is found in 90% of HIV-infected people with the so-called chronic fatigue syndrome or sudden exanthema in the form of spotty and papular rashes that do not have specific features and usually passing under the diagnosis of toxicodermia.

molluscum contagiosum, the etiological factor of which are 2 types of poxviruses, manifests itself in the form of dense, often shiny hemispherical nodules of normal skin color, ranging in size from 1 mm to 1 cm, with an umbilical depression in the center. HIV-infected people have many hundreds of elements, they reach large sizes and often affect the face.

Simple (vulgar) warts caused by the human papillomavirus. Localized benign hyperplasia of the epidermis in the form of papules or keratinizing plaques with a rough, uneven surface is not difficult to diagnose. The prevalence and severity of manifestations depends on the degree of immunodeficiency.

kaposi's sarcoma, included in the group of mesenchymal tumors of the vascular tissue, is a pathognomonic clinical manifestation of HIV infection. The classic skin signs of epidemic Kaposi's sarcoma, as well as sporadic, are macules, nodules, plaques, and tumor-like formations. Spotted elements are able to occupy a significant area, exceeding that in patients with sporadic Kaposi's sarcoma. Hemispherical nodules and nodules of a dense or elastic consistency with a diameter of several millimeters to 1-2 cm or more are localized in the dermis and capture the hypodermis. Fresh elements are red-purple or red-violet, the color of old ones is closer to red-brown (Fig. 104).

Kaposi's sarcoma against the background of immunodeficiency is more often located on the upper half of the trunk. Eruptions are prone to plaque formation, often there is damage to the mucous membranes, the tip of the nose and internal

early organs. Rashes on the oral mucosa are observed in about a third of patients, more often on soft palate sometimes on the tongue or gums.

The life expectancy of patients at this stage depends on the degree of immunodeficiency and the activity of associated opportunistic infections.

Bacterial infections

Staphylococcal and streptococcal skin lesions in the form of folliculitis, boils, carbuncles, phlegmon, impetigo, abscesses occur most often with HIV infection. The torpidity of the course, the low effectiveness of antibiotic treatment should be alarming and serve as the basis for a serological examination for HIV.

Syphilis in HIV-infected patients, it is accompanied by more frequent and pronounced lesions of the palms and soles up to syphilitic keratoderma, papulopustular rashes in the secondary period, hyperpigmentation of the skin of the palms and axillary areas. Developing immunodeficiency contributes to rapid emergence symptoms of neurosyphilis as a result of damage to the central nervous system pale trepon-mute, despite the full-fledged treatment.

Any ulcerative lesions of the genital organs (syphilis, herpes, chancre) becomes a risk factor, and the patient must undergo a comprehensive serological examination, in particular for HIV.

Scabies often accompanies immunodeficiency, taking atypical forms with a large number of hyperkeratotic rashes on the trunk, in the large

Rice. 103. Genital warts

Rice. 104. Kaposi's sarcoma in an HIV-infected person

folds, on the knees and elbows, as well as on the neck. Cases of Norwegian scabies have been reported in HIV-infected patients. Other dermatoses

Seborrheic dermatitis in HIV-infected people, it is localized both in typical areas (scalp, nasolabial and behind-the-ear folds, chest, interscapular region), and on the nose, cheeks, and chin. Psoriasiform rashes are noted in HIV-infected people. The prevalence and severity of the process depend on the degree of immunodeficiency.

Staphylococcal infections in the form of folliculitis, boils, carbuncles, phlegmon, long-term and difficult to treat, may indicate reduced immunity.

Thus, dermatological manifestations in immunodeficiency allow not only to suspect it and confirm the clinical diagnosis by serological examination, but also to predict the course of AIDS. Leukoplakia of the tongue, candidiasis of the oral cavity and pharynx, chronic shingles or its localization in the head, Kaposi's sarcoma serve as a poor prognosis for the course of the disease.

Diagnosis of HIV infection

HIV testing should be offered to all patients with suspicious clinical signs, as well as those at risk.

Diagnosis of HIV infection is usually carried out in specialized institutions using a sensitive enzyme immunoassay(ELISA) blood serum for antibodies to HIV-1. A positive screening ELISA result must be confirmed by a more specific test, such as Western immunoblotting (WB). Antibodies to HIV are detected in 95% of patients within 3 months after infection. Negative tests obtained less than 6 months after suspected infection do not rule out infection.

Treatment HIV infection is a complex problem and is carried out only in specialized institutions. Combinations of antiretroviral drugs are selected individually, taking into account general condition patient, the number of helper lymphocytes (CD4+), concomitant diseases and others. Combined antiviral therapy is carried out

not one, but three or more drugs (timazid, chivid, videks, viracept, etc.) various combinations depending on the persistence of the virus. At the heart of modern pharmacological preparations lies the inhibition of some HIV enzymes (reverse transcriptase, proteases, etc.), which prevents the virus from multiplying.

Prevention of HIV infection. The main ways of spreading HIV infection are infection through sexual contact or the sharing of syringes by drug addicts. In this regard, the main preventive measures:

All activities aimed at combating drug addiction;

Informing the population about available HIV prevention measures (protected sex, using only disposable syringes);

Security medical manipulations, transfusion of donor blood, biological fluids or their preparations, transplantation of organs and tissues;

Regular information from doctors of all profiles about the clinic, diagnosis, epidemiology and prevention of HIV infection.

HIV infection is one of the causes of immunodeficiency. Its causative agents HIV-1 and HIV-2 cause the same clinical manifestations in humans. What are skin lesions in HIV, read below in the article.

The time between infection and the appearance of signs of AIDS is on average 10 years. Skin lesions in HIV before the development of immunodeficiency are typical and do not require special methods treatment. With the development of immunodeficiency, their clinic and course change, and therefore there are not only difficulties in the diagnosis, but also in the treatment of dermatosis.

What are skin lesions in HIV?

Seborrheic dermatitis as a type of skin lesion in HIV

Seborrheic dermatitis is one of the most common manifestations of AIDS and usually begins before the development of other symptoms. The severity of this type of skin lesion in HIV correlates with an increase in immunosuppression and a deterioration in the general condition of the patient. The process of skin lesions begins with the appearance of itchy erythematous spots covered with greasy and hyperkeratotic scales and gray-yellow crusts in the face, scalp, inguinal folds and extensor surfaces of the upper extremities. On the scalp, the lesion is accompanied by thick, dirty gray hyperkeratotic plaques that may be accompanied by non-scarring alopecia. With AIDS, the process can become generalized or spread to the entire skin in the form of intensely itchy confluent erythematous follicular plaques. Treatment is with 2% ketoconazole cream.

Herpes simplex as a skin lesion in HIV

Herpes simplex – frequent illness AIDS patients. Herpesvirus can manifest and exacerbate subclinical HIV infection. herpetic infection may have an atypical clinic and a persistent severe course. The rash is often disseminated and without treatment leads to the formation chronic ulcers in the mouth, on the face, in the genital area and any other part of the body. Ulcers become deep and difficult to treat. Their course is further aggravated by the addition of a secondary bacterial infection. Severe, progressive and painful perianal and rectal ulcers primarily occur in homosexual men. Chronic perianal ulcers, skin lesions associated with HIV, were mistaken for bedsores. The infection can spread widely and can be confused with other illnesses such as impetigo.

Shingles may be early symptom AIDS of persons belonging to risk groups. It often occurs in patients before the onset of clinical manifestations of AIDS. Consideration should be given to the potential airborne transmission of varicella and herpes zoster, especially in rooms where most of patients are immunosuppressive. For viral skin lesions in people infected with HIV, acyclovir is used (by mouth or intravenously). There are acyclovir-resistant forms.

Fungal infections of the skin with HIV

frequent various forms of fungal skin lesions. Candidiasis of the mouth and throat occurs in almost all patients, often as the first symptom of AIDS and indicates the progression of the disease. Allocate four clinical forms lesions of the mouth and pharynx:

thrush(pseudomembranous candidiasis);

hyperplastic candidiasis(candidiasis leukoplakia);

atrophic candidiasis

and I will come(candidiasis cheilitis). Plaques form on the cheeks and tongue, often causing sore throat and dysphagia. The infection may descend into the esophagus.

Candidiasis as a skin lesion in HIV

Skin lesions in HIV. Candidiasis of the esophagus, trachea, bronchi and lungs develops with severe immunodeficiency. Without treatment, the disease becomes severe, but damage to internal organs and fungemia, as a rule, does not occur. Sometimes there are candidal onychia and recurrent candidal vulvovaginitis. Mycosis and onychomycosis caused by Trichophiton rubrum is common. Moreover, onychomycosis occurs, as a rule, in the proximal subungual form, accompanied by a milky white spot in the proximal part of the nail plate, which is rare in other people.

Treatment of fungal skin lesions in HIV is carried out with ketoconazole, orungal and other systemic antimycotic drugs, which do not always prevent the development of relapses. In such cases, repeated courses of treatment are required. In resistant and especially severe cases, intravenous infusions of miconazole or amphotericin B are used.

Kaposi's sarcoma on the skin with HIV

AIDS-associated Kaposi's sarcoma clinically manifested by multiple and widespread elements both on the skin and on the mucous membrane. The disease, as a rule, develops in homosexual men and women who are infected with HIV sexually, and not by syringe. Initially, the pathological process is represented by slightly raised oval or elongated bluish-violet infiltrates with fuzzy boundaries. They are most commonly found on the trunk, head, and neck and may occur at sites of trauma (including injections) in an isomorphic Koebner reaction or occur in a dermatome previously affected by herpes zoster. As the process progresses rapidly, red or purple plaques and nodules appear. Generalized polylymphadenopathy is characteristic. Ultimately, the majority of HIV patients develop a specific lesion of the internal organs (primarily gastrointestinal tract). The histological picture is similar to the classical form of Kaposi's sarcoma.

The treatment is carried out with injections of α-interferon.

Other Skin Lesions in HIV

Psoriasis in HIV-infected people is severe in the form of generalized pustular psoriasis or erythroderma, often with damage to the palms. Usually the appearance or exacerbation of psoriasis is a poor prognostic sign of AIDS.

AIDS patients also have disseminated pityriasis versicolor with the development of infiltration and lichenification of the skin;

single or widespread viral warts,

molluscum contagiosum,

bacterial infections skin (more common staphylococcal and streptococcal pyoderma ,

chancriform, chronic ulcerative, vegetative forms of pyoderma);

atypically flowing scabies with lesions of the linden, scalp, multiple hyperkeratotic scaly plaques on an erythematous background ( norwegian scabies), intense itching, difficult to treat post-scabious dermatitis; nodular pruritus, malignant lymphomas of the skin, etc.

Syphilis in HIV-infected people progresses faster; before the development of tertiary syphilis sometimes takes several months.

Treatment of skin lesions in HIV-infected patients requires constant clinical and laboratory monitoring. Doses of etiotropic drugs for bacterial, viral and fungal infections should be higher, and courses of treatment should be longer and, if necessary, repeated. After achieving clinical recovery, prophylactic administration of etiotropic drugs is necessary. Patients with HIV infection need psychological support and regular close monitoring.

Reasons for development

AIDS is viral disease, which is provoked by an infectious agent belonging to the family of retroviruses.

Virologists distinguish two types of HIV - types 1 and 2, viruses differ in antigenic and structural characteristics. The most common cause of AIDS is HIV type 1. In an infected person, the virus is found in most biological media and cellular elements.

The infection is transmitted through biological fluids- blood, including menstrual discharge, breast milk, semen. HIV risk groups include:

• People who engage in promiscuity;
• Drug addicts;
• People with hemophilia;
• Children whose mothers were infected before pregnancy or during gestation.

Skin manifestations of AIDS develop due to a decrease in immunity in patients. Therefore, many dermatological diseases in such patients, the course is atypical with more severe symptoms than usual.

II. Stage of primary manifestations of HIV infection

After the incubation period, the stage develops primary manifestations HIV infections. It is due to the direct interaction of the patient's body with the immunodeficiency virus and is divided into:

• IIA - acute febrile stage of HIV.
• IIB - asymptomatic stage of HIV.
• IIB - stage of persistent generalized lymphadenopathy.

Signs and symptoms of HIV in IIA (acute febrile) stage

Signs and symptoms of HIV infection in stage IIIA

Stage IIIA of HIV infection is a transitional period from persistent generalized lymphadenopathy to an AIDS-associated complex, which is a clinical manifestation of HIV-induced secondary immunodeficiency.

Rice. 11. The most severe shingles occurs in adults with severe suppression of the immune system, which is observed, including with AIDS.

Signs and symptoms of HIV infection in stage IIIB

This stage of HIV infection is characterized by severe symptoms violations cellular immunity, and according to clinical manifestations, there is nothing more than an AIDS-associated complex, when a patient develops infections and tumors that are not found in the AIDS stage.

• During this period, there is a decrease in the CD4/CD8 ratio and the blast transformation reaction rate, the level of CD4-lymphocytes is recorded in the range from 200 to 500 per 1 μl. In the general analysis of blood, leukopenia, anemia, thrombocytopenia increase, in the blood plasma there is an increase in circulating immune complexes.
• The clinical picture is characterized by prolonged (more than 1 month) fever, persistent diarrhea, profuse night sweats, pronounced symptoms of intoxication, weight loss of more than 10%. Lymphadenopathy becomes generalized. There are symptoms of damage to internal organs and the peripheral nervous system.
• Identified diseases such as viral (hepatitis C, common herpes zoster), fungal diseases(oral and vaginal candidiasis), persistent and long-term bacterial infections of the bronchi and lungs, protozoal lesions (without dissemination) of internal organs, Kaposi's sarcoma in a localized form, pulmonary tuberculosis. Skin lesions are more common, severe, and longer in duration.

Rice. 12. Bacillary angiomatosis in HIV patients. The causative agent of the disease is a bacterium of the genus Bartonella.

Rice. 13. Signs of HIV in men on late stages: damage to the rectum and soft tissues (photo on the left), genital warts(photo on the right).

Signs and symptoms of HIV infection in stage IIIB (stage AIDS)

IIIB stage of HIV infection represents a detailed picture of AIDS, characterized by deep suppression of the immune system and the development of opportunistic diseases that occur in severe form, threatening the life of the patient.

The transition to the terminal stage of AIDS occurs when the level of CD4-lymphocytes decreases to 50 and below in 1 µl. During this period, an uncontrolled course of the disease is noted and an unfavorable outcome is expected in the near future. The patient is exhausted, depressed and loses faith in recovery.

The lower the level of CD4-lymphocytes, the more severe the manifestations of infections and the shorter the duration of the terminal stage of HIV infection.

Signs and symptoms of HIV infection in the terminal (last) stage

• The patient develops atypical mycobacteriosis, CMV (cytomegalovirus) retinitis, cryptococcal meningitis, widespread aspergillosis, disseminated histoplasmosis, coccidioidomycosis and bartonnellosis, leukoencephalitis progresses.
• Disease symptoms overlap. The patient's body is rapidly depleted. In connection with constant fever, severe symptoms of intoxication and cachexia, the patient is constantly in bed. Diarrhea and loss of appetite leads to weight loss. dementia develops.
• Viremia increases, CD4-lymphocyte counts reach critically minimal values.

Rice. 16. terminal stage diseases. Complete loss of the patient's faith in recovery. In the photo on the left is an AIDS patient with severe somatic pathology, in the photo on the right is a patient with a common form of Kaposi's sarcoma.

HIV stages

Throughout the entire period of study of this disease and the search for an antidote to it, the classification of the stages of HIV infection has repeatedly changed.

To date, there are 5 stages of the HIV infection process:

1. The incubation stage is the period of the disease, the beginning of which is associated with the moment a person is infected with a virus, and the end with the time the immune system produces antibodies. The duration of this period directly depends on the immunity of the patient - as a rule, it ranges from 2 weeks to 3 months.
2. The stage of primary manifestations is the period of introduction, development and spread of HIV throughout the patient's body. This stage can last from 2 weeks to a month and a half - most often its duration is a couple of weeks.
3. The latent (subclinical) stage is the period of asymptomatic struggle of the immune system with the virus. This stage is the longest - it can last from 2 to 10-20 years.
4. The stage of secondary diseases (pre-AIDS) is a period when the immune system is already significantly undermined and destroyed - it does not have enough strength to cope with those infections to which a person has hitherto been immune.
5. The terminal stage (AIDS) is the last, final stage, characterized by irreversible processes in the human body. The end of this period is death.

At this stage, there is a rapid defeat of all internal organs. The course of the virus can be complicated by an additional infection or by the development of an oncological process.

At this stage, the disease does not stay for more than two years, since the last stage comes - AIDS. But, before the carrier of the virus, such pathological manifestations begin to activate:

The danger of HIV infection is that a few years later, a carrier of the virus is diagnosed with a new, already fatal diagnosis of AIDS. During this period, the man is completely weakened, and his internal organs and systems are destroyed.

In this case, fatal outcome maybe even from a banal SARS. Therefore, urgent therapy is required, eliminating the main symptoms and slightly prolonging life.

If left untreated, a patient diagnosed with AIDS cannot live more than one year.

At the final stage, the virus provokes the development of additional dangerous ailments (sarcoma, tuberculosis, oncology). In addition, the brain suffers greatly from the virus, and as a result, the patient's intellectual abilities noticeably decrease, and memory deteriorates.

It must be remembered that the main risk group is made up of people leading a disorderly sexual life, homosexuals, drug addicts. It is also very important when planning a child to go through all necessary tests, since one of the ways HIV is transmitted involves infection from mother to baby.

Therefore, experts recommend once a year to carry out a complete diagnosis of the body for the timely detection of pathologies. Indeed, in most cases, HIV in men is already detected in an advanced form, which significantly reduces life expectancy and brings the diagnosis of AIDS closer.

Testing to detect HIV is mandatory, as the virus has been asymptomatic for many years. The only warning symptom may appear in the form of cold symptoms, thereby leading the man astray.

Signs of HIV: Video

The first signs of HIV

The first signs of HIV in children

Children infected in utero often develop HIV infection much faster than children infected after one year. Symptoms in such small patients appear already in the first 12 months of their life.

In many children, the signs of the disease may not make themselves felt until 6-7, and sometimes 10-12 years.

Signs of HIV infection include:

• delay in physical development
• delayed psychomotor development
• lymphadenopathy
• enlargement of the liver and spleen (myalgia)
• frequent acute respiratory infections
• problems with the gastrointestinal tract
• skin rashes
• CNS disorders
• cardiovascular failure
• encephalopathy
• anemia

When do the first symptoms of HIV begin to appear?

Very often, the onset of the disease in people of all genders and ages is completely asymptomatic, and sometimes its symptoms can be easily confused with other, less dangerous infectious diseases.

In other cases, the first signs of HIV infection may appear as early as 2-6 months after infection. Such symptoms will indicate the onset of the acute phase of the disease.

External manifestations HIV

The most common sign of the presence of HIV infection in the body in a patient of any gender and age is enlarged lymph nodes. At what, as a rule, not one group of lymph nodes increases, but several at once - on the neck, in the groin, armpits, on the elbows.

On palpation, such nodes do not hurt and have a normal color. Lymph nodes can increase from 2 to 6 cm.

As for the rashes and neoplasms that very often appear with HIV infection, they can be of the following nature:

• pinkish rash
• burgundy tumors
• condylomas
• papillomas
• herpes
• mucosal inflammation
• ulcers and erosions in the mouth
• inflammation in the vagina
• hives
• maculopapular rash
• seborrheic dermatitis
• rash with vascular changes
• pyoderma
• lichen
• psoriasis
• rubrophytia
• molluscum contagiosum
• hairy leukoplakia
• Kaposi's sarcoma

Herpes in HIV

The herpes virus infects 90% of the world's population. About 95% of those infected are unaware of the presence of this virus in their body, and only 5% of infected patients experience its obvious symptoms - bubble formations on the skin of the face, genitals, and mucous membranes.

If there is also an HIV infection in the patient's body, the herpes virus can manifest itself as follows:

How to recognize HIV in a general blood test?

A general blood test does not identify the human immunodeficiency virus itself, but it can reveal a number of changes in his body.

If a person has HIV infection general analysis blood can fix the following conditions:

• Lymphocytosis - increased concentration lymphocytes in the blood, due to the arming of immunity against HIV; characteristic of the early stage of the disease.
• Lymphopenia - a decrease in the level of T-lymphocytes in the blood due to the weakening of the immune system in the process of fighting the virus; occurs at the end of the acute phase.
• Thrombocytopenia is a decrease in the level of platelets responsible for blood clotting.
• Neutropenia is a decrease in the concentration of neutrophils (granular leukocytes), which are responsible for the initial stage of the fight against pathogenic agents in the blood.
• Anemia is a decrease in hemoglobin levels.
• High ESR (erythrocyte sedimentation rate).
• Increased content of mononuclear cells (atypical cell forms).

What to do if diagnosed with HIV?

Most carriers report a tendency to damage the liver and respiratory tract. Based on this, the body cannot resist pneumocystis, cytomegalovirus, and tuberculosis bacteria.

Also, hepatitis B and C are of particular danger with weakened immunity. The patient may note the following complaints:

1. Unreasonable feeling of fear.
2. Painful syndrome in the region of the heart muscle.
3. Unmotivated fear.
4. Cardiopalmus.
5. Attacks of asthenia.

Under the influence of the virus nerve cells significant changes are taking place leading to various symptoms. For example, the following should not be ignored:

• constant feeling of powerlessness;
• low level of physical activity;
• uncharacteristic irritability;
• headache attacks;
• sleep disturbance;
• general weakness in the body.

Symptoms of the disease

The infected person does not immediately realize that the HIV virus is activated in his body. Then, depending on the stage of development of the process, the manifestation of the first warning signs. On average, it takes from three weeks to three months to notice uncharacteristic symptoms.

For example, in many men, after a few months, begins to manifest acute symptoms. An infected person may present with complaints of fever, mild chills, a sore throat, and swollen lymph nodes.

All these signs are misleading, therefore, in order to block the symptoms, men begin to take antiviral drugs. But, it is not taken into account that during this period, during palpation, you can feel an enlarged liver, which is not typical for a common cold.

That should be the motivation to go to the doctor immediately for general diagnostics organism.

Signs of HIV infection in a man and a woman who has contracted it are usually no different. After about 1-2 months, a man may feel the following symptoms:

• Change in body temperature (uncharacteristic jumps).
• Constant chill.
• Very often, a man notes weakness or soreness of the muscles.
• Enlarged lymph nodes.
• Headache.
• Increased sweating, especially at night.

• Indigestion (frequent diarrhea).
• Sore throat.
• Skin rash.
• Symptoms of thrush and ulcers in the oral cavity.
• Pain in the joints.
• Violation of concentration.

An alarming symptom of HIV in a man is a rash on the body.

Table 2. The nature of the rash

In addition, a man constantly feels tired, his physical activity. Possibly the onset of depression. During palpation, the doctor will note an increase in the size of the liver.

When such signs of HIV infection appear in a man, it is important to immediately consult a doctor, undergo the necessary examination and begin treatment with antiviral drugs, without which life expectancy is significantly reduced.

Diagnostic methods

The atypical course of skin diseases is the basis for referring the patient for HIV testing.

Laboratory diagnostics is carried out in three stages:

• First, the fact of infection is established;
• Next, the stage of the process is determined, and diagnostics secondary disease provoked by HIV infection.
• The last stage of the examination is regular monitoring clinical course disease and treatment outcomes.

Treatment methods

In the treatment of dermatological manifestations of AIDS, intensive antiretroviral therapy is also used.

Skin diseases in HIV infection are treated according to the methods adopted for the treatment of a particular disease. However, given the fact that skin diseases against the background of HIV, the course is more difficult, it may be necessary to increase the doses of the drugs used and prolong the courses of treatment.

Simultaneously with the treatment of skin diseases, intensive antiretroviral therapy is carried out. The choice of the drug is carried out by the doctor depending on the patient's condition.

Today, the treatment regimen for HIV infection includes:

• Didanosine, Zalcitabine, Zidovudine are drugs used in the first stages of treatment.
• Stavudin, Saquinavir, Indivinar - drugs for the treatment of adult patients in the late stages of the disease;

In addition to the appointment of antiretroviral drugs, in the treatment of AIDS, antiviral, antimicrobial, antimycotic and anticancer drugs. This is necessary to prevent the development of complications, including skin diseases.

It is impossible to cure a disease in a man. However, if HIV was detected at the initial stages of development (regardless of the presence of symptoms) and its treatment was started on time, then the patient has a chance to prolong his life.

As a therapy, the patient is prescribed antiviral drugs, the main task of which is to slow down the development of the disease. In addition, he needs to take immunostimulating drugs. Additionally, the symptoms of concomitant pathologies are treated.

Prevention

The prognosis for HIV infection depends on the stage of detection of diseases. Early initiation of antiretroviral and symptomatic therapy allows you to significantly extend the life and improve its quality.

Prevention of HIV infection lies in the knowledge and application of the rules of safe sex, in refusing to use drugs. When performing various medical procedures, only disposable or sterilized equipment should be used.

To exclude the transmission of the virus from a sick mother to a child, breastfeeding is prohibited.

most important role has a constant diagnosis and the passage of various tests to detect infection. All people who are donors of blood, organs, sperm, and tissues should be examined.

It is important for every person to know the rules of protection against infectious diseases and to undergo an annual free examination using special tests or analyses.

Knowing how HIV is transmitted, doctors identify some principles for its prevention:

1. Avoid casual sexual contact, and in case of contact, be sure to use barrier methods contraception. This is important to do regardless of the type of sexual intercourse, as it has been proven that HIV can be transmitted not only during traditional, but also during anal or oral sex.
2. Avoid using used needles and syringes. Due to the neglect of this rule, there is a wide spread of the disease among drug addicts who use one common syringe for injection.
3. During the passage medical examinations or treatment, it is important to always use disposable or sterile instruments. The same goes for beauty salons where all devices must be sterilized.

HIV infection is dangerous because it primarily affects immune system a person, as a result of which his body is not able to cope even with a common cold.

In addition, HIV inevitably leads to acquired immunodeficiency syndrome, a disease that is incurable and fatal within a short time.

Accessible words about the prevention of HIV infection. Lecture by Dr. Makarova:

The insidiousness of the virus lies in the fact that it is impossible to detect it on your own. Also long time he may not give characteristic symptoms, so a man may not be aware that he is a carrier and continue to infect others at this time.

Only special people can detect the virus in the body laboratory tests, which were carried out a few months after infection, since earlier the result may be negative, despite its presence in the body.

Therefore, every man from 18 to 45 years old, leading an active sex life, it is important to donate blood about 1 time per year for an analysis to detect HIV.

When an infection can be detected on initial stage its development, a man has every chance to prolong his life, thanks to special antiviral therapy.

Post Views: 7 727

HIV infection is a disease caused by immune deficiency. It attacks the patient's immune system, which is the body's natural defenses. If a person is infected with HIV, it is more difficult for their body to fight infections.

In HIV-infected patients with low quantity white blood cells were noted serious allergic reactions, manifested on the skin in the form of a rash and hyperemia, while high concentrations leukocytes indicate skin diseases associated with hypersensitivity.

Understanding nature skin manifestations HIV infection can help identify immune status patient.

Urticaria in HIV appears very abruptly and suddenly:

1. Urticaria often occurs at the site of an injection (such as a drug).
2. Cold allergy is also associated with HIV infection and is sometimes one of the distinctive symptoms, by which a specialist can determine that the patient is infected.
3. Seborrheic dermatitis is seen in many AIDS patients.
4. Psoriasis and reactive arthritis are also quite common among HIV patients. Against the background of these diseases, painful blisters or plaques appear on the skin.
5. HIV-infected patients are very sensitive to sunlight and often develop sun allergies when exposed to it.

Therapy Methods can only be prescribed by the attending physician. Urticaria is not the most pleasant concomitant HIV disease, it only complicates the life of an infected patient.

Drugs that the patient takes to maintain immunity, often interact negatively with antihistamines and glucocorticosteroids used in the fight against urticaria.

In this case, the specialist will most likely prescribe non-hormonal ointments (Fenistil-gel).

Also, HIV-infected patients with acute and severe forms of urticaria (blisters and plaques are inflamed) should be very careful, because often the inflammation and rash bleed.

This poses a risk to healthy people be infected by an HIV-infected patient.

With the flu

Sometimes hives are the immune system's response to a recent past infection such as a cold or the flu.

The disease sometimes occurs against the backdrop of receiving such funds how:

• Tylenol;
• Aspirin;
• as well as many antipyretic compounds (Teraflu, Coldrex) in the presence of an allergy to vitamin C.

Urticaria with influenza not dangerous, symptoms usually resolve within a few days (maximum a week). If the rash itches, then you should use the non-hormonal drug Fenistil-gel, or take a tablet of Tavegil or Claritin. In this case, you do not need to see a doctor.

With worms

In a study of 50 patients with chronic urticaria, blood samples (complete blood count) and blood for the content of eosinophils (a subspecies of leukocytes) were taken to identify the allergen, as well as fecal analysis. All patients had positive results on worms.

1. Itching in anus(as well as hyperemia of the mucous membranes).
2. Dizziness.
3. Nausea and vomiting.
4. Slight rise in temperature.
5. Constipation or diarrhea.

If you have been tested for worms and they are positive, and you have symptoms of hives, you should immediately see an allergist.

When there are worms and hives, specialists prescribe to relieve symptoms, as well as anthelmintic drugs(Helmintox, Nemozol, Pirkon). A course of treatment anthelmintic drugs is about 14 days. And the symptoms of urticaria disappear on the second day.

Patients with giardiasis and urticaria developing against it experience the following symptoms:

• increased fatigue;
• nausea, vomiting, loss of appetite;
• diarrhea, bloating, flatulence, spasms;
• characteristic reddish eruption, rash often itchy, blisters usually absent.

Episodes of urticaria often correlate with the presence of Giardia lamblia in the stool.

Treatment giardiasis completely relieves the symptoms of urticaria and includes:

1. Metronidazole is an antibiotic (may cause nausea).
2. Tinidazole is an analogue of metronidazole.
3. Nitazoxanide is a popular treatment option for children and is available in liquid form.
4. Paromomycin - can be used with caution during pregnancy.

With pancreatitis

Pancreatitis is an inflammation of the pancreas. It is often accompanied by urticaria. It may appear as allergic reaction on drugs used to treat the disease, and become a symptom of jaundice. Jaundice is caused by a buildup of bilirubin in the blood and tissues of the body. The most obvious sign of jaundice is yellow skin and yellow squirrels eye.

being treated urticaria in pancreatitis complex. The main risk factor for developing pancreatitis is excessive alcohol consumption(which is also a common allergen) or the presence of gallstones.

Treatment acute pancreatitis performed in a hospital, and the goal is to alleviate the symptoms, the patient most often takes antibiotics, replacement enzymes (Mezim, Creon). Treatment chronic pancreatitis is done with antibiotics, pain medications, and dietary changes and vitamin supplements.

Symptoms of urticaria disappear against the background of such therapy in a few weeks (up to a month).

Antihistamines, as well as glucocorticosteroids, are rarely prescribed by a doctor, as they interact negatively with drugs for the treatment of pancreatitis.

With candidiasis

Candidiasis is a fungal infection (common in women - thrush). AT normal conditions the body may contain small amounts of this fungus, but there are times when it begins to multiply.

Most infections are caused by a type of fungus called Candida albicans.

Generally, candidiasis is not a serious condition and responds well to treatment.

But ignoring the symptoms and untimely appeal Seeing a doctor can lead to potentially life-threatening problems, especially in those with weakened immune systems.

There are different types of candidiasis- intestinal, fecal, diffusion (in the intestine), perianal. Exactly intestinal candidiasis usually accompanied by urticaria. His symptoms include:

1. Chronic fatigue.
2. From the gastrointestinal tract: increased gas formation, bloating and cramps, rectal itching, constipation or diarrhea.
3. From the nervous system: depression, irritability, problems with concentration.
4. On the part of the immune system: the appearance of allergies and hypersensitivity to certain chemicals - a rash can occur on various parts of the body, but usually manifests itself on the face, hands, or affects the mucous membranes.

With candidiasis, it is important to seek medical care. The specialist is most likely prescribe antifungal drugs(Flucostat, Fluconazole, Itraconazole, Diflucan), antifungal ointments (Clotrimazole, Pimafucin), as well as l medicines to restore the intestinal flora(Linex, Bifidumbacterin, Baktisubtil).

Against the background of their intake, the symptoms of urticaria disappear within a few days. Antihistamines are not required.

With cholecystitis

May develop against the background of cholecystitis. This is an inflammation of the gallbladder. The most common symptom acute cholecystitis is pain in upper area belly.

Other symptoms may include:

• shoulder blade pain;
• nausea, vomiting;
• fever.

All these symptoms usually occur after eating fatty foods.

Since this disease is of an infectious nature, it can cause hives in patients with allergies. Exacerbation of cholecystitis is often the cause of an acute form of urticaria or Quincke's edema.

In this case, you should immediately consult a doctor. The specialist will appoint balanced diet, painkillers (mainly antispasmodics - No-shpa, Spazmolgon), as well as choleretic drugs.

For elimination local inflammation urticaria are prescribed non-hormonal ointments - Fenistil-gel.

Urticaria with cholecystitis responds well to treatment, a allergic symptoms pass within a few days (up to a week).

With hepatitis C

The hepatitis C virus is an infection that affects the liver. Chronic cases, if left untreated, can lead to liver failure.

Skin rashes can be a sign of hepatitis C and should not be ignored. Urticaria in hepatitis C can also be associated with liver damage or be side effect from the use of anti-hepatitis drugs.

Against the background of hepatitis C develops only acute form disease, but rarely it can develop into a chronic one.

Dermal signs of acute viral hepatitis:

1. Acute urticaria usually occurs in patients with viral infections including hepatitis A, B, C.
2. Urticaria is accompanied by fever, headache and joint pain.
3. The rash is usually red (sometimes burgundy), and blisters may appear.
4. With the development of urticaria with hepatitis C, you should immediately consult an emergency doctor.

An exacerbation of hepatitis C is usually lasts up to 6 weeks. Periodic episodes of urticaria may accompany the entire period of exacerbation. The rash develops within a few minutes and lasts for several hours, then subsides.

At acute hepatitis C, the best course of action for treating urticaria is taking antihistamines and the use of ointments and gels to relieve itching.

Chronic rashes are more difficult to treat due to the ongoing nature of the disease. The specialist will also advise To you:

• limit sun exposure;
• take a warm bath;
• use moisturizers for the body, refuse laundry soap.

It is best to see a doctor as soon as you notice any unusual skin changes.

For eczema

Eczema is a term for a group of conditions that cause irritation or inflammation of the skin. The most common type of eczema is atopic dermatitis . Unlike hives, the pruritus of eczema is not caused by the release of histamine. Eczema is more likely a consequence of hives than a concomitant disease.

Treatment can only be prescribed by a specialist (allergist, dermatologist). But if allergic agent cannot be eliminated or identified, then steps to relieve an allergic reaction:

1. Applying non-steroidal creams (hydrocortisone) to the affected area along with anti-itch lotions (eg Calamine).
2. Benadryl tablets.
3. Corticosteroids.
4. Immunosuppressants are drugs that suppress the immune system (cyclosporine, azathioprine, methotrexate).
5. Immunomodulators (Elidel).

Eczema poorly treatable. It is especially unpleasant for teenagers because of external manifestations.

This can lead to depression. In this case, you need to contact a psychotherapist for professional help.

Urticaria itself is not serious illness. But often it can be accompanied by severe forms of other diseases.

To know exactly what measures to take and what drugs to use, consult your doctor. But remember that in most cases, the causes of hives are irritants, its symptoms are not dangerous, and are almost always temporary.

In all manifest forms of HIV infection, frequent clinical manifestations are lesions of the skin and mucous membranes (they can regress, reappear, be replaced by one another, give combinations, and eventually become common with severe course). A reliable clinical sign in the recognition of AIDS is Kaposi's sarcoma (in 1/3 of patients).

Kaposi's sarcoma

Fungal diseases (rubrophytosis, candidiasis, athlete's groin, versicolor versicolor)

Rubrophytia

versicolor

Candidiasis

Viral diseases of the skin and mucous membranes

Lichen simplex

molluscum contagiosum

Cytomegalovirus

Genital warts

"Hairy leukoplakia"

Pustular diseases

Acneiform folliculitis

Impetiginous rashes

Vegetative pyoderma

shancriform pyoderma

Spotty rashes

Xeroderma

Reiter's disease