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艾滋病的臨床表現(xiàn)
我國(guó)將HIV感染分為急性期、無(wú)癥狀期和艾滋病期。
（一）急性期：通常發(fā)生在初次感染HIV后2-4周左右。臨床主要表現(xiàn)為發(fā)熱、咽痛、盜汗、惡心、嘔吐、腹瀉、皮疹、關(guān)節(jié)痛、淋巴結(jié)腫大及神經(jīng)系統(tǒng)癥狀。多數(shù)患者臨床癥狀輕微，持續(xù)1-3周后緩解。
此期在血液中可檢出HIV－RNA和P24抗原，而HIV抗體則在感染后數(shù)周才出現(xiàn)。CD4+ T淋巴細(xì)胞計(jì)數(shù)一過(guò)性減少，CD4/CD8比例可倒置。
（二）無(wú)癥狀期
可從急性期進(jìn)入此期，或無(wú)明顯的急性期癥狀而直接進(jìn)入此期。
此期持續(xù)時(shí)間一般為6-8年。但也有快速進(jìn)展和長(zhǎng)期不進(jìn)展者。此期的長(zhǎng)短與感染病毒的數(shù)量、型別，感染途徑，機(jī)體免疫狀況等多種因素有關(guān)。
（三）艾滋病期
為感染HIV后的最終階段。病人CD4+ T淋巴細(xì)胞計(jì)數(shù)明顯下降，多<200/mm3，HIV血漿病毒載量明顯升高。此期主要臨床表現(xiàn)為HIV相關(guān)癥狀、各種機(jī)會(huì)性感染及腫瘤。
HIV相關(guān)癥狀：主要表現(xiàn)為持續(xù)一個(gè)月以上的發(fā)熱、盜汗、腹瀉；體重減輕10%以上。部分病人表現(xiàn)為神經(jīng)精神癥狀，如記憶力減退、精神淡漠、性格改變、頭痛、癲癇及癡呆等。另外還可出現(xiàn)持續(xù)性全身性淋巴結(jié)腫大，其特點(diǎn)為①.除腹股溝以外有兩個(gè)或兩個(gè)以上部位的淋巴結(jié)腫大；②.淋巴結(jié)直徑≥1cm，無(wú)壓痛，無(wú)粘連；③持續(xù)時(shí)間3個(gè)月以上。
HIV相關(guān)機(jī)會(huì)性感染及腫瘤的常見(jiàn)癥狀：發(fā)熱、盜汗、淋巴結(jié)腫大、咳嗽咳痰咯血、呼吸困難、頭痛、嘔吐、腹痛腹瀉、消化道出血、吞咽困難、食欲下降、口腔白斑及潰瘍、各種皮疹、視力下降、失明、癡呆、癲癇、肢體癱瘓、消瘦、貧血、二便失禁、尿儲(chǔ)留、腸梗阻等。
常見(jiàn)的機(jī)會(huì)性感染
呼吸系統(tǒng)：卡氏肺孢子蟲(chóng)肺炎（PCP）、肺結(jié)核、復(fù)發(fā)性細(xì)菌、真菌性肺炎。
中樞神經(jīng)系統(tǒng)：隱球菌腦膜炎、結(jié)核性腦膜炎、弓形蟲(chóng)腦病、各種病毒性腦膜腦炎。
消化系統(tǒng)：白色念珠菌食道炎，及巨細(xì)胞病毒性食道炎、腸炎；沙門(mén)氏菌、痢疾桿菌、空腸彎曲菌及隱孢子蟲(chóng)性腸炎。
口腔：鵝口瘡、舌毛狀白斑、復(fù)發(fā)性口腔潰瘍、牙齦炎等。
皮膚、淋巴結(jié)：帶狀皰疹、傳染性軟疣、尖銳濕疣、真菌性皮炎、甲癬、淋巴結(jié)結(jié)核。
眼部：巨細(xì)胞病毒性及弓形蟲(chóng)性視網(wǎng)膜炎。
常見(jiàn)腫瘤：子宮頸癌、惡性淋巴瘤、卡波氏肉瘤等。
In our country, HIV infection is divided into acute, asymptomatic and AIDS.
(I) Acute period: Usually occurs about 2-4 weeks after the first infection with HIV. The main clinical manifestations are fever, pharyngeal pain, night sweats, nausea, vomiting, diarrhea, rash, joint pain, lymph node enlargement and neurological symptoms. Most patients had mild clinical symptoms and continued to ease after 1-3 weeks.
During this period, HIV-RNA and P24 antigens can be detected in the blood, while HIV antibodies appear only a few weeks after infection. The CD4 + T lymphocyte count is reduced and the CD4/CD8 ratio can be reversed.
(II) asymptomatic period
Can enter this period from the acute period, or directly into this period without obvious acute symptoms.
The duration of this period is generally 6-8 years. But there are also those who have made rapid progress and have not made progress for a long time. The length of this period is related to the number, type, route of infection, and immune status of the body.
(III) AIDS period
Pathways of AIDS transmission
Pathways of AIDS transmission
For the final stage after HIV infection. The CD4 + T lymphocyte count of the patient decreased significantly, and more & lt; 200 / mm3, HIV plasma viral load increased significantly. The main clinical manifestations of this period were HIV-related symptoms, various opportunistic infections and tumors.
HIV related symptoms: The main manifestation is fever, night sweat, diarrhea that lasts for more than one month; More than 10 % weight loss. Some patients showed neuropsychiatric symptoms such as memory loss, apathy, personality changes, headaches, epilepsy, and dementia. In addition, persistent systemic lymphadenopathy can also occur, which is characterized by 1. There are two or more lymph nodes other than the groin; 2. lymph node diameter ≥ 1cm, no pressure pain, no adhesion; The duration is more than three months.
Common symptoms of HIV-related opportunistic infections and tumors: fever, night sweats, enlarged lymph nodes, cough, phlegm, hemoptysis, dyspnea, headache, vomiting, abdominal pain, diarrhea, gastrointestinal bleeding, dysphagia, loss of appetite, oral white spots and ulcers, various rashes, visual impairment, blindness , dementia, epilepsy, limb paralysis, wasting, anemia, second incontinence, urine storage, intestinal obstruction, etc..
Common opportunistic infections
Respiratory system: Carcinosporidium pneumoniae pneumonia(PCP), tuberculosis, recurrent bacteria, fungal pneumonia.
Central nervous system: cryptococcal meningitis, tuberculous meningitis, toxoplasmosis encephalopathy, various viral meningeal encephalitis.
Digestive system: Candida albicans esophagitis, and giant cell viral esophagitis, enteritis; Salmonella, Bacillus dysentery, Aspergillus jejunum and Cryptosporidium enteritis.
Oral: thrush, tongue hair white spot, recurrent oral ulcer, gingivitis.
Skin and lymph nodes: herpes zoster, infectious soft wart, condyloma acuminatum, fungal dermatitis, psoriasis, lymph node tuberculosis.
Eye: cytomegalovirus and toxoplasmosis retinitis.
Common tumors: cervical cancer, malignant lymphoma, Kapo's sarcoma, etc..