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Early stages of Aids
Jan 9, 2002

Dear Doctor, can you explain to me the difference between HIV positive and actually developing AIDS. What is the outlook for a person whose initial visited to the clinic because of developing opportunisitic infections, within the last two weeks. Are the treatments available good for a person who has recently developed AIDS.

Response from Dr. Young

HIV "positive" means infected with the human immunodeficiency virus. Person who are infected with the virus may or may not have significant symptoms or immune deficiency.

AIDS refers to an epidemiologically defined syndrome of conditions that are comprised of infections (PCP, MAC, CMV, for example), cancers (Kaposi's sarcoma, lymphoma) or advanced depletion of CD4-positive T lymphocytes (CD4 cells, "T-cells").

The likelihood of the development of an opportunistic infection is directly related to the magnitude of immune deficiency, most commonly and readily measured by loss of CD4 cells. The risk is most increased with counts less than 200, though some individuals may have AIDS-related complications with counts that are higher than 200. The risk also appears to increase with decreasing CD4 cell counts. The risk of acquiring an opportunistic infection in a two week period should be quite low-- but not zero.

There are excellent treatments for both HIV and opportunistic infections. The response rates for antiretroviral therapies appear to decrease with declining CD4 cell counts, but still are very good. BY



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