The Effects of HIV on the Body

What does human immunodeficiency virus (HIV) look like?

Though symptoms can go undetected for some time, eventually the disease takes its toll on the body by damaging a person’s immune system, paving the way for numerous diseases to move in. While many of the diseases and infections that strike people with HIV are common, others are unusual and their presence is what often leads to a diagnosis of acquired immune deficiency syndrome (AIDS) — the final stage of HIV disease.

HIV: Early Symptoms

The earliest symptoms of HIV can resemble the flu and they generally clear up within a month or two. These symptoms may include fever, headache, fatigue, and swelling in the lymph nodes, particularly those in the neck and groin. However, not everyone who acquires HIV will experience these symptoms. Similarly, for several years, perhaps as long as a decade, a person with HIV may not have any symptoms at all. During that time, though, the virus is still multiplying and it's possible to transmit HIV to someone else.

HIV progresses differently for each person affected. The course of the disease is determined by the specific infections or complications a person with HIV develops. HIV complications can affect different parts of the body: Some are localized to the mouth, others in the brain, and others result in total body changes like losing body weight. Skin conditions are also common.

HIV: Skin Effects

Several of the main skin conditions that affect people with HIV are caused by viruses most people already have in their bodies. However, these viruses typically do not cause disease in people whose immune systems are healthy. Some of the more common dermatological, or skin, effects of HIV include:

• Varicella zoster virus (VZV) infection. VZV is a herpes virus that causes both chicken pox (varicella) and shingles (herpes zoster). Most adults have already been exposed to this virus. HIV-infected individuals may develop new skin sores from either of these diseases. HIV patients who didn’t have chicken pox earlier in their life may develop the condition, which in some cases can affect their organs and become life-threatening. Shingles can be localized to one area or it can spread over large areas of the skin. Shingles lesions can become infected and even lead to the development of encephalitis (brain inflammation) in people with HIV.
• Herpes simplex virus (HSV). HSV was one of the first diseases identified in people with advanced HIV disease and is now considered one of the AIDS-defining diseases by the U.S. Centers for Disease Control and Prevention. HSV causes open sores that may look like a cluster of blisters. They pop and crust over before healing completely; this process takes about 7 to 10 days in otherwise healthy individuals, but in people with advanced HIV disease, the sores may enlarge to 2 to 10 centimeters in diameter, becoming crusted and painful.
• Kaposi’s sarcoma (KS). KS is a cancer caused by a herpes virus called Kaposi sarcoma herpes virus. Healthy individuals may be infected with Kaposi sarcoma herpes virus without developing the cancer. However, as HIV-infected people become sicker, KS may develop. KS tumors grow from cells that line blood vessels and lymph nodes. The cells form tumors on the skin that appear as brown, purple, or red splotches, called lesions. In some cases, the lesions look worse than they are, as they may cause no other symptoms. Other people with KS may experience painful swelling, particularly around the eyes, in the legs, or in the groin. Although less common, KS lesions can also form in organs, like the liver, digestive system, or the lungs, which could be deadly.

HIV: Oral Health Problems

HIV infection can also cause oral health problems that are rare in uninfected people, including:

• Candidiasis. Candidiasis is a fungal infection that HIV patients often get as their CD4+ cell count decreases. One of the most common types associated with HIV, thrush (or pseudomembranous candidiasis), appears as white patches in the mouth or pharynx.
• Periodontal disease. HIV-positive individuals very often have periodontal disease caused by bacterial infections even if they do not have any other symptoms of HIV. At first, the periodontal disease is characterized by the sudden and rapid loss of soft tissue and jaw bone. As the disease progresses, the person may also develop gingivitis with ulcers that leave crater-like crevices after healing.
• Herpes simplex virus. HSV can also cause sores in and around the mouth. Typically, HSV-1 causes ulcers in the mouth and HSV-2 causes genital herpes. However, oral infection with HSV-2 and genital infection with HSV-1 can occur — this infection is usually spread during oral sex. The symptoms of both types are identical.

Kaposi’s sarcoma and shingles can also cause ulcers in the mouth. Kaposi’s sarcoma oral lesions are very similar to the skin lesions. Shingles lesions in the oral tissue may merge into large ulcers instead of crusting over as they do on the skin. Shingles oral ulcers often get into the gum tissue, causing tooth pain.

HIV: Neurological Effects

Although HIV does not appear to infect nerve cells, it does somehow affect their ability to function normally. People with HIV can experience:

• AIDS-related dementia
• A decrease in the ability to think properly and process information
• Brain tumors that either begin in the brain or spread to the brain from elsewhere in the body
• Progressive multifocal leukoencephalopathy (PML), which is caused by a virus most people are already infected with, but does not cause disease in people with healthy immune systems. Symptoms include difficulty walking and talking, weakness in the limbs, and seizures.

Other neurological complications such as headaches, fever, nausea, and dizziness may occur as a result of HIV treatments.

HIV: Weight Effects and Wasting Syndrome

A big concern for people who have HIV that has progressed to AIDS is AIDS wasting syndrome, which is defined as any unintentional weight loss of 10 percent or more of your body weight. HIV patients may lose muscle as well as fat, and once lost, the weight is difficult to regain. The person may also have diarrhea and a slight fever. These symptoms are usually accompanied by a complete loss of appetite. AIDS wasting syndrome is extremely dangerous for HIV-infected people but it can largely be prevented by eating a healthy, nutrient-rich diet (including such foods as peanut butter, eggs, cheeses, and legumes) and regular exercise to maintain muscle mass.

While HIV infection can lead to a variety of very serious complications, advances in treatments have significantly improved the outlook for people with HIV infection. In fact, a study found that only about 10 percent of people with HIV die of one of the conditions that defines AIDS. Since HIV-infected individuals are now living longer, they are more likely to die from other causes.