Asymptomatic HIV infection

Causes

Asymptomatic HIV infection is phase in which the immune system in someone with HIV slowly deteriorates, but the person has no symptoms. How long this phase lasts depends on how quickly the HIV virus copies itself, and how the person's genes affects the way the body handles the virus.

Some people can go 10 years or longer without symptoms. Others may have symptoms and worsening immune function within a few years after the original infection.

Symptoms

Asymptomatic HIV means a person does not have symptoms typically seen in people with HIV.

Symptoms of HIV include

• Fever
• Opportunistic infections, which are infections that occur because a weakened immune system can't fight them off. Serious ones include Pneumocystis jirovecii pneumonia, cytomegalovirus, and Mycobacterium avium.
• Oral thrush
• Weight loss

Exams and Tests

The health care provider will perform a physical exam and ask questions about your medical history and symptoms.

A diagnosis of HIV infection is based on results from blood tests, including the HIV antibody test (ELISA). A Western blot confirms the diagnosis.

Blood tests to check the level of a type of white blood cell called helper T lymphocytes (CD4 lymphocytes) are also done. The test result helps your doctor understand how well your immune system is working.

Treatment

When a person without symptoms of AIDs should receive therapy remains controversial. Those who do not have symptoms but who have CD4 lymphocyte counts of less than 350 should receive anti-viral treatment. This therapy helps the immune system better fight the virus and prevents other infections.

Most doctors also recommend antiretroviral therapy for some individuals with CD4 counts between 350-500, and perhaps for those with even higher CD4 counts (depending on the level of HIV in the person's blood). Other things besides blood test results must be considered. This includes the patient's overall health and how well he or she is able to adhere to a treatment plan.

Support Groups

See: AIDS - support group

Outlook (Prognosis)

There is no cure for HIV infection or AIDS. However, antiviral therapy can dramatically improve the length and quality of life of a person infected with HIV, and can delay the onset of AIDS.

Possible Complications

People with asymptomatic infection can progress to symptomatic HIV infection, develop opportunistic infections associated with HIV, and transmit HIV to other people. In addition, pregnant women with asymptomatic HIV infection can still transmit HIV to their fetus.

When to Contact a Medical Professional

Call your health care provider if you have HIV and you develop fevers, weight loss, swollen glands, night sweats, or any other persistent symptoms. You will need to be checked, and your doctor might consider giving you antiretroviral therapy.

Prevention

You can lower the risk of sexually transmitting the HIV infection by practicing safer sex behaviors, as well as avoiding contact with contaminated blood (not using injection drugs or not sharing needles or syringes).

Abstinence is the only absolutely sure way to prevent sexual transmission of the virus.

People who have had positive HIV antibody tests should not donate blood, plasma, body organs, or sperm. They should not exchange genital fluids during sexual activity.

People at risk for HIV infection should have regular testing to ensure early diagnosis of this infection, as many treatment options are available.

Alternative Names

HIV infection - asymptomatic

References

Blankson JN, Siliciano RF. Immunopathogenesis of human immunodeficiency infection. In: Goldman L, Schafer AI, eds.Cecil Medicine. 24th ed.Philadelphia,PA: Saunders Elsevier; 2011:chap 393.

Masur H, Healey L, Hadigan C. Treatment of human immunodeficiency virus infection and acquired immunodeficiency syndrome. In: Goldman L, Schafer AI, eds.Cecil Medicine. 24th ed.Philadelphia,PA: Saunders Elsevier; 2011:chap 396.

Update Date: 12/6/2011

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.