Acquired immune deficiency syndrome (AIDS) is a potentially life-threatening syndrome resulting from the progression of HIV infection, characterized by advanced deterioration of the cellular immune system leading to secondary infections or malignancies. AIDS typically develops 8-10 years following primary infection with HIV acquired through sexual contact, vertical transmission, needle sharing, or blood transfusion. Nonspecific clinical findings include fever, generalized lymphadenopathy, weight loss, anorexia, and chronic diarrhea. Patients may be anemic.

Opportunistic infections and malignancies that develop in patients with AIDS include respiratory infections with Pneumocystis jirovecii, tuberculosis, or other bacteria; neoplasms such as Kaposi sarcoma and non-Hodgkin lymphoma; disseminated or localized fungal infections such as cryptococcosis and candidiasis; disseminated or localized parasitic infections such as toxoplasmosis, strongyloidiasis, and cryptosporidiosis; and other viral infections such as cytomegalovirus and herpes simplex.

Treatment includes continuation of antiretroviral therapy (available in several one-pill, once-daily regimens and a monthly 2-injection combination therapy with cabotegravir and rilpivirine [Cabenuva]) and infection control measures including vaccination, avoidance of high-risk behaviors, good hygiene, and avoidance of other sources of opportunistic infection including reptiles, cat feces, and birds, travel to developing nations, and consuming contaminated food or water. Needle exchange programs may be useful.

Related topics: HIV/AIDS-related pruritus, HIV-associated lung disease, HIV primary infection, papular pruritic eruption of HIV