Source: Anderson PL, Kakuda TN, Fletcher CV. Human immunodeficiency virus infection. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146074012. Accessed April 10, 2017.
HIV infects cells expressing CD4 (T-helper cell) receptors, such as:
Unrelenting destruction of CD4 cells causes profound immunosuppression and AIDS.
RNA-dependent DNA polymerase (reverse transcriptase) transcribes RNA into DNA.
Double-stranded DNA migrates into nucleus and is integrated into host-cell chromosome.
HIV replicates in activated cells.
Three phases of viral replication and pathogenesis:
TABLE 1.Surveillance Case Definition for HIV Infection Stage Based on CD4+ T-lymphocyte Counts, United States, 2014 ||Download (.pdf) TABLE 1. Surveillance Case Definition for HIV Infection Stage Based on CD4+ T-lymphocyte Counts, United States, 2014
| ||Age on date of CD4+ T-lymphocyte test |
| ||<1 year ||1-5 years ||≥6 years |
|Stage ||Cells/μL (×106/L) ||% ||Cells/μL (×106/L) ||% ||Cells/μL (×106/L) ||% |
|1 ||≥1,500 ||≥34 ||≥1,000 ||≥30 ||≥500 ||≥26 |
|2 ||750–1,499 ||26–33 ||500–999 ||22–29 ||200–499 ||14–25 |
|3 (AIDS) ||<750 ||<26 ||<500 ||<22 ||<200 ||<14 |
|AIDS Indicator Conditions |
|Bacterial infections, multiple or recurrent (specific to children <6 years) |
|Candidiasis of bronchi, trachea, or lungs ||Lymphoma, Burkitt |
|Candidiasis, esophageal ||Lymphoma, immunoblastic |
|Cervical cancer, invasive (specific to adults, adolescents, children >6 years) ||Lymphoma, primary, or brain |
|Coccidioidomycosis, disseminated or extrapulmonary ||Mycobacterium avium complex or Mycobacterium kansasii, disseminated or extrapulmonary...|