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Asymptomatic stage

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Begins when the symptoms of primary infection subsides. During the asymptomatic stage of HIV infection the patient is well for some or many years.

  • laboratory test values may sometimes show anaemia, neutropaenia, lymphopaenia and thrombocytopaenia
  • CD4 count remains over 500 cells/mm3 (1)

The virus is not latent, rather it is replicating rapidly and infecting large numbers of CD4-positive macrophages and lymphocytes. Viral load is low because the intact immune system is continually clearing infected cells.

In untreated individuals the CD4 count reduces at a rate of 40-80 cells/mm3 per year but the time taken for progression from primary infection to symptomatic disease may vary widely (1).

Persistent generalized lymphadenopathy:

  • is common
  • is mild and often the patient is unaware
  • affects cervical, axillary and inguinal nodes symetrically

Some conditions are more common during the asymptomatic stage of HIV infection:

  • recurrent herpes zoster (shingles)
  • seborrhoeic dermatitis
  • pruritic folliculitis
  • increasing severity of pre-existing psoriasis
  • more severe hypersensitivity reactions
  • thrombocytopenia

Reference:

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