Nonsense. There are ample data showing that HIV infection can cause
wasting and neurological problems.

Nonsense again. HIV infection usually does this in the setting where
people are not using ARV.

        George M. Carter

**
Abrams DI. Clinical manifestations of HIV infection, including
persistent generalized lymphadenopathy and AIDS-related complex. J Am
Acad Dermatol. 1990 Jun;22(6 Pt 2):1217-22.

Department of Medicine, University of California, San Francisco.

   The ability to recognize disease related to the human
immunodeficiency virus (HIV) and subsequent acquired immunodeficiency
syndrome (AIDS) has improved in recent years with refinement of
laboratory techniques. Because of this progress, several clinical
conditions can now be identified as "pre-AIDS" syndromes. These
include the persistent generalized lymphadenopathy syndrome, immune
thrombocytopenic purpura, the wasting syndrome, and certain
predominantly neurologic presentations. All are characterized by the
presence of infection with HIV, symptomatic disease, and, over time,
an increasing tendency to progress to "full-blown" AIDS.

**
Charurat M, Blattner W, Hershow R, Buck A, Zorrilla CD, Watts DH, Paul
M, Landesman S, Adeniyi-Jones S, Tuomala R; Women And Infants
Transmission Study. Changing trends in clinical AIDS presentations and
survival among HIV-1-infected women. J Womens Health (Larchmt). 2004
Jul-Aug;13(6):719-30.

Division of Epidemiology and Prevention, Institute of Human Virology,
University of Maryland, Baltimore, MD, USA. charurat@umbi.umd.edu

   OBJECTIVES: To profile trends of clinical AIDS-defining illness
(ADI) among a cohort of human immunodeficiency virus (HIV)-infected
women over a 12-year period. METHODS: In a prospective evaluation of
AIDS clinical presentation in the Women and Infants Transmission Study
(WITS), 2255 subjects were enrolled and followed between December 1989
and June 2002 (total, 4993 person-years). Data on clinical AIDS
presentation of 140 (6.2%) HIV-seropositive subjects were evaluated
across three calendar periods corresponding to the use of different
therapy regimens. Incidence rates (per 1000 woman-years) for AIDS and
specific ADIs were compared between periods using Poisson regression
methods. RESULTS: Incidence rates of AIDS, Mycobacterium tuberculosis,
recurrent bacterial pneumonia, herpes simplex disease,
esophageal/bronchial candidiasis, wasting syndrome, and neurological
diseases have showed significant downward trends. Among women with
ADI, the frequency of either esophageal or bronchial candidiasis as
initial ADI showed an increasing trend (p(trend) = 0.03), whereas a
decrease in proportion of cases with nontuberculosis mycobacterial
infection (P(trend) = 0.05) was observed over the same periods. In the
multivariate analysis, both the CD4+ lymphocyte count and HIV-1 RNA at
the time of diagnosis were independently associated with survival
after AIDS. Highly active antiretroviral therapy (HAART) was
associated with a 70% reduction in progression to death following
AIDS. CONCLUSIONS: Temporal changes in the incidence and clinical
presentations in HIV-positive women in our cohort reflect an increased
use of HAART that may have a differential effect on reduction in the
risk of ADIs. These illnesses, although considerably less frequent in
recent years, are still important contributors to morbidity in
HIV-positive women.

**
An older review:
Lloyd A. HIV infection and AIDS. P N G Med J. 1996 Sep;39(3):174-80.

Prince Henry Hospital, Sydney, Australia.

Many of the clinical features of HIV/AIDS can be ascribed to the
profound immune deficiency which develops in infected patients. The
destruction of the immune system by the virus results in opportunistic
infection, as well as an increased risk of autoimmune disease and
malignancy. In addition, disease manifestations related to the virus
itself may occur. For example, during the primary illness which occurs
within weeks after first exposure to HIV, clinical symptoms occur in
at least 50% of cases, typically as a mononucleosis syndrome.
HIV-related complications are rarely encountered in patients with
preserved immunity (i.e. CD4 T-cell counts greater than 500
cells/mm3). Recurrent mucocutaneous herpes simplex (HSV), herpes
zoster (VZV), oral candidiasis and oral hairy leukoplakia occur with
increasing frequency as the CD4 count drops below this level. Immune
thrombocytopenia (ITP) occurs in association with HIV and often
presents early in the clinical course. The risk of developing
opportunistic infections and malignancies typical of AIDS increases
progressively as CD4 counts fall below 200 cells/mm3. The clinical
manifestations of infections associated with AIDS tend to fall into
well-recognized patterns of presentation, including pneumonia,
dysphagia/odynophagia, diarrhoea, neurological symptoms, fever,
wasting, anaemia and visual loss. The commonest pathogens include
Candida albicans, Pneumocystis carinii, Mycobacterium tuberculosis,
Toxoplasma gondii, Cryptococcus neoformans, Mycobacterium avium
intracellulare and cytomegalovirus. Malignant disease in patients with
HIV infection also occurs in a characteristic pattern. Only two
tumours are prevalent: Kaposi's sarcoma, a multifocal tumour of
vascular endothelium which typically involves skin and mucosal
surfaces; and non-Hodgkin's lymphoma, which is typically high grade in
phenotype, often arising within the central nervous system. The
principles of therapy include reduction of HIV replication by
antiretroviral agents, prophylaxis against the common opportunistic
infections and treatment followed by subsequent lifelong maintenance
therapy for infections when they do occur.

   PIP: This article presents basic information on the clinical
features of HIV infection, most of which are related to the profound
immune deficiency associated with HIV/AIDS. Primary HIV infection is
associated with clinical symptoms, primarily a mononucleosis syndrome,
in about 50% of cases. In the ensuing 10 years, more than 50% of
HIV-infected individuals develop the opportunistic infections (OIs)
indicative of the onset of AIDS. Common presentations of AIDS include
pneumonia, dysphagia, diarrhea, neurologic symptoms, fever, wasting,
anemia, and vision loss. Monitoring of peripheral blood CD4
T-lymphocytes provides a measure of the current risk of OIs and a
guide for antiretroviral therapy. Protease inhibitors, used in
combination with other antiretrovirals, allow long-term control of HIV
disease, but the substantial cost of these drugs has prohibited their
widespread use in developing countries. Treatment of HIV-related
infections must be followed by a maintenance regimen intended to
prevent relapse.

He does that, because is both a layman and stupid. :)

Alex