Infection with the Human Immunodeficiecy Virus (HIV) causes Acquired Immunodeficiency Syndrome, or AIDS. This disease progresses over many years, weakening and ultimately destroying a patient's immune system. As an AIDS patient's infection-fighting CD4 cell counts decline, infection with usual or opportunistic infections occur. To bolster their immune systems and counter infection, AIDS patients receive a cocktail of highly active antiretroviral agents and other antibacterial drugs for prophylaxis.
HIV Infection
According to the New England Journal of Medicine, as stated by James Kahn, M.D., 80 percent to 90 percent of HIV patients develop fever and rash when they first become infected with HIV, also called primary HIV infection. Fever occurs as a result of the virus multiplying rapidly and infecting immune cells. This phase usually lasts two to three weeks, then patients become asymptomatic for several years. Fever may accompany HIV infection at various stages of disease. When the CD4 cell count declines, patients develop low-grade fevers.
Infections
In AIDS patients, fever most often results from infection. AIDS patients become infected with usual organisms such as Streptococcus pneumoniae--which causes community-acquired pneumonia--or opportunistic pathogens, such as Cryptococcus neoformans that causes meningitis. All of these infections cause fever.
Fever of Unknown Origin
"Harrison's Principles of Internal Medicine" defines HIV-associated fever of unknown origin as a temperature greater than or equal to 38.3 degrees C or 101 degrees F on several occasions over a period of greater than four weeks for outpatients, or greater than three days for hospitalized patients with HIV infection. This term applies if all lab tests over three days don't reveal the source of the fever. Mycobacterial infection, tuberculosis, non-Hodgkin's lymphoma and drugs can cause fever of unknown origin.
Drugs
According to Uptodate.com, drug fever is defined as "a disorder characterized by fever coinciding with the administration of the drug and disappearing after the discontinuation of the drug, when no other cause for the fever is evident after a careful physical examination and laboratory investigation."
"J Acquired Immunodeficiency Syndrme" says patients with HIV infection also have an increased susceptibility to drug reactions of all types, including fever. AIDS patients take many drugs that potentially can cause fever.
According to emedicinemedscape.com, the most common drugs that cause fever include beta-lactam antibiotics, procainamide, isoniazid, alpha-methyldopa, quinidine and diphenylhydantoin.
References
- Harrison's Principles of Internal Medicine; Dennis Kasper, M.D.; 2005
- New England Journal of Medicine; Acute Human Immunodeficiency Virus Type 1; James Kahn, M.D., Jul 2, 1998; 339:33-9
- emedicinemedscape.com
- J Acquired Immunodeficiency Syndrme; Drug hypersensitivity reactions and human immunodeficiency virus disease; Bayard PJ; Dec.1992; 5(12):1237-57
- Uptodate.com: Drug Fever
