How does HIV show up in older men?

Question

Hello doctor,

My 65-year-old father has been losing weight rapidly, feeling fatigued, and having recurring fevers. Could this be a sign of HIV in older adults? He is not sexually active now, but could a blood transfusion from years ago have caused this? What tests should we request, and how is treatment different for someone of his age? Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Unexplained rapid weight loss, fatigue, and recurring fevers in older adults can be concerning and may suggest an underlying illness, including HIV (human immunodeficiency virus). Notice if he is coughing up a lot of blood in sputum, vomit, urine, or stool, then these may indicate cancer of the lungs or GI (gastrointestinal) tract, or kidney stones. All the above-mentioned symptoms are also present in these conditions. To confirm HIV, you can do the following tests:

1. Fourth-generation HIV antigen/antibody test.

2. If the first test is positive, then do a CD4 count and viral load.

3. CBC (complete blood count) if HIV is negative, but the patient's WBC (white blood cells) is high, it will suggest other infections, and if HIV is positive with high WBC, it can be due to HIV itself or a secondary infection.

4. Chest X-ray and sputum test (in case of persistent cough, blood in sputum, and HIV-positive result, tuberculosis is the most common secondary infection seen in HIV-positive patients).

5. Blood culture (for other infections).

6. LFT (liver function test) and KFT (kidney function test).

7. Endoscopy or colonoscopy (if blood in vomit or stool is shown).

I hope this helps.

Thank you and take care.