Effects of HIV on The Body

Human immunodeficiency virus, HIV, destroys CD4+ cells, which are critical to your immune system.

HIV targets the type of cells that would normally fight off an invader like HIV. As the virus replicates, it damages or destroys the infected CD4+ cell and produces more virus to infect more CD4+ cells.

“Acquired immunodeficiency syndrome (AIDS) is the final stage of HIV. At this stage, the immune system is severely weakened, and the risk of contracting opportunistic infections is much greater. However, not everyone with HIV will go on to develop AIDS.” (Healthline.com)

Threats to The Immune System

Acute symptoms can include:

• fever
• chills
• night sweats
• diarrhea
• headache
• muscle aches
• joint pain
• sore throat
• rash
• swollen lymph glands
• mouth or genital ulcers

The next stage is called the clinical latent infection state. On average, it lasts 8 to 10 years. In some cases, it lasts much longer than that. You may or may not show signs or have symptoms during this stage.As the virus advances, your CD4+ count decreases more drastically. This can lead to symptoms such as:

• fatigue
• shortness of breath
• cough
• fever
• swollen lymph nodes
• weight loss
• diarrhea

Prior’s Illness in Angels in America

“Lesion number one. Lookit. The wine-dark kiss of the angel of death” (Act 1 Scene 4).

The first sign of Prior’s illness is the presence of purple lesions, a sign of his having contracted kaposi sarcoma due to his weakened immune system.

Kaposi sarcoma: another possible infection, is a cancer of the blood vessel walls. It’s rare among the general population, but common in people who are HIV-positive. Symptoms include red or dark purple lesions on the mouth and skin. It can also cause problems in the lungs, digestive tract, and other internal organs.

“There’s protein in my urine, the doctor says, but who knows what the fuck that portends” (Act 1 Scene 8).

Protein in Urine (Proteinuria):

People with proteinuria have urine containing an abnormal amount of protein. The condition is often a sign of kidney disease. Healthy kidneys do not allow a significant amount of protein to pass through their filters. But filters damaged by kidney disease may let proteins such as albumin leak from the blood into the urine. (WebMD)

AIDS Wasting Syndrome (Untechnical terminology)

Before the creation of clear distinctions between HIV and AIDS, those with AIDS were thought to be “wasting away” and diagnosed with AIDS once they had lost at least 10% of their body weight and muscle. Other indicators: diarrhea for at least a month, extreme weakness, and fever.

The Line Between HIV and AIDS

AIDS diagnosis is more complicated AIDS is the final stage of the HIV infection. There are a few factors that determine when a person’s diagnosis has crossed from HIV latency to AIDS. Because HIV destroys immune cells called CD4 cells, one part of the AIDS diagnosis contains a count of those cells. A person without HIV can have anywhere from 500 to 1,200 CD4 cells. When the cells have dropped to 200, a person with HIV is considered to have AIDS. (Healthline)

“DON’T TOUCH MY LEG!” (Act 2 Scene 1).

Prior’s ongoing discomfort in his leg is either a symptom of HIV itself, a symptom of other illnesses or infections, or a side effect of HIV drugs. The most likely cause of leg pain is Peripheral Neuropathy, a direct symptom of HIV itself. Peripheral Neuropathy is defined as “pain due to nerve damage, mostly in the feet and hands. It may be described as numbness, tingling, or burning.” This nerve damage can be caused by HIV itself, HIV drugs, or other medical conditions such as diabetes. The older HIV drugs that caused the most peripheral neuropathy are not commonly used today. (Thewellproject.org)

Joe’s Illness

LOUIS: “Yeah, well, the shape, I can’t help myself, plus I’m trying to commit suicide, what’s your excuse?

JOE: I don’t have an excuse. I just have Pepto-Bismol. (takes a bottle of Pepto-Bismol and chugs it. Louis shudders audibly.) (Act 2 Scene 7)

JOE: “Oh. Wait, I. … Oh!” (He covers his mouth with his hand, gags, and removes his hand, red with blood) “I’m bleeding.” (Act 2 Scene 9)

JOE: “My wife is missing, Roy. My mother’s coming from Salt Lake to … to help look, I guess. I’m supposed to be at the airport now, picking her up but. . .. I just spent two days in a hospital, Roy, with a bleeding ulcer, I was spitting up blood.

ROY: Blood, huh? Look, I’m very busy here and …” (Act 3 Scene 5)

There is no clear explanation for Joe’s ulcers throughout the play. They seem to be peptic ulcers caused by untreated stress. “The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night. Nearly three-quarters of people with peptic ulcers don’t have symptoms. Less often, ulcers may cause severe signs or symptoms such as: Vomiting or vomiting blood — which may appear red or black, dark blood in stools, or stools that are black, trouble breathing, feeling faint, nausea or vomiting, unexplained weight loss, and appetite changes.” (Mayo clinic)

The consumption of bland foods such as bread and hot dogs points to Joe’s attempt to stop his burning stomach pain due to stress-related stomach problems. Pepto-Bismol seems to be all that Joe “has.” It is a constant aid to his ailment, albeit temporary and not directly addressing the bigger issue of his stomach ulcers/his stress surrounding his sexual orientation. His chugging action indicates that it is a regime that he is used to and has put himself through before. As Joe realizes that he is bleeding in Act 2 Scene 9, it is the visual imagery of blood that awakens him to the severity of his mental unease which is physically manifesting itself upon his body. There are resonances between the bodily imagery of Joe’s ulcers and the “AIDS wasting syndrome” that Prior experiences. While Joe does not have HIV/AIDS, he seems to carry the pain of having to come out during the AIDS epidemic, mirroring the despair and bodily decay that surrounds him in the 1980s.