HIV infection comes in three stages: acute infection, chronic infection, and AIDS.
Acute HIV infection is the earliest and shortest stage of HIV infection. Not everyone gets symptoms, but most people come down with a flu-like illness three to six weeks after infection. The symptoms are the same as flu or mononucleosis: fever and fatigue lasting for a week or two. There may or may not be other symptoms:
Many people with HIV do not know they are infected. In the United States, it is likely that 14% of HIV-positive individuals are unaware of their infection. HIV infection progresses in different stages.
A blotchy red rash, usually on the upper torso, that does not itch
Swollen lymph glands
You think you have come in contact with HIV. Doctors can now prevent HIV from taking hold in the body if they act quickly after initial infection. Health care workers, police, and firefighters who are exposed to HIV-infected blood often use a process that involves taking anti-HIV drugs to protect themselves. These drugs must be taken within 72 hours of initial exposure.
You may be tested for HIV using highly sensitive tests that detect both HIV antigen, a protein produced by the virus immediately after infection, and HIV antibodies. This test can confirm a diagnosis within days of infection. (Regular HIV tests don’t work this soon after infection; they can only detect antibodies.) You may be given anti-HIV drugs to take for a prescribed period of time. There may be unpleasant side effects to these drugs, but they may stop HIV from infecting you.
Most people don’t know they’ve been infected with HIV, but weeks later they may experience the symptoms of seroconversion. These symptoms mean the body is trying to fight HIV.
IMPORTANT: If you have been at risk of getting HIV and then come down with these flu-like symptoms, tell a doctor right away. Sensitive new tests can tell whether you have acute HIV infection. Treatment during the acute stage of HIV infection works much, much better than later treatment. Be sure to tell your doctor about your HIV risk. If you don’t, you may not get the right tests. Standard HIV tests - either home tests or lab tests - won’t detect acute HIV infection.
The body puts up a terrific struggle against HIV. At the end of this struggle, the body reaches a kind of standoff with the virus. This is chronic HIV infection, which begins three to six months after a person gets HIV. There aren’t any symptoms. For most people, this stage of HIV infection lasts about 10 years.
Even though there are no symptoms, the immune system slowly runs down. A normal person has a CD4 T-cell count of 450 to 1,200 cells per microliter. When people with HIV have their T-cell counts drop to 200 or lower, they have reached the stage of AIDS.
AIDS itself has no symptoms. Because the immune system is devastated, disease symptoms are specific to the kind of infections a person may have. When a person’s T cells get very low, doctors prescribe drugs to prevent infections.
Sometimes people don’t seek medical help until they have AIDS. They may have some of the following symptoms:
Within a month or two of HIV entering the body, 40% to 90% of people experience flulike symptoms known as acute retroviral syndrome (ARS).
But sometimes HIV symptoms don’t appear for years - sometimes even a decade - after infection.
“In the early stages of HIV infection, the most common symptoms are none,” says Michael Horberg, MD, director of HIV/AIDS for Kaiser Permanente, in Oakland, Calif. One in five people in the United States with HIV doesn’t know they have it, which is why it’s so important to get tested, especially if you have unprotected sex with more than one partner or use intravenous drugs.
Here are some signs that you may be HIV-positive.
- Being tired all the time
- Swollen lymph nodes in the neck or groin
- Fever lasting more than 10 days
- Night sweats
- Unexplained weight loss
- Purplish spots on the skin that don’t go away
- Shortness of breath
- Severe, long-lasting diarrhea
- Yeast infections in the mouth, throat, or vagina
- Easy bruising or unexplained bleeding
Call your doctor if you have any of these symptoms.
Source: Your Health Encyclopedia, 4-rd Edition, 2002