Signs and Symptoms of Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus (HIV) can move through stages: acute HIV (stage 1), clinical latency (stage 2), and AIDS (stage 3). The symptoms of each stage can look different. Those in an early stage of HIV can have flu-like symptoms, while those in an advanced stage can have severe infections.   

HIV affects the immune system's ability to fight infections. You can get HIV or pass HIV to someone through blood, semen and pre-seminal fluid, rectal fluid, vaginal fluid, and breast milk that contains the virus. The virus is transmitted from person to person when these body fluids come into contact with your body's tissue, blood, or broken skin (e.g., open wounds).

The method of transmission of HIV can vary. You may get or pass HIV through:

• Perinatal transmission from birth parent to child (i.e., through pregnancy, childbirth, or breastfeeding)
• Sharing needles, syringes, and other drug injection equipment
• Unprotected vaginal or anal sex

Stage 1: Acute HIV Symptoms  

Acute (sudden) HIV starts two to four weeks after you get the virus. Acute HIV is also known as primary HIV. The virus multiplies very quickly in the immune system during this stage. Two-thirds of people in this stage experience flu-like symptoms, while some people don't have symptoms at all.

Symptoms in the acute stage can last a few days to several weeks and may include:

• Chills
• Fatigue
• Fever
• Mouth ulcers
• Muscle aches
• Night sweats
• Rash
• Sore throat
• Swollen lymph nodes

Symptoms can last a few days to several weeks. Acute-stage HIV symptoms can mimic other conditions, like the flu or common cold. It's important to not assume that you have HIV. You may consider getting tested for the virus if you think you may have been exposed to HIV.

Stage 2: Clinical Latency Symptoms 

The clinical latency stage, or chronic HIV, is the second stage of HIV. The virus continues to multiply but much more slowly than in the acute stage during this stage. You might not experience any symptoms as a result.

You can still transmit the virus to someone else even if you have no symptoms if you are not taking any treatment for HIV. People can stay in the clinical latency stage for an average of 10 years without treatment. Symptoms and disease progression vary from person to person. You can move through this stage more quickly or slowly than the average time.

You can decrease your viral load (the amount of HIV that you have that you can transmit to someone else) to an undetectable level if you are taking treatments. This stage can last for several decades while you're on treatment.

Stage 3: AIDS Symptoms 

HIV can continue to slowly multiply and weaken your immune system over time and without treatment. This can result in the third and final stage of HIV: acquired immunodeficiency syndrome (AIDS), also known as late-stage HIV.

AIDS symptoms include:

• Colored blotches or patches on or under the skin and inside the mouth, nose, and eyelids
• Depression
• Diarrhea that lasts for more than seven days
• Feeling extremely tired 
• Memory loss 
• Pneumonia
• Rapid weight loss (sometimes called wasting)
• Recurring fever
• Sores on the mouth, buttocks, and genitals
• Swollen lymph nodes in the armpits, neck, and groin that last a long time

You may receive an AIDS stage diagnosis if:

• The number of CD4 cells in your blood falls below 200 cells per cubic millimeter of blood (200 cells/mm³).
• You develop one or more opportunistic infections regardless of how many CD4 cells you have.

AIDS symptoms are often related to opportunistic infections (OIs) or an AIDS-defining illness. Certain illnesses occur more frequently and severely in people with AIDS. OIs occur when HIV has caused too much damage to the body's immune system and can no longer fight off infections.

Some OIs include: 

• Herpes simplex virus (HSV)
• Pneumonia
• Salmonella
• Thrush
• Toxoplasmosis
  
• Tuberculosis (TB)

Taking HIV medications as prescribed can slow disease progression and prevent AIDS. You can live with AIDS for about three years without treatment. Your life expectancy can shorten to one year if you develop an OI and are not taking treatment. 

When To Contact a Healthcare Provider

The only way to know if you have HIV is to get tested. Knowing your HIV status is a powerful way to help take care of yourself and your partners. 

Keep in mind: Don't rely only on symptoms as a way to tell if you are living with HIV. HIV symptoms can mimic other conditions. You might not have any symptoms at all. Reach out to a healthcare provider or local clinic to learn more about testing if you think you may have been exposed to HIV.

A Quick Review

HIV is a serious and chronic (long-lasting) condition that attacks and destroys CD4 cells in your immune system. HIV can progress through three stages: the acute stage, the clinical latency stage, and the AIDS stage. Your symptoms may change depending on your HIV's current stage. 

It's good practice to get tested if you think you may have been exposed to HIV. Testing is the only way you can confirm a diagnosis and rule out other conditions.