HIV symptoms

Updated on:
August 7, 2021

HIV is a virus that damages the infected person’s immune system over time. If someone who is infected is not on treatment, the HIV virus will seek to hurt and kill CD4 cells (a type of T-cell), which are white blood cells that protect your body against infections, pathogens, and illnesses by providing instructions to other parts of the immune system.

Anyone can become infected with HIV, no matter their age, sex, gender, sexual orientation, or race.

The two main ways HIV is transmitted are through sex or the sharing of needles or other drug-injection equipment. It can only be transmitted through blood, semen, rectal fluid, vaginal fluid, and breast milk.

HIV involves three stages, with each having its own distinct set of potential symptoms:

  1. Acute HIV
  2. Clinical Latency / Chronic HIV
  3. AIDS

Before we explore the symptoms found within each stage, it’s important to remember a few things:

  • Getting tested is the only way to know for sure if you’re infected with HIV. Many symptoms can be mistaken for common illnesses like the cold or flu.
  • A significant portion of people don’t present symptoms during the early stages of the infection, even for years. Symptoms aren’t a reliable way to diagnose HIV infection.
  • The severity and frequency of the symptoms are different for each person. There is no one unique way to experience HIV and its subsequent symptoms.

Stage 1: Acute HIV

It’s estimated that somewhere between 10-60% (source) of people infected with HIV will be asymptomatic during this stage. This possibility of being asymptomatic is why a test is the only way to be sure instead of relying on the presence of symptoms.

Those who do develop symptoms usually experience them during the first 2-6 weeks after their initial exposure to HIV

These symptoms are difficult to prevent as a diagnosis and initiation of treatment has not yet occured. 

Symptoms for acute HIV

Swollen lymph nodes

These are sensitive, painful lumps that are commonly found around the:

  • Neck
  • Armpits
  • Groin

Lymph nodes are reservoirs of the cells of the immune system. Their swelling is a standard indicator that your body is fighting back an infection. In addition, this swelling process can lead to other symptoms like a sore throat, cough, or fever.

Flu-like symptoms (fever, chills, sore throat, body aches, headaches, coughing, and nausea)

This is the point that your body recognizes a new infection as the virus has had time to replicate (multiply). Just like any other infection, the immune system causes these symptoms as a result of its fight with the new infection. This is also when your body begins producing antibodies to recognize HIV. It is just after this period of fighting that an HIV test will first turn positive as there is enough virus and antibodies to the virus to detect its presence.

Skin rash

A typical example of a skin rash that can develop is called a maculopapular rash. These rashes typically look like a series of red bumps on top of a flat, red patch of skin.

Stage 2: Clinical latency / chronic HIV

This stage is often referred to as the asymptomatic stage. Many infected individuals do not present symptoms, ranging from a few short years to over 20 years.

Though this chronic stage advances in time, the symptoms experienced are more severe than those in the acute stage.

All of the symptoms in this stage can be prevented through treatment of HIV that currently is required life-long. 

Symptoms for clinical latency / chronic HIV

Sores

Between 32-46% (source) of those infected with HIV will experience mouth sores as a symptom. They usually appear as red sores in and around the mouth. There are a variety of sores that HIV individuals are more prone to experience:

  • Cold sores
  • Ulcers/canker sores
  • HPV warts
  • Thrush

Weight loss

This weight loss is sometimes called HIV wasting syndrome. It’s when there is unexpected weight loss of more than 10% in body weight. A 2016 study (source) indicates that between 14-38% of infected individuals experience it.

A variety of sources can cause this loss of mass:

  • Infections taking advantage of the weakened immune system (opportunistic infections)
  • Less food intake due to mouth sores and pain while chewing
  • Declining efficiency in nutrient absorption
  • Hormone and metabolic changes
  • Side effects from HIV medications
  • Fat transferring from one part of the body to the other (lipodystrophy)
  • Mental health

Diarrhea

Diarrhea is one of the most common symptoms for those infected with HIV.

Reasons that diarrhea occurs in HIV patients include:

  • Intestinal infections from bacteria which are unique to HIV
  • When bacteria that usually grow in other parts of the gut begin growing in the small intestine
  • Medications taken to treat HIV
  • HIV itself causing diarrhea rather than an external reason (HIV enteropathy)

Fatigue

Fatigue is a common issue for those infected with HIV.

Fatigue occurs because HIV-infected individuals expend a significant portion of energy as they constantly battle the virus.

You’re more likely to develop fatigue if you have a high viral load, which means a high level of HIV detectable in your blood. The higher the viral load, the faster your CD4 T-cell count will fall and the more exhausted you feel.

Without treatment, this stage of HIV can last for many years before a diagnosis of AIDS is made. Though the time it can take for this period to end varies by person, some individuals move through this stage quicker than others.

Stage 3: AIDS

Healthy adults usually have a CD4 T-cell count of 350-1600 per cubic millimeter. If a person’s T-cell level falls below 200 per cubic millimeter, they will be diagnosed with AIDS.

An AIDS diagnosis can also occur if someone has HIV and develops an opportunistic infection or cancer rare for individuals who are not infected with HIV. An opportunistic infection is an illness that occurs more often and is more severe for people who have a weakened immune system. These are known as “AIDS-defining” conditions.

AIDS can be reversed, meaning the diagnosis is removed, with effective treatment of HIV and treatment of the opportunistic infection or illness. This is because AIDS is a syndrome and not the infection itself. 

Symptoms of untreated AIDS

  • Chills and night sweats
  • Genital or anal sores
  • Rashes (brown, red, purple, pink)
  • Random bruises or bleeding
  • Memory problems
  • Pneumonia
  • Death

If HIV is left untreated, it can progress to AIDS within even just a few years. If the lack of treatment continues, life expectancy is limited to just a few years.

But there is still hope at this stage. If you start on HIV medications and follow the advice of your doctor, it is possible for your health to improve.

Sources:

  • https://www.healthline.com/health/hiv-aids
Reviewed by:
Dr. Caley Shukalek

Caley is passionate about evidence-based, patient-centred care, including telemedicine that can provide high quality care from wherever a patient may choose.

He helped create Alberta's PrEP guidelines and works as a specialist in General Internal Medicine with additional training in sexual health, including HIV and sexually transmitted infections.

He holds an Masters of Public Health from Johns Hopkins University, an MD from the University of Calgary and an MSc from the University of Alberta.