In 2014, a UNAIDS report claimed that 35 million people across the world were living with HIV. Of them, 19 million did not know they had the virus. By the end of 2015, the number of affected had risen to 36.7 million.1 2
The fact that so many people were unaware of carrying the virus tells us two very important things:
1. HIV does not present unique symptoms that would help you identify it in the initial stages.
2. Many people spread the virus without knowing have it. So you are always at risk of contracting HIV infection through unsafe interactions.
What Is HIV Infection?
The human immunodeficiency virus (HIV) is transmitted chiefly through 4 body fluids. In an infected person, it destroys the CD4 cells of the immune system.
HIV, or human immunodeficiency virus, attacks the immune system in the human body. It specifically attacks the CD4 cells or T cells, which are a type of infection-fighting white blood cells.
An HIV infection occurs when your body becomes exposed to this virus, which is transmitted chiefly through 4 infected body fluids: semen, vaginal fluid, blood, and breast milk.3 The infection eventually develops into AIDS (acquired immunodeficiency syndrome).
Signs And Symptoms Of HIV Infection
There are no specific signs and symptoms of HIV infection in the early stages. Of the infected, 20% experience no initial symptoms.
HIV infection cannot be identified on the basis of symptoms alone. The flu-like symptoms that manifest in the early stage of infection are generic. Unless you are aware of your risk of contracting the infection, it will be dismissed as a flu.
Also, about 20% of the people infected with HIV do not experience any symptoms at all.4 Symptoms that indicate HIV infection with some certainty manifest years later when the disease has already progressed into AIDS. Even then, the symptoms are not specific to HIV. They can be caused by multiple other conditions.
Here are the signs and symptoms of HIV infection in its 4 stages.
Symptoms Of HIV Infection Stage 1
The first flu-like symptoms – fever, chills, and sore throat – appear about 42 days after infection. You have the highest chance of spreading the disease within these 42 days.
The first phase of the infection is also known as acute or primary HIV infection. There are many opinions on how long it takes for the signs and symptoms of HIV infection to manifest. That’s because people have different immune responses, in terms of when it begins, how severe it is, and how long it lasts.
NHS says it takes about 2 to 6 weeks for the first symptoms to manifest.5 CDC says it takes 2 to 4 weeks.6 One source further narrows it down to about 42 days.7 This is the window period. The antibody test would show you HIV negative even if you are infected.
You have the highest chance of transmitting the disease. There is a very high concentration of the virus in the body and not enough antibodies to fight it, yet. To be certain, take the test for the viral load too.8
Seroconversion Illness: The First Symptoms
Some scientists claim that if your seroconversion illness is severe and continues for a longer period of time, the disease will likely progress rapidly.9
When the body starts producing antibodies to fight the virus and remove it, flu-like symptoms manifest. This process is known as seroconversion. The symptoms can last from 14 days to even 10 weeks.
The symptoms of HIV stage 1 are:
- Headache, muscle pain
- Sore throat
- Rash on the abdomen, arms, legs, and face
- Swollen lymph nodes in the neck, armpit, and groin
- Night sweat
- Nausea, vomiting
- Enlarged liver or spleen
Skin rashes may be one sign that distinguishes an HIV infection from an influenza. An HIV rash in the first stage is in the form of little non-itchy red bumps that seem to merge.
Symptoms Of HIV Infection Stage 2
Swollen glands and a deficiency of platelets are the only symptoms in the second stage of HIV infection.
The second stage of HIV infection is also known as the chronic HIV infection stage. The only symptoms are swollen lymph nodes and a lack of platelets in the blood, a condition known as thrombocytopenia. The lymph nodes are part of your immune system. A swollen lymph node implies that your antibodies are still fighting the HIV in this location.
Because this stage may shows no symptoms in some individuals, it is also called the asymptomatic HIV stage. Scientists also refer to it as the clinical latency stage.
It seems as though the infection is dormant, but this is the incubation period of the virus, and the virus reproduces very slowly. It usually takes an average of 10 years for the infection to develop into AIDS.
There aren’t enough virus to overpower your immune system; so, you will still appear and function well.10 But if you take an HIV test now, it will show you as HIV positive.11 Even if you are undergoing HIV infection treatment at this stage, you can transmit the disease.12
Symptoms Of HIV Infection Stage 3
If you have HIV, and multiple bacterial, fungal, and viral infections attack, persist, and recur, you have reached the third stage.
As the HIV infection progresses, more and more CD4 cells are destroyed. As a result, your body is vulnerable to infections. These stay longer and keep coming back.
You may notice most symptoms on your skin and in the mouth. Don’t dismiss them as caused by other conditions. Take a test to confirm the presence of the virus and the status of the disease. The symptoms include:13
- Oral thrush: The tongue, hard and soft palates, and the mucous membrane in the cheek become coated with thick, white, curd-like patches. When these are removed with a tongue blade, red and slightly bleeding spots can be seen. This fungal infection indicates that the body’s immune system is weak.
Gum diseases and herpes are symptoms of advanced HIV infection. Left untreated, it can develop into AIDS in less than 2 years.
- Hairy leukoplakia: The tongue and some other parts of the mouth have hairy, corrugated white patches that cannot be removed with a tongue blade. This is caused by the Epstein-Barr virus and indicates a weak immune system.
- Gum diseases: Rapidly progressing diseases of the gum tissue (periodontal diseases) caused by bacteria are good reasons for the dentist to suggest an HIV test.
- Herpes simplex infection: Herpes is common among HIV-infected people. Red and painful sores appear in the mouth and on the genital and the anal area. This is caused by the herpes simplex virus. The skin and the mucous membranes are also affected.
Symptoms Of HIV Infection Stage 4 Or AIDS
The CD4 cell count drops to 200 from the normal range of 500–1,500 cells/mm3 of blood.
If you leave your HIV infection untreated, even after the symptomatic stage or the third stage, the infection is most likely to develop into AIDS in less than 2 years.14
The normal count of CD4 cells in a healthy adult is between 500 and 1,500 cells/mm3 of blood. In the terminal stage of HIV infection, the count drops to less than 200 cells/mm3.15
Your body now has no ability to fight infections. So various opportunistic illnesses like pneumonia, tuberculosis, and cancer take advantage of the weakened immune system.16 Other signs and symptoms include:17
- Enlarged glands and lymph nodes
- Weight loss and energy loss
- Fever, sweats
The AIDS patient rapidly loses weight and energy and has skin rashes and shingles. Female patients suffer from pelvic inflammatory disease.
- Herpes infections on mouth, genitals, or anus
- Short-term memory loss
- Incurable pelvic inflammatory disease in women
Test For HIV
Whenever a virus enters your body, your body releases antibodies to fight it and flush it out. So when the HIV enters the body, there is a rise in the number of antibodies. Traditionally, an HIV detection test involved counting only the antibodies. But it can take 3 to 12 weeks after the infection for the antibodies to reach the detectable levels. If you test before this window period, your test results will show negative even if you have the infection.
A combination of tests that count both the antibodies and the antigens (the part of the virus that triggers the release of antibodies) are more effective. The test for viral load, that is the number of virus present in the blood, can detect HIV 2 to 6 weeks after the infection.
Nucleic Acid Test
These tests look for the virus in the blood and can detect it within 7 to 28 days of infection. However, it’s very expensive and not recommended unless you have had a high-risk exposure.18
The HIV antibody test is available both as a blood test and a saliva test, but a blood test is more accurate.
HIV infection is not curable, but antiretroviral therapy (ART) or highly active antiretroviral therapy (HAART) can suppress the reproduction of the virus and reduce the viral load to bring down the risk of transmission. Without ART, an AIDS patient lives only about 3 years.19 And an opportunistic infection can cut it further down by 2 years.
But whether you should undergo ART at any given point of time depends on your risk profile because ART itself has several severe side effects.20
In case of emergencies, the infected person can be put on antiretroviral therapy within 72 hours of infection.
If you know that you’ve had a high-risk exposure in the past 3 days, we’d recommend you go for post-exposure prophylaxis (PEP). You need to be put on ART within 72 hours of infection.21 However, since ART has severe side effects, this form of prevention is best reserved for emergencies.
HIV And AIDS
An HIV infection is not AIDS in the initial stages. But it almost always ends up in AIDS without the right medical intervention at the right time. This is why it is so crucial to detect the infection at the earliest stage.
|↑1||UNAIDS Report Shows that 19 Milllion of the 35 Million People Living with HIV Today Do Not Know that They Have the Virus. UNAIDS|
|↑2||Global Statistics. AIDS.gov|
|↑3||How is HIV spread?. US Department of Veteran Affairs.|
|↑4, ↑5, ↑10||HIV and AIDS – Symptoms. NHS Choices.|
|↑6||Stages of HIV Infection. Centers For Disease Control And Prevention.|
|↑7, ↑14||The Progression of HIV Infection to AIDS. Stellenbosch University.|
|↑8||What is Acute HIV Infection?. Johns Hopkins Bloomberg School of Public Health.|
|↑9||O’Brien, Meagan, and Martin Markowitz. “Should we treat acute HIV infection?.” Current HIV/AIDS Reports 9, no. 2 (2012): 101-110.|
|↑11, ↑13||Miedzinski, Lil J. “Early Clinical Signs and Symptoms of HIV Infection: Delaying progression to AIDS.” Canadian Family Physician 38 (1992): 1401.|
|↑12||Symptoms Of HIV. AIDS.gov.|
|↑15||HIV/AIDS: CD4 count (or T-cell count). U.S. Department of Veteran Affairs|
|↑16, ↑19||About HIV/AIDS. Centers for Disease Control and Prevention.|
|↑17||HIV Signs And Symptoms. University of California San Francisco.|
|↑18||HIV Test Types. AIDS.gov.|
|↑20||Hare, C. Bradley. Clinical Overview of HIV Disease. HIV InSite, University of California San Francisco.|
|↑21||HIV/AIDS: PEP. Centers for Disease Control and Prevention|