A Timeline of HIV Symptoms

A Timeline of HIV Symptoms

What Is HIV?

The human immunodeficiency virus (HIV) is a serious infection that compromises the immune system. There is no cure for HIV. In the vast majority of cases, once chronic HIV infection has been established, the virus stays in the body for life. Despite the potential severity of the disease(s) it causes, HIV symptoms don’t suddenly appear and peak overnight. Unlike other types of viruses, it causes a progressive illness in which symptoms and severity vary from person to person. 

Early Symptoms in Primary HIV

The first noticeable stage of this viral syndrome is “primary HIV infection.” This stage is also called acute retroviral syndrome (ARS) or acute HIV infection. HIV at this stage is notorious for causing flu-like symptoms in infected individuals. It may be possible for someone in this stage to pass off their symptoms as being caused by a severe flu rather than HIV. Fever is the most common sign. Other symptoms include:

  • headaches
  • sore throat
  • excessive fatigue
  • chills
  • muscle pain
  • swollen glands

According to the Centers for Disease Control and Prevention (CDC), primary HIV infection symptoms may show up two to four weeks after initial exposure. Symptoms can continue for up to several weeks. However, some patients may only exhibit the signs for a few days. In a dangerous combination, patients with early HIV, though sometimes showing no symptoms, are very contagious. This is attributed to the fast, unrestrained viral replication in the early weeks of infection.

Lack of Symptoms in Early Stages

ARS is common once a person is infected with HIV. Still, this isn’t the case for everyone. Some infected patients carry HIV for years before knowing they have it. According to AIDS.gov, signs of HIV may not even appear for a decade or longer. This doesn’t mean that cases of HIV without symptoms are not as bad or not eventually fatal.

Symptoms in early HIV tend to appear if the rate of cell destruction is high. Not having symptoms can mean that not as many CD4 cells are killed early on in the disease as other infected individuals. Even though a person has no symptoms, they still have the virus. That’s why regular HIV testing is critical to prevent transmission.

Latency Causes a Break in Symptoms

After initial exposure and possible primary infection, HIV may transition into a stage called “clinically latent infection.” It’s also referred to as “asymptomatic HIV infection” due to a noticeable lack of symptoms. This lack of symptoms includes possible chronic symptoms.

According to the Mayo Clinic, latency in HIV can last from eight to 10 years. This doesn’t mean the HIV is gone, nor does it mean that you can’t pass the infection to others. Latency may progress to AIDS. Your risk for progression is higher if you aren’t receiving treatment, such as antiretroviral therapy. It’s important to take prescribed medications during all stages of HIV — even if you don’t exhibit any symptoms.

Chronic HIV

After acute infection, HIV is considered “chronic.” This means that the disease is ongoing. Symptoms of chronic HIV can vary. There can be long periods of chronic infection when the virus is present but symptoms are minimal. In more advanced stages of chronic infection, symptoms can be much more severe than in ARS. People with advanced, chronic HIV can experience episodes of:

  • coughing or breathing difficulties
  • weight loss
  • diarrhea
  • fatigue
  • high fever

AIDS Is the Final Stage

Controlling HIV with medications is crucial to both quality of life and to help prevent a rapid progression of the disease. Acquired immunodeficiency syndrome (AIDS) develops when HIV has significantly weakened the immune system. According to the CDC, this occurs when CD4 levels decrease below 200 cells per cubic milliliter of blood (mm3). A normal range is considered 500 to 1,600 cells/mm3. AIDS can be diagnosed with a blood test to measure CD4, but sometimes it’s also determined simply by your overall health, particularly the presence of certain infections that are rare in persons with a normal immune system. Symptoms of AIDS include:

  • persistent high fevers of over 100 degrees Fahrenheit
  • severe chills and night sweats
  • white spots in the mouth
  • genital or anal sores
  • severe fatigue
  • rashes that can be brown, red, purple, or pink in color
  • regular coughing and breathing problems
  • significant weight loss
  • persistent headaches
  • memory problems
  • pneumonia

AIDS is the final stage of HIV. Without treating HIV, the Mayo Clinic says that most patients develop AIDS within 10 years. At this point, your body is susceptible to a wide range of infections and cannot effectively fight them off. Medical intervention is necessary to treat infections or else death can occur. Without treatments, the CDC estimates the average survival rate to be three years once AIDS is diagnosed. Depending on the severity of infection, prognosis may be significantly shorter.

The key to surviving HIV and AIDS is to continue seeing your doctor for regular treatments. You should also schedule a visit as you experience new or worsening symptoms.

Read Video Transcript »

Dr.’s Whiteboard: Understanding HIV Treatments Treatments for HIV have come a long way since the virus was first discovered in 1983. While scientists are still working on a cure for HIV, there are several drug therapies that can help HIV patients live long and full lives. The most common and effective therapies used today are retroviral drugs, which work by specifically targeting the virus that’s infected a person’s cells. Current retroviral drugs cannot completely eliminate the HIV virus, but they can keep virus levels—called viral loads—to a manageable level and prevent HIV from progressing to AIDS. There are five classes of retroviral drugs, and each is designed to attack the living virus at different points in its lifespan. 1. Nucleoside/nucleotide reverse transcriptase inhibitors, or NRTIs 2. Non-nucleoside reverse transcriptase inhibitors, or NNRTIs 3. Protease inhibitors 4. Entry or fusion inhibitors 5. Integrase inhibitors Many of these drugs stop or interrupt the virus from replicating and creating new copies of itself. Other drugs stop HIV from spreading in the body by blocking the virus from docking on, and infecting, healthy cells. Because many of these drugs work against the HIV virus differently, they are often combined in a “cocktail” form to prevent the virus from developing resistance and rendering treatment ineffective. Early HIV patients were subject to a handful of pills throughout the day, but now these drugs can be lumped together in a once-daily pill. This type of treatment goes by many names, including combined antiretroviral therapy, cART, or highly active antiretroviral therapy, HAART. Taking only one pill a day makes adhering to treatment much easier for patients, and adherence is the most important thing a patient can to ensure their therapy is effective. While these drugs can help HIV from progressing, there are some side effects. The most common effects of retroviral drugs are nausea, vomiting, diarrhea, fatigue, weakness, and dizziness. Some patients may develop a rash as well. Your doctor may prescribe medicine or recommend certain lifestyle changes to help combat these effects. In rare cases, people undergoing HIV treatment may experience other side effects such as an imbalance of sugars and lipids in the blood, bone loss, or abnormal fat distribution in the belly, neck, arms, or face. Working closely with your doctor can help mitigate these potential side effects. There is no one-size-fits all treatment plan for HIV treatments, but talking to your doctor about you concerns such as side effects, resistance, and how to incorporate treatment into your daily life can help you find the best drug regimen to keep the HIV virus in check. For more, browse through the expensive information available here on Healthline or make an appointment with your doctor.

More Resources

HIV: Guide to Protease Inhibitors
Understanding HIV Treatments
The Best HIV/STD Health Blogs of the Year
More HIV Resources