Acute HIV infection is a condition that can develop as early as two to four weeks after someone contracts HIV. Acute HIV infection is also known as primary HIV infection or acute retroviral syndrome. It’s the initial stage of HIV, and it lasts until the body has created antibodies against the virus.
During this initial stage, the virus is multiplying at a rapid rate. Unlike other viruses, which the body’s immune system can normally fight off, HIV can’t be eliminated by the immune system. Over a long time, the virus attacks and destroys immune cells, leaving the immune system unable to fight off other diseases and infections. When this happens, it can lead to late stage HIV, known as AIDS or stage 3 HIV.
Acute HIV is contagious. However, most people with acute HIV infection don’t even know they’ve contracted the virus as the initial symptoms resolve on their own or may be mistaken for another illness such as the flu. Standard HIV antibody tests aren’t always able to detect this stage of HIV.
Acute HIV infection symptoms are similar to those of the flu and other viral illnesses, so people may not suspect that they have contracted HIV. In fact, the CDC estimates that of the more than 1.1 million people in the United States living with HIV, about 15 percent of them don’t know they have the virus. Getting tested is the only way to know.
Symptoms of acute HIV infection can include:
- sore throat
- night sweats
- loss of appetite
- ulcers that appear in the mouth, esophagus, or genitals
- swollen lymph nodes
- muscle aches
Not all symptoms may be present, and many people with acute HIV infection don’t have any symptoms. However, if a person does experience symptoms, they may last for a few days or up to four weeks, then disappear without treatment.
Acute HIV infection occurs most often two to four weeks after initial exposure to the virus. HIV is transmitted through:
- contaminated blood transfusions, usually before 1992
- sharing syringes or needles with someone living with HIV
- contact with blood, semen, vaginal fluids, or anal secretions containing HIV
- pregnancy or breastfeeding if the mother has HIV
HIV isn’t transmitted through casual physical contact, such as hugging, kissing, holding hands, or sharing food utensils. Saliva doesn’t transmit HIV.
HIV can affect people of any age, race, or sexual orientation. However, behavioral factors may put certain groups at a higher risk for HIV. These include:
- people who share needles and syringes
- men who have sex with men
A healthcare provider will perform a series of tests to check for HIV if the virus is suspected.
A standard HIV screening test won’t necessarily detect acute HIV infection. Many HIV screening tests look for antibodies to HIV rather than the virus itself. Antibodies are proteins that recognize and destroy harmful substances, such as viruses and bacteria. The presence of certain antibodies usually indicates a current infection. However, it can take several weeks after an initial transmission for antibodies to appear.
Some tests that may be able to detect signs of acute HIV infection include:
- p24 antigen blood test
- CD4 count and HIV RNA viral load test
- HIV antigen and antibody tests
Anyone who’s been exposed to HIV and may be experiencing acute HIV infection should get tested right away. A healthcare provider will use one of the tests capable of detecting acute HIV infection if they know of a possible recent exposure to HIV.
Proper treatment is crucial for people diagnosed with HIV. Healthcare providers and scientists agree that early treatment should be used for all people with HIV who are ready to start taking a daily medication. Early treatment with antiretroviral drugs may minimize the effects of the virus on the immune system.
However, antiretroviral medications can have serious side effects when used for long-term treatment. It’s important to discuss all treatment options and potential side effects with your healthcare provider to determine the right time to start and continue HIV treatment.
In addition to medical treatment, healthcare providers may suggest certain lifestyle adjustments, including:
- eating a healthy, balanced diet to help strengthen the immune system
- practicing sex with condoms to decrease the risk of transmitting the virus on to others and getting sexually transmitted infections (STIs)
- using clean needles
- reducing stress, which can also weaken the immune system
- avoiding exposure to people with infections and viruses, since those with HIV may have a harder time fighting off disease
- exercising on a regular basis
- staying active and maintaining hobbies
- reducing alcohol and recreational drugs
- stopping smoking
There’s no cure for HIV, but people living with HIV can still live a long and healthy life with treatment. The outlook is best for people who begin treatment before HIV has damaged their immune system.
Early diagnosis and the right treatment reduce the chance of stage 3 HIV. Successful treatment improves both the life expectancy and quality of life of someone living with HIV.
In most cases, HIV can be manageable over the long term and considered a chronic condition. Treatment also can help someone living with HIV reach an undetectable viral load, at which point they will be unable to transmit HIV to a sexual partner.
Acute HIV infection can be prevented by avoiding exposure to HIV from infected blood, semen, anal secretions and vaginal fluid. Ways to reduce the risk of contracting HIV include:
- Reduce exposure before, during, and after sex. A variety of prevention methods are available including condoms (male or female), pre-exposure prophylaxis (PrEP), treatment as prevention, and post-exposure prophylaxis (PEP).
- Avoid sharing needles. Never share or reuse needles when injecting drugs or getting a tattoo. Many cities have needle exchange programs that provide sterile needles.
- Take precautions handling blood. Use latex gloves and other barriers, if handling blood.
- Get tested for HIV and other STIs. Getting tested is the only way a person can know whether they have HIV or another STI. Those testing positive can then seek treatment that can eventually eliminate their risk of transmitting HIV to their sexual partners. Being tested for and receiving treatment for STIs reduces the risk of transmitting them to a sexual partner. The Centers for Disease Control and Prevention recommend yearly testing for people who use drugs or who are sexually active.
Getting an HIV diagnosis can feel emotionally devastating, so it’s important to find a strong support network to help deal with any resulting stress and anxiety. There are many organizations and individuals dedicated to supporting people living with HIV, as well as many local and online communities that can offer support. Speaking with a counselor or joining a support group allows people with HIV to discuss their concerns with others who can relate to what they’re going through. Hotlines for HIV groups by state can be found at ProjectInform.org.