HIV is a virus that compromises the immune system. There’s currently no cure for it, but there are treatments available to reduce its effects on people’s lives.
In the majority of cases, once HIV infection takes hold, the virus stays in the body for life. However, unlike what may occur with infections by other types of viruses, HIV symptoms don’t suddenly appear and peak overnight.
If left untreated, the disease progresses over time through three stages, each with its own set of possible symptoms and complications — some severe.
Regular antiretroviral treatment can reduce HIV to undetectable levels in the blood. At undetectable levels, the virus won’t progress to the later stages of HIV infection. In addition, the virus can’t be transmitted to a partner during sex.
The first noticeable stage is primary HIV infection. This stage is also called acute retroviral syndrome (ARS), or acute HIV infection. Because HIV infection at this stage usually causes flu-like symptoms, it’s possible for someone in this stage to think their symptoms are due to a severe flu rather than HIV. Fever is the most common symptom.
Other symptoms include:
According to the Centers for Disease Control and Prevention (CDC), primary HIV symptoms may show up two to four weeks after initial exposure. Symptoms can continue for up to several weeks. However, some people may exhibit the symptoms only for a few days.
People with early HIV sometimes don’t show any symptoms, yet they can still transmit the virus to others. This is attributed to the fast, unrestrained viral replication that occurs in the early weeks after contracting the virus.
ARS is common once a person has HIV. Still, this isn’t the case for everyone. Some people have HIV for years before they know they have it. According to HIV.gov, symptoms of HIV may not appear for a decade or longer. This doesn’t mean that cases of HIV without symptoms are less serious. Also, a person who doesn’t experience symptoms could still transmit HIV to others.
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, a type of white blood cell, are killed early on in the disease. Even though a person has no symptoms, they still have the virus. That’s why regular HIV testing is critical to prevent transmission. It’s also important to understand the difference between a CD4 count and a viral load.
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 infection can last for 10 years. This doesn’t mean that HIV is gone, nor does it mean that the virus can’t be transmitted to others. Clinically latent infection may progress to the third and final stage of HIV, also referred to as AIDS.
The risk for progression is higher if a person with HIV isn’t receiving treatment, such as antiretroviral therapy. It’s important to take prescribed medications during all stages of HIV — even if there aren’t any noticeable symptoms. There are several medications used for HIV treatment.
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 when the virus is present but symptoms are minimal.
In more advanced stages of chronic HIV, symptoms can be much more severe than they are in ARS. People with advanced, chronic HIV can experience episodes of:
Controlling HIV with medications is crucial to both maintaining quality of life and helping prevent progression of the disease. Stage 3 HIV, also known as AIDS, develops when HIV has significantly weakened the immune system.
According to the CDC National Prevention Information Network, CD4 levels give one indication that HIV has progressed to its final stage. CD4 levels decreasing below 200 cells per cubic millimeter (mm3) of blood is considered a sign of AIDS. A normal range is considered 500 to 1,600 cells/mm3.
AIDS can be diagnosed with a blood test to measure CD4. Sometimes it’s also determined simply by a person’s overall health. In particular, an infection that’s rare in people who don’t have HIV may indicate AIDS. Symptoms of AIDS include:
- persistent high fevers of over 100°F (37.8°C)
- 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
AIDS is the final stage of HIV. According to the Mayo Clinic, most people with HIV who don’t get treatment develop AIDS within 10 years.
At that point, the body is susceptible to a wide range of infections and can’t effectively fight them off. Medical intervention is necessary to treat AIDS-related illnesses or complications that can otherwise be fatal. Without treatments, the CDC estimates the average survival rate to be three years once AIDS is diagnosed. Depending on the severity of their condition, a person’s outlook may be significantly shorter.
The key to living with HIV is to continue seeing a healthcare provider for regular treatments. New or worsening symptoms are reasons enough to visit one as soon as possible. It’s also important to know how HIV affects the body.