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Frequently Asked Questions About HIV/AIDS (Part Two)

January 2010

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What Are the Symptoms of AIDS?

I am making the following recommendations to persons concerned about symptoms that they may be having.

  1. Carefully read all the information found on The Body's Safe Sex and Prevention Forum. It should answer the vast majority of questions regarding symptoms.

  2. If you are having flu-like symptoms or a rash, I cannot tell you whether these may be due to acute viral syndrome (AVS) or not. Only HIV testing at three months after your possible exposure can determine whether a person has HIV.

  3. If you are having any symptoms that are not going away after one to two weeks, or if your symptoms are very severe, see your physician, regardless of what you think the cause of your symptoms may be.

  4. If you have been exposed to HIV, consider getting tested three months after a possible exposure to the virus. This is true whether you are having symptoms or not. This is the only way to know whether you have been infected with HIV.

  5. Remember that I cannot tell you whether your symptoms may be due to HIV or not. Because every symptom associated with HIV/AIDS looks like the symptoms of other illnesses, I cannot tell you if your personal symptoms may be related to HIV/AIDS. Again, only HIV testing can determine that.

I have seen a lot of people convincing themselves that they may have AIDS, based on their symptoms. Many people have tried to "match their symptoms" to that of acute viral syndrome and AIDS. Please do not do this! It's very easy to convince yourself you have HIV/AIDS based on symptoms, when in fact you may not even be infected.

I have personally seen many cases where a person convinced themselves that they had HIV (based on their symptoms), went through major stress and anxiety (for months or even years), and then turned up HIV negative six months or more after the exposure that they were concerned about. I'm trying to keep other people from going through the same unnecessary mental torment.

The only thing that symptoms tell you is -- if they do not go away, or if they get very severe -- that you need to see a doctor. That's all they tell you. Please do not diagnose yourself based on symptoms!

You will also note that nobody, not you, me, or anybody on the Internet or at any HIV/AIDS hotline, can tell you if your symptoms may be HIV-related, without having laboratory tests done. [Click here to see a list of hotlines.]

That said, let me review with you the symptoms of HIV/AIDS in detail.

The following information compares the symptoms of both recent HIV infection, and the symptoms due to AIDS. You will note that the symptoms of HIV/AIDS itself tend to be chronic, long-term and can occur over and over. This differs from the symptoms of recent HIV/AIDS infection, which are acute, only last for a week or two, and do not occur over and over.

When we're talking about AIDS symptoms, it's important to remember that there are actually two periods of time when one may show symptoms.

Within the first four to six weeks after infection, some people with HIV (up to 70%) show symptoms due to what's called acute HIV syndrome or acute viral syndrome (AVS). This occurs during your bodies initial response against the virus. During this time, a person may show symptoms that look exactly like the flu (headaches, body aches, fevers, fatigue, etc.). These symptoms do not appear as cold symptoms (coughing, sneezing, congestion, runny nose, etc.).

A rash is sometimes seen, primarily in the upper portion of the body. The rash may or may not itch, and can be raised. There is no such thing as an "HIV/AIDS rash," and if a rash is seen at all, it resembles rashes seen from many other skin conditions. All of the symptoms last for a week or two, then go away by themselves. They do not persist for many weeks or months.

In some people with acute HIV infection, the symptoms can be very severe. In other people with HIV, these symptoms may be very mild. In still other people with HIV, they may not show these symptoms at all. A person may, or may not, show positive on an HIV test during this period of time. I must strongly emphasize here that all of the symptoms of acute HIV infection look exactly like the symptoms of other illnesses, so having flu symptoms or a rash does not indicate HIV infection, in of itself. It is also important to remember that not all people will get acute viral syndrome, and in those that do get it, the severity can vary significantly from person to person. Because acute infection looks exactly like the symptoms of many other illnesses, nobody can tell you whether or not your symptoms are due to this syndrome. Only HIV testing can determine if a person has HIV or not.

I have had a lot of people come to me concerned about acute infection, and exactly when it occurs. Can it happen in the first hour after an exposure? The first day? The first week? The first month? The first year?

Because the symptoms of acute infection are so non-specific, it's difficult for anybody to determine the exact time that this syndrome occurs. The fact is, nobody can give you an exact time, since it can vary from person to person.

Also remember that during this time, a person may or may not test positive. This makes it even more difficult to determine if symptoms are related to acute HIV infection or not. All anybody can say is that the symptoms occur within the first month or so (that is, within the first four to six weeks) after infection. The symptoms usually last for a week or two, although this, too, can vary from person to person. They do not however last for many weeks or months. And these symptoms do not occur in all people; the estimate is about 70% of people get this syndrome. That's all anybody can say.

How soon you get any symptoms after an exposure is unimportant and irrelevant. What is important is that if you've been exposed to the virus, that you get tested, regardless of whether you have symptoms or not. And if your symptoms are persistent or very severe, it's important that you see a physician, regardless of what you think the cause may be.

In regard to the symptoms related to advanced HIV or AIDS, they don't usually begin until literally years after infection. Before that time, a person can look and feel totally healthy with no symptoms at all. As for the specific symptoms of AIDS, there are none. This is because AIDS is actually a group of diseases, and therefore you're dealing with literally dozens of different symptoms. Not everyone with AIDS has every disease and therefore not everyone has every symptom.

Every symptom of AIDS looks like the symptoms of other illnesses. There are no symptoms that are unique to AIDS. Symptoms can include severe weight loss, fevers, drenching night sweats, fatigue, purple-colored blotches on the skin, severe headaches, severe diarrhea -- the list goes on and on.

Generally the symptoms tend to last for many weeks or months at a time, and do not go away by themselves (not without treatment). They can also recur over and over. Notice how this differs from the symptoms of acute HIV infection, which only lasts for a week or two, and does not recur over and over. AIDS symptoms are ongoing and can be very severe. AIDS-related symptoms do not begin until an average of 10 years after infection. You can have HIV and even full-blown AIDS and have no symptoms at all!

Generally speaking, if you have any symptoms that last for more than one to two weeks and do not go away, or if you have any symptoms that are very severe, always seek medical attention, regardless of what you think the problem is. You can't assume any symptom is HIV/AIDS related until you get laboratory tests. Remember, every symptom related to HIV/AIDS looks like the symptoms of other illnesses. Therefore symptoms alone cannot determine whether a person has HIV or not. Nobody can tell you whether or not your symptoms are due to HIV/AIDS, without getting tested. That's why laboratory testing is so important.

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This article was provided by Rick Sowadsky, M.S.P.H..
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