There's a big difference between the symptoms of HIV and the symptoms of advanced HIV, also known as AIDS.
During the first few weeks of having HIV, in the phase of recent HIV infection, the immune system tries to mount a defense. It's similar to the defense that occurs if the immune system detects influenza, mononucleosis or rubella. This immune response can cause some people to have symptoms that usually go away within a few weeks. But other people don't notice that anything is wrong.
This is usually followed by a long period in which there are no symptoms at all. Even if the person doesn't take antiretroviral treatment, they usually remain in fairly good health for several years.
But untreated HIV will, slowly and surely, damage the immune system (the body's natural defense system). This makes people vulnerable to a wide range of health problems.
The symptoms of advanced HIV disease (AIDS) are in fact the symptoms of other infections and diseases that the weakened immune system has been unable to keep under control. As such, the list of possible symptoms is highly varied. They are not symptoms of HIV itself.
You Can't Rely on Symptoms to Tell if You Have HIV
A key message of this article is that consulting web pages such as this and checking yourself for the symptoms mentioned is a completely unreliable way to tell whether you have HIV.
This is because:
- The symptoms of recent HIV infection are hard to tell apart from the symptoms of other viral infections.
- Many people with recent HIV infection don't notice any symptoms at all.
- After that, most people living with HIV suffer no health problems for several years.
- Although there are no symptoms, HIV may slowly and subtly damage a person's immune system.
- The symptoms of advanced HIV only occur after many years of infection, when the immune system is already significantly weakened.
The only way to know whether you have HIV is to take an HIV test. Testing is easy to do and available at a huge range of locations. Modern tests are extremely reliable, detecting most infections within four weeks after exposure.
If you are told that the test result is negative, you can be confident that this result was accurate three months ago. Occasionally, infections take up to three months to be picked up by a test. But if the last time you could have been exposed to HIV was more than three months ago, you can be sure that your negative result is accurate -- you do not have HIV.
What Are the Symptoms of Recent HIV Infection?
Remember, many people who have recently become HIV positive don't notice anything at all. It may be many months or years until they take an HIV test and get their diagnosis.
But when people do notice symptoms, they usually develop within one to four weeks after acquiring HIV and last for two to four weeks. These symptoms are associated with the immune system's natural defense against HIV. They are sometimes referred to as acute retroviral syndrome (ARS).
Typically, people experience three, four or more symptoms at the same time. These are the ones most commonly reported:
- Fever (high body temperature).
- Fatigue, tiredness or lethargy.
- A skin rash, typically on the trunk or face rather than the limbs.
- Muscle aches and pains.
Symptoms reported by fewer people (less than half of those noticing symptoms) include:
- Sore throat.
- Swollen lymph nodes in the neck or armpit. They can be unusually large and tender.
- Joint pain.
- Oral ulcers.
- Genital or anal ulcers.
- Weight loss.
- Night sweats.
Relatively few people with recent HIV infection experience some other symptoms. These include abdominal pain, thrush, vomiting, light sensitivity and genital ulcers.
What Else Could It Be?
You should not assume you have HIV just because you have some of these symptoms. In fact, the symptoms are almost impossible to tell apart from symptoms you might have with another type of viral infection, such as the flu.
For most people, one of these other infections is a much more likely explanation.
For example, the flu and mono affect millions of Americans every year. HIV infections occur much less frequently.
- The flu (influenza) is a viral infection that can cause fever, sore throat, swollen lymph glands, muscle aches, headache, chills and cough. Other viral infections of the upper respiratory tract, including the common cold, can also cause some of these symptoms.
- Mono (infectious mononucleosis, usually caused by Epstein-Barr virus) can cause fever, sore throat, swollen lymph glands, fatigue and rash. It's diagnosed with a blood test. There's no specific treatment, but you should get plenty of rest and the symptoms will go away in a few weeks.
- A strep throat (infection with Group A Streptococcus bacteria) can also cause sore throat, fever, swollen lymph glands, pain when swallowing, headache and nausea. Strep infections can be diagnosed by your physician using a throat swab and treated with antibiotics.
- Viral infections that cause gastroenteritis (inflammation of the intestines) are sometimes called "stomach flu." In adults, norovirus is the most common of these viral infections. They can cause diarrhea, vomiting, headache, fever, chills and abdominal pain. Most cases resolve over time without treatment.
- An allergic reaction to a new medicine can cause a skin rash, hives and some other problems.
- A recent infection with hepatitis B or C can cause fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain and joint pain. Blood tests are needed to diagnose viral hepatitis.
- Herpes simplex infection can cause cold sores, genital ulcers, fever, muscle aches and swollen lymph glands.
- Syphilis can cause a skin rash, sore throat, tiredness, headache, swollen lymph glands, fever and weight loss.
Other infections that can cause some of the same symptoms as acute HIV include measles, rubella, cytomegalovirus and toxoplasmosis.
If you are constantly worried about the possibility that you have HIV, it's possible that some feelings you have are symptoms of anxiety, rather than of HIV. Excessive anxiety -- an anxiety disorder -- can have symptoms including restlessness, fatigue, difficulty concentrating, a feeling of being on edge, muscle tension, irritability and problems sleeping. Support is available to help you overcome these feelings.
Get Yourself Checked
If you have some of the symptoms we've been discussing, you need to see a health care provider. Something is making you feel unwell, and you may need treatment. Medical professionals have the training and the diagnostic tools to identify the cause of the problem.
If you are concerned that HIV could be the cause, mention it to your provider. If you've recently had a sexual encounter that could have exposed you to HIV, then HIV should be among the possibilities that are considered. Similarly, if you've recently shared injecting equipment or could have been exposed to HIV in another way, you need to be candid about this.
Your provider may want to ask you in some detail about the incident you are concerned about. This is so he or she can assess whether it really could have exposed you to HIV. It's quite common for people to become overly worried about an event and convince themselves that it's given them HIV. It's possible that you are anxious about an incident that, in fact, poses no HIV risk at all.
If that's the case, your provider will focus on potential causes of your symptoms that are more plausible and likely. For example, he or she may want to test you for Epstein-Barr virus or Group A Streptococcus bacteria. That way, you will be closer to getting the medical treatment you need.
But, if you have the symptoms mentioned above and you could have been exposed to HIV in recent weeks (for example through penetrative sex without a condom), then HIV needs to be considered. Your provider should include an HIV test among the other tests that are run.
In this situation, it's important that the most sensitive type of HIV test is used. This is a blood test that can detect both antibodies and antigen (part of the virus itself). It can detect HIV as soon as three weeks after exposure to the virus, which is sooner than antibody-only tests, tests that provide an instant result and tests that you can use at home. As the most sensitive tests are not always used by default, make sure that your provider knows you are concerned about a possible recent exposure.
If You Have No Symptoms
Up to half of people who have recently become HIV positive don't notice any symptoms. This means that the only way to know whether you have HIV is to take a test. Modern HIV tests usually provide accurate results one month after possible exposure.
Symptoms of Advanced HIV Disease
If a person with HIV has not received antiretroviral treatment, several years later his or her immune system might be so severely weakened that it cannot fight off other infections and diseases.
This stage is known as advanced HIV disease or AIDS. It is completely preventable and does not occur in people who take effective antiretroviral treatment.
The symptoms are those of the other infections and diseases -- not of HIV itself. For example, because the immune system is weak, pneumonia may take hold. In this case, the symptoms would be those seen in any other case of pneumonia: fever, trouble breathing and a cough that produces mucus.
Because so many other infections and diseases may occur when a person has advanced HIV disease, the list of potential symptoms is endless. It includes lack of energy, weight loss, yeast infections, skin rashes and short-term memory loss.
Equally, the list of other medical conditions that could cause the same symptoms is endless. A person may have pneumonia, tuberculosis or a cancer that it not in any way HIV-related. Another health condition could cause the same symptoms.
Again, if there is any doubt about whether such symptoms are HIV related or not, an HIV test is required.