What Are The Symptoms And Stages Of A HIV Infection?

The World Health Organization estimates that 38 million people were living with HIV (human immunodeficiency virus) in 2018, and 1.7 million were newly infected.

Thanks to modern treatment approaches, HIV no longer has to be a death sentence and people with HIV can live long and healthy lives. That does require getting started with treatment as soon as possible, though, so early diagnosis is crucial.

1. Acute HIV infection

The first stage of HIV, also called acute retroviral syndrome, starts after the virus enters a person's body, and will typically last three to six months. HIV cells will begin invading white blood cells called CD4 lymphocytes, using the process to replicate at an alarming rate of billions of copies a day. The newly infected patient's body will not have had time to make antibodies yet, and it will come as no surprise that HIV is highly contagious at this time. 

Many people will be familiar with the possibility of experiencing flu-like symptoms two to four weeks after being infected with HIV, but let's have a closer look:

• Just over half — 52 percent — of people who are tested for HIV report that they experience symptoms known to be associated with acute HIV when they get the test. Another 28 percent will have symptoms a few weeks before they are tested. 
• The most common symptoms are fever, fatigue, swollen lymph nodes and tonsils, a sore throat, muscle aches and pains, diarrhea, headache, and a skin rash. Night sweats, genital sores, oral ulcers, weight loss, nausea and vomiting, and a cough are also recognized to fall into the range of typical symptoms during an acute HIV infection. 
• A minority of people newly infected with HIV will have atypical symptoms that can range from yeast infections to pneumonia, inflammation of the liver, and acute kidney failure.
• An even smaller minority — five percent, according to one study — have no symptoms at all. 

HIV testing should be part of everyone's routine healthcare, in line with CDC recommendations, but it is good to be aware of the initial symptoms of HIV. Different kinds of tests exist. Early testing, within 10 to 33 days after exposure, is possible with a nucleic acid test , while antigen/antibody HIV tests are usually accurate 18 to 45 days after exposure. Antibody tests, though most often used, can take up to 90 days after exposure to show accurate results. 

Talk to your doctor about the right test for you. 

2. Clinical latency

The second stage of a HIV infection is also called chronic or asymptomatic HIV. Patients typically experience no symptoms or only very mild symptoms at this point, and if they were not tested, they may have no idea that they are HIV positive. Even without treatment, this phase last a decade or beyond, though it may also run its course much more quickly. 

During the chronic stage of HIV, the virus reproduces in much lower numbers — but it does reproduce. Though this stage is less contagious than acute HIV, the virus can still be transmitted. This is a particular risk for people who remain unaware that they are HIV positive. 

The good news is that proper HIV treatment with antiretroviral therapy can keep people living with HIV in this phase for a very long time. Antiretroviral treatment reduces patient's viral load (the amount of HIV within their blood and other fluids), in some people so successfully that HIV becomes undetectable. ART is of crucial importance not only to the health of people with HIV, but also their partners — when the virus is undetectable, it cannot be transmitted, either. 

3. AIDS

AIDS, or acquired immunodeficiency syndrome, is the final and most severe stage of HIV. It is diagnosed in people with CD4 counts below 200/mm3 (healthy people have between 500 and 1,500), or those who have fallen victim to opportunistic infections. People with AIDS can have extremely high viral loads and easily transmit the virus. 

Common symptoms of AIDS include:

• Severe and prolonged diarrhea
• Memory loss
• Depression
• Weight loss
• Pneumonia
• Frequent fevers
• Night sweats
• Discoloration and rashes of the skin 
• Swollen lymph nodes

As the immune system is weakened more and more, AIDS presents a serious risk of opportunistic infections — infections healthy people would be able to fight off, but that present a grave threat to immunocompromised patients. These infections can themselves lead to shortness of breath, exhaustion, difficulty swallowing, vision loss, seizures, and coma, among other symptoms. 

Get tested for HIV!

Once someone is diagnosed with AIDS, they will live an average of three years without treatment — with an ever-decreasing quality of life. Someone who is diagnosed with HIV soon after infection, begins taking antiretroviral therapy, and remains adherent to it can, on the other hand, live a long and healthy life, with a life expectancy very close to average. With the right treatment, HIV does not have to progress to AIDS. 

Some groups of people — like those with multiple sex partners, men who have sex with men, and people who use IV drugs — have a higher risk of being exposed to HIV. However, anyone who has ever had unprotected sex with someone whose HIV status they aren't sure of is potentially at risk. Getting tested for HIV can be intimidating, but it becomes far less so once you know that it could save your life.