HIV/AIDS

HIV/AIDS Overview

HIV infection happens in three stages. Without treatment, it will get worse over time and eventually overwhelm your immune system.

First Stage: Acute HIV Infection

Most people don’t know right away when they’ve been infected with HIV, but a short time later, they may have symptoms. This is when your body’s immune system puts up a fight, typically within 2 to 6 weeks after you’ve gotten the virus. It’s called acute retroviral syndrome or primary HIV infection.

The symptoms are similar to those of other viral illnesses, and they’re often compared to the flu. They typically last a week or two and then completely go away. They include:

  • Headache
  • Diarrhea
  • Nausea and vomiting
  • Fatigue
  • Aching muscles
  • Sore throat
  • Swollen lymph nodes
  • A red rash that doesn’t itch, usually on your torso
  • Fever

Doctors can now prevent HIV from taking hold in your body if they act quickly. People who may have been infected — for example, had unprotected sex with someone who is HIV-positive — can take anti-HIV drugsto protect themselves. This is called PEP. But you must start the process within 72 hours of when you were exposed, and the medicines can have unpleasant side effects.

Second Stage: Chronic HIV Infection

After your immune system loses the battle with HIV, the flu-like symptoms will go away. Doctors may call this the asymptomatic or clinical latent period. Most people don’t have symptoms you can see or feel. You may not realize you’re infected and can pass HIV on to others. This stage can last 10 years or more.

During this time, untreated HIV will be killing CD4 T-cells and destroying your immune system. Your doctor can check how many you have with blood tests (normal counts are between 450 and 1,400 cells per microliter). As the number drops, you become vulnerable to other infections.

Fortunately, a combination, or “cocktail,” of medications can help fight HIV, rebuild your immune system, and prevent spreading the virus. if you’re taking medications and have healthy habits, your HIV infection may not progress further.

Third Stage: AIDS

AIDS is the advanced stage of HIV infection. This is usually when your CD4 T-cell number drops below 200. You can also be diagnosed with AIDS if you have an “AIDS defining illness” such as Kaposi’s sarcoma (a form of skin cancer) or pneumocystis pneumonia (a lung disease).

If you didn’t know you were infected with HIV earlier, you may realize it after you have some of these symptoms:

  • Being tired all of the time
  • Swollen lymph nodes in your neck or groin
  • Fever that lasts for more than 10 days
  • Night sweats
  • Unexplained weight loss
  • Purplish spots on your skin​ ​that don’t go away
  • Shortness of breath
  • Severe, long-lasting diarrhea
  • Yeast infections in your mouth, throat, or vagina
  • Bruises or bleeding you can’t explain

People with AIDS who don’t take medication only survive about 3 years, even less if they get a dangerous infection. But with the right treatment and a healthy lifestyle, you can live a long time.

The only way you can know for sure if you have HIV is to get tested. Although the virus can cause symptoms, they’re not a reliable way to tell if you’re infected. In fact, some people won’t have any symptoms at all. So even if you don’t have any of the typical signs of an infection, you should always get tested if you think you are at risk.

Am I at Risk for HIV?

You get HIV through direct contact with certain kinds of body fluids — blood, semen, pre-seminal fluid (also called pre-cum), vaginal fluids, rectal fluids, and breast milk. The biggest risks are having vaginal or anal sex without a condom or sharing needles with someone who has HIV. But other things can increase your odds of having it, too.

The CDC recommends that everyone in the United States between the ages of 13 and 64 get tested for HIV at least once as a precaution. In addition, you should ask yourself the following questions, and if you answer yes to any of them, you should get tested:

  • Have you had unprotected sex with someone who has HIV or a person whose HIV status you don’t know?
  • Have you injected drugs (including hormones, steroids, and silicone) and shared needles or syringes with others?
  • Have you been diagnosed with an STD?
  • Have you been diagnosed with tuberculosis (TB) or hepatitis?
  • Have you had sex with anyone who would answer “yes” to any of the questions above?
  • Have you been sexually assaulted?

What Are the Signs and Symptoms of HIV?

No two people with HIV will have the same symptoms, and some may not have any at all. But the infection can cause some common changes over time:

In the first few weeks: Between 1 and 4 weeks after someone is infected with the virus, they may have flu-like symptoms that last a week or two. It happens because the body is reacting to HIV, and the immune system tries to fight it off. The symptoms at this stage can include:

  • Fever
  • Headache
  • Upset stomach
  • Sore throat
  • Swollen glands
  • Rash
  • Aches and pains in muscles and joints

Keep in mind that even if you have these symptoms, that doesn’t automatically mean you are HIV-positive. Many different illnesses can cause these problems. Talk to a doctor or an HIV testing facility if you think you might be infected.

At this early stage of HIV infection, it’s important to know that you may not get accurate results from an HIV test. It can take 3-12 weeks for enough signs of the virus to show up on routine tests for the infection, which measure antibodies against HIV. A new kind of screening, called a nucleic acid test, can detect the virus itself during this early stage, but it’s expensive and not usually used for routine HIV testing.

Let the testing site or your doctor know if you think you might be recently infected. Also, be sure to use a condom every time you have sex, and take other steps to prevent spreading the virus.

Months to years after infection:After the first stage has passed, most people with HIV will start to feel healthier. But that doesn’t mean the virus is gone. It can take as long as 10 years for other symptoms to show up. During this time, the virus is still active and infecting new cells in your body.

After up to 10 years with an HIV infection, the virus has damaged your immune system. Now you’re more likely to get infections caused by bacteria, viruses, or fungi that your body is no longer strong enough to fight off. They can be a sign that your infection has gone from HIV to AIDS. You might have:

  • Weight loss
  • Diarrhea
  • Fever
  • A cough that won’t go away
  • Night sweats
  • Mouth and skin problems
  • Frequent infections
  • Serious illnesses or diseases

Again, these symptoms can also be the signs of other illnesses and don’t necessarily mean you have HIV or AIDS. Get tested to know for sure.

Early treatment is the key to surviving and living with HIV. In the 20 years since combination therapy has been implemented, survival rates among those infected and who adhere to treatment have increased significantly. Studies have found that the life span of HIV patients undergoing regular treatment is essentially no different from someone who does not have HIV.

You have HIV. Now, you’re getting symptoms you’ve never had before. Perhaps you’re dropping weight for no reason or can’t seem to shake a nagging cough.

Why are you feeling sick?

It’s possible your HIV isn’t under control. That’s more likely to happen if you’re not on antiretroviral therapy (ART), medicines that fight the virus. It can also happen if you aren’t taking ART correctly, or the drugs don’t work for you.

When HIV grows uncontrollably, the amount of virus in your blood goes up and hurts your immune system. It destroys cells called CD4s. Without enough of these, your body has a hard time fighting common infections and other health problems that it could normally handle easily.

Call your doctor if you get new symptoms. She can get to the bottom of what’s wrong and find ways to help you feel better.

HIV Symptoms and Treatment

Weight loss: Shedding pounds without trying is an obvious sign that your HIV may be going in the wrong direction. Untreated HIV itself or infections you get because of it can make you lose weight. Plus, if you’re sick, you may not feel like eating.

If you lose 10% or more of your body weight (like 15 pounds if you weigh 150 pounds), you could have what’s called wasting syndrome. You also have diarrhea, weakness, and fever for about a month. This mostly affects people with advanced HIV.

It’s important to try to put weight back on. A few things can help:

  • Talk to a dietitian to make sure your diet is balanced and gives you the calories you need.
  • Build up your muscle mass with workouts like weightlifting or resistance exercises, like pushups, planks, and squats.
  • Try high-protein supplements. (First, ask your doctor or dietitian if you need them.)
  • Treat infections that may cause diarrhea or loss of appetite.
  • Your doctor may prescribe medicines to help with wasting syndrome, called megestrol acetate (Megace) and dronabinol (Marinol).

Skin problems: Dry, itchy skin is a common issue for people whose immune systems are damaged from HIV. Skin infections like impetigo or tinea can be a problem, too.

Treatments include:

  • Antifungal or antibacterial creams
  • Steroids and antihistamines
  • Moisturizers

Molluscum contagiosum is a viral infection that causes small, flesh-colored bumps on the skin. The virus can grow out of control in people with HIV, so see a dermatologist for treatment right away.

Painful, blistering rash: It could be shingles if you’ve ever had chickenpox — the same virus causes both. Usually, shingles affects people over age 60. But if you have HIV, you can get it even if you’re younger.

It’s important to see your doctor if you think you have shingles. Antiviral medicines can help you get over it more quickly — but you need to start taking them as soon as possible.

Other treatments include:

  • Pain medicine
  • Calamine lotion, colloidal oatmeal baths, or wet compresses to relieve itching

Fever: Running a temperature usually means your body is fighting an infection. Your doctor may do some tests to figure out what’s causing your fever so she can decide how to treat the problem.

Do these things to bring down a fever:

  • Take ibuprofen or acetaminophen
  • Use cold compresses

Nagging cough: A cough isn’t always a sign of something serious. But one that hangs around for weeks can be.

People with weak immune systems are more likely to get tuberculosis (TB). You may bring up lots of phlegm when you cough and have chest pain, fever, and weight loss, too. If tests show that you have TB, you’ll need to take antibiotics for several months.

People with low CD4 counts are more likely to get a lung infection called pneumocystis pneumonia. It can cause a dry cough, shortness of breath, and make you feel very tired.

Treatments include prescription antibiotics, which most people take for 3 weeks. Be sure you talk to your doctor if you have the symptoms of this infection — without treatment, it can be deadly.

Night sweats: Do you wake up in the middle of the night drenched in sweat? It can be a symptom of HIV itself or other infections (like TB). The sweating will stop when your doctor figures out what’s causing the problem and treats it.

What else can you do in the meantime?

Make your bedroom as cool as possible by turning down the temperature and running fans.
Buy moisture-wicking pajamas and sheets.

Mouth problems: It’s not unusual for people with HIV to have sores in their mouths. Infections can cause problems like thrush or cold sores as the disease gets worse.

These conditions can make it painful to chew and swallow your food. Your doctor may suggest medicines to fight the infection and the pain.

Long-lasting diarrhea: People with weak immune systems can get infections that cause diarrhea. It can last for a few weeks. Your doctor will do a thorough workup to figure out the problem.

To control symptoms, your doctor may suggest:

  • Anti-diarrhea meds to slow down the waste in your intestines and keep you from going as often
  • Soft, easy-to-digest foods like bananas, rice, and potatoes
  • Plenty of water, tea, and other healthy drinks to stay hydrated

Let your doctor know if your diarrhea gets worse or you get a fever, vomiting, or pain.

Get Treated to Prevent Symptoms

Some symptoms and illnesses may go away (or never start in the first place) if you treat HIV with ART. These medications can lower the amount of the virus in your blood so your immune system can recover.

If you’re not on ART or you’re not taking it exactly as you’re supposed to, now is the time to start. Even people with uncontrolled HIV can get the right treatment and go on to live a healthy life.

You may need to change your meds if you can’t stand the side effects or if they’re not controlling your disease well. Don’t stop taking them before you talk to your doctor.​

For more information, please visit our LEARN section.

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