Symptoms and Stages of HIV Infection

The acronym HIV stands for the human immunodeficiency virus which attacks the immune system that is responsible for fighting off infections. The body’s defense mechanism suffers from weakened immunity as a result. HIV can be life-threatening unless treated on time and may escalate into acquired immunodeficiency syndrome (AIDS.) Several years may pass before the weakened immune system transforms into AIDS. HIV is sexually transmitted and infections result from blood or shared needles, vaginal fluids, and semen. Mothers can transmit the infection to babies via pregnancy, birth, and breastfeeding.

HIV/AIDS has no cure. Medicines restrict infection and prevent chronic conditions. Anti-retroviral therapy or ART prevents advanced disease. As a result, patients lead longer and healthier lives. The medicines restricted AIDS deaths globally. Greater prevention and treatment measures help prevent serious conditions and deaths in economically weaker countries.

The ART Functions

The purpose of Antiretroviral therapy reduces the viral load in a person to a minimal level. A viral load test cannot detect the virus in such a case. The HIV level has reached a very low level. Such persons cannot transmit HIV to partners through sex.

3 HIV Stages

Unless immediate medicines are taken, HIV infection develops over 3 stages, getting worse each time.

  • Acute HIV infection

  • Chronic HIV infection

  • Acquired immunodeficiency syndrome

A variety of HIV symptoms

While symptoms differ across patients, the three stages of the infection result in a variety of symptoms.

Acute HIV Infection (first stage)

In the first stage of infection, some people experience absolutely no symptoms. Within 2-4 weeks of exposure to the virus, symptoms that resemble the flu usually develop as a natural physical response. Muscle aches and fever, sore throat, and night sweats are some. Fatigue, mouth ulcers and rash, swollen lymph nodes, and chills are others. Some or all of these symptoms may last a few days or several weeks. Such symptoms may be similar to those in other illnesses. The confirmation comes from an HIV test in case of doubt.

In this early stage, the virus multiplies fast and spreads through the entire body. The virus destroys the CD4 cells (CD4 T lymphocytes) that guard the body’s immunity. With widespread viruses in the body, transmission chances rapidly increase. Commencing ART early results in great benefits.

If tested positive, start treatment at the earliest. The danger of transmitting the virus is high during the early stage. If tested negative, get the treatment to prevent such an infection. Pre-exposure prophylaxis (PrEP) is a prevention tool like some others.

Chronic HIV Infection (Second Stage)

After the initial phase comes the chronic infection period. Asymptomatic HIV infection or clinical latency period also describes this stage. The virus multiplies but very slowly. Symptoms may be lacking. If ART HIV treatment is not availed, the chronic HIV stage could continue for a very long time. It could be as long as 10 or 15 years and eventually, weak immunity leads to AIDS. Some patients have quicker second stages on ART. Those patients who systematically follow medications and reach the undetectable viral load may live a long and healthy life. Further, they don’t transmit the virus through sex. Patients on ART may spend a few decades in this stage. Transmission is still possible but an undetectable viral load on ART reduces the risk to zero.

Virus transmission through sex can occur in those who have not reached a very low level even though symptoms are absent. It is wise to get the viral load checked regularly.

AIDS (Third Stage)

The danger of not taking HIV medications eventually results in an extremely weak body immune system. The final most severe stage of HIV is AIDS or acquired immunodeficiency syndrome. The weakened immunity cannot prevent opportunistic infections from attacking the body. Opportunistic infections like cancers occur frequently and more severely because of weak immunity as compared to healthy persons. CD4 count of fewer than 200 cells/mm3 or the presence of opportunistic infections indicates the third stage of AIDS.

An AIDS diagnosis indicates a high viral load and transmission is very easy and fast at this stage. In the absence of treatment, patients may only survive 3 years longer.

Several symptoms occur like rapid weight loss and fever that keeps recurring. Deep exhaustion without reason and pneumonia is possible. Night sweats and long-lasting diarrhea may occur. Additional symptoms could be depression along with other neurologic problems. Sores may break out in the genital regions, anus, and mouth. The lymph glands located in the armpits, groin, or neck may witness intense swelling. Spots may appear on and under the skin. Spots of red and brown, pink or purple may appear in the mouth, nose, and eyelids.

Since such symptoms may prove confusing, appearing as they do in other afflictions, testing is the answer. A healthcare professional diagnoses the condition based on criteria that indicate stage 3.

Opportunistic Infections

In the third AIDS phase, weak immunity makes the body extremely vulnerable to opportunistic infections. The severest symptoms arise due to opportunistic infections. A healthy immune system can normally keep such germs in check. With AIDS, germs invade the body easily with no resistance. Those patients who showed no symptoms in the early stage can now show symptoms in the AIDS phase. They feel sick to a greater extent.

Symptoms appear like nausea and vomiting. Fever, cough, and fatigue appear. Night sweats, rashes, and weight loss are possible. Cognitive decline may occur like in HIV.


Blood or saliva testing indicates the presence of the virus. Antigen or antibody tests require a blood sample from a vein. Antigens from the virus may be detected in the blood within a few weeks of the infection. The immune system generates antibodies to fight the infection. Detecting antibodies may require months. Self-testing for antibodies in blood or saliva may take 3-12 weeks after exposure to show positive results. Nucleic acid tests search for the virus in the blood obtained from a vein. NAT detects the virus early.

ART Treatments for HIV

Antiretroviral therapy at different stages helps to keep the infection in control. At the early stage, some of these drugs may be used. Dolutegravir may be prescribed along with tenofovir with emtricitabine or lamivudine. Bictegravir-tenofovir alafenamide-emtricitabine and Ritonavir-boosted darunavir plus tenofovir and either emtricitabine or lamivudine.

Early diagnosis and treatment may make the difference between life and death for the HIV patient. Avoid unsafe sex. Take preventive medications. If infected, follow prescriptions and instructions to the letter.

Updated on: 29-Mar-2023


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