HIV Symptoms: Acute Phase, Chronic Phase & AIDS Symptoms

The first symptoms of an HIV infection are headaches, low-grade fever, excessive fatigue, sore throat and joint pain. These may appear about 2 to 4 weeks after the initial infection and disappear spontaneously, however it does not mean that the virus has been totally eliminated from the body.

As the virus multiplies in the body, the immune system's defense cells decrease, which can lead to the development of AIDS. Symptoms of AIDS include a persistent fever, frequent infections or the development of cancer, such as Kaposi's sarcoma.

If you notice symptoms of HIV or AIDS appear, you should seek urgent medical attention for an HIV test. If it is positive, treatment will be started with antiretroviral medicines, as directed by an infectious disease specialist.

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Symptoms of acute HIV infection phase

The initial infection with HIV is referred to as the "acute phase". This phase presents with symptoms such as:

  • Excessive fatigue
  • Headache
  • Low-grade fever or chill
  • Lumps, especially on the neck
  • Sore throat
  • Joint or muscle pain
  • Canker sores or mouth sores
  • Night sweat
  • Cough
  • Diarrhea
  • Skin rash

In general, the first symptoms of HIV infection appear approximately 2 to 4 weeks after initial contact with the virus. However, in some people, HIV infection does not cause any signs or symptoms. This asymptomatic phase can last up to 10 years.

Symptoms of clinical latency phase

After the initial, acute phase, patients with HIV may not have any other symptoms for many years. This period is referred to as the clinical latency phase, chronic HIV infection or asymptomatic HIV.

The fact that there are no signs or symptoms does not mean that the virus has been eliminated from the body, but rather that the virus is silently multiplying, affecting the functioning of the immune system and the subsequent emergence of AIDS.

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The main symptoms of the clinical latency phase, or a chronic HIV infection, without the development of AIDS, are:

  • Vaginal or oral candidiasis
  • White plaques or balls on the tongue, the inside of the cheeks or on the gums
  • White, rough spot on the tongue
  • Purple to bright red lumps on the skin
  • Herpes zoster
  • Chronic diarrhea
  • Ease of getting purple spots on the body
  • Weight loss for no apparent reason

Furthermore, in women, changes may appear on the Pap smear such as cervical dysplasia or cervical cancer in situ. Know how to identify the symptoms of cervical cancer.

Symptoms of AIDS

The main symptoms of AIDS are:

  • Persistent high fever
  • Frequent night sweats
  • Persistent diarrhea
  • Excessive fatigue that does not improve
  • Weakness
  • Red spots on the skin
  • Chronic ulcers caused by herpes simplex
  • Difficulty breathing
  • Persistent cough
  • Constant white spots on the tongue and mouth
  • Wounds in the genital region
  • Rapid weight loss
  • Memory problems

At this stage, it is also common for the person to have frequent opportunistic infections such as tonsillitis, yeast infections and pneumonia.

AIDS symptoms emerge due to immune system dysfunction caused by the HIV virus. The immune system becomes very weakened, which increases the risk for infections or other opportunistic diseases, such as cervical cancer, Kaposi's sarcoma or lymphoma.

When to get tested for HIV

Ideally, HIV should be diagnosed during its initial phase, before AIDS develops. During this period, the virus is detected in low levels in the body, making it easier to control its multiplication with antiretrovirals.

Early diagnosis also prevents the virus from spreading to other people, as from that moment on, unprotected sex can transmit the virus to others.

Treatment options 

Treatment for HIV and AIDS should be directed by an infectious disease specialist who can recommend a combination of medications called antiretrovirals.

These antiretrovirals prevent the HIV virus from multiplying, which reduces and controls the viral load and prevents the development of AIDS.

Some antiretrovirals that your doctor may consider prescribing include ​etravirine, tipranavir, tenofovir, lamivudine or efavirenz.

When AIDS has already developed, it is much more difficult to control disease progression with medication. Therefore, hospitalization is often necessary for IV antibiotics, antivirals or antifungals to prevent and/or treat emergent infections.

Care during treatment

Some important considerations during HIV and AIDS treatment include:

  • Take antiretroviral medications correctly at the times and doses prescribed by the infectious disease specialist
  • Attend regular follow-up appointments
  • Complete regular testing as ordered by your doctor to assess for CD4 lymphocytes and viral load
  • Maintain a balanced, healthy and nutritious diet
  • Do not breastfeed your baby if you are HIV positive
  • Exercise regularly, as approved by your doctor
  • See your dentist regularly to assess your oral health

Furthermore, condoms must be used during all sexual contact to avoid transmission of the disease, even if your partner is already HIV positive. There are several types of HIV viruses and partners can be infected with a new type of virus, making it even more difficult to control the disease.

It is important to note that, when carrying out prescribed treatment, it is possible for the HIV viral load to become undetectable. This represents a lower risk of transmitting the disease, but does not mean it has been eliminated.

Understanding AIDS

AIDS is an illness caused by HIV that debilitates the immune system, leaving a person with weak defenses. Individual infected with AIDS are at risk for catching other aggressive viruses that would otherwise be easy to fight off in a healthy person. After a virus enters the body, the defensive cells of the body will try to stop the virus, but when they are finally able to fight it off, the virus mutates. The body at this point requires other cells to stop the virus from multiplying.

When there is a low viral load of HIV in the body and a good quantity of defense cells, the patient will essentially be in an asymptomatic phase of the illness. This can last for about 10 years. When the body’s HIV viral load surpass the amount of available defense cells, signs or symptoms of AIDS will emerge.

This is because the body has become weaker and is no longer able to contain illnesses, not even illnesses that should be relatively easy to combat. Therefore, the best way to treat AIDS is to prevent reinfection with HIV and to comply with the treatment plan indicated to you by your doctor.