HIV Symptoms by Stage: Early Signs (2–4 Weeks), Chronic & AIDS

HIV symptoms may include headache, low-grade fever, fatigue, sore throat, swollen lymph nodes, rash, and joint pain. Early HIV symptoms usually appear 2 to 4 weeks after infection, although some people do not notice any symptoms for years.

Without treatment, HIV weakens the immune system over time and can progress to AIDS, increasing the risk of frequent infections, certain cancers, and other serious complications. Even if early HIV symptoms go away, the virus remains in the body and continues to multiply if left untreated.

Treatment with antiretroviral therapy can control HIV, prevent it from progressing to AIDS, and lower the viral load to an undetectable level. Early diagnosis through HIV testing and prompt treatment are important for protecting the immune system and reducing the risk of transmitting the virus.

Early signs of HIV

The first symptoms of HIV infection include:

• Extreme fatigue

• Headache

• Low-grade fever or chills

• Swollen lymph nodes, especially in the neck

• Sore throat

• Joint or muscle pain

• Canker sores or other sores in the mouth

• Night sweats

• Cough

• Diarrhea

• Skin rash

In general, the first HIV symptoms appear about 2 to 4 weeks after exposure to the virus. However, some people do not develop any signs or symptoms, and this asymptomatic period may last for up to 10 years.

Latent HIV

After the initial symptoms go away, HIV may not cause noticeable symptoms for many years. This period is known as the latent stage.

The absence of signs or symptoms does not mean that the virus has been eliminated from the body. HIV continues to multiply and affect the immune system, which can eventually lead to AIDS if the infection is not treated.

Chronic HIV

The main symptoms of chronic HIV infection (before AIDS develops) include:

• Vaginal or oral candidiasis

• White patches or small white bumps on the tongue, inside the cheeks, or on the gums

• A rough white patch on the tongue

• Purple to bright red bumps on the skin

• Shingles

• Chronic diarrhea

• Easy bruising

• Unexplained weight loss

Women may also have abnormal Pap smear results, such as cervical dysplasia or cervical carcinoma in situ.

AIDS symptoms

The main symptoms of AIDS include:

• Persistent high fever

• Frequent night sweats

• Ongoing diarrhea

• Extreme fatigue that does not improve

• Weakness;

• Red spots on the skin

• Chronic sores caused by herpes simplex

• Difficulty breathing

• Persistent cough

• Persistent white patches on the tongue or inside the mouth

• Sores in the genital area

• Rapid weight loss

• Memory problems

At this stage, people may also develop frequent opportunistic infections, such as tonsillitis, candidiasis, and pneumonia.

HIV infection may therefore be suspected when a person has frequent or recurring infections.

AIDS symptoms occur because HIV damages the immune system, leaving it severely weakened. This increases the risk of opportunistic infections and other diseases, including cervical cancer, Kaposi sarcoma, and lymphoma.

When to get tested

Ideally, HIV should be diagnosed as early as possible, before it progresses to AIDS. Starting antiretroviral therapy early helps control the virus, preserve the immune system, and reduce the risk of complications.

Early diagnosis also helps reduce the risk of transmitting HIV to others because antiretroviral treatment can lower the viral load to an undetectable level.

Treatment options

HIV treatment should be managed by a healthcare provider experienced in HIV care, such as an infectious disease specialist. According to the National Institutes of Health, antiretroviral therapy is recommended for everyone with HIV and should be started as soon as possible after diagnosis.

Antiretroviral therapy prevents HIV from multiplying, lowers the viral load, helps the immune system recover, and prevents HIV from progressing to AIDS. Treatment usually involves a combination of antiretroviral medications selected according to factors such as a person’s overall health, possible drug interactions, and resistance test results.

Antiretroviral medications may include tenofovir alafenamide or tenofovir disoproxil fumarate and lamivudine as components of a treatment regimen.

People who have developed AIDS should still begin or continue antiretroviral therapy. They may also need antibiotics, antiviral medications, or antifungal medications to prevent or treat specific opportunistic infections, and hospitalization may be necessary if an infection or other complication is severe.

Care during treatment

Important precautions during HIV and AIDS treatment include:

• Taking antiretroviral medications exactly as prescribed by a healthcare provider
• Attending regular follow-up appointments with a healthcare provider experienced in HIV care
• Having regular tests to monitor the CD4 cell count and viral load
• Eating a well-balanced diet
• Discussing infant feeding options with a healthcare provider if you are living with HIV
• Exercising regularly, as recommended by a healthcare provider
• Visiting the dentist regularly to monitor the health of the mouth and teeth

Condoms can help prevent other sexually transmitted infections (STIs) and unintended pregnancy. They are also recommended until an undetectable viral load is achieved. According to the CDC, people who achieve and maintain an undetectable viral load do not sexually transmit HIV.

Because different strains of HIV exist, a person living with HIV can become infected with another strain, although this is uncommon. This can make HIV more difficult to treat.

Understanding AIDS

AIDS is the most advanced stage of HIV infection. It occurs when HIV severely weakens the immune system by damaging CD4+ cells.

This makes it harder for the body to fight infections and increases the risk of opportunistic infections and certain cancers.

According to the CDC, a person living with HIV is considered to have stage 3 HIV, also known as AIDS, when their CD4+ cell count falls below 200 cells/mcL.