The Human Immunodeficiency Virus (HIV) is a virus most commonly associated with causing AIDS. This virus attacks the immune system, targeting the body’s natural defense system that protects us against diseases. When you contract HIV, the symptoms start becoming apparent within a few weeks. Flu-like symptoms are the first to appear, which include fever, a tickle at the back of your throat, sore throat, and fatigue. After this stage, the disease tends to remain in an asymptomatic stage until it progresses to AIDS. Left untreated, HIV infection will keep progressing in stages, getting worse over time, and ultimately developing into AIDS. There are three stages of HIV infection, and the symptoms of each of these steps are different from person to person. We take a look at the various symptoms associated with the various stages in this timeline of HIV symptoms.
What is HIV, and How Does It Progress?
HIV is a virus that is commonly known to cause AIDS (acquired immunodeficiency syndrome).(1) It stands for human immunodeficiency virus, and it attacks the immune system, damaging it over a period of time. There is presently no cure for HIV, but various treatments are available for managing your condition.(2)
HIV attacks the CD4 cells present in the immune system, which is a type of white blood cell that is responsible for protecting the body against various illnesses. By attacking the CD4 cells, HIV weakens the body’s defense mechanism to fight against diseases and infections.(3)
HIV is transmitted through bodily fluids, and it is a lifelong condition. The virus activity progresses over time, but there are many treatments that can help slow down or even stop the progression of the disease.
If left untreated, though, HIV infection tends to progress in stages, becoming worse and more severe over time. It will gradually destroy the immune system, eventually causing AIDS.(4)
HIV progresses in three stages of infection, and the symptoms vary from person to person of each of these stages.
In most cases, once you contract HIV infection, the virus will remain in the body for life. However, unlike other infections caused by different viruses, the symptoms of HIV do not appear suddenly and peak almost overnight.
Regular treatment with antiretrovirals can help decrease the levels of HIV to almost undetectable levels in your bloodstream.(5) Once the virus reaches undetectable levels, it is no longer able to progress to the more advanced stages of HIV infection or AIDS. At an undetectable stage, the risk of the virus getting transmitted through sexual intercourse also finishes.
Understanding the Timeline of HIV Symptoms
An HIV infection progresses in three stages. Here is a snapshot of the symptoms you are likely to experience at each of the three stages:
Stage 1 – Acute HIV Infection: This stage is the first stage of HIV infection in which the early symptoms start appearing within 2 to 4 weeks after infection.(6) This stage has flu-like symptoms such as:
Some people do not experience any symptoms during this stage of HIV infection.
Stage 2 – Chronic HIV Infection: In the second stage of infection, the symptoms can vary in severity depending on person to person and also depending on how much the disease has progressed.(7) Typical stage two symptoms include:
Some people do not experience any signs at this stage also. In this case, it is known as a latent infection. This asymptomatic stage can last up to nearly ten years or even more in some cases.
Stage 3 – AIDS: By stage three of the infection, the infection has advanced to become AIDS.(8) This is the final stage of HIV infection, and by this time, the levels of CD4 cells have fallen below 200 cells per cubic millimeter of blood (mm3), indicating that there is widespread damage to your immune system. Common symptoms of this stage include:
- Severe fatigue
- Persistent high fevers with temperature going over 100oF (37.8oC)
- Severe chills
- Night sweats
- Anal or genital sores
- White spots in the mouth
- Rashes that can be red, brown, purple, or pink in color
- Significant weight loss
- Persistent headaches
- Memory problems
- Regular coughing
- Breathing problems
The first noticeable stage of symptoms is known as primary HIV infection or acute retroviral syndrome (ARS). It is also commonly just referred to as acute HIV infection. Symptoms at this stage resemble flu-like symptoms, and naturally, many people just end up assuming that they have severe flu instead of HIV infection.
The Centers for Disease Control and Prevention (CDC) states that the first HIV symptoms become apparent around two to four weeks after exposure to the virus.(9)
Symptoms can tend to linger on for a couple of weeks. In some cases, though, people may only experience the symptoms for a few days.
Some people infected with HIV do not show any symptoms in the early stages. However, this does not mean that they are not able to pass on the virus to others. They can still easily transmit the virus to others because in the early weeks after infection, the virus tends to multiply rapidly.
Early Stages of HIV Infection and a Lack of Symptoms
Once a person has contracted HIV, acute retroviral syndrome is commonly observed in most people, but not in everyone. Some people may continue being infected with HIV for many years and not experience any symptoms of the disease. According to experts, a person may go on for nearly a decade without showing any signs of HIV infection. This does not mean, though, that their condition is any less dangerous. It is also likely that in such cases, the person does not show any symptoms till the time they transmit the virus to others.(10)
Symptoms appear in early HIV because of the fast rate of cell destruction. In people who are asymptomatic, it might mean that not that many CD4 cells are being damaged in the early stages of the disease. Even though a person is not showing any symptoms, they remain infected with HIV, and due to this, regular testing for HIV is essential in order to prevent transmission to others.
After the stage of acute infection, HIV progresses to a chronic stage. During this stage, the disease is ongoing, and the symptoms will vary from person to person. Some people may also go through a long time with minimal signs.
Clinically Latent Stage
After the initial phase of exposure and symptoms, the virus transitions into the latent stage, known as a clinically latent infection. At this point, the infection is also known as asymptomatic HIV infection, as there is a noticeable lack of symptoms. This asymptomatic phase, though, may also include some chronic symptoms.
The latent phase of HIV infection can last up to a decade or even 15 years. But this does not mean that the infection is gone or that the virus can no longer be transmitted to others.(11) The clinically latent HIV infection progresses on to the final and third stage of HIV, which is commonly known as AIDS.
The risk of progression to the last stage is higher if HIV is left untreated. Treatments such as antiretroviral therapy help slow down or even stop the progression to AIDS.
Final Stage: AIDS
The final stage of HIV infection is AIDS. It is essential that you follow the prescribed treatment protocol for HIV infection to avoid reaching stage 3 of the disease. It is possible to prevent the progression of the disease and maintain a good quality of life by taking proper medications.
Stage 3 of the HIV infections, known as AIDS, is a sign that the HIV infection has significantly damaged your immune system. At this final stage, the CD4 cells are known to have fallen below 200 cells per cubic millimeter of blood. This is considered to be an indication of AIDS. The average CD4 range is known to be between 500 to 1,600 cells per cubic millimeter of blood.(12)
The primary method of diagnosing AIDS is with a blood test that measures the levels of CD4 cells in the bloodstream. Sometimes a person’s overall health can also help a doctor determine the stage of HIV infection.
It takes around ten years without treatment for most HIV-positive people to develop AIDS.
At this point, the body becomes susceptible to various infections and is unable to fight off these diseases. It becomes necessary to take medical help at this point for treating AIDS-related conditions or complications. Without treatment, even these illnesses can prove to be fatal. Left untreated, the average survival rate is three years after AIDS is diagnosed.
The most crucial factor in living a healthy life even with HIV infection is to seek early intervention and treatment. If you are HIV-positive, then getting regular HIV tests done is necessary to manage your condition. If you notice any new symptoms or your symptoms are worsening, then it is essential to contact your doctor immediately. Following a healthy lifestyle can help prevent many of the complications commonly associated with HIV and AIDS.
- Avert. (2020). What are HIV and AIDS?. [online] Available at: https://www.avert.org/about-hiv-aids/what-hiv-aids?gclid=EAIaIQobChMIyKCNw6XM5wIVVLaWCh0MJAvSEAAYAiAAEgI28vD_BwE [Accessed 12 Feb. 2020].
- Cdc.gov. (2020). About HIV/AIDS | HIV Basics | HIV/AIDS | CDC. [online] Available at: https://www.cdc.gov/hiv/basics/whatishiv.html [Accessed 12 Feb. 2020].
- Hiv.va.gov. (2020). VA.gov | Veterans Affairs. [online] Available at: https://www.hiv.va.gov/patient/diagnosis/labs-CD4-count.asp [Accessed 12 Feb. 2020].
- Mylabbox.com. (2020). [online] Available at: https://www.mylabbox.com/hiv-left-untreated/ [Accessed 12 Feb. 2020].
- Gebrekristos, H.T., Mlisana, K.P. and Karim, Q.A., 2005. Patients’ readiness to start highly active antiretroviral treatment for HIV. Bmj, 331(7519), pp.772-775.
- Cohen, M.S., Shaw, G.M., McMichael, A.J. and Haynes, B.F., 2011. Acute HIV-1 infection. New England Journal of Medicine, 364(20), pp.1943-1954.
- AIDSinfo. (2020). Chronic HIV Infection Definition. [online] Available at: https://aidsinfo.nih.gov/understanding-hiv-aids/glossary/2929/chronic-hiv-infection [Accessed 12 Feb. 2020].
- Wwwn.cdc.gov. (2020). Stages of HIV Infection | HIV Risk Reduction Tool | CDC. [online] Available at: https://wwwn.cdc.gov/hivrisk/what_is/stages_hiv_infection.html [Accessed 12 Feb. 2020].
- Cdc.gov. (2020). About HIV/AIDS | HIV Basics | HIV/AIDS | CDC. [online] Available at: https://www.cdc.gov/hiv/basics/whatishiv.html [Accessed 13 Feb. 2020].
- HIV.gov. (2020). Symptoms of HIV. [online] Available at: https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/symptoms-of-hiv [Accessed 13 Feb. 2020].
- Pantaleo, G., Graziosi, C., Demarest, J.F., Butini, L., Montroni, M., Fox, C.H., Orenstein, J.M., Kotler, D.P. and Fauci, A.S., 1993. HIV infection is active and progressive in lymphoid tissue during the clinically latent stage of disease. Nature, 362(6418), pp.355-358.
- Npin.cdc.gov. (2020). HIV/AIDS Basics | National Prevention Information Network. [online] Available at: https://npin.cdc.gov/pages/hivaids-basics [Accessed 13 Feb. 2020].
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