HIV, or the Human Immunodeficiency Virus, is a viral infection transmitted through contact with the genital fluids or blood of a carrier.
If the HIV infection is left untreated or is improperly treated, it can develop into AIDS, or the Acquired Immune Deficiency Syndrome, which makes the body of the infected person vulnerable to secondary infections and prone to cancers, ultimately resulting in a fatal outcome.
While the development of both HIV symptoms and AIDS symptoms depends on the immune system of the carrier and is not going to be the same for everyone, the progression of the illness, especially in the earlier (HIV) stage, has a more predictable course.
Learning about how the infection manifests, and especially being aware of the first HIV symptoms, is one of the most important ways to boost testing rates, contain the spread of the virus, promote treatment, and lower the mortality associated with AIDS.
That’s why, in this article, we take a look at the most common symptoms of HIV and explore what’s behind them as well as their progression depending on whether the infection is treated or not.
NOTE: If you suspect you might have been exposed to the virus and/or experience the symptoms described below, make sure to get tested for HIV immediately. You can order an at-home blood or saliva HIV self-test kit from our Webshop; discreet delivery in under 24h available for most European countries.
There are two general stages of the HIV infection: acute HIV and chronic HIV, with the third stage being AIDS.
The acute stage is marked by the onset of the first HIV symptoms and it usually starts 2 to 4 (sometimes up to 6) weeks after the virus enters the body. This stage may last for a few days, weeks, or months. It is then followed by the chronic stage, which is typically symptomless or with manageable symptoms, and which can last for many years before evolving into AIDS.
During the primary, acute stage of HIV infection, up to 80% of carriers reportedly experience some or many of the following flu-like symptoms:
This phase of the infection has been described by many as ‘the worst flu ever.’ The symptoms are reported somewhat more frequently by those who contracted the virus in homosexual intercourse.
At this stage, before HIV antibodies have been created, the virus replicates rapidly, spreading throughout the body and attacking and destroying the immune system's infection-fighting CD4 cells (CD4 T lymphocytes).
This attack causes inflammation in various parts of the organism, and the symptoms are a sign that the body is fighting the infection. Depending on the immune system of the carrier, some may experience more subtle first HIV symptoms or even nothing that would make them suspect that they are infected.
With or without the symptoms, however, in this primary stage the virus particles multiply exponentially, completely inundating the organism and making the carrier significantly more likely to pass on the infection to others. This is partly why most new HIV infections are transmitted by undiagnosed carriers and why regular testing would make such a significant difference in our level of control over the HIV epidemic.
The primary infection period can last anywhere from a few days to a few months. If a carrier gets diagnosed and starts antiretroviral therapy (ART) during this time, they may have a major advantage in reducing the viral load and curbing the progression of the infection.
Since the onset of the infection, the body starts producing antibodies, which, after 3 weeks to 3 months, can reach sufficient levels to be detected by HIV antibody tests. Before this time, only highly sophisticated tests that screen for antigens or viral copies themselves can reliably detect the infection.
Eventually, the antibodies form a sufficient defense to suppress the virus enough for the symptoms to subside. This marks the evolution of the infection into its chronic stage.
During the chronic stage of HIV, many carriers may look and feel completely normal, at least for a while, depending on treatment. During this stage of HIV infection, which is also referred to as an ‘asymptomatic HIV infection’ or ‘clinical latent infection,’ HIV continues to multiply in the body, although at a much slower pace.
In those who are not receiving ART at this time, chronic HIV infection can take about 8 to 10 years or longer to defeat the immune system and progress to AIDS, but this process may go faster in some.
As the virus continues to multiply and destroy the CD4 immune cells, those who are not being treated may develop mild infections or experience chronic symptoms during this period, which may include:
On the other hand, those who are on ART may be in the chronic stage without symptoms for several decades and have a chance to completely prevent the infection from developing into AIDS. With diligent treatment, the viral load can actually be reduced to undetectable levels, allowing the carrier to live a full, normal life with virtually no risk of transmitting the virus to others, even through unprotected sex.
While the majority of the symptoms experienced in both stages don’t discriminate gender-wise, some of them may manifest distinctly in males and females, as a consequence of their respective anatomies.
One of the primary HIV symptoms in men specifically, typically later on in an untreated infection, is hypogonadism. Hypogonadism is a condition in which the testicles produce less than normal amounts of testosterone, a hormone that regulates mood, behavior, and the growth and maintenance of hair and muscle and bone mass.
The lack of testosterone can further cause:
Prostatitis, an inflammation of the prostate, is also commonly associated as one of the HIV symptoms in men. It may appear as a result of a bacterial infection enabled by the weakened immune system. Prostatitis can manifest as:
Among the most common HIV symptoms in women, typically experienced in later stages of an untreated infection, are changes in the menstrual cycle. Periods may become lighter or heavier, less regular, or missed, and PMS can become more intense.
These deviations can be caused by hormonal changes that are the result of the infection itself, but they may also stem from stress or other infections that can be contracted due to a weakened immune response.
An infection may also occur in the uterus, ovaries, and/or fallopian tubes, causing symptoms like:
Infection of one or all of these organs is known as pelvic inflammatory disease (PID), and it can eventually cause scar tissue and abscesses (clumps of infected fluid) to develop in the reproductive tract, which can leave permanent damage.
Finally, while it’s not one of direct HIV symptoms in women, female carriers who progress to AIDS may eventually develop cervical cancer.
AIDS is the third and final stage of HIV infection; one that, thankfully, with the highly effective modern treatments available today, fewer and fewer HIV-infected people develop.
AIDS signals the victory of the virus and the (more or less rapid) collapse of the immune system of the patient. It is a fatal condition and nothing can be done to stop the progress of the illness once this stage is reached.
Symptoms of AIDS commonly include:
These symptoms can also be associated with other, comorbid conditions, such as secondary (opportunistic) infections, sepsis, cancers, and organ failures.
Depending on the immune system of the carrier, initial flu-like HIV symptoms may appear 2-4 or up to 6 weeks following the infection. However, some might not experience any symptoms or recognize what they experience as concerning due to its similarity to the flu.
If these carriers do not test and remain unaware of their status, the “first” symptoms they can experience might be in the later stages of the infection, when the condition is significantly more difficult to treat.
This is a common myth — there can be no discernible HIV symptoms after 5 days since infection onset. While the virus is actively and rapidly replicating at this point, the viral load is still insufficient to trigger the body’s immune response.
There’s no denying that HIV is a scary illness. However, fear must not overshadow the responsibility we carry toward ourselves and those we are in intimate contact with.
If you engage in unprotected sexual intercourse or suspect that you may have been exposed to HIV, and especially if you experience any of the primary HIV symptoms listed in this article, make sure to get tested as soon as possible.
With the recent advancements in medical technology, at-home HIV self-test kits of comparable reliability to clinical tests (up to 99.5-99.8%, provided the test is done after the ‘window’ period) are now available for purchase online.
You can order an easy-to-use, rapid saliva or blood HIV test from our Webshop by clicking on the button below