What is HIV?

HIV is a virus that compromises the immune system. There’s currently no cure for it, but there are available treatments to reduce its effects on people’s lives.

In the majority of cases, once chronic HIV has been established, the virus stays in the body for life. Despite the potential severity of the illnesses it causes, HIV symptoms don’t suddenly appear and peak overnight. Unlike other types of viruses, HIV can be a progressive condition in which symptoms and severity vary from person to person.

Symptoms timeline

timeline of hiv symptoms

Early symptoms in primary HIV

The first noticeable stage is primary HIV infection. This stage is also called acute retroviral syndrome (ARS), or acute HIV infection. HIV at this stage usually cause flu-like symptoms. It may be possible for someone in this stage to think their symptoms are caused by a severe flu rather than HIV. Fever is the most common symptom. Other symptoms include:

According to the Centers for Disease Control and Prevention (CDC), primary HIV symptoms may show up two to four weeks after initial exposure. Symptoms can continue for up to several weeks. However, some people may only exhibit the symptoms for a few days. People with early HIV sometimes don’t show any symptoms, yet are still contagious. This is attributed to the fast, unrestrained viral replication in the early weeks of transmission.

Lack of symptoms in early stages

ARS is common once a person has HIV. Still, this isn’t the case for everyone. Some people have HIV for years before they know they have it. According to HIV.gov, sometimes symptoms of HIV may not appear for a decade or longer. This doesn’t mean that cases of HIV without symptoms are less serious. Also, if someone doesn’t experience symptoms, they could still transmit HIV to others.

Symptoms in early HIV tend to appear if the rate of cell destruction is high. Not having symptoms can mean that not as many CD4 cells are killed early on in the disease. Even though a person has no symptoms, they still have the virus. That’s why regular HIV testing is critical to prevent transmission. It’s also important to understand the difference between a CD4 count and a viral load.

Latency causes a break in symptoms

After initial exposure and possible primary infection, HIV may transition into a stage called clinically latent infection. It’s also referred to as asymptomatic HIV infection due to a noticeable lack of symptoms. This lack of symptoms includes possible chronic symptoms.

According to the Mayo Clinic, latency in HIV can last for 10 years. This doesn’t mean HIV is gone, nor does it mean that someone can’t transmit it to others. Latency may progress to stage 3 HIV, a more appropriate term for AIDS.

The risk for progression is higher if a person with HIV isn’t receiving treatment, such as antiretroviral therapy. It’s important to take prescribed medications during all stages of HIV — even if there aren’t any noticeable symptoms. There are several medications used for HIV treatment.

Chronic HIV

After acute infection, HIV is considered chronic. This means that the disease is ongoing. Symptoms of chronic HIV can vary. There can be long periods when the virus is present but symptoms are minimal. In more advanced stages of chronic HIV, symptoms can be much more severe than they are in ARS. People with advanced, chronic HIV can experience episodes of:

AIDS is the final stage

Controlling HIV with medications is crucial to both maintaining quality of life and helping prevent a rapid progression of the disease. Stage 3 HIV, also known as AIDS, develops when HIV has significantly weakened the immune system.

According to the CDC National Prevention Information Network, one way AIDS develops is when CD4 levels decrease below 200 cells per cubic milliliter of blood (mm3). A normal range is considered 500 to 1,600 cells/mm3.

AIDS can be diagnosed with a blood test to measure CD4. Sometimes it’s also determined simply by a person’s overall health. In particular, someone having an infection that’s rare in people with a normal immune system may indicate that they have AIDS. Symptoms of AIDS include:

AIDS is the final stage of HIV. According to the Mayo Clinic, without treating HIV, most people develop AIDS within 10 years. At that point, the body is susceptible to a wide range of infections and can’t effectively fight them off. Medical intervention is necessary to treat the AIDS-related illnesses or complications, or else death can occur. Without treatments, the CDC estimates the average survival rate to be three years once AIDS is diagnosed. Depending on the severity of their condition, a person’s outlook may be significantly shorter.

The key to living with HIV is to continue seeing a healthcare provider for regular treatments. Consider a visit as soon as you experience new or worsening symptoms. It’s also important to know how HIV affects the body.