Symptoms - HIV and AIDS
Most people infected with HIV experience a short, flu-like illness that occurs 2-6 weeks after infection. After this, HIV may not cause any symptoms for several years. It's estimated up to 80% of people who are infected with HIV experience this flu-like illness. The most common symptoms are:
raised temperature (fever) , sore throat, body rash
Other symptoms can include:
tiredness joint pain muscle pain swollen glands
The symptoms usually last 1-2 weeks, but can be longer. They're a sign that your immune system is putting up a fight against the virus. But having these symptoms doesn't necessarily mean you have the HIV virus. Remember: they're commonly caused by conditions other than HIV.
If you have several of these symptoms and think you've been at risk of HIV infection within the past few weeks, you should get an HIV test. After the initial symptoms disappear, HIV may not cause any further symptoms for many years.
During this time, the virus continues to be active and causes progressive damage to your immune system.This process can vary from person to person, but may take up to 10 years, during which you'll feel and appear well. Once the immune system becomes severely damaged, symptoms can include:
weight loss, chronic diarrhoea night sweats skin problems recurrent infections serious life-threatening illnesses Earlier diagnosis and treatment of HIV can prevent these problems. You should still take an HIV test if you may have been at risk at any time in the past, even if you don't experience any symptoms.
What is HIV?
HIV is a virus that damages the immune system. The immune system helps the body fight off infections. Untreated HIV infects and kills CD4 cells, which are a type of immune cell called T cells. Over time, as HIV kills more CD4 cells, the body is more likely to get various types of infections and cancers.
HIV is a lifelong condition and currently there is no cure, although many scientists are working to find one. However, with medical care, including treatment called antiretroviral therapy, it’s possible to manage HIV and live with the virus for many years.
Without treatment, a person with HIV is likely to develop a serious condition called AIDS. At that point, the immune system is too weak to fight off other diseases and infections. Untreated, life expectancy with AIDS is about three yearsTrusted Source. With antiretroviral therapy, HIV can be well-controlled and life expectancy can be nearly the same as someone who has not contracted HIV.
It’s estimated that 1.1 million Americans are currently living with HIV. Of those people, 1 in 5 don’t know they have the virus.
What is AIDS?
AIDS is a disease that can develop in people with HIV. It’s the most advanced stage of HIV. But just because a person has HIV doesn’t mean they’ll develop AIDS.
HIV kills CD4 cells. Healthy adults generally have a CD4 count of 500 to 1,500 per cubic millimeter. A person with HIV whose CD4 count falls below 200 per cubic millimeter will be diagnosed with AIDS.
A person can also be diagnosed with AIDS if they have HIV and develop an opportunistic infection or cancer that’s rare in people who don’t have HIV. An opportunistic infection, such as pneumonia, is one that takes advantage of a unique situation, such as HIV.
Untreated, HIV can progress to AIDS within a decade. There’s no cure for AIDS, and without treatment, life expectancy after diagnosis is about three yearsTrusted Source. This may be shorter if the person develops a severe opportunistic illness. However, treatment with antiretroviral drugs can prevent AIDS from developing
HIV and AIDS: What’s the connection?
To develop AIDS, a person has to have contracted HIV. But having HIV doesn’t necessarily mean that someone will develop AIDS.
Cases of HIV progress through three stages:
stage 1: acute stage, the first few weeks after transmissionstage 2: clinical latency, or chronic stage stage 3: AIDS
As HIV lowers the CD4 cell count, the immune system weakens. A typical adult’s CD4 count is 500 to 1,500 per cubic millimeter. A person with a count below 200 is considered to have AIDS.
How quickly a case of HIV progresses through the chronic stage varies significantly from person to person. Without treatment, it can last up to a decade before advancing to AIDS. With treatment, it can last indefinitely.
There is no cure for HIV, but it can be controlled. People with HIV often have a near-normal lifespan with early treatment with antiretroviral therapy. Along those same lines, there’s technically no cure for AIDS.
However, treatment can increase a person’s CD4 count to the point where they’re considered to no longer have AIDS. (This point is a count of 200 or higher.) Also, treatment can typically help manage opportunistic infections.
HIV transmission: Know the facts
Anyone can contract HIV. The virus is transmitted in bodily fluids that include:
bloodsemen vaginal and rectal fluids breast milk
Some of the ways HIV is spread from person to person include:
through vaginal or anal sex — the most common route of transmission, especially among men who have sex with men
by sharing needles, syringes, and other items for injection drug use
by sharing tattoo equipment without sterilizing it between uses
during pregnancy, labor, or delivery from a woman to her baby
through “pre-mastication,” or chewing a baby’s food before feeding it to them through exposure to the blood of someone living with HIV, such as through a needle stick
The virus can also be transmitted through a blood transfusion or organ and tissue transplant. However, rigorous testing for HIV among blood, organ, and tissue donors ensures that this is very rare in the United States.
It’s theoretically possible, but considered extremely rare, for HIV to spread through:
oral sex (only if there are bleeding gums or open sores in the person’s mouth)
being bitten by a person with HIV (only if the saliva is bloody or there are open sores in the person’s mouth)
contact between broken skin, wounds, or mucous membranes and the blood of someone living with HIV
HIV does NOT spread through:
skin-to-skin contacthugging, shaking hands, or kissing air or water sharing food or drinks, including drinking fountains saliva, tears, or sweat (unless mixed with the blood of a person with HIV) sharing a toilet, towels, or bedding mosquitoes or other insects
It’s important to note that if a person with HIV is being treated and has a persistently undetectable viral load, it’s virtually impossible to transmit the virus to another person. Learn more about HIV transmission.
Causes of HIV
HIV is a variation of a virus that infects African chimpanzees. Scientists suspect the simian immunodeficiency virus (SIV) jumped from chimps to humans when people consumed infected chimpanzee meat. Once inside the human population, the virus mutated into what we now know as HIV. This likely occurred as long ago as the 1920s.
HIV spread from person to person throughout Africa over the course of several decades. Eventually, the virus migrated to other parts of the world. Scientists first discovered HIV in a human blood sample in 1959.
Causes of AIDS
AIDS is caused by HIV. A person can’t get AIDS if they haven’t contracted HIV.
Healthy individuals have a CD4 count of 500 to 1,500 per cubic millimeter. Without treatment, HIV continues to multiply and destroy CD4 cells. If a person’s CD4 count falls below 200, they have AIDS.
Also, if someone with HIV develops an opportunistic infection associated with HIV, they can still be diagnosed with AIDS, even if their CD4 count is above 200.
What tests are used to diagnose HIV?
Several different tests can be used to diagnose HIV. Healthcare providers determine which test is best for each person.
Antibody/antigen tests are the most commonly used tests. They can show positive results typically within 18–45 daysTrusted Source after someone initially contracts HIV.
These tests check the blood for antibodies and antigens. An antibody is a type of protein the body makes to fight an infection. An antigen, on the other hand, is the part of the virus that activates the immune system.
These tests check the blood solely for antibodies. Between 23 and 90 daysTrusted Source after transmission, most people will develop detectable HIV antibodies, which can be found in the blood or saliva.
These tests are done using blood tests or mouth swabs, and there’s no preparation necessary. Some tests provide results in 30 minutes or less and can be performed in a healthcare provider’s office or clinic.
If someone suspects they’ve been exposed to HIV but tested negative in a home test, they should repeat the test in three months. If they have a positive result, they should follow up with their healthcare provider to confirm.
Nucleic acid test (NAT)
This expensive test isn’t used for general screening. It’s for people who have early symptoms of HIV or have a known risk factor. This test doesn’t look for antibodies; it looks for the virus itself. It takes from 5 to 21 days for HIV to be detectable in the blood. This test is usually accompanied or confirmed by an antibody test.
What’s the HIV window period?
As soon as someone contracts HIV, it starts to reproduce in their body. The person’s immune system reacts to the antigens (parts of the virus) by producing antibodies (cells that fight the virus).
The time between exposure to HIV and when it becomes detectable in the blood is called the HIV window period. Most people develop detectable HIV antibodies within 23 to 90 days after infection.
If a person takes an HIV test during the window period, it’s likely they’ll receive a negative result. However, they can still transmit the virus to others during this time. If someone thinks they may have been exposed to HIV but tested negative during this time, they should repeat the test in a few months to confirm (the timing depends on the test used). And during that time, they need to use condoms to prevent possibly spreading HIV.
Someone who tests negative during the window might benefit from post-exposure prophylaxis (PEP). This is medication taken after an exposure to prevent getting HIV. PEP needs to be taken as soon as possible after the exposure; it should be taken no later than 72 hours after exposure, but ideally before then.
Early symptoms of HIV
The first few weeks after someone contracts HIV is called the acute infection stage. During this time, the virus reproduces rapidly. The person’s immune system responds by producing HIV antibodies. These are proteins that fight infection.
During this stage, some people have no symptoms at first. However, many people experience symptoms in the first month or two after contracting the virus, but often don’t realize they’re caused by HIV.
This is because symptoms of the acute stage can be very similar to those of the flu or other seasonal viruses. They may be mild to severe, they may come and go, and they may last anywhere from a few days to several weeks.
Early symptoms of HIV can include:
feverchills swollen lymph nodes general aches and pains sore throat headache nausea upset stomach
Because these symptoms are similar to common illnesses like the flu, the person with them might not think they need to see a healthcare provider. And even if they do, their healthcare provider might suspect the flu or mononucleosis and might not even consider HIV.
Whether a person has symptoms or not, during this period their viral load is very high. The viral load is the amount of HIV found in the bloodstream. A high viral load means that HIV can be easily transmitted to someone else during this time.
Initial HIV symptoms usually resolve within a few months as the person enters the chronic, or clinical latency, stage of HIV. This stage can last many years or even decades with treatment
What are the symptoms of HIV?
After the first month or so, HIV enters the clinical latency stage. This stage can last from a few years to a few decades. Some people don’t have any symptoms during this time, while others may have minimal or nonspecific symptoms. A nonspecific symptom is a symptom that doesn’t pertain to one specific disease or condition.
These nonspecific symptoms may include:
headaches and other aches and painsswollen lymph nodes recurrent fevers night sweats fatigue nausea vomiting diarrhea weight loss skin rashes
As with the early stage, HIV is still infectious during this time even without symptoms and can be transmitted to another person. However, a person won’t know they have HIV unless they get tested. If someone has these symptoms and thinks they may have been exposed to HIV, it’s important that they get tested.
HIV symptoms at this stage may come and go, or they may progress rapidly. This progression can be slowed substantially with treatment. With the consistent use of this antiretroviral therapy, chronic HIV can last for decades and will likely not develop into AIDS, if treatment was started early enough.
Is rash a symptom of HIV?
About 90 percent of people with HIV experience changes to their skin. Rash is often one of the first symptoms of HIV infection. Generally, an HIV rash appears as multiple small red lesions that are flat and raised.
Rash related to medication
While rash can be caused by HIV co-infections, it can also be caused by medication. Some drugs used to treat HIV or other infections can cause a rash. This type of rash usually appears within a week or two of starting a new medication. Sometimes the rash will clear up on its own. If it doesn’t, a change in medications may be needed.
Rash due to an allergic reaction to medication can be serious. Other symptoms of an allergic reaction include trouble breathing or swallowing, dizziness, and fever.
Stevens-Johnson syndrome (SJS) is a rare allergic reaction to HIV medication. Symptoms include fever and swelling of the face and tongue. A blistering rash, which can involve the skin and mucous membranes, appears and spreads quickly. When 30 percent of the skin is affected it’s called toxic epidermal necrolysis, which is a life-threatening condition. If this develops, emergency medical care is needed.
While rash can be linked with HIV or HIV medications, it’s important to keep in mind that rashes are common and can have many other causes
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