The symptoms of HIV and AIDS

Human immunodeficiency virus (HIV) is a retrovirus that weakens the immune system. HIV infection is usually divided into three stages:

  1. acute HIV infection
  2. clinical latency
  3. AIDS.


Each phase has its own symptoms. In treatment and medication, some people will never develop AIDS and even people with AIDS can stay healthy for a long time.


HIV and the immune system

The HIV virus needs special immune cells, the CD4 cells, to multiply. The HIV particles in your blood look for those CD4 cells, which they can easily penetrate because they fit exactly. Once inside, the HIV virus uses the CD4 cell as a kind of copier to multiply itself. The HIV virus forces the healthy CD4 cell to make new virus particles. Eventually that CD4 cell opens up and is then so damaged that it dies. The released new virus particles enter the body and all seek a CD4 cell again. This way everything starts all over again and more and more immune cells break down.

Your body naturally tries to fight HIV infection. Your immune system has recognized the HIV cells and wants to attack and destroy them. But because the virus multiplies so quickly, mistakes are made and the copy always looks slightly different. That is called mutation. The immune cells no longer recognize the virus particle and do not destroy it immediately. This way the virus particle can continue to multiply undisturbed.

Every day billions of new virus particles are created and billions of CD4 cells die. Those CD4 cells, however, have a very important role in the immune system; they control all other immune cells so that every cell knows exactly what to do. When many CD4 cells die, the other immune cells do not know what to do anymore. Your immune system will not work properly anymore, so you can no longer defend against pathogens. You will then become more susceptible to ordinary, common viruses, bacteria or fungi. Eventually you can even get infections of viruses, bacteria or fungi that you would not even get sick of. We call that with a difficult word ‘opportunistic infections’. Opportunism means: acting according to the possibilities of that moment. An opportunistic infection is an infection that can occur at that time because someone has a reduced immune system.


Symptoms in the three stages of HIV infection

HIV causes various symptoms at different stages. Usually it starts shortly after infection with flu-like symptoms that automatically change again. It can then take years before you get AIDS-related symptoms.

Phase 1: the acute infection

Of all people with acute HIV infection, the majority experiences physical complaints within weeks to months. It is often thought of flu or possibly Pfeiffer, because it involves about the same symptoms. The most common symptoms and how often they occur can be found in the table below. The phase of acute HIV infection applies for the first 2 weeks to 3 months after infection.


Symptoms acute HIV infection

A few weeks after the HIV infection, the amount of HIV in your body increases and the immune system starts. You can get flu-like symptoms. Symptoms and symptoms that are consistent with acute HIV infection are:

Most common symptoms of acute HIV infection, among gay and bisexual boys and men

  • Fever
  • Fatigue or feeling sick
  • Skin rash
  • Muscle pain or joint pain
  • Ear infection
  • Swollen lymph nodes
  • Headache
  • Persistent diarrhea
  • Night sweats
  • Meningitis
  • Sores in the mouth
  • Sores on the genitals

Most people who are infected with HIV get complaints in the acute phase. These complaints are not always recognized as complaints that fit with HIV. Symptoms usually develop 2 weeks to 3 months after HIV infection. The symptoms usually last 2 weeks, this duration varies from a few days to 10 weeks.


Phase 2 – Chronic HIV infection

After your immune system has lost the battle against HIV, the first flu-like symptoms disappear and HIV can not cause symptoms for months or years. Doctors call this asymptomatic or clinical latency. During this time the virus proliferates and weakens the immune system. A person at this stage does not feel ill, but the virus is still active. Infected individuals can easily transfer the virus to others. That is why early testing is so important for people who also feel good. With the INSTI HIV self-test you can be tested for HIV at an early stage. The earlier you know that you have HIV, the sooner you can be treated with HIV inhibitors that prevent AIDS. This is important for your own health, but you can also prevent it from infecting another person.

It may take a while, but HIV can ultimately destroy the immune system of those affected. As the HIV infection progresses, enough CD4 cells are attacked and destroyed, so that the body can no longer fight infections and diseases. Your doctor can check with blood tests how many CD4 cells you have left (the normal number is between 450 and 1400 cells per microliter). As the number decreases, you become vulnerable to other infections. As soon as this happens, HIV is often referred to as AIDS (level 3). AIDS is the last stage of the disease. The time required for HIV to reach this stage can vary from a few months to 10 years, or even longer.

Fortunately, a combination or “cocktail” of medicines can help to fight HIV, rebuild the immune system and prevent the spread of the virus. If you use medication and have healthy habits, the HIV infection can not get any further.


Fase 3 – AIDS

If certain illnesses are caused by a serious immunodeficiency caused by HIV, it is called “AIDS”. These include e.g. Pneumocystis pneumonia (PcP), a form of pneumonia, or infectious diseases of other organs, e.g. the esophagus with the yeast Candida albicans. Even viruses such as herpes simplex or herpes zoster can lead to serious illnesses. The most common tumor diseases related to AIDS are viral cancers, e.g. Kaposi’s sarcoma or cervix cancer as well as lymphomas (malignant tumors of the immune system). Because HIV can also damage the cells of the central nervous system, in the course of HIV infection, neuritis and brain disorders can occur, which usually begin slowly and unobtrusively.


General symptoms of AIDS are:

  • Fatigue
  • Weight loss
  • Fever
  • Night sweats
  • Diarrhea
  • Shortness of breath
  • Rare late symptoms of AIDS include blindness and AIDS dementia.

Although it can take a long time, an HIV infection without treatment ultimately always causes AIDS. The big danger is that many HIV positive people do not know that they are infected and unknowingly infect others, for example through unsafe sex. If AIDS is not treated, it is a deadly disease.


HIV / AIDS symptoms in men

Symptoms that may indicate a recent HIV infection:

  • Fever over several days
  • limpness
  • Headache, joint and muscle pain
  • Rash on the back, ribcage or abdomen
  • diarrhea
  • strong night sweats
  • aching tonsils, swollen lymph nodes
  • sores in the mouth

Important: These symptoms do not always occur or are not always noticed and usually do not all occur together.

Shortly after an infection with HIV, the virus in the body temporarily proliferates particularly strong. In the mucous membranes and body fluids that are involved in sex between men (mucous membranes on the penis, in the rectum and in the front hole, blood, semen and the liquid in the front hole), the amount of virus is then very high. As a result, the risk of HIV transmission in unprotected sex is particularly high.


HIV / AIDS symptoms in women

One of the symptoms women can get after HIV infection is changes in menstruation. A woman can bleed more easily or harder, periods can be absent or women can have severe PMS. Stress or other sexually transmitted diseases that are common in HIV can also cause these problems. But they can also affect the immune system and influence the hormones because of the effects of the virus.
Another HIV symptom for women is fungal infections. Yeasts are microscopic fungi that naturally live in the vagina. However, if a woman is infected with HIV, the fungi can become uncontrollable and cause vaginal yeast infections several times a year. Sometimes they are the first sign that the body is infected with the HIV virus. A fungal infection can cause the following symptoms:

  • thick, white discharge from your vagina
  • pain during sex
  • pain when urinating
  • burning of the vagina or pain


Lower abdominal pain can also occur after HIV infection. They are among the signs of a pelvic inflammatory disease. This is the collective name for an infection of the uterus, ovaries and / or fallopian tubes. For some women, this is one of the first signs that they have HIV. Together with pelvic pain, pelvic inflammation can cause the following symptoms:

  • unusual vaginal discharge
  • fever
  • irregular periods
  • pain during sex
  • pain in the upper abdomen

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