Within a month or two of HIV entering the body, 40% to 90% of people experience flu-like symptoms known as acute retroviral syndrome (ARS).
But sometimes HIV symptoms don’t appear for years, sometimes even a decade, after infection.
So don’t believe what you may see in movies or on TV of a person having sex then the next week they have lesions on their lip or are pale. Some symptoms you don’t even see outside the body.
Here are some signs that you may be HIV-positive (especially if you are engaging in unprotected sex).
Fever
One of the first signs of ARS can be a mild fever, up to about 102 degrees F. The fever, if it occurs at all, is often accompanied by other usually mild symptoms, such as fatigue, swollen lymph glands, and a sore throat.
“At this point the virus is moving into the blood stream and starting to replicate in large numbers,” says Carlos Malvestutto, MD, instructor of infectious diseases and immunology in the department of medicine at NYU School of Medicine in New York City. “As that happens, there is an inflammatory reaction by the immune system.”
Fatigue
The inflammatory response generated by your besieged immune system also can cause you to feel tired and lethargic. Fatigue can be both an early and later sign of HIV. Ron, 54, a public relations executive in the Midwest, started to worry about his health when he suddenly got winded just walking. “Everything I did, I got out of breath,” he says. “Before that I had been walking three miles a day.” Ron had tested HIV positive 25 years before feeling so tired; fatigue during acute, or newly contracted, HIV might not be so obvious.
Achy Muscles & Joint Pain
ARS is often mistaken for the flu, mononucleosis, or another viral infection, even syphilis or hepatitis. That’s not surprising: Many of the symptoms are the same, including pain in the joints and muscles and swollen lymph glands. Lymph nodes are part of your body’s immune system and tend to get inflamed when there’s an infection. Many of them are located in your armpit, groin, and neck.
Sore Throat & Headache
As with other symptoms, sore throat and headache can often be recognized as ARS only in context, Dr. Horberg says, “If you’ve engaged recently in high-risk behavior, an HIV test is a good idea. Get tested for your own sake and for others: HIV is most infectious in the earliest stage.” Keep in mind that the body hasn’t produced antibodies to HIV yet so an antibody test may not pick it up. (It can take a few weeks to a few months for HIV antibodies to show in a blood test). Investigate other test options such as one that detects viral RNA, typically within nine days of infection.
Nausea, Vomiting & Diarrhea
Anywhere from 30% to 60% of people have short-term nausea, vomiting, or diarrhea in the early stages of HIV, Dr. Malvestutto says, “These symptoms can also appear as a result of antiretroviral therapy and later in the infection, usually as the result of an opportunistic infection.” Diarrhea that is unremitting and not responding at all to usual therapy might be an indication,” Dr. Horberg says. Or symptoms may be caused by an organism not usually seen in people with healthy immune systems, he adds.
Dry Cough
Have a bad cough that Benadryl, antibiotics, and inhalers don’t seem to fix? This symptom—an “insidious cough that could be going on for weeks that doesn’t seem to resolve,” Dr. Malvestutto says—is typical in very ill HIV patients.
Night Sweats
About half of people get night sweats during the early stages of HIV infection, Dr. Malvestutto says. These can be even more common later in infection and aren’t related to exercise or the temperature of the room. Similar to the hot flashes that menopausal women suffer, they’re also hard to dismiss, given that they soak your bedclothes and sheets.
Yeast Infections
Another fungal infection that’s common in later stages is thrush, a mouth infection caused by Candida, a type of yeast. ”It’s a very common fungus and the one that causes yeast infections in women,” Dr. Malvestutto says. “They tend to appear in the mouth or esophagus, making it difficult to swallow.” Ron woke up one day to find white patches on his tongue. He had thrush. For him, “It was not bothersome other than I didn’t like having it.” The infection was hard to get rid of, but finally cleared up after Ron started taking drugs to combat HIV.
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