A Timeline of HIV Symptoms

Human immunodeficiency virus (HIV) infection is a progressive disease, meaning that it typically worsens over time. In the early stages, the symptoms may be mild and easily mistaken for an illness like the flu. However, as the disease progresses and weakens the immune system, other, more serious symptoms can develop. That’s why many people won’t know they’ve been infected until years after they were first exposed to the virus.

It’s important, therefore, to recognize the signs of HIV at different stages of the infection. By doing so, you can get tested and begin HIV treatment, which can allow you to live a healthy life.

“Even if you don’t have symptoms, early testing and treatment confers far better health and near-normal life expectancy,” says Linda-Gail Bekker, MD, an infectious disease specialist who is the deputy director of the Desmond Tutu HIV Centre, based in South Africa, and the former president of the International AIDS Society.

While the signs and symptoms of HIV may vary from person to person, here’s a look at the common ones, along with the stages of infection in which they likely appear.

• Fever
• Fatigue
• Headache
• Sore throat
• Muscle aches
• Joint pain
• Swollen lymph nodes
• Night sweats
• Nausea
• Diarrhea

The exception: a symptom called lymphadenopathy, a sometimes painful swelling of the lymph nodes in various areas of the body, such as the neck, armpits, or groin region. Even when other symptoms have disappeared, lymphadenopathy may continue for months or even longer.

HIV latency can persist without symptoms for 10 years or more, although some people may experience symptoms within a year or two.

Even during latency, the virus will multiply subtly and gradually deplete immune cells known as CD4 T-cells. As immune deficiency develops, a number of nonspecific symptoms are likely to appear, including:

• Oral candidiasis (thrush), a fungal infection that causes creamy, white patches on the sides of the tongue and lining of the mouth to form
• Unexplained fevers or weight loss
• Severe, uncontrolled diarrhea that lasts for more than three days

These symptoms are commonly seen in people with an immune deficiency. With the exception of thrush, they may, in some cases, be caused by HIV itself or by an infection that has yet to be diagnosed.

• Lungs (bacterial pneumonia, tuberculosis, pneumocystis pneumonia)
• Skin (shingles, Kaposi sarcoma)
• Gastrointestinal system (Mycobacterium avium complex, cryptosporidiosis)
• Brain (toxoplasmosis, cryptococcal meningitis)
• Eyes (cytomegalovirus retinitis, herpes zoster ophthalmicus)
• Blood (Salmonella septicemia)

• Two to three weeks after HIV exposure marks the acute stage of the infection (ARS), where many people may experience flu-like symptoms accompanied by a rash.
• At the three- to four-week mark, the immune system will begin to bring the infection under control, and people may start feeling better.
• At the four-week mark, the infection will go into hiding and remain dormant, though the virus will still be active at very low levels.
• It’s important to recognize the different stages of HIV, so that you can get tested and begin treatment. Early testing and treatment can allow you to live a healthy life and prevent HIV from progressing to later-stage HIV or AIDS.