HIV/AIDS Symptoms Print Common Questions About HIV Lymphadenopathy By James Myhre and Dennis Sifris, MD Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator. Learn about our editorial process James Myhre and Dennis Sifris, MD Medically reviewed by Medically reviewed by Richard N. Fogoros, MD on September 18, 2019 facebook linkedin Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. He is Verywell's Senior Medical Advisor. Learn about our Medical Review Board Richard N. Fogoros, MD Updated on November 20, 2019 HIV/AIDS Overview Symptoms Causes Diagnosis Treatment Coping Lymphadenopathy is the enlargement in the size or number of lymph nodes. The incidence of lymphadenopathy in people with HIV is especially high and can occur at any stage of infection. The swollen nodes most commonly develop on either side of the neck, under the jaw, or in the armpits and groin. In some cases, they can be painful and visibly swollen. 1 Why Are Your Lymph Nodes Swollen? Arthur Tilley/Getty Images Lymph nodes are distributed throughout the body and support the immune system by filtering bacteria, viruses, and other microorganisms from the bloodstream. The particles are then killed by specialized white blood cells known as lymphocytes. Any number of diseases can cause lymphadenopathy from strep throat to life-threatening cancers. The swelling is caused by the accumulation of lymphocytes as more and more cells are filtered through the glands. Lymphadenopathy is not a sign of a malignancy. Rather, it is an indication of a robust immune response with the aim of controlling the infection. 2 How Long Will Your Lymph Nodes Be Swollen? PIXOLOGICSTUDIO/SCIENCE PHOTO LIBRARY / Getty Images Lymphadenopathy is common during early HIV infection. It is during this acute phase that the body is launching an immune defense to gain control over the virus. In some cases, this can take months or even years. Lymphadenopathy during acute infection is often generalized, meaning that it occurs in two or more sites in the body. When the nodes are larger than two centimeters (roughly an inch) and last for more than three months, the condition is typically referred to as persistent generalized lymphadenopathy (PGL). If you have not been tested for HIV and the lymph glands remain swollen more than two to four weeks, see your doctor or visit your local clinic. The U.S. Preventive Services Task Force currently recommends that all Americans age 15 to 65 be tested for HIV as part of a routine doctor visit. 3 Could It Be a Sign of Something Worse? FatCamera / Getty Images During early HIV infection, lymphadenopathy is most often benign and self-limiting. Oftentimes, the duration and severity of the condition are directly related to the degree of immune suppression as measured by the CD4 count. You should never assume that lymphadenopathy is the sign of a recent HIV infection. In some cases, lymphadenopathy isn't seen until the later stages of the disease and is more an indication of an associated infection such as tuberculosis or toxoplasmosis. Lymphadenopathy occurring during chronic HIV infection will most often resolve when HIV treatment is started. During advanced infection, when the CD4 count has dipped below 100, the rapid involution of lymphadenopathy (meaning the lymph nodes return to normal without treatment) can be a sign of imminent immune collapse and a prelude to a serious opportunistic infection. 4 Can Lymphadenopathy Be Treated? Amanda Mills/USCDCP The one surefire way to treat HIV-associated lymphadenopathy is to start antiretroviral therapy. Not only does it actively suppress the virus, easing the burden on the lymphatic system, it helps maintain or restore immune function to better fight associated infections. Currently, it is recommended that HIV treatment be started on diagnosis irrespective of CD4 count or stage of disease. According to studies, it not only reduces the risk of illness by 53%, but it also offers benefits in terms of longer life and a reduced risk of transmission. Until the lymphadenopathy is fully resolved, an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) can be used to relieve swelling, tenderness, and pain. Was this page helpful? Thanks for your feedback! Get information on prevention, symptoms, and treatment to better ensure a long and healthy life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Nandi A, Nag D, Dey S, Bandyopadhyay R, Roychowdhury D, Roy R. Etiological study of lymphadenopathy in HIV-infected patients in a tertiary care hospital. Journal of Cytology. 2016;33(2):66. doi:10.4103/0970-9371.182518 Tirelli U, Vaccher E, Carbone A, et al. Persistent generalized lymphadenopathy: clinical characteristics of a lymphadenopathy syndrome in intravenous drug abusers. AIDS Res. 1986;2(3):227-30. doi:10.1089/aid.1.1986.2.227 Kazama I, Miura C, Nakajima T. Nonsteroidal Anti-Inflammatory Drugs Quickly Resolve Symptoms Associated with EBV-Induced Infectious Mononucleosis in Patients with Atopic Predispositions. Am J Case Rep. 2016;17:84-8. doi:10.12659/AJCR.895399 Additional Reading Department of Health and Human Services. "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents." Rockville, Maryland; accessed November 19, 2015. National Institutes of Health. "Starting antiretroviral therapy early improves outcomes for HIV-infected individuals." Bethesda, Maryland; issued May 27, 2015. U.S. Preventive Services Task Force (USPSTF). "Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement." Rockville, Maryland; April 2013.