HIV and Swollen Lymph Nodes

In those with human immunodeficiency virus (HIV), swollen lymph nodes are not only a common occurrence, but one that can occur at any stage of infection. Lymph nodes on the side of the neck, under the jaw, or in the armpits or groin are most often involved.

Any type of infection can cause swollen lymph nodes, also known as lymphadenopathy. But in some cases of HIV, the swelling can be extremely painful and the nodes can get as large as a walnut.

This article describes the cause of swollen lymph nodes in HIV, including when it is more likely to occur. It also explains how lymphadenopathy is treated in people who are infected.

What Is Lymphadenopathy?

Lymphadenopathy is not a disease but a symptom of a disease.

Lymph nodes are tiny organs distributed throughout the body that support the immune system by filtering bacteria, viruses, and other disease-causing organisms (pathogens) from lymph fluid.

The pathogens are then killed by specialized white blood cells known as lymphocytes.

Lymphadenopathy is common when the body is fighting infections like colds and flu or strep throat. But, it can occur with autoimmune diseases, cancer, and even use of certain medications.

The location of the swollen lymph nodes can tell a lot about the type of disease you have. Lymph node locations include:

• Axillary lymph nodes (armpits)
• Cervical lymph nodes (neck)
• Inguinal lymph nodes (groin)
• Mediastinal lymph nodes (in the chest cavity)
• Pelvic lymph nodes (in the pelvis)
• Retroperitoneal lymph nodes (back of the abdomen)

Lymphadenopathy can also be generalized, meaning that there are swollen lymph nodes throughout the body. This is common with systemic diseases that affect the body as a whole, like HIV.

When Do Lymph Nodes Swell in Someone With HIV?

Lymph nodes can swell during the acute or chronic stage of HIV and mean entirely different things based on when the symptom occurs.

• The acute stage occurs soon after infection during which the immune system is actively fighting the virus.
• The chronic stage is when the body brings the acute infection under control but the virus persists at lower levels, causing progressing damage to the immune system.

Symptoms of Swollen Lymph Nodes Due to HIV

During acute HIV infection, swollen lymph nodes most often occur in two or more sites in the body. The cervical lymph nodes are commonly affected as well as the axillary and inguinal lymph nodes.

In this stage, lymphadenopathy is self-limiting and will usually resolve on its own within weeks or months. The swelling may be mild and relatively painless.

With that said, some people may experience visible, unsightly swelling with severe pain.

In addition to the swelling, lymphadenopathy may be accompanied by other symptoms during the acute phase, including:

• Fever
• Fatigue
• Tiredness
• Muscle or joint pain
• Sore throat
• Headache
• Diarrhea
• Rash

Not everyone newly infected with HIV develops lymphadenopathy or realizes that they have it. It is not uncommon for people to think they have a cold or flu and miss the early signs of HIV infection.

For some people, lymphadenopathy doesn't occur until HIV is advanced and the immune system is fully compromised. This is when opportunistic infections (OIs) like tuberculosis or toxoplasmosis can develop. In such cases, lymphadenopathy is the result of the OI rather than HIV itself.

Could My Swollen Lymph Nodes Mean HIV?

When the lymph nodes are larger than 2 centimeters (roughly 1 inch) and last for more than three months, the condition is referred to as persistent generalized lymphadenopathy (PGL).

Although lymphadenopathy can occur for any number of reasons, PGL is a stronger indication that HIV is involved.

As a rule of thumb, you should get tested for HIV if the following occurs:

• Your lymph glands remain swollen for more than two to four weeks.
• The swelling persists even after other signs of illness have cleared.
• You are sexually active or an injecting drug user.

The U.S. Preventive Services Task Force recommends that all people ages 15 to 65 who reside in the United States be tested for HIV as part of a routine doctor visit, whether they experience swollen glands or not.

Treating Lymphadenopathy

If left untreated, HIV lymphadenopathy can resolve on its within weeks or months. With that said, HIV is never left untreated.

In the end, the one surefire way to resolve swollen lymph nodes due to HIV is to start antiretroviral therapy. This is the daily use of two or more drugs able to bring the virus under control.

Antiretroviral therapy can also extend life expectancy to near-normal levels and dramatically reduce the risk of HIV-associated and non-HIV-associated diseases. Moreover, if the viral load remains undetectable, your odds of infecting someone else are reduced to zero.

Until lymphadenopathy symptoms are fully resolved, an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) like Advil (ibuprofen) or Aleve (naproxen) can provide short-term pain relief.