HIV/AIDS Symptoms Common Questions About HIV Lymphadenopathy By James Myhre & 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 & Dennis Sifris, MD Medically reviewed by Medically reviewed by Latesha Elopre, MD, MSPH on June 23, 2020 linkedin Latesha Elopre, MD, is a board-certified internist specializing in HIV. She is an assistant professor of infectious diseases at the University of Alabama at Birmingham. Learn about our Medical Review Board Latesha Elopre, MD, MSPH Updated on October 05, 2020 Print Lymphadenopathy is a medical term used to describe the enlargement in the size and/or number of lymph nodes. Lymphadenopathy is common in people with HIV and can occur at any stage of the infection. In people with HIV, lymphadenopathy most commonly develops on either side of the neck, under the jaw, or in the armpits or groin. In some cases, the nodes can be extremely painful and as large as a walnut. Common Signs and Symptoms of HIV 1 Why Causes Lymphadenopathy? Coronation Dental Specialty Group / Wikimedia Commons Lymph nodes are distributed throughout the body and support the immune system by filtering bacteria, viruses, and other disease-causing microorganisms (pathogens) from the lymphatic system. The pathogens are then killed by specialized white blood cells known as lymphocytes. Lymphadenopathy can be generalized (affecting large parts of the body) or regional (affecting only a part of the body). The causes can vary and may include infections, medications, autoimmune diseases, and cancer. Generalized HIV Acute lymphoblastic leukemia (ALL) Acute myeloblastic leukemia (AML) Gaucher disease Graft-versus-host disease (GvHD) Hodgkin lymphoma Rheumatic arthritis Sarcoidosis Syphilis Tuberculosis Typhoid fever Regional Colds, flu, and other upper respiratory infections Gingivitis Herpes viruses Infectious mononucleosis Kawasaki disease Leukemia Non-Hodgkin lymphoma Otitis media (middle ear infections) Solid tumor malignancies (cancers) Staphylococcal skin infections Streptococcal pharyngitis (strep throat) Whatever the underlying cause, lymphadenopathy is triggered by the filtration of pathogens in the lymph nodes. This instigates an inflammatory response in which lymphocytes and other immune cells are recruited to kill the invaders. If there is a local infection like strep throat, the swelling may only involve nearby lymph nodes (such as the cervical lymph nodes in the neck). If there is a systemic infection like HIV, clusters of lymph nodes throughout the body may be affected. As uncomfortable and unsightly as lymphadenopathy can be, it is not the sign of immune failure. Rather, it is an indication of a robust immune response as the body fights anything it considers to be foreign or harmful. Uncommon Signs and Symptoms of Early HIV 2 Is Lymphadenopathy a Sign of HIV? BSIP / Getty Images Lymphadenopathy is common during the acute (early) stage of HIV. It is during this phase that the body launches an immune defense to gain control over the virus. It can usually do so within weeks or months, at which point the virus will level off and enter the chronic (persistent) stage of infection. Lymphadenopathy during an acute HIV infection is most 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 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 continues even after any signs of illness have cleared.You are sexually active or an injecting drug user. The U.S. Preventive Services Task Force currently recommends that all Americans ages 15 to 65 be tested for HIV as part of a routine doctor visit. What Happens If My HIV Test Is Positive? 3 Is Lymphadenopathy Dangerous? Tharakorn / Getty Images During acute 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). In short, the weaker the immune response, the more extensive or severe the swelling will be. But not always. In some cases, lymphadenopathy doesn't develop until the chronic stage when the immune system is fully compromised. It is at this point that opportunistic infections like tuberculosis or toxoplasmosis can develop. In this context, lymphadenopathy is anything but benign. If not treated aggressively, opportunistic infections like these can quickly disseminate (spread), manifesting with generalized lymphadenopathy, severe multi-organ symptoms, and an increased risk of death. It is important to remember that lymphadenopathy is not a disease but a symptom of a disease. It can occur during the acute or chronic stage of HIV and mean entirely different things based on when the symptom develops. How to Tell If an HIV Infection Is Recent 4 Can Lymphadenopathy Be Treated? Letizia Le Fur / Getty Images If left untreated, lymphadenopathy can resolve after an acute infection within weeks or months. With that said, HIV is never left untreated. Even if the CD4 count is normal (500 or above), HIV is still treated without exception. In the end, the one surefire way to resolve HIV-associated lymphadenopathy is to start antiretroviral therapy (ART). Not only does ART actively suppress the virus, but it also helps maintain or replenish the immune response to better prevent HIV-associated infections. Even in people with advanced HIV (CD4 counts under 100), ART can dramatically restore the immune response and reduce the risk of illness and death. According to a 2015 study published in the New England Journal of Medicine, the early treatment of HIV reduces the risk of serious illness and death by 53% while extending life expectancy to near-normal levels. Until the lymphadenopathy symptom are fully resolved, an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) like Advil (ibuprofen) can be used for the occasional relief of pain, tenderness, and swelling. How to Live Long and Well With HIV 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. 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