Signs and Symptoms of HIV Infection

Experts usually describe the progression of the human immunodeficiency virus (HIV) as having distinct phases during which certain symptoms tend to develop. In each, HIV symptoms—fever, night sweats, joint pain, and so on—can vary, overlap, or be mistaken for those of another illness. What's more, there is a stretch of time after primary infection with HIV when there may be no symptoms even though the virus is continuing to severely damage the immune system behind the scenes.

When HIV is detected early, it can be prevented from progressing with retroviral medication. In fact, most people with HIV in the United States who receive treatment never reach stage 3 of the infection, what's better known as acquired immunodeficiency syndrome (HIV/AIDS)—the point at which HIV symptoms become severe and life-threatening.

Stage 1: Primary Infection (Acute HIV)

This is the period when the virus first enters the body and the immune system begins to react. According to the United States Department of Health and Human Services (HHS), 40% to 90% of people will experience flu-like symptoms within two to four weeks of being infected with the human immunodeficiency virus as the body fights to control the infection.

Symptoms of acute HIV infection include:

  • Fever
  • Chills
  • Headache
  • Night sweats
  • Pharyngitis (sore throat)
  • Myalgia (muscle aches and pains)
  • Arthralgia (joint pain)
  • Fatigue
  • Lymphadenopathy (swollen lymph nodes, mainly on the neck)
  • Mouth ulcers

Some people with ARS also will experience nausea, diarrhea, or vomiting, and one in five will develop an "HIV rash," a maculopapular skin condition characterized by raised, pink/red areas covered with small, pimple-like bumps that often merge together into one. HIV rash usually affects the upper body and sometimes is accompanied by ulcers on the mucous membranes of the mouth or genitals. Outbreaks usually resolve within one to two weeks.

Collectively, these symptoms are referred to as acute retroviral syndrome (ARS) or, less often, acute seroconversion syndrome or seroconversion illness.

Stage 2: Clinical Latent HIV Infection (Chronic HIV)

This phase begins after the acute symptoms have resolved and the only indication of infection may be mild swelling of the lymph nodes in the neck.

This can be a tricky time because, despite the lack of obvious illness, the HIV virus is still active, damaging and destroying cells in the immune system. Without treatment, the clinical latent phase of HIV can last for around 10 years, during which the infected person can easily pass the virus along to someone else even if they're experiencing no symptoms whatsoever.

Stage 3: Symptomatic HIV Infection/AIDS

It takes about 10 years of going untreated for HIV to develop into what is known as HIV/AIDS. At this point, symptoms of ongoing destruction of the immune system may develop, such as recurring fever, persistent and extreme fatigue, chronic diarrhea, and neurological disorders such as depression and memory loss.

Other distinctive symptoms that may occur at this time include:

  • Swollen lymph glands: Frequently appearing on the neck, below or behind the ear, in the groin, or under the armpit, in severe cases, the lymphadenopathy experienced during this stage of HIV infection can be painful and unsightly. When nodes grow larger than 2 centimeters (approximately an inch) and last more than three months, a person may be said to have persistent generalized lymphadenopathy (PGL). This can take months or years to resolve.
  • Candidiasis (thrush): This fungal infection often is an early sign of approaching illness. Although most commonly seen in the mouth, candidiasis also can occur in the throat or vagina. Candidiasis is most likely to develop in people with very low CD4 counts (under 200 cells/mL). The prevalence of candidiasis is so high in people with advanced HIV that it's currently classified as an AIDS-defining condition if it affects the bronchi, trachea, esophagus, or lungs.
  • Skin problems: These may be red, pink, brown, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids; white spots or unusual mouth or tongue lesions; or sores on the anus or genitals.
  • Sleep hyperhidrosis: Unexplained, drenching night sweats can be a sign of a serious, underlying HIV-related condition such as tuberculosis, Mycobacterium avium complex, or histoplasmosis).
  • Extreme weight loss (HIV wasting): HIV wasting is sudden, unexplained loss of at least 10% of body weight, especially when accompanied by fever and diarrhea for a period of 30 days or more.

People with HIV/AIDs also may develop diseases such as shingles (herpes zoster) pneumonia, and many others.

A Word From Verywell

Knowing the symptoms of HIV infection are important in directing you to timely testing, care, and treatment. But they alone should not be the reason for you to get a test. If you suspect that you've been exposed to HIV, either now or anytime in the past, see your doctor and ask to be tested. It is the only way to know for sure if you have HIV. By doing so, you can better ensure not only your long-term health but the health of those around you.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. HIV.gov. How Can You Tell If You Have HIV? Updated June 21, 2019.

  2. National Sleep Foundation. Four Common Causes of Night Sweats.

  3. National Institute of Allergy and Infectious Diseases. U.S. Department of Health and Human Services. HIV Wasting Syndrome. Updated May 1, 1997.

  4. Erdmann NB, Prentice HA, Bansal A, et al. Herpes Zoster in Persons Living with HIV-1 Infection: Viremia and Immunological Defects Are Strong Risk Factors in the Era of Combination Antiretroviral Therapy. Front Public Health. 2018;6:70. doi:10.3389/fpubh.2018.00070

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