Signs and Symptoms of HIV

The 4 Most Frequently Asked Questions

Used under a Creative Commons license at
Photograph © Adrian Clark

Understanding the signs and symptoms of HIV allows us to proactively treat (and even avoid) certain  well before they occur. It's important to note, however, that there are often no symptoms at the onset of HIV infection, and that when symptoms finally do appear, it's often after the virus has caused irreparable damage to a person’s immune system.

Fear and misconceptions about HIV can often prevent people from seeking the treatment and care they need, with some misinterpreting the term "asymptomatic" as meaning "without infection."

Others, meanwhile, wait until symptoms intensify or ignore them altogether until they eventually subside—failing to realize that the abatement of short-term symptoms is neither an indication of improvement nor the "all clear" sign that an infection has been averted.

So widespread are these misconceptions that many continue to avoid treatment unnecessarily, often for years. Today, the average CD4 count at the start of antiretroviral therapy (ART) stands at a mere 145 cells/mL for low income countries, 155 cells/mL for lower-middle income countries, 135 cells/mL for upper-middle income countries, and 274 cells/mL in high income countries.

(U.S. guidelines recommend ART at or even above CD4 counts of 500, while persons with a CD4 count below 200 are considered to have AIDS.)   

So while it is important to recognize the signs of HIV, symptoms alone can never confirm whether an infection has occurred or if an HIV-associated illness is developing. Only an HIV test or an diagnosis from your doctor can confirm that.

What you can do is educate yourself. And it all starts by asking yourself a few, key questions:

1. What Are the Early Signs of HIV?

In 40% of recent HIV infections, flu-like symptoms will develop within 7-14 days of an exposure. This condition is commonly referred to as "acute retroviral syndrome" (or ARS). Symptoms can range from mild to severe and persist for months at a time and include:

  • Fever
  • Headache
  • Night sweats
  • Malaise
  • Myalgia (a generalized, muscular ache or pain)
  • Rash (eczema-like in appearance and usually distributed around the upper parts of the body and/or palms of the hands)

Learn why it is so important to identify the signs of ARS, and how early intervention can prevent the development of long-term illness, both HIV- and non-HIV-related.

2. What Are the Symptoms of HIV by Stage?

Many of the symptoms related to early infection are due to body's response to HIV itself, wherein the immune system is placed on high alert in the presence of a foreign invader. The symptoms of later-stage infection occur when HIV gradually depletes the body's immune defenses, reducing its ability to fight infection. Learn why this occurs and how untreated HIV can lead to the development of so-called "AIDS defining illnesses."

3. What Are the AIDS Defining Illnesses?"

Infections are said to be "opportunistic" when the depletion of a body's immune defenses allows bacteria, viruses and other foreign agents the opportunity to infect. Among these are AIDS-defining illnesses, a subset of disease classified by the Centers for Disease Control and Prevention (CDC) as being directly associated the deterioration of the immune system as a result of HIV infection.

There are currently 27 clinical conditions considered AIDS defining:

  • Bacterial infections, multiple or recurrent
  • Candidiasis of bronchi, trachea, or lungs
  • Candidiasis of the esophagus
  • Cervical cancer (invasive)
  • Coccidioidomycosis, disseminated beyond the lung
  • Cryptococcosis,presenting outside of the lung
  • Cryptosporidiosis, chronic intestinal for more than one month
  • Cytomegalovirus disease (other than in the liver, spleen, or lymph nodes)
  • Cytomegalovirus disease with loss of vision
  • Encephalopathy (HIV-related)
  • Herpes simplex virus, lasting longer than one month or in an area other than the skin, such as esophagus or lungs
  • Histoplasmosis, disseminated outside of the lung
  • Kaposi's sarcoma (KS)
  • Lymphoid interstitial pneumonia or pulmonary lymphoid hyperplasia complex
  • Burkitt lymphoma (or equivalent term)
  • Immunoblastic lymphoma (or equivalent term)
  • Primary lymphoma of the brain
  • Mycobacterium avium complex or Mycobacterium kansasii, disseminated outside of the lung
  • Mycobacterium tuberculosis of any site (lung, disseminated, or outside the lung)
  • Mycobacterium, other species or unidentified species, disseminated outside of the lung

Learn why these particular infections are considered AIDS defining and what the presence of these conditions mean to your long-term health outcomes.

4. How Long Can I Live If I Get HIV?

A 2014 update by the Multicenter AIDS Cohort Study suggests that people who start HIV therapy at or above a CD4 count of 350 cells/mL may be able to enjoy a life expectancy equal to—or even greater than—that of the general population. Learn the factors that influence life expectancy in people living with HIV, as well as the conditions that can reduce longevity by as much as 22 years.

Was this page helpful?
Article Sources
  • Sources:
  • Willard, S.; Holzemer, W.; Wantland, D.; et al. "Does 'Asymptomatic' Mean Without Symptoms for Those Living with HIV Infection?" AIDS Care. March 2009; 21(3):322-328.
  • The IeDEA and ART Cohort Collaborations. “CD4 counts at antiretroviral therapy start rising globally, but could do better!” Journal of Acquired Immune Deficiency Syndromes. January 2014; 65(1):e8-e16. doi: 10.1097