6 Signs of HIV to Know

Unexplained rash, swollen lymph nodes, oral thrush, night sweats, and sudden and unexplained weight loss are all possible signs of HIV. Having a sexually transmitted infection (STI) isn't a physical sign of HIV, but it does indicate a greater risk of having HIV as well.

The signs or symptoms of human immunodeficiency virus (HIV) are not always obvious, though. And in fact, most people who have HIV do not exhibit any of them. Signs of HIV can also depend on whether a person is in the new (acute) or persistent (chronic) stage of infection.

Only an HIV test can tell you for sure if you have the virus. Still, it is important to know about these six common signs and symptoms of HIV, especially if you are someone who is considered to be at higher risk for infection. This article explains each of them.

An Unexplained Rash

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A rash is often the first sign of HIV, but it only appears in 2 of every 5 newly infected people.

An HIV rash looks a certain way: large areas of flat, reddened skin peppered with tiny bumps.

The rash can be itchy or painful. Once a person gets the rash, flu-like symptoms are also common.

The HIV rash usually starts two to six weeks after exposure to the virus and will go away within one to two weeks. The rash is widespread and mainly affects the trunk and face, but can also be on the arms, legs, hands, and feet.

Swollen Lymph Nodes

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Swollen lymph nodes (lymphadenopathy) can occur in the early stages of HIV as the body tries to kill the virus.

The lymph nodes of the armpits, neck, groin, or behind the ear may get bigger— sometimes, the swelling is very noticeable. Swollen lymph nodes may hurt or be tender to the touch.

Even as the other signs of the acute HIV infection go away, swollen lymph nodes can persist in some people for many weeks or months.

Lymphadenopathy is also common with opportunistic infections like tuberculosis and HIV-associated cancers.

Oral Thrush

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One of the early opportunistic infections in people living with HIV is oral thrush. It is considered "opportunistic" because it takes the opportunity to infect a person when their immune system is weak.

Oral thrush is also called oral candidiasis. It's caused by a fungus that can invade the inside of the mouth and throat.

People who are relatively healthy can also get oral thrush, but it is a sign that their immune system is breaking down.

When a person's immune system function is poor, the fungus can spread into the windpipe, lungs, and even the bloodstream.

Having oral thrush does not automatically mean that you have HIV, but it could be a sign that you should get tested if you're at risk.

Night Sweats

Night sweats can occur during the acute stage as the body fights the virus and during the chronic phase if there is an opportunistic infection.

Also called sleep hyperhidrosis, night sweats are more than just being sweaty in your sleep—they will drench your clothes and bedding. Night sweats can also soak through these materials and cause shivers.

Drenching night sweats are never considered normal. You should let your provider know if you're having them.

Night sweats can have causes other than HIV, and some of them are not as serious as others—for example, menopause commonly causes night sweats but many types of cancer can as well.

Sudden, Unexplained Weight Loss

Weight loss is common in people living with HIV during the advanced stages of the disease.

This type of weight loss is more than just a few pounds—it's a sudden, unexplained weight loss of 10% or more of a person's body weight, in which both fat mass and lean muscle are lost.

The condition is also called HIV wasting syndrome. It's not as common today as it once was because antiretroviral drugs keep the virus suppressed and allow the immune system to rebuild itself. Wasting is mainly seen in people who have not been treated for HIV.

The exact cause of HIV wasting is unknown, but it is thought that the constant inflammation caused by HIV makes the body burn energy faster and reduces testosterone levels (which the body needs need to build lean muscle).

Other causes of wasting include malnutrition, chronic diarrhea, tuberculosis, and cancer—all of which require urgent diagnosis and treatment.

A Sexually Transmitted Infection (STI)

If you have a sexually transmitted infection (STI), there is a chance you may have HIV as well.

Some STIs like syphilis and herpes cause open sores that make it easier for HIV to get inside the body.

STIs like gonorrhea and chlamydia cause inflammation in the genitals that attract the immune cells (CD4 T cells) that HIV likes to target and infect.

Having syphilis can increase your risk of HIV by as much as 500%. Other STIs can also raise your risk for HIV. You should be tested for HIV if you test positive for any STI.

Summary

Many people who are HIV-positive do not know they have the virus. The only way to find out for sure is to get tested.

There are some clues that could mean you have HIV, especially if you're at risk:

• An unexplained rash with flu-like symptoms
• Swollen lymph nodes
• Oral thrush
• Drenching night sweats
• Unexplained weight loss of 10% or more
• Having another sexually transmitted infection (STI)

Never assume that not having symptoms is the same thing as not having HIV. Not feeling sick does not mean that the virus is "mild" or that your immune system is not being harmed by it. If you are at risk of HIV, it's important to get tested and treated.