Within a month or two of HIV entering the body, 40% to 90% of people experience flu-like symptoms known as acute retroviral syndrome (ARS).
But sometimes HIV symptoms don’t appear for years—sometimes even a decade—after infection.
“In the early stages of HIV infection, the most common symptoms are none,” says Michael Horberg, MD, director of HIV/AIDS for Kaiser Permanente, in Oakland, Calif. One in five people in the United States with HIV doesn’t know they have it, which is why it’s so important to get tested, especially if you have unprotected sex with more than one partner or use intravenous drugs.
Here are some signs that you may be HIV-positive.
One of the first signs of ARS can be a mild fever, up to about 102 degrees F.
The fever, if it occurs at all, is often accompanied by other usually mild symptoms, such as fatigue, swollen lymph glands, and a sore throat.
“At this point, the virus is moving into the bloodstream and starting to replicate in large numbers,” says Carlos Malvestutto, MD, instructor of infectious diseases and immunology in the department of medicine at NYU School of Medicine in New York City. “As that happens, there is an inflammatory reaction by the immune system.”
The inflammatory response generated by your besieged immune system also can cause you to feel tired and lethargic. Fatigue can be both an early and later sign of HIV.
Ron, 54, a public relations executive in the Midwest, started to worry about his health when he suddenly got winded just walking. “Everything I did, I got out of breath,” he says. “Before that I had been walking three miles a day.”
Ron had tested HIV positive 25 years before feeling so tired; fatigue during acute, or newly contracted, HIV might not be so obvious.
Achy muscles, joint pain, swollen lymph nodes
ARS is often mistaken for the flu, mononucleosis, or another viral infection, even syphilis or hepatitis.
That’s not surprising: Many of the symptoms are the same, including pain in the joints and muscles and swollen lymph glands.
Lymph nodes are part of your body’s immune system and tend to get inflamed when there’s an infection. Many of them are located in your armpit, groin, and neck.
Sore throat and headache
As with other symptoms, sore throat and headache can often be recognized as ARS only in context, Dr. Horberg says.
If you’ve engaged recently in high-risk behavior, an HIV test is a good idea. Get tested for your own sake and for others: HIV is most infectious in the earliest stage.
Keep in mind that the body hasn’t produced antibodies to HIV yet so an antibody test may not pick it up. (It can take a few weeks to a few months for HIV antibodies to show in a blood test). Investigate other test options such as one that detects viral RNA, typically within nine days of infection.
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