Hives, medically known as urticaria, are a common skin reaction characterized by itchy, red or skin-colored welts on the skin. These welts can vary in size and shape, often appearing suddenly and sometimes fading within 24 hours, though new ones may emerge. Understanding the causes of hives, including their link to infections, helps determine when to seek care.
Hives During Acute HIV Infection
Hives can manifest during the acute, or primary, stage of HIV infection, occurring two to four weeks after exposure. This period, called seroconversion, involves the body’s initial immune response as it produces antibodies against HIV. Many individuals (50-90%) with acute HIV experience flu-like symptoms, and some develop a rash.
Acute HIV hives often appear as flat, reddish or discolored patches, sometimes with small, raised bumps. On lighter skin, they may look red; on darker skin, they might appear dark purplish. These eruptions are usually mildly itchy or non-itchy and can appear anywhere, though often on the face, chest, hands, and feet. While a possible indicator, hives are not a definitive diagnostic sign; comprehensive testing is necessary for confirmation. The rash typically resolves within one to two weeks without specific treatment, but the virus remains.
Common Causes of Hives
Hives are a widespread skin reaction with many triggers; HIV is a relatively rare cause compared to other factors. Allergic reactions are a common cause, stemming from foods like nuts, shellfish, eggs, and milk, or medications such as antibiotics, aspirin, and ibuprofen. Insect stings or bites can also provoke an immediate response.
Beyond allergies, infections are common causes, including viral ones like the common cold, hepatitis, or mononucleosis, and bacterial ones such as strep throat or urinary tract infections. Physical stimuli can also induce hives, known as physical urticaria. Triggers include cold, heat, pressure, sunlight, exercise, or scratching. Often, despite thorough investigation, the precise cause is never identified, a condition called idiopathic urticaria.
When to Consult a Healthcare Professional
Seeking medical advice for hives is important in several situations. If hives are persistent, lasting more than a few days, or if they recur frequently, a healthcare provider can help identify potential triggers and recommend appropriate management. Severe itching disrupting sleep or daily activities also warrants evaluation.
Immediate medical attention is necessary if hives are accompanied by severe symptoms, such as difficulty breathing or swallowing, swelling of the face, lips, or tongue, or lightheadedness. These could be signs of anaphylaxis, a severe allergic reaction. If there is concern about potential HIV exposure, or if hives appear alongside other flu-like symptoms like fever, muscle aches, or swollen glands, consult a healthcare professional for testing and diagnosis.