Human Immunodeficiency Virus (HIV) is a chronic condition that affects the body’s immune system. Symptoms of HIV can vary significantly among individuals and evolve over time.
Initial Symptoms
Within approximately 2 to 4 weeks after initial exposure, many individuals experience an acute, flu-like illness known as acute retroviral syndrome (ARS). Common manifestations include fever, fatigue, muscle aches, sore throat, and a skin rash. Swollen lymph nodes are also a frequent early sign. These symptoms are often mild and can easily be mistaken for other common viral infections, such as the flu or mononucleosis. The duration of these initial symptoms typically ranges from a few days to several weeks.
The Asymptomatic Period
Following the acute phase, HIV infection often transitions into clinical latency or chronic HIV infection. During this stage, the virus remains active within the body, reproducing at lower levels, but often causes few to no noticeable symptoms. This asymptomatic period can last for many years, potentially a decade or more, for some individuals if they do not receive treatment. Even without overt symptoms, the virus continues to damage the immune system by gradually depleting CD4+ T cells, which are crucial for fighting infections. While many people remain largely symptom-free, some might experience mild, non-specific symptoms such as persistent swollen lymph nodes, particularly in the neck, armpits, or groin, or general fatigue during this time.
Untreated Progression
If HIV infection is left untreated, the immune system weakens further, leading to the emergence of more severe and persistent symptoms. This advanced stage can manifest with chronic and debilitating issues as the body loses its ability to fight off infections and diseases effectively. Common symptoms include significant and unexplained weight loss, chronic diarrhea, persistent fevers, and night sweats. Individuals may also develop opportunistic infections, which are illnesses that a healthy immune system would typically resist. These severe symptoms are typically long-lasting and indicate substantial immune system damage, often progressing to acquired immunodeficiency syndrome (AIDS) without intervention.
How Treatment Changes Symptoms
Antiretroviral therapy (ART) profoundly changes the duration and manifestation of HIV symptoms. ART works by suppressing the virus, allowing the immune system to recover and preventing the progression to the severe, debilitating symptoms seen in untreated HIV. With consistent and effective ART, most people living with HIV can achieve an undetectable viral load, meaning the virus is present at very low levels, which allows them to live without significant HIV-related symptoms for decades. This effective suppression of the virus makes the severe symptoms associated with advanced, untreated HIV rare in individuals adhering to treatment. While ART can cause some mild side effects, such as nausea, diarrhea, headache, or fatigue, these are generally distinct from the symptoms of HIV itself and often lessen over time as the body adjusts to the medication.