Early symptoms of HIV, the human immunodeficiency virus that attacks your body’s immune system, vary from person to person.Many people experience flu-like symptoms within two to four weeks of being exposed to HIV. However, when they experience other HIV symptoms is not as predictable.
Left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS). Early diagnosis is key to slowing down disease progression, and knowing the early symptoms can help you get diagnosed and treated as soon as possible.
This article will discuss the various stages of HIV, how symptoms may present in different people, how testing works, and what to expect if you test positive for the virus.
What Is Acute HIV Infection?
There are three stages of HIV infection:
- Stage 1: Acute HIV infection
- Stage 2: Chronic HIV infection
- Stage 3: AIDS
Acute HIV infection is the first stage of the infection. Usually within two to four weeks of infection, two-thirds of those with HIV will experience flu-like symptoms. They are the main first symptoms of HIV, lasting for several days or even weeks. However, some people may have no symptoms at all.
In this stage, there is a large amount of HIV in your blood, which is known as the viral load. Studies have noted incredibly high viral loads during the acute stage, meaning you are more contagious at this time.
When Do Symptoms Occur?
Some people have flu-like symptoms within two to four weeks after infection, but others may not feel sick or not develop symptoms at all until later.
Only antigen/antibody tests or nucleic acid tests (NATs) can diagnose acute HIV infection. NATs look for actual virus in the blood, and antigen/antibody tests look for HIV antibodies and antigens.
Antibodies are produced by your immune system when you’re exposed to viruses like HIV, and antigens are foreign substances that cause your immune system to activate.
However, no test can detect HIV immediately after infection. NATs can usually tell if you have an HIV infection 10 to 33 days after exposure, while antigen/antibody tests can tell 18 to 45 days after exposure.
How Long Can It Take to Realize You Have HIV?
See a healthcare provider if you have symptoms of HIV and think you may have been exposed to HIV.Getting testedis the only way to know for sure. The nucleic acid tests (NATs) can confirm an HIV infection in 10 to 33 days. The antigen/antibody tests do so in 18 to 45 days.
What to Expect Before, During, and After an HIV Test
Early Symptoms of HIV
How long it takes to show symptoms of HIV after infection will vary with each infected person, but there are some consistent patterns in how you feel when you have HIV.
Many symptoms of HIV do not show up immediately, but early symptoms can include:
- Night sweats
- Muscle aches
- Sore throat
- Swollen lymph nodes
- Mouth ulcers or sores
Early symptoms of HIV infection are similar, regardless of race or the sex and gender with which people identify. However, women may develop some unique HIV symptoms that include:
- More frequent vaginal yeast infections
- A higher risk of vaginal and sexually transmitted infections (STIs) overall, including chlamydia and the human papillomavirus (HPV) infections that may lead to cervical cancer
- Missed periods and other menstrual cycle changes
Men who have sex with men (MSM) have a much higher risk of HIV infection than other groups, and anal sex carries the highest risk regardless of sexual orientation or gender identity. Because HIV commonly occurs with other STI infections, symptoms to watch for include:
- Urethral discharge
- Pain or other changes with urination
- Ulcers or a rash around the penis or anus
- Rectal discharge or bleeding
- Pain during sex
- Pain when having a bowel movement
- Swollen lymph glands
Do Symptoms of HIV Show Up Immediately?
No. Many people will have an early, flu-like illness but some people can live for years without symptoms. As a result, about 13% of people living with HIV in the United States are unaware of their diagnosis. This makes testing all the more critical. The Centers for Disease Control and Prevention (CDC) recommends people ages 13 to 64 years be tested for HIV at least once in their life, regardless of symptoms.
How to Tell If Symptoms Are HIV
There are three types of HIV tests:
- AnNAT involves drawing blood from a vein. It can tell if you have HIV or how much virus is present in your blood. While an NAT can detect HIV sooner than other types of tests, this test isvery expensive and not routinely used for screening individualsunless they recently had a high-risk exposure or a possible exposure and have early symptoms of HIV infection. This test takes several days for results to come back.
- Anantigen/antibody testis recommended for testing done in labs and is now common in the U.S. It involves drawing blood from a vein, and results take several days to come back. There is also a rapid antigen/antibody test available that is done with a finger prick and takes 30 minutes or less to get results.
- HIVantibody testsonly look for antibodies to HIV in your blood or oral fluid. In general, antibody tests that use blood from a vein can detect HIV sooner after infection than tests done with blood from a finger prick or with oral fluid. Antibody tests can detect an HIV infection 23 to 90 days after exposure. Most rapid tests and the only currently approved HIV self-test are antibody tests. They take 20 minutes or less to provide results.
Keep in mind, any positive result (known as the preliminary positive) would necessitate a second test to confirm it. The only test that would not require a second confirmatory test is the NAT.
The time between when a person may have been exposed to HIV and when a test can tell for sure whether they have the virus is called thewindow period. The window period varies from person to person and depends on the type of test used to detect HIV.If you get an HIV test after a potential HIV exposure and the result is negative, you need to get tested again after the window period.
Which At-Home HIV Test Is Best?
What to Expect Next
If you find out you are HIV-positive, it’s important to keep in mind the condition is treatable. Antiretroviral therapy (ART) is recommended for all people with HIV, regardless of how long they’ve had the virus or how healthy they are.
ART works by lowering the amount of virus in the body to very low levels. ART medication is vital to slowing the progression of HIV infection and protecting the immune system.
Left untreated, HIV will progress to the second stage. During this stage, people may experience no symptoms at all. If no treatment is administered, an individual can stay in this stage for 10 to 15 years.
HIV Symptoms and Disease Progression
Studies vary on how long it takes for disease progression in people who have no symptoms of an acute HIV infection, in part because of differences in how progression is defined. A 2015 study from Japan reported an average of 2.9 years. The authors note results comparable to studies done in Germany and Holland, but they add that other study results show longer times and more research is needed.
How Do You Get HIV?
A Word From Verywell
Most people living with HIV in the U.S. will not experience progression to AIDS, due to advancements in treatment options. But early diagnosis is vital to slowing the progression of HIV. If you are in a high-risk group, it's recommended that you test every three to six months. A number of tests are available, including at-home options.
Frequently Asked Questions
How long does it take to show symptoms of HIV in a child?
HIV may be passed on from the parent during pregnancy, childbirth, or breastfeeding. Babies with HIV should be treated right away. Symptoms in children are similar to those in adults, and also may not emerge from several months or longer. They include swollen lymph nodes, fevers and sweats, and frequent infections.
Learn More:Diagnosing HIV in Infants and Toddlers
How is HIV spread and how can I prevent infection?
In the United States, HIV is spread mainly through having anal or vaginal sex or sharing needles or syringes with an HIV-positive partner. You can prevent HIV by always usingcondomscorrectly, and ensuring that HIV-negative partners take daily pre-exposure HIV medicine while HIV-positive partners maintain undetectable viral loads through medication.
Learn More:8 Steps to Prevent HIV
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
HIV.gov. How can you tell if you have HIV?
Centers for Disease Control and Prevention. About HIV.
Selik RM, Linley L. Viral loads within 6 weeks after diagnosis of HIV infection in early and later stages: observational study using national surveillance data.JMIR Public Health Surveill. 2018;4(4):e10770. doi:10.2196/10770
Centers for Disease Control and Prevention. HIV testing.
Illinois Department of Public Health. Facts About Women and HIV/AIDS.
Centers for Disease Control and Prevention. Men Who Have Sex With Men.
Centers for Disease Control and Prevention. HIV in the United States and dependent areas.
Centers for Disease Control and Prevention. Understanding a positive result.
Watanabe D, Suzuki S, Ashida M, Shimoji Y, Hirota K, Ogawa Y,et al.Disease progression of HIV-1 infection in symptomatic and asymptomatic seroconverters in Osaka, Japan: a retrospective observational study.AIDS Res Ther12, 19 (2015). doi:10.1186/s12981-015-0059-6
Planned Parenthood. What are the Symptoms & Signs of HIV in babies.
By Molly Burford
Molly Burford is a mental health advocate and wellness book author with almost 10 years of experience in digital media.
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