Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Sep 14, 2018
Last Modified Date: Sep 14, 2018
Published Date: Aug 08, 2018
Human immunodeficiency virus, or HIV, is a virus that attacks the body's immune system, making it dangerously susceptible to infections. HIV compromises the CD4 cells that are responsible for fighting off infections and infection-related cancers. If HIV progresses to the point in which the body has so few CD4 cells that it can no longer fight off diseases and infections, the patient will develop AIDS, which is the final stage of this infection.
There's no cure for HIV, but you can control it with antiretroviral therapy (ART). This is a daily medication that lowers the patient's chance of transmitting HIV and helps to keep him or her healthy. The sooner you diagnose HIV, the better your chances of successfully controlling it and enjoying a long lifespan. Watch out for these key symptoms that may indicate HIV.
Fever and Chills
Image via Flickr by Claus Rebler
A fever is often one of the first symptoms an individual experiences with HIV. Any temperature over 100.4 is considered a significant fever. Fevers with HIV may climb up to 102. Fevers typically show up two to four weeks after the patient contracts HIV in what's known as the acute stage of the infection. This fever is often accompanied by other flu-like symptoms, such as fatigue, sore throat, and swollen lymph nodes.
Fevers typically accompany a viral infection and may appear with a variety of viruses the individual might pick up. A persistent fever in someone with stage 3 HIV is often the sign of an opportunistic infection. This type of infection takes hold because the immune system is too weak to fight it off as it would in a healthy person. Opportunistic infections include pneumonia, herpes simplex, tuberculosis, and bronchitis, among others.
Headaches are a common occurrence for some people, and may not be a cause for major concern. If you've been diagnosed with migraines or develop headaches through known triggers such as alcohol, dehydration, or stress, then you can typically treat these with pain medication. There are, however, some headaches that require more attention.
If you're experiencing frequent, prolonged headaches, you should speak to your healthcare provider as soon as possible. You should also call your doctor if you're battling a headache that's unusually severe. This type of headache may indicate a more severe underlying problem such as an HIV-related systemic disease. Patients with diagnosed HIV might experience headaches as a side effect of some ART medications. Don't let worrisome headaches go undiagnosed, as this may offer an early indicator of a bigger problem.
HIV can result in brain deficiencies as it progresses. Though ART can dramatically reduce levels of the virus in the body, HIV may continue to cause damage to the brain. Roughly half of the patients with HIV experience brain-related symptoms from HIV-associated neurocognitive disorder. The earlier you start HIV treatment, the lower your risk of suffering from damage to the brain cells.
Trouble concentrating is a later symptom of HIV. It's most commonly seen in patients who have had the virus undiagnosed for a long time. If HIV goes unnoticed, it can cause cognitive difficulties including trouble concentrating, memory loss, and confusion. If HIV is left untreated, this can progress to HIV-associated dementia. At this point, the patient may have trouble with reasoning and experience notable personality changes. Neurological symptoms should never be ignored. If you can't focus or concentrate as you used to, see a doctor as soon as possible.
Night sweats are just what they sound like. Patients wake up drenched in excessive perspiration for no apparent reason. The sweating is often so profuse that the individual has to change their pajamas or bedding. There are many conditions that can cause night sweats including diabetes, menopause, pregnancy, and sleep disorders.
In HIV patients, night sweats typically occur either very early in the disease or very late. During the acute stage of HIV, night sweats may accompany other symptoms such as muscle aches, fever, and headaches. Patients with later-stage HIV may experience night sweats in conjunction with a serious infection such as tuberculosis or cytomegalovirus. If you're experiencing frequent night sweats, it's best to discuss these with your doctor so you can uncover the underlying cause of this uncomfortable symptom.
HIV can lead to a number of infections that cause skin conditions. Rashes are extremely common among HIV patients, with roughly 90 percent exhibiting a rash at some point in the course of the disease. These rashes may appear as generalized dermatitis, an infection, or a skin lesion.
There are also several classes of antiretroviral drugs that can cause skin rashes. These typically exhibit as small, flat red bumps on the body that are very itchy.
If you haven't been diagnosed with HIV, a skin rash might be an early indicator of the acute stage of HIV. As the virus multiplies rapidly, it can cause a range of flu-like symptoms accompanied by a rash. Rashes are uncommon during the second stage, known as clinical latency. They may reappear in stage 3 HIV when the virus progresses to AIDS.
Changes in Your Nails
Changes in the nails are a subtle but distinctive indication of HIV. Most nail problems associated with HIV are the result of a fungal infection like onychomycosis. You might notice that the nails are thickening, splitting, or curving.
Discoloration of the nails is another sign you should pay attention to. You might notice dark black or brown lines running either vertically or horizontally. While some nail discolorations are harmless, it's important to discuss these nail changes with your healthcare provider. Don't simply cover the markings with nail polish and move on. Sudden unexplained nail changes often indicate a deeper problem that you need to address.
A sore throat is a common symptom of HIV that's easy to overlook. The sore throat is typically accompanied by a headache, muscle aches, and fever. You might attribute these to a cold or flu and put them out of your mind. However, if these symptoms persist, they may indicate something more serious.
If you've engaged in risky behavior such as unprotected sex, you should speak to your healthcare provider about any subsequent illness as soon as possible. Though it can take weeks or months for HIV to show up in a blood test, you can request a test that detects viral RNA to help you identify exposure to HIV sooner. These tests are accurate in just nine days of infection.
Sore throats aren't exclusive to the acute stage of HIV. HIV patients often experience recurring sore throats. In many cases, these are caused by thrush, a secondary infection that can take hold more easily in an individual with a compromised immune system. If you have thrush, your sore throat may be accompanied by difficulty swallowing.
Patients with HIV have a compromised immune system that makes them more susceptible to other conditions, such as pneumonia. Pneumonia is an infection causing inflammation of the lungs. Symptoms of pneumonia include chills, coughing, fatigue, low appetite, high fever, rapid breathing and heartbeat, and stabbing chest pain.
If you believe you may have pneumonia, you should always see a healthcare provider. In extreme cases, pneumonia is fatal. If you've experienced other common signs and symptoms of HIV or you've engaged in risky behavior that may have exposed you to the disease, speak with your doctor about getting tested for HIV as well.
In the acute stage of HIV, the virus reproduces rapidly. As your immune system produces its inflammatory response, you're likely to feel fatigued as a result. Though you can't see it, your body is waging a strenuous war inside. This can take all the energy out of you and leave you feeling like you need nothing more than to lay down and stay in bed for days.
HIV-related fatigue may exhibit itself in many ways. You might find that you're unusually winded after climbing a flight of stairs, or you're suddenly out of breath though you're not sure why. Perhaps you simply can't summon the energy for common tasks and activities like doing chores or going out with friends. Fatigue generally lets up some during stage 2 of HIV but will return again later as the virus progresses.
You may also experience fatigue with HIV that's an indirect, rather than direct, cause of the virus. HIV patients often struggle with depression or insomnia as a result of their diagnosis that may cause persistent fatigue as a result.
Nausea, Vomiting, or Diarrhea
Patients with HIV often experience a variety of stomach problems. These usually occur in later stages of the disease as a result of opportunistic infections that take hold. Nausea, vomiting, and diarrhea are common side effects with some antiretroviral medications as well.
If you're struggling with ongoing nausea, diarrhea, or vomiting, you should talk to your doctor to determine the underlying cause. In some cases, nausea is the result of something less serious, such as anxiety. In other cases, it can be a manifestation of a potentially serious virus.
If you're dealing with ongoing stomach problems with HIV, try switching to a bland diet. Avoid excessively hot or cold foods and stay away from anything spicy, greasy, or acidic. Eating smaller snacks throughout the day rather than three large meals may help as well.
HIV can cause muscle aches throughout the body. This symptom may also be the result of another virus or bacteria that was able to take hold because of the body's weakened immune system. Muscle pain with HIV can be mild in the early stages, feeling very much like the flu. This is particularly common in the acute stage.
HIV can also cause more severe muscle pain. This can be the result of HIV itself or a side effect of medications. This type of pain is also associated with high cholesterol or hepatitis. If you have achy muscles for no reason, speak with your doctor to find out the underlying cause of this discomfort.
Viral infections may cause painful joints. These infections cause the joints to become swollen and hot. HIV patients often develop HIV-related arthritis which can cause bone and joint pain. This pain usually starts in the feet and ankles, though it can later progress to other joints in the body. HIV-associated reactive arthritis causes pain and swelling in the fingers and toes.
Swollen Lymph Nodes
The lymph nodes are a key part of your body's immune system, which is why they're so frequently affected by HIV. Your lymph nodes assist the body in getting rid of viruses and bacteria when they're functioning properly. If there's an infection, the lymph nodes become inflamed in response.
You have lymph nodes in your neck, groin, and armpits. You may have felt these swell and become tender with other viruses. Doctors will frequently feel your lymph nodes when diagnosing you with an illness. If your lymph nodes are enlarged and painful, this is a sure sign that your body is battling something. HIV could be at the root of the problem. If you have painful lymph nodes for an extended period of time, you should call your doctor.
A dry, persistent cough is a common symptom in patients with late-stage HIV. This type of cough doesn't resolve with inhalers, allergy medication, or antibiotics and continues for an extended period of time. Patients may initially believe the cough is simply caused by a cold. Seasonally, it may seem like a symptom of allergies.
A cough related to HIV will outlive other common coughs. If you're still experiencing a dry hacking cough weeks after its initial onset, you should discuss the symptom with your doctor. This is an indicator of a more serious problem. If the cough is associated with HIV, it's a clue that you're very ill and should seek treatment as soon as possible.
Frequent Yeast Infections
Although they may seem innocent, too many yeast infections can indicate the presence of HIV. Symptoms of a vaginal yeast infection include persistent itching, a white discharge, and vaginal discomfort. Most women will experience one or more yeast infections in their lifetimes, as they're extremely common.
This fungal infection is caused by an overgrowth of yeast. Maintaining the right balance of bacteria and fungi in the body is particularly difficult for patients with HIV, as their immune systems are compromised. Yeast infections are particularly common in women with a CD4 count below 350 cells/mL. At this point, yeast infections are not only more frequent, they're also more severe and difficult to get rid of.
If you haven't been diagnosed with HIV but you're struggling with yeast infections that won't go away or persistently reoccur, discuss the problem with your healthcare provider as soon as you can.
One-third of all people with HIV develop mouth sores at some point. This is a direct result of the weakened immune system. It's important to address mouth sores with your doctor as soon as possible. Open sores make you more susceptible to infection. They can interfere with your medications and make eating difficult and painful.
Many HIV patients also suffer from herpes simplex, which will cause red mouth sores. These can look more like blisters when they appear outside the mouth. An oral herpes outbreak is treatable with medication, but patients with HIV may have more difficulty healing such sores. It's not uncommon for a herpes outbreak to last longer and be more severe in a patient with HIV.
There's a strong connection between genital herpes and HIV. People with sores from genital herpes are more likely to contract HIV from intercourse. These sores are a magnet for immune system cells, which attempt to heal them. HIV is drawn directly to these cells, so any infected bodily fluids that come into contact with herpes sores present an extremely high risk of infection.
An active herpes virus also allows HIV to replicate more quickly once the patient is infected. Individuals with HIV will have more outbreaks of genital herpes. These are often longer and more severe than they would be in a patient without HIV. If you have genital herpes, it's important to be particularly mindful of the increased risk for HIV infection. A sharp increase in the frequency and severity of herpes outbreaks could be an indicator of HIV for a patient who isn't yet aware of the virus.
Unexplained Weight Loss
Unexplained weight loss may be a concern when you lose 10 pounds or five percent of your body weight over a period of six to 12 months without cause. Weight loss is a common problem for patients with advanced HIV. Weight loss and wasting frequently happen as CD4 cell counts drop. Weight loss is even an independent predictor of mortality for patients with HIV.
Since weight loss happens so late in the progression of HIV, patients typically know that they have the virus by that point. Any unexplained weight loss should be addressed with your healthcare provider, regardless of the cause. If you have HIV, weight loss is particularly concerning because it will further hamper your body's ability to fight infection.
Changes in one's menstrual cycle can be an indicator of HIV in women. Changes to your immune system caused by HIV will affect the hormone levels in your body. This, in turn, can have a noticeable impact on your menstrual cycle. If estrogen, testosterone, and progesterone levels change significantly, your period can adjust in many ways.
Though the timing, length, and heaviness of a woman's period can vary from person to person, most women know what's familiar to them. If you notice that your periods are occurring more or less frequently, the duration has changed, or you're spotting between cycles, you should address the issue. You should also speak with your doctor about periods that are lighter or heavier than usual, particularly if these types of changes persist past a single cycle.
Women who are on an anti-HIV medication are less likely to experience these issues. Therefore, menstrual irregularities are most pronounced in women with HIV that has not been diagnosed.
Numbness and Tingling
In later stages of HIV, patients may have damage to the nerves in the spinal column and brain. This chronic inflammatory polyneuropathy causes a feeling of numbness and tingling in the extremities. This is usually experienced in the fingers and toes. As the condition progresses, the sensation may extend into the arms and legs.
HIV neuropathy may also cause severe aching or burning sensations in the arms, fingers, legs, and toes. Weakness in the extremities may occur as well. This is one of the more difficult effects of HIV neuropathy as it can greatly interfere with daily activities. If you have a known HIV infection, you should address numbness and tingling with your doctor as soon as possible. If you haven't been diagnosed with HIV, these symptoms may indicate the need to get tested.
Depression and other neurological symptoms are a common sign of HIV. However, patients who are already diagnosed with HIV may also suffer from depression as a result. Following this diagnosis, individuals often experience feelings of sadness and grief. If these emotions worsen into a case of serious clinical depression, this should be addressed so patients can manage both their HIV and their depression to live a healthy life.
HIV-positive women are more likely to suffer from depression than HIV-positive men. Those in rural America are also at a higher risk because they may have access to less information, not realizing the improved outcomes that are now possible for people who have the virus. Anyone with HIV should receive regular mental health screenings.
Though most symptoms of HIV are also attributable to other causes, noting long-lasting or recurring symptoms may tip you off to a bigger concern. If you suffer from several of these symptoms or have troublesome symptoms on a frequent basis, speak with your doctor about whether HIV blood testing is an appropriate move.