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HIV symptoms: What are the early signs of HIV?

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician
Updated Apr. 10, 2024  •  Published Sep. 15, 2023
Fact Checked
HIV symptoms: What are the early signs of HIV?

Overview: What does HIV feel like?

The human immunodeficiency retrovirus, or HIV, infects the body's immune system cells. Without treatment, an HIV infection weakens the immune system. It eventually causes acquired immune deficiency syndrome (AIDS), the most advanced stage of HIV infection. HIV/AIDS is a serious and life-threatening illness in which the immune system cannot fight off infections and cancers. Though incurable, HIV can be controlled. AIDS can be avoided with treatment. Left untreated, AIDS is always fatal. The time between initial exposure to HIV and the development of symptoms is usually 2 to 4 weeks. When a person is first infected with HIV, the infection feels like a flu infection. Fever, fatigue, generalized rash, headache, sore throat, and swollen lymph nodes are the most common symptoms and are easily mistaken for a less serious infection. Most of these symptoms self-resolve after a few days. After this initial episode of symptoms, HIV can be asymptomatic for several years. If HIV is untreated, people with the infection can feel normal and healthy for up to ten years. Meanwhile, during this time, the retrovirus is multiplying and weakening their immune system. People who are immunocompromised are too weak to fight off even routine infections. At that point, the warning signs are unusual yeast infections, herpes breakouts, rare cancers, or pneumonia. Once HIV evolves into AIDS, people experience a steadily increasing number of severe infections and illnesses unless antiretroviral drugs can control the HIV infection and improve immune function.

Key takeaways:

  • HIV is a common health condition affecting anyone regardless of age, sex, race, or ethnicity. 

  • Early signs of HIV include a constellation of symptoms: fever, fatigue, feeling sick, joint pain, headache, appetite loss, rash, night sweats, muscle pain, nausea, diarrhea, and sore throat. Some have no symptoms after initial exposure.

  • Serious symptoms of HIV may require immediate medical attention. These symptoms may include severe pain, uncontrolled bleeding, trouble breathing, shortness of breath, chest pain, seizures, severe vomiting, severe diarrhea, or changes in mental status.

  • HIV infection is caused by the human immunodeficiency virus. HIV transmission is primarily through sexual contact or blood exchange. You may be at risk for developing HIV symptoms if you are male and have sex with men, use intravenous drugs, or have unsafe sex. Other risk factors include blood transfusions, tissue transplants, medical procedures, or needle stick injuries among healthcare providers.

  • HIV requires a medical diagnosis.

  • HIV requires treatment. HIV advancing to AIDS can be prevented with treatment. HIV or AIDS symptoms can resolve with treatment, but the timeline is variable depending on the severity of the illness and responsiveness to medications. 

  • Treatment of HIV may include antiretroviral drugs and treatment of opportunistic infections and cancers. Read more about HIV treatments here.

  • Untreated HIV often results in complications like acquired immune deficiency syndrome (AIDS), opportunistic infections, cancers, kidney disease, dementia, and death.

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What are the early signs of HIV?

The early signs of HIV infection appear about two to four weeks after exposure but can sometimes take up to three months after exposure. The symptoms are similar to the flu or mononucleosis:

  • Fever (80% of people who experience acute HIV symptoms)

  • Fatigue (78%)

  • Feeling sick (68%)

  • Joint pain (54%)

  • Headache (54%)

  • Loss of appetite (54%)

  • Skin rash (51%)

  • Night sweats (51%)

  • Muscle pain (49%)

  • Nausea (49%)

  • Diarrhea (46%)

  • Sore throat (44%)

  • Mouth sores (37%)

  • Neck stiffness (34%)

  • Weight loss (32%)

  • Confusion (25%)

  • Light sensitivity (24%)

  • Vomiting (12%)

  • Gum infections (10%)

Other HIV symptoms

HIV symptoms depend on the stage of the infection. HIV is a progressive infection that steadily weakens the immune system by destroying a type of white blood cell called CD4 cells (or “helper T cells”). These cells are critical to immune health. The stages of an HIV infection are diagnosed by symptoms and the CD4 cell count (the number of CD4 cells per milliliter of blood). Healthy CD4 counts are greater than 500. The immune system is progressively more unhealthy when the count falls below 500 and critical when the count falls below 200.

Acute HIV infection (two to four weeks after exposure)

The initial stage of the infection occurs within a few weeks of exposure to the virus. It is called acute HIV infection or acute retroviral syndrome (ARS). The symptoms are caused by the immune system’s reaction to the virus. Not everyone will have these symptoms, but most people will:

  • Fever 

  • Fatigue 

  • Feeling sick 

  • Joint pain 

  • Headache 

  • Appetite loss

  • Rash 

  • Night sweats 

  • Muscle pain 

  • Nausea 

  • Diarrhea 

  • Sore throat 

  • Mouth sores 

  • Neck stiffness 

  • Weight loss 

  • Confusion 

  • Light sensitivity 

  • Vomiting 

  • Gum infections 

Chronic HIV infection (one to three months after exposure)

After the initial symptoms resolve in a week or two, the HIV infection does not produce symptoms for a decade or more. During this time, the retrovirus multiplies in the body and weakens the immune system. This second stage is called chronic HIV infection or clinically latent HIV. For most of this time, the CD4 count remains in the healthy range and slowly drops.

Symptomatic HIV infection (years after exposure)

At some point, an untreated chronic HIV infection may involve opportunistic infections if the immune system is weakened but not weak enough for an AIDS diagnosis. In these cases, the CD4 count will be between 200 and 500. Called symptomatic HIV infection, the common symptoms include:

  • Fever

  • Fatigue

  • Swollen lymph nodes

  • Yeast infections such as oral thrush

  • Herpes infections

  • Unusual infections

Symptoms of AIDS (8–10 years after exposure)

AIDS is diagnosed when the immune system is too weak to fight routine infections and cancers. The CD4 count drops below 200. This stage is marked by a progression of serious and potentially life-threatening illnesses. These infections and cancers involve every system in the body, so the number and variety of symptoms are numerous and variable: 

  • Symptoms of opportunistic infections such as fever, night sweats, fatigue, swollen lymph glands, and mouth or skin ulcers

  • Heart problems such as chest pain, shortness of breath, and fatigue

  • Blood vessel problems such as swelling of the extremities.

  • Lung problems such as difficulty breathing and respiratory distress.

  • Digestive system complaints, including diarrhea (the most common), abdominal pain, nausea, vomiting, and constipation

  • Pancreatitis symptoms such as upper abdominal pain

  • Liver dysfunction symptoms such as jaundice

  • Central nervous system symptoms such as headache, vision changes, confusion, difficulty speaking, memory loss, weakness, loss of motor skills, dementia, seizures, and coma

  • Symptoms of anemia, such as weakness, chest pain, or shortness of breath

  • Cancer symptoms such as weight loss

  • Skin symptoms such as rash, sores, nodules, and lesions

  • Kidney dysfunction

  • Rapid weight loss (wasting)

HIV vs. AIDS symptoms

Acute HIV is the first stage of an HIV infection. It is caused by the body’s aggressive immune response to the virus rapidly filling the bloodstream. Symptoms are similar to the flu or mononucleosis. Acquired immunodeficiency syndrome (AIDS) is the last life-threatening stage of an HIV infection. It involves a cascade of serious infections, cancers, and HIV complications, so AIDS is characterized by many symptoms that can affect any part of the body. 

HIV AIDS
Shared symptoms
  • Fever 
  • Fatigue 
  • Feeling sick 
  • Joint pain 
  • Headache 
  • Loss of appetite 
  • Skin rash 
  • Night sweats 
  • Muscle pain 
  • Nausea 
  • Diarrhea 
  • Sore throat 
  • Mouth sores 
  • Neck stiffness 
  • Weight loss 
  • Confusion 
  • Light sensitivity 
  • Vomiting 
Unique symptoms
  • Numerous, variable, and changing symptoms involving multiple organs and parts of the body, including:
  • Rapid weight loss
  • Weakness
  • Chronic lymph node swelling
  • Persistent diarrhea
  • Chest pain
  • Shortness of breath
  • Difficult breathing
  • Respiratory distress
  • Severe pain
  • Vision changes
  • Memory loss
  • Seizures
  • Coma
  • Abdominal pain
  • Constipation
  • Peripheral edema
  • Skin blotches, sores, nodules, or lesions

When to see a doctor for HIV symptoms

People who suspect they are infected with HIV for any reason should get tested. It doesn’t matter if there are symptoms. If you have any reason to worry about an HIV infection, you should be worried about an HIV infection. 

The only way to diagnose an HIV infection is with a blood or saliva test. Rapid testing of blood or saliva can return a result in hours. An assay test looks for antibodies in the blood, while more precise polymerase-chain-reaction tests detect the virus and can roughly estimate the viral load (the amount of virus in the body). These test results may take a few days to complete.

Complications of HIV

Untreated HIV, in nearly all cases, will progress to AIDS. Complications include:

How to treat HIV symptoms

HIV infection is treated with antiretroviral drugs. There are several types of drugs, and most people will take combinations of two or three drugs daily for the rest of their lives. 

People not yet infected but at risk of HIV infection may opt to start antiretroviral therapy to prevent HIV infection. Called pre-exposure prophylaxis (PrEP), the treatment involves taking pills that combine two different types of antiretroviral drugs. These pills are taken daily until a person does not believe they are at high risk for the infection. 

People who may have been exposed to HIV can also be treated with HIV medicines even if no virus is detectable. Called post-exposure prophylaxis (PEP), treatment must start within 72 hours of a suspected exposure. The treatment involves taking three types of antiretroviral drugs daily for 28 days. PEP is estimated to be 90% effective at preventing HIV infection.

For chronic HIV infection, people will take antiretroviral drugs every day for the rest of their lives to prevent AIDS. 

People with AIDS will be treated with antiretroviral drugs, antivirals, antifungals, and antibiotics to help ward off opportunistic infections. They may also take treatments specific to their illnesses. With timely treatment, AIDS symptoms can be reversed in many people with the disease. 

Living with HIV

HIV is a lifelong infection. The virus cannot be eliminated from the body but can be controlled. People on antiretroviral therapy have life expectancies nearly equal to those not HIV-infected. Here’s how to help treatment succeed:

  • Get treatment as soon as possible, no matter how well you feel

  • Take the medications as prescribed

  • Keep all appointments with healthcare providers

  • Get treatment for any other STDs or substance abuse issues

  • Tell your sexual partners that you are HIV-positive 

  • Use condoms to prevent transmission

  • Consider less risky sexual activities that do not involve the exchange of body fluids

  • Get support from friends, family, support groups, or mental health professionals

  • Eat a healthy diet

  • Exercise regularly

  • Stop smoking

Most importantly, get tested

If there’s any reason to worry about an HIV infection, get tested. HIV tests are simple and the only way to diagnose an HIV infection. The sooner antiretroviral therapy is started, the better the chance that a person will live a long and healthy life with HIV.

FAQs about HIV symptoms

What is the number one HIV symptom?

Fever is the most common symptom after exposure to the virus. Recurrent fevers and night sweats are the most common symptoms of AIDS, the last stage of an HIV infection.

How long can you have HIV without knowing?

Most HIV infections will cause symptoms a few weeks after exposure. However, these symptoms are easily mistaken for more familiar infections like the flu. Some people may not have any initial symptoms after acquiring the retrovirus. Once the initial symptoms subside, a chronic HIV infection can have no symptoms for over a decade. 

When do HIV signs start showing?

Early HIV infections typically have flu-like symptoms within a few weeks of exposure. Once those early symptoms pass, it can take eight, ten, or more years for symptoms of advanced HIV infection to appear. 

What’s next? Additional resources for people with HIV symptoms

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician

Leslie Greenberg, MD, is a board-certified practicing family physician with more than 25 years of doctoring experience. She was a psychology major at Northwestern University near Chicago, then graduated with an MD from the University of Nevada School of Medicine. She completed her family medicine residency at St. Joseph Hospital in Wichita, Kansas. She has trained more than 350 family medicine resident-physicians, been in private practice, and delivered babies for 22 years.

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