16 Signs You May Have HIV
Think you have HIV? The only way to tell is to get an HIV test, but here are some possible
symptoms. HIV symptoms
Within a month or two of HIV entering the body, 40% to 90% of people experience flulike
symptoms known as acute retroviral syndrome (ARS). But sometimes HIV symptoms don’t appear for
years—sometimes even a decade—after infection. “In the early stages of HIV infection, the
most common symptoms are none,” says Michael Horberg, MD, director of HIV/AIDS for Kaiser
Permanente, in Oakland, Calif. One in five people in the United States with HIV doesn’t
know they have it, which is why it’s so important to get tested, especially if you have unprotected
sex with more than one partner or use intravenous drugs.
Here are some signs that you may be HIV-positive. Fever
One of the first signs of ARS can be a mild fever, up to about 102 degrees F. The fever, if it occurs at all, is often accompanied
by other usually mild symptoms, such as fatigue, swollen lymph glands, and a sore throat.
“At this point the virus is moving into the blood stream and starting to replicate in
large numbers,” says Carlos Malvestutto, MD, instructor of infectious diseases and immunology
in the department of medicine at NYU School of Medicine in New York City. “As that happens,
there is an inflammatory reaction by the immune system.”
Fatigue The inflammatory response generated by your
besieged immune system also can cause you to feel tired and lethargic. Fatigue can be
both an early and later sign of HIV. Ron, 54, a public relations executive in the
Midwest, started to worry about his health when he suddenly got winded just walking.
“Everything I did, I got out of breath,” he says. “Before that I had been walking three
miles a day.” Ron had tested HIV positive 25 years before
feeling so tired; fatigue during acute, or newly contracted, HIV might not be so obvious.
Achy muscles, joint pain, swollen lymph nodes ARS is often mistaken for the flu, mononucleosis,
or another viral infection, even syphilis or hepatitis.
That’s not surprising: Many of the symptoms are the same, including pain in the joints
and muscles and swollen lymph glands. Lymph nodes are part of your body’s immune
system and tend to get inflamed when there’s an infection. Many of them are located in
your armpit, groin, and neck. Sore throat and headache
As with other symptoms, sore throat and headache can often be recognized as ARS only in context,
Dr. Horberg says. If you’ve engaged recently in high-risk behavior,
an HIV test is a good idea. Get tested for your own sake and for others: HIV is most
infectious in the earliest stage. Keep in mind that the body hasn’t produced
antibodies to HIV yet so an antibody test may not pick it up. (It can take a few weeks
to a few monthsfor HIV antibodies to show in a blood test). Investigate other test options
such as one that detects viral RNA, typically within nine days of infection.
Skin rash Skin rashes can occur early or late in the
course of HIV/AIDS. For Ron, this was another sign that he might
not have run-of-the-mill allergies or a cold. “They were like boils, with some itchy pink
areas on my arms,” Ron says. The rashes can also appear on the trunk of the body. “If
[the rashes] aren’t easily explained or easily treated, you should think about having an
HIV test,” Dr. Horberg says. Nausea, vomiting, diarrhea
Anywhere from 30% to 60% of people have short-term nausea, vomiting, or diarrhea in the early
stages of HIV, Dr. Malvestutto says. These symptoms can also appear as a result
of antiretroviral therapy and later in the infection, usually as the result of an opportunistic
infection. “Diarrhea that is unremitting and not responding
at all to usual therapy might be an indication,” Dr. Horberg says. Or symptoms may be caused
by an organism not usually seen in people with healthy immune systems, he adds.
Weight loss Once called “AIDS wasting,” weight loss is
a sign of more advanced illness and could be due in part to severe diarrhea.
“If you’re already losing weight, that means the immune system is usually fairly depleted,”
Dr. Malvestutto says. “This is the patient who has lost a lot of weight even if they
continue to eat as much as possible. This is late presentation. We still see a lot of
these.” It has become less common, however, thanks to antiretroviral therapy.
A person is considered to have wasting syndrome if they lose 10% or more of their body weight
and have had diarrhea or weakness and fever for more than 30 days, according to the U.S.
Department of Health and Human Services. Dry cough
A dry cough was the first sign Ron had that something was wrong. He at first dismissed
it as bad allergies. But it went on for a year and a half—and
kept getting worse. Benadryl, antibiotics, and inhalers didn’t fix the problem. Neither
did allergists. This symptom—an “insidious cough that could
be going on for weeks that doesn’t seem to resolve,” Dr. Malvestutto says—is typical
in very ill HIV patients. Pneumonia
The cough and the weight loss may also presage a serious infection caused by a germ that
wouldn’t bother you if your immune system was working properly.
“There are many different opportunistic infections and each one can present differently,” Dr.
Malvestutto says. In Ron’s case, it was Pneumocystis pneumonia (PCP), aka “AIDS pneumonia,” which
eventually landed him in the hospital. Other opportunistic infections include toxoplasmosis,
a parasitic infection that affects the brain; a type of herpes virus called cytomegalovirus;
and yeast infections such as thrush. Night sweats
About half of people get night sweats during the early stages of HIV infection, Dr. Malvestutto
says. These can be even more common later in infection
and aren’t related to exercise or the temperature of the room.
Similar to the hot flashes that menopausal women suffer, they’re also hard to dismiss,
given that they soak your bedclothes and sheets. Nail changes
Another sign of late HIV infection are nail changes, such as clubbing (thickening and
curving of the nails), splitting of the nails, or discoloration (black or brown lines going
either vertically or horizontally). Often this is due to a fungal infection, such
as candida. “Patients with depleted immune systems will be more susceptible to fungal
infections,” Dr. Malvestutto says. Yeast infections
Another fungal infection that’s common in later stages is thrush, a mouth infection
caused by Candida, a type of yeast. “It’s a very common fungus and the one that
causes yeast infections in women,” Dr. Malvestutto says. “They tend to appear in the mouth or
esophagus, making it difficult to swallow.” Ron woke up one day to find white patches
on his tongue. He had thrush. For him, “It was not bothersome other than I didn’t like
having it.” The infection was hard to get rid of, but finally cleared up after Ron started
taking drugs to combat HIV. Confusion or difficulty concentrating
Cognitive problems could be a sign of HIV-related dementia, which usually occurs late in the
course of the disease. In addition to confusion and difficulty concentrating,
AIDS-related dementia might also involve memory problems and behavioral issues such as anger
or irritability. It may even include motor changes: becoming
clumsy, lack of coordination, and problems with tasks requiring fine motor skills such
as writing by hand. Cold sores or genital herpes
Cold sores (oral herpes) and genital herpes can be a sign of both ARS and late-stage HIV
infection. And having herpes can also be a risk factor
for contracting HIV. This is because genital herpes can cause ulcers that make it easier
for HIV to enter the body during sex. And people who have HIV tend to have more severe
herpes outbreaks more often because HIV weakens the immune system.
Tingling and weakness Late HIV can also cause numbness and tingling
in the hands and feet. This is called peripheral neuropathy, which also occurs in people with
uncontrolled diabetes. “This is when the nerves are actually damaged,”
Dr. Malvestutto says. These symptoms can be treated with over-the-counter pain relievers
and antiseizure medicines such as Neurontin (gabapentin).
Menstrual irregularities Advanced HIV disease appears to increase the
risk of having menstrual irregularities, such as fewer and lighter periods.
These changes, however, probably have more to do with the weight loss and poor health
of women with late-stage infection rather than the infection itself.
Infection with HIV also has been associated with earlier age of menopause (47 to 48 years
for infected women compared to 49 to 51 years for uninfected women).
Individuals pictured are models and are used for illustrative purposes only.
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