Conditions That Look Like HIV but Are Not
What I Wish I Knew About HIV Symptoms
When I was diagnosed with AIDS in 1999, I had no knowledge of HIV/AIDS. My doctor told me that with my T-cell count so low and viral load so high, I had probably contracted the virus at least eight to 10 years earlier. This meant the virus had entered my body between 1989 and 1992. The majority of the time between when I contracted the virus and when I was diagnosed, I did not have any symptoms—or so I thought.
The first sign of HIV can be flu-like symptoms. Once those flu-like symptoms go away, the virus remains in you and continues to slowly multiply. During this time, you may have no symptoms at all. Or, as the immune system weakens, you may experience symptoms. I had to look back through the years before my diagnosis to think of any health concerns I had had that might have actually been symptoms of HIV. Turns out I did have symptoms of HIV—I just didn't know it at the time.
I'm not sure the exact years my symptoms started, but this is the order that I had them.
First I started to get more and more colds. I also felt like I had the flu when it was not flu season.
Then I started to get rashes on different parts of the body. I was getting the rashes right around the time my father passed away, my mom was diagnosed with cancer, and I got engaged. I assumed the rash had to do with the stress in my life. The rashes looked like poison ivy, so that's what doctors thought it was. The "poison ivy" rashes became less bumpy and bigger in size, so the doctor then thought the bump was a spider bite. The bump went away for awhile
Then I was planning my wedding, working, and taking care of my mother. I was feeling tired all the time and started to lose weight. Again, I assumed this running tired and losing weight was from stress. I was getting compliments about my weight loss and being asked what I was doing to lose weight. I was not doing anything to lose weight and was eating the way I normally ate. I was so tired I could not enjoy anything. After my wedding, I was so tired all I wanted to do was lie down. The rashes also started to come back.
Then the right side of my stomach and ribs started to hurt very badly from what felt like gas. Turns out I was having a gallbladder attack and had to have an emergency removal of my gallbladder. Now the doctors were really starting to wonder what was going on with me. The healthcare providers did all kinds of tests to see what had caused my gallbladder attack, and nothing was conclusive.
Editor's Note: HIV is one of the potential causes of acute cholecystitis, which is when the gallbladder becomes suddenly swollen and irritated.
The rash was then spreading to my anal area. My gynecologist saw the rash and sent me to the dermatologist. The dermatologist ran bloodwork to try to determine what was causing the rash. One of the blood tests was for HIV, which no doctor or me had ever thought of.
When I got the blood test results, I was told I had shingles and AIDS and that I had six months to live.
Editor's Note: People with HIV have a higher risk of shingles, a rash that develops after the virus that causes chickenpox reactivate in the body. Shingles can be a sign of chronic HIV infection.
The dermatologist referred me to an infectious disease doctor, but I couldn't be seen within the next six months because the infectious disease doctor had a waiting list of patients. My mom called my gynecologist and found a clinic that had just opened up in the area. We contacted the clinic, and they got me in right away. I was told that if I take medication for HIV, I could live many years.
It has been 24 years that I have been living and thriving with HIV/AIDS. If I knew more about HIV and its symptoms, I would have been more open to doctors about my sex life. I would have told them that I had unprotected sex with my previous boyfriend. I would have asked for an HIV test. The sooner you are tested for HIV, the sooner you can get on medication and the fewer symptoms you may have. Had I gotten an HIV test earlier, I might not have gotten so weak or developed shingles, and I could've started my treatment sooner.
What Are The Early Signs And Symptoms Of HIV?
Early symptoms of HIV can vary. However, possible signs and symptoms can include fever, night sweats, muscle aches, rashes, and more.
HIV is a virus that attacks the immune system. It can weaken a person's immunity to the point where their body has difficulties fighting infections and diseases.
If a person receives treatment for HIV after early diagnosis, they are less likely to develop more severe complications.
The annual number of new HIV diagnoses has declined in the United States since the mid-1980s. In 2020, 30,635 people in the U.S. Received an HIV diagnosis.
Historically, the virus disproportionally affects marginalized groups, among those with a diagnosis. For example, Black people and African Americans represent about 40% of those living with HIV despite comprising only 13% of the U.S. Population as of 2019.
Meanwhile, Hispanic and Latino people represent about 25% of people living with HIV while only 18.5% of the population. The rate of new HIV infections among Black women is 11 times that of the rate of white women and four times that of Latina women.
Similarly, transgender people represent about 2% of new HIV diagnoses, and among them, the majority are Black or African American people.
A person should never rely on symptoms alone to determine whether they have HIV. The only way they can know for sure is to undergo testing.
Early testing can help someone receive effective treatment and prevent transmission to other people.
The symptoms of HIV vary among individuals. However, early stage symptoms typically include the following:
However, not everyone will experience these symptoms.
How HIV affects the bodyHIV attacks the immune system. It specifically attacks the CD4 cells, a subtype of a T cell group. T cells help the body fight off infections.
Without treatment, HIV reduces the number of CD4 cells in the body, increasing a person's risk of getting infections.
If HIV progresses to stage 3, a person will have a higher chance of developing several complications, including an increased risk of developing certain cancers and opportunistic infections.
The Centers for Disease Control and Prevention (CDC) provides information on where individuals can find their nearest HIV testing center.
Do signs differ across genders?Many HIV symptoms present regardless of biological sex. However, people with vaginas living with HIV are at a higher risk of vaginal yeast infections.
People living with HIV are at a higher risk of sexually transmitted infections (STIs), regardless of sex or gender.
Doctors call the first stage of HIV an acute HIV infection. In the first few weeks after infection, people have large amounts of HIV in their blood and can easily spread it to others.
The first symptoms of HIV may develop within 2–4 weeks after infection, according to the Department of Health and Human Services, but some research suggests that it can take as long as 10 months.
Flu-like symptoms are the most common symptoms in the acute stage of HIV, also known as acute retroviral syndrome. Some symptoms a person may experience in this early stage, from most to least frequent, include:
Symptoms may last for a few days or several weeks, but not everyone with HIV will experience them.
Having these symptoms also does not mean that a person has HIV. These symptoms can occur with other infections, including the flu.
The only way a person can know for sure if they have HIV is to receive an HIV test.
The stages of HIV are as follows:
A person who receives antiretroviral treatment for HIV during stage 2 may stay in this phase for several decades, and the disease may never progress to stage 3 HIV. Because of this, they are less likely to experience serious complications.
Additionally, a person who receives treatment during the earlier stages may have a reduced HIV viral load. If the viral load is undetectable in HIV tests, it will not transmit to other individuals.
HIV can transmit from one person to another in different ways.
According to the CDC, most people transmit HIV through anal and vaginal sex without using a barrier method, such as a condom. The virus can also spread through the use of needles or syringes during intravenous (IV) drug use.
People can acquire HIV through contact with bodily fluids that contain the virus. The only bodily fluids that can transmit HIV are:
HIV can also pass to another person when these fluids enter their bloodstream, either through an injection or coming into contact with a mucous membrane or damaged tissue. Mucous membranes are present inside the rectum, vagina, penis, and mouth.
Additionally, a pregnant person can transmit the condition to an infant during pregnancy, although this is not always the case. Many pregnant people living with HIV can give birth to an infant without HIV if they receive the appropriate prenatal care and follow their treatment plan.
The World Health Organization (WHO) states that without any medical treatment, transmission rates from pregnant parents to their infants range from 15–45%. If an infant receives treatment during and after pregnancy, these rates can fall below 5%.
When can a person transmit HIV?In the early stage of HIV infection, the levels of the virus in the blood and semen are high, meaning a person can easily transmit the virus during this time. Additionally, transmission is more likely during this primary acute stage than in the following stage.
During stage 2, a person with HIV experiences fewer symptoms. However, they can still transmit the virus to others.
According to the CDC, a person with an undetectable viral load cannot transmit HIV to another individual. This is because HIV treatment suppresses the virus, leaving a low presence of the virus in the blood.
When medical professionals can no longer detect HIV in a test, the person cannot transmit it to others.
If a person believes they may have had exposure to HIV, they should undergo testing immediately.
People with a higher risk of HIV, such as those who work in healthcare or those who have sex without using protection, may also wish to consider routine testing.
Early diagnosis of HIV is crucial for preventing other potentially life threatening health conditions. Once a person receives a diagnosis, effective treatments are available.
Early diagnosis is also vital for helping prevent the transmission of HIV. If an individual knows they have the virus, they can take steps to avoid spreading it to others. One way to do this is through antiretroviral treatment.
What is a fourth-generation HIV test? Find out here.
If a person with HIV does not receive treatment, the condition may eventually progress to stage 3 HIV. Thanks to modern medical advances, current HIV infections rarely reach stage 3 in the U.S.
Stage 3 HIV is not a specific disease but a syndrome with a wide range of identifiable symptoms. The symptoms can also stem from other illnesses because opportunistic infections take advantage of the body's reduced immune activity.
Symptoms include:
If a person recognizes the early signs of HIV and seeks prompt diagnosis and treatment, there is a viable chance of preventing progression to stage 3.
With appropriate management of the virus, a person with HIV can live a long and healthy life.
What are HIV and AIDS? Find out more.
Treatment will depend on the individual and their complications. A person can consult a healthcare team to develop a suitable plan.
Antiretroviral drugsFor most people with HIV, antiretroviral therapy can help manage the virus. There are different types of antiretroviral medication, and the person may need a combination of drugs.
These medications can reduce the level of the virus in the blood until it becomes undetectable in tests. When this happens, there is no longer a risk of transmitting the virus to another person.
Following the prescribed treatment plan is essential to keep the virus at this low level.
Other therapiesPeople with HIV are more susceptible to other health conditions than those without HIV and may need specific treatment.
HIV affects the immune system, so an individual may be more likely to develop an infection, such as viral hepatitis or tuberculosis. A doctor can prescribe medication to prevent or treat these and other infections.
Other possible complications include cardiovascular disease, cancer, and some neurological disorders. If these arise, a healthcare team will help a person make a suitable treatment plan.
People with HIV who receive an early diagnosis have a viable chance of receiving effective treatment. This treatment can help them stay healthy and maintain their quality of life.
Anyone who notices symptoms or believes they may have contracted HIV should ask about testing immediately. With early testing and treatment, the outlook for many people with HIV is promising.
Read the article in Spanish.
HIV Symptoms
HIV infection happens in three stages. Without treatment, it gets worse over time and eventually overpowers your immune system. Your symptoms will depend on your stage.
The only way you can know for sure if you have HIV is to get tested. Although the virus can cause symptoms, they're not a reliable way to tell if you're infected. In fact, some people won't have any symptoms at all. So even if you don't have any of the typical signs of an infection, you should always get tested if you think you are at risk.
Some people notice flu-like symptoms 1-4 weeks after they're first infected. These often only last a week or two. This first stage is called acute or primary HIV infection. Then, you may go for 10 years or more without further symptoms. This is called asymptomatic HIV infection. Even though you feel fine, the virus is still active in your body. And you can still give it to someone else.
Once HIV has seriously harmed your immune system, you're at risk for diseases that a healthy body could fight off. In this stage, symptomatic HIV infection, you start to notice problems caused by these "opportunistic" infections.
Most people don't know right away when they've been infected with HIV. But they may have symptoms within 2 to 4 weeks after they've gotten the virus. This is when your body's immune system puts up a fight. It's called acute retroviral syndrome or primary HIV infection.
The symptoms are similar to those of other viral illnesses, and they're often compared to the flu. They typically last a week or two and then go away. Early signs of HIV include:
If you have symptoms like these and might have come into contact with someone with HIV in the past 2 to 6 weeks, go to a doctor and ask that you get an HIV test. If you don't have symptoms but still think you might have come into contact with the virus, get tested.
Early testing is important for two reasons. First, at this stage, levels of HIV in your blood and bodily fluids are very high. This makes it especially contagious. Second, starting treatment as soon as possible will help boost your immune system and ease your symptoms.
A combination of medications (called HIV drugs, antiretroviral therapy, or ART) can help fight HIV, keep your immune system healthy, and keep you from spreading the virus. If you take these medications and have healthy habits, your HIV infection probably won't get worse.
After your immune system loses the battle with HIV, the flu-like symptoms will go away. But there's a lot going on inside your body. Doctors call this the asymptomatic period or chronic HIV infection.
In your body, cells called CD4 T cells coordinate your immune system's response. During this stage, untreated HIV will kill CD4 cells and destroy your immune system. Your doctor can check how many of these cells you have with blood tests. Without treatment, the number of CD4 cells will drop, and you'll be more likely to get other infections.
Most people don't have symptoms they can see or feel. You may not realize that you're infected and can pass HIV on to others.
If you're taking ART, you might stay in this phase for decades. You can pass the virus on to other people, but it's extremely rare if you take your medicines.
AIDS is the advanced stage of HIV infection. This is usually when your CD4 T-cell number drops below 200 and your immune system is badly damaged. You might get an opportunistic infection, an illness that happens more often and is worse in people who have weakened immune systems. Some of these, such as Kaposi's sarcoma (a form of skin cancer) and pneumocystis pneumonia (a lung disease), are also considered "AIDS-defining illnesses."
If you didn't know earlier that you were infected with HIV, you may realize it after you have some of these symptoms:
People with AIDS who don't take medication live about 3 years, or less if they get another infection. But HIV can still be treated at this stage. If you start on HIV drugs, stay on them, follow your doctor's advice, and keep healthy habits, you can live a long time.
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