What are the symptoms of HIV and AIDS in the chronic and acute phase?

The HIV , which stands for human immunodeficiency virus is a causative retrovirus of AIDS .

In the body, this virus acts by attacking the immune system of the individual, especially damaging the CD4 + T lymphocytes, white blood cells or defense cells that act in the fight against invading infectious agents.

It is from the attack on these cells that HIV is able to multiply and, after this replication, break these lymphocytes and continue the infection.

The main form of HIV transmission occurs through unprotected sex. However, the virus can also be passed through the sharing of contaminated syringes or from mother to child, during pregnancy, childbirth and breastfeeding.

In the latter case, transmission can be prevented, when preventive measures are followed correctly, especially during prenatal care. In all cases, early diagnosis is essential.

There is still no cure for HIV infection, but it is possible to prevent and help reduce the rates of transmission and mortality from the disease, which is still considered a serious global public health problem.

In the following text, we will describe the symptoms present in the different stages of the infection.

AIDS or HIV?

In order to understand the symptoms, it is first important to know how to distinguish the difference between a person who has the HIV virus and a person who has AIDS.

The AIDS is the disease caused by the virus is the condition in which the HIV positive patient receives no treatment or does not follow properly. In this situation, your immune system is potentially weakened, favoring the development of other diseases.

On the other hand, people with the HIV virus can lead a normal life. Many people living with HIV live without symptoms and without developing the disease when they receive and follow the treatment correctly.

However, even in these cases, precautions for prevention must be taken, so that they do not transmit the virus to other people.

Acute infection: first symptoms of HIV

Acute infection or acute retroviral syndrome is the first stage of infection caused by the HIV virus, present in about 50% to 90% of patients. At that moment, the virus incubates, the time between the initial infection and the multiplication of the infectious agent in the organism, until the appearance of the first symptoms.

According to the Ministry of Health, the incubation time normally lasts from 3 to 6 weeks, with the time to produce antibodies against the virus from 30 to 60 days. However, this time may vary slightly for each patient.

In addition, the acute phase is characterized by the body’s autoimmune response and the presence of the virus in the bloodstream (viremia), after its replication in the incubation period.

According to the Centers for Disease Control and Prevention (CDC), after 2 to 4 weeks of infection, patients can already show the first symptoms.

Usually, they are similar to those of a cold or flu , which makes the diagnosis of HIV difficult. Because they are milder symptoms, they usually go unnoticed or without the attention they should have.

However, although in most cases the symptoms are similar to those of the flu, there are cases in which the acute phase may manifest signs similar to those of a mononucleosis-like syndrome, the name given to the set of diseases with nonspecific symptoms.

Symptoms usually last an average of 14 days. However, it is important to observe whether this time is prolonged, as the duration of symptoms may be related to the more accelerated evolution of the disease.

The main symptoms in this phase, according to data from the Ministry of Health, are the following:

Fever

The temperature during the period of acute HIV infection is prevalent in 80% to 90% of patients who may have temperatures of 38.3 ° C or more.

Fatigue

It affects 70% to 90% of patients with HIV in the acute phase, and may also be present in the advanced stage of the disease.

The fatigue is a characteristic symptom to cause a feeling of fatigue , stress and lack of energy, is common in many diseases.

In the case of HIV, when the symptom is progressive or even debilitating, a more accurate diagnosis is necessary.

Tests may be necessary to eliminate the possibility of an opportunistic infection, a type of infection that occurs in people with low immunity that would not happen in healthy people.

Skin rash or rash

The skin rash, also called an exanthema, is a type of lesion that affects the skin, causing reddish rashes in the patient with the HIV virus. It is present in between 40% and 80% of cases during the acute phase.

Headache (headache)

In the first stage of infection, headache is present in 32% to 70% of patients, usually being a symptom accompanied by other signs listed here.

Lymphadenopathy

Lymphadenopathy, a condition also known as adenopathy and adenomegaly, occurs when there is an increase in the size of the lymph nodes (or lymph nodes).

These ganglia are small glands scattered throughout the body, which help the immune system.

They appear in the body in a distributed way, but also grouped. Some are found in the regions of the neck, groin and armpits. When an infection occurs close to these nodes, as in the case of HIV, they become swollen.

In the acute phase of infection, lymphadenopathy can be present in 40% to 70% of cases.

Pharyngitis

The pharyngitis is an inflammation that occurs in the pharynx, organ located in the throat area. It usually causes symptoms such as pain, itching, discomfort and irritation in the throat.

In patients with HIV, pharyngitis manifests itself frequently. It is estimated that the condition is present in 50% to 70% of cases of acute infection.

Muscle and joint pain

Some of the symptoms present in the acute phase of HIV infection are muscle pain (myalgia) and joints (arthralgia). These two symptoms can occur in 50% to 70% of cases.

Nausea, diarrhea and vomiting

These symptoms, which can manifest themselves in isolation or in association, occur between 30% and 60% of cases during this phase of HIV.

Night sweats

Night sweating is common in HIV patients. It can happen in isolation or accompanied by symptoms such as fever. The presence of these two symptoms together, however, can be an indication of an opportunistic infection, such as tuberculosis , for example.

The incidence in which night sweats are manifested in the acute phase can be up to 50% of cases.

Viral meningitis

The meningitis is a disease characterized by inflammation of the meninges, membranes which coat and protect the central nervous system (CNS). The most common type is viral meningitis , that is, caused by viruses.

In the case of infection caused by the HIV virus, this type of meningitis can occur in 24% of patients who are in the acute asymptomatic phase of HIV.

Mucocutaneous ulcers

Ulcers, in the acute phase of infection, can affect the oral mucosa (10% to 20% of patients) and genital mucosa (5% to 15% of patients). They may have a red appearance around and whitish in the center, causing pain and discomfort in the affected region.

Thrombocytopenia and lymphopenia

The thrombocytopenia is the reduction of platelets in blood cells important for stagnation and clotting of bleeding. The condition can occur in 45% of cases in the acute infection phase.

Lymphopenia, a condition in which there is a deficiency in the number of lymphocytes, affects, on average, 40% of cases.

Chronic infection: asymptomatic period of HIV

In the asymptomatic phase, a period also known as chronic HIV infection or latency stage, the patient has no symptoms or minimal symptoms .

However, in some cases, patients have persistent generalized lymphadenopathy, a painless and oscillating condition in which the lymph nodes (or lymph nodes) change in size and appearance.

At this stage of the infection, even in latency, the virus remains active in the body, reproducing at levels low enough not to make the patient sick.

When he is not under treatment, this phase can extend for 10 years or more, and can progress rapidly in some people.

According to Dr. Mônica Gomes, an infectious disease specialist at the Brazilian Society of Infectious Diseases (SBI), the asymptomatic or latency period is relatively long because this is the natural history of the virus.

“Each infectious agent, when it promotes a disease, has a natural history. When you get influenza , the natural history is that you get sick for about 7 or 10 days. But the natural history of HIV is a history of an average of 10 years of illness, ”he explains.

Thus, after an acute infection, which may or may not have symptoms, there is a phase in which the patient’s immunity fights against the virus.

After this period, according to the infectologist, there is a control of the replication of the virus, which happens in a smaller amount, while the immune system is strengthened.

“Over time, the virus creates mutations to overcome the immune response and kills the defense cells until the virus carrier becomes sick. This takes an average of 8 years, but it is only an average ”.

For those who receive treatment and make use of the remedies properly, this phase can last for several decades. However, it is essential to reinforce that, even in a latency period, people with HIV can continue to transmit the virus.

For this reason, people who receive treatment and use medication daily, even though they are less likely to transmit it, should continue to maintain care to avoid passing the virus on to others.

At this stage, the virus is generally not able to cause specific symptoms, but it continues to damage the immune system. Diagnosis and treatment are essential so that the condition does not progress to a more advanced stage of infection (AIDS).

At the end of the asymptomatic period, the patient’s body begins to produce fewer CD4 cells, lymphocytes that are part of the immune system and are the main target of HIV.

Thus, as the virus progresses and the defense system weakens, the symptoms appear and the patient progresses to the more advanced stage of the infection.

Acquired Immunodeficiency Syndrome (AIDS)

AIDS is the most serious condition of infection caused by the HIV virus , considered the third stage of infection.

In this phase, the patient has a very weakened immune system, which only increases the risks of developing opportunistic diseases, which can be serious and lead to death.

According to the Centers for Disease Control and Prevention (CDC), without treatment, a patient with AIDS has low life expectancy and can survive about 3 years.

For the patient to be diagnosed with AIDS, the number of CD4 cells must be below 200 cells / mm. The diagnosis of opportunistic diseases (or defining diseases) and pregnant women infected with the HIV virus is also taken into account.

The pathologies with the highest incidence in AIDS patients include tuberculosis, Kaposi’s sarcoma , esophageal candidiasis and pneumonia , often caused by the fungus P. jirovecii  (P. carinii)  and cytomegalovirus (virus of the herpes simplex family, etc.).

Regarding the symptoms of AIDS, it is difficult to present a single clinical picture, as it depends a lot on the diseases that can develop from the infection of the HIV virus and the affected organs.

Thus, it is possible to consider that there are several symptoms of AIDS. Some of them include:

  • Chills;
  • Fever;
  • Night sweat;
  • Swollen lymphatic glands (lymphadenopathy);
  • Weight loss;
  • Weakness;
  • Lack of air;
  • Dry cough;
  • Difficulty swallowing;
  • Diarrhea;
  • Nausea, vomiting and abdominal cramps;
  • Headache;
  • Stains on the lining of the mouth or on the skin, near the nose and eyelids;
  • Development of some types of cancer;
  • Neck stiffness;
  • Neurological disorders, such as depression, impaired memory and confusion;
  • Photophobia or loss of vision.

In relation to opportunistic diseases, there are several conditions that can affect AIDS patients, due to low immunity. Associated pathologies are also called defining diseases. Are they:

  • Sarcoma de Kaposi;
  • Central Nervous System lymphoma and Burkitt’s lymphoma;
  • Esophageal candidiasis and pulmonary (or tracheal) candidiasis;
  • Herpes labial e genital;
  • Histoplasmose;
  • Cervical cancer;
  • Fungal infections such as disseminated coccidioidomycosis and extrapulmonary cryptococcosis;
  • Viral diseases, such as cytomegalovirus and recurrent multifocal leukoencephalopathy
  • Parasitic diseases, such as chronic intestinal isosporiasis;
  • Tuberculosis;
  • Toxoplasmosis;
  • Sepsis (generalized infection) caused by salmonella bacteria ;
  • Recurrent pneumonia;
  • Encephalopathy (brain disorder) caused by HIV.

These types of disease can be caused by the presence of infectious agents such as bacteria, viruses, protozoa and fungi, and the development of types of cancer .

In patients with this condition, even microorganisms that are not considered a risk can cause an opportunistic disease.


HIV causes different symptoms depending on the stage at which the patient is, considering cases in which treatment is not performed.

This article sought to clarify how the symptoms manifest themselves, from the infection of the HIV virus.

If you think you have been exposed to the virus, seek medical help to perform a test and always remember how important it is to prevent yourself to prevent this and other sexually transmitted diseases. Thanks for reading!

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