HIV infection may not cause symptoms for a number of years or you may experience some early symptoms within 6-8 weeks of becoming infected. During this acute HIV infection, the virus is rapidly reproducing, and the body’s immune system is mounting a defense. The virus can easily be passed to other people during this period.

Initial symptoms may include:

• Fever
• Extreme, unexplained fatigue
• Swollen lymph nodes in armpits, neck, or groin
• Headache
• Dry cough
• Night sweats
• Rash
• Sore throat
• Joint Pain

After these initial symptoms are gone, there may be no symptoms for months to years, depending on your health status and lifestyle choices. It may be as long as 10 years before a person with HIV develops symptoms. Some infected people have had the virus for even longer periods without developing symptoms. Even though there are no symptoms, the virus is multiplying and damaging the immune system and can be passed on to someone else.

Once the virus sufficiently weakens the immune system, the following symptoms may occur over the course of 1-3 years:

• Swollen lymph glands all over the body
• Fatigue
• Fungal infections of the mouth, fingernails, toes
• Repeated vaginal infections (yeast and trichomonas)
• Development of lots of warts
• Exacerbations of prior conditions, such as eczema, psoriasis, and herpes infection
• Shingles
• Fever
• Night sweats
• Weight loss
• Chronic diarrhea
• Memory loss

Once HIV has progressed to AIDS, the immune system has become quite weakened and prone to opportunistic infections—infections that people with a normal immune system don't usually get. These infections occur in people with AIDS because the immune system isn't able to fight them off.

Examples of opportunistic infections and other complications of AIDS include:

• Thrush (an overgrowth of yeast)
• Pneumonia (particularly Pneumocystis jiroveci [formerly, carinii])
• Invasive fungal infections (resulting in brain and/or lung infections)
• Toxoplasmosis infection
• Tuberculosis
• Viral brain infection
• Kaposi's sarcoma
• Lymphoma
• Cervical cancer
• Eye disease due to cytomegalovirus infection
• Intestinal infections, especially due to shigella, salmonella, and campylobacter
• Severe weight loss (wasting syndrome)
• Severe skin rashes
• Reactions to medications
• Psychiatric problems, including depression and dementia

Symptoms of these conditions (opportunistic infections and other complications of AIDS) include:

• Shortness of breath
• Coughing with blood-tinged sputum
• Swallowing problems
• Confusion and forgetfulness
• Severe diarrhea
• Nausea and vomiting
• Vision loss
• Severe headaches
• Coma, but only in very severe cases of viral brain infection or terminal cases
• Reddish, brownish, or purple spots on the mouth or skin

References:

Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov.

Conn's Current Therapy 2001. 53rd edition. WB Saunders Company; 2001.

National Institute of Allergy and Infectious Diseases website. Available at: http://www3.niaid.nih.gov/.

Textbook of Primary Care Medicine. 3rd edition. Mosby, Inc.; 2001.

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