- First Stage: Acute HIV Infection Symptoms
- A Timeline of HIV Symptoms
- 29 Days to 20 Years After Exposure
- Later-Stage HIV and AIDS
- Acute HIV Infection
- What is acute HIV infection?
- Symptoms of acute HIV infection
- Causes and stages of acute HIV infection
- Diagnosis of acute HIV infection
- Treatment of acute HIV infection
- Prevention of acute HIV infection
- Acute HIV infection FAQs
- Other names for acute HIV infection
- Diagnosing AIDS-Related Lymphoma
- HIV Infection and Lymphoma
- Blood Tests to Diagnose HIV
- Lymph Node Biopsy
- Bone Marrow Aspiration and Biopsy
- Lumbar Puncture
- Imaging Tests
- Additional Blood Tests
- More on HIV Symptoms at TheBody.com
- HIV Swollen Lymph Nodes Singapore | Shim Clinic
- What is the link between HIV and shingles?
- CATIE News
- What Is It?
- HIV And Swollen Lymph Nodes
- What are Lymph Nodes?
- How does HIV affect lymph nodes?
- Other Symptoms:
- HIV Signs and Symptoms
First Stage: Acute HIV Infection Symptoms
Most people don’t know right away when they’ve been infected with HIV. But they may have symptoms within 2 to 6 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:
- Aching muscles
- Sore throat
- Swollen lymph nodes
- A red rash that doesn’t itch, usually on your torso
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 might 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.
A Timeline of HIV Symptoms
29 Days to 20 Years After Exposure
The chronic stage of infection occurs once the immune system brings the virus under control. During this phase, HIV will go into hiding, where it resides in various cells and tissues throughout the body in a dormant state known as latency. HIV latency can persist without symptoms for 10 years or more, although some people may experience signs within a year or two.
During the early chronic phase, lymphadenopathy may be the only notable sign of an HIV infection. In some cases, the glands may be visibly enlarged and reach up to an inch or more in size. If the condition persists for more than three months, it’s referred to as persistent generalized lymphadenopathy (PGL).
Even during latency, the virus will multiple imperceptibly and gradually deplete immune cells known as CD4 T-cells. As immune deficiency develops, a number of nonspecific symptoms are likely to appear, including:
- Oral candidiasis (thrush), a fungal infection that causes the formation of creamy, white lesions on the sides of the tongue and lining of the mouth
- Unexplained fevers and drenching night sweats that soak through bedsheets and nightclothes
- Severe, uncontrolled diarrhea that lasts for more than three days
Each of these symptoms is commonly seen in persons with immune deficiency. They may, in some cases, be caused by HIV itself or by an infection that has yet to be diagnosed.
Later-Stage HIV and AIDS
If left untreated, HIV will almost invariably lead to symptomatic disease. There is no timeline or pattern as to when this might occur. Generally speaking, the lower a person’s immune health (as measured by the CD4 count), the greater the risk of illness. We refer to these illnesses as “opportunistic” because they are harmful only when a person’s immune defenses are down.
At a certain point, if still untreated, the depletion of CD4 T-cells can lead to a stage of disease called AIDS, or acquired immunodeficiency syndrome. This is when the most serious opportunistic infections tend to occur. AIDS is officially defined as either having a CD4 count under 200 or the presence of at least one of 27 different AIDS-defining conditions as outlined by the Centers for Disease Control and Prevention.
Symptoms in later-stage HIV and AIDS include viral, bacterial, fungal, and parasitic infections as well as cancers (like invasive cervical cancer and non-Hodgkin lymphoma) and idiopathic disorders of unknown origin. These infections affect the organs and other areas of the body, including:
- Lungs (bacterial pneumonia, tuberculosis, pneumocystis pneumonia)
- Skin (shingles, Kaposi sarcoma)
- Gastrointestinal system (mycobacterium avium complex, cryptosporidiosis)
- Brain (AIDS dementia, cryptococcal meningitis)
- Eyes (cytomegalovirus retinitis, herpes zoster ophthalmicus)
- Blood (salmonella septicaemia)
Acute HIV Infection
- What is acute HIV infection?
- Other names for acute HIV infection
What is acute HIV infection?
Acute HIV infection, also known as an early or primary retroviral infection, is a condition that develops within two to four weeks of contracting human immunodeficiency virus (HIV).
Symptoms of acute HIV infection are similar to other viral infections, such as the flu or mononucleosis (mono or glandular fever). For this reason, many people do not realize they have been infected with HIV. A blood test is the best way to confirm an HIV infection.
There are two types of HIV: HIV-1 and HIV-2. HIV-1 is the more common form of HIV found in the United States. The term HIV in this resource refers to HIV-1, unless otherwise stated.
HIV attacks the body’s immune cells. Without treatment, a person with HIV becomes more likely to develop infections or infection-related cancers. The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome), when the immune system is severely damaged.
There is currently no effective cure for HIV infection but, with the right treatment and medical care, the outlook for people with HIV is good.
Symptoms of acute HIV infection
Many people develop symptoms of acute HIV infection two to four weeks after contracting HIV. Symptoms can last for several weeks and are similar to other viral infections such as flu. Signs and symptoms can include the following, starting with the most common:
- Mouth ulcers
- Red rash
- Aching muscles
- Joint pains
- Unintentional weight loss
- Loss of coordination
- Swollen lymph nodes
- Sore throat
Some HIV-infected people do not have any symptoms, or may have symptoms that are mild and not particularly troublesome.
All these symptoms can also be caused by other illnesses. If a person has symptoms following potential exposure to HIV, they should be tested for HIV as soon as possible. People concerned that they may be experiencing symptoms of acute HIV can also use the free Ada app to carry out a symptom assessment.
Causes and stages of acute HIV infection
HIV is caused by a retrovirus which attacks the body’s immune system, specifically CD4 blood cells which are responsible for fighting infections. During acute HIV infection, the HIV retrovirus destroys a lot of CD4 cells as it replicates. This can cause some people to fall ill with flu-like symptoms.
Acute HIV infection is the first stage of HIV infection. It is followed by two further stages:
Clinical latency, also known as asymptomatic HIV infection or chronic HIV infection. The HIV retrovirus continues to replicate within the body, but at low levels. The infected person may not experience any HIV-related symptoms, but can still transmit the virus to other people. Without treatment, this stage can last around 10 years. Towards the end of this phase, the person’s CD4 count starts to decrease and they may start to show symptoms.
AIDS (acquired immunodeficiency syndrome) is the final stage of HIV infection. Without treatment, a person can expect to develop AIDS after approximately 10 years. During this stage, a person’s immune system is badly damaged and they are susceptible to severe illnesses such as chronic cryptosporidiosis, lymphoma and pneumonia. Without treatment, a person with AIDS will typically only live around three years.
Treatment can slow the progression of HIV infection, often by decades.
Who is at risk of acute HIV infection?
HIV can affect people of any age, sexual orientation or race, in any part of the world. However, certain groups of people are more at risk of contracting HIV than others. These can include people who:
- Have unprotected sex, particularly anal sex, with multiple partners
- Share needles when injecting substances
HIV can be spread in the following ways:
- Contact with infected blood
- Contact with infected semen
- Contact with infected vaginal and/or rectal fluids
- From mother to child during pregnancy or birth if the pregnant woman has HIV
- Less commonly, during breastfeeding if the breastfeeding woman has HIV and is not on antiretroviral treatment
- Sharing needles, syringes or drug preparation equipment with someone who has HIV
Other physical contact, such as hand-holding, kissing or hugging, does not transfer HIV..
Risks of transmission during acute HIV infection
During the acute HIV infection phase, there are very high levels of HIV in the body. This means the risk of transmitting HIV to another person is high.
Diagnosis of acute HIV infection
The only way to confirm an acute HIV infection diagnosis is to be tested for HIV. There are different types of tests, depending on how long it has been since the person’s potential exposure to the HIV virus. Testing will involve either a sample of fluid swabbed from the mouth, or a blood sample.
Antibody tests are the most common tests for HIV, including rapid tests and home tests. Antibody tests screen for HIV-1 antibodies, which are produced by the immune system after exposure to the HIV virus. It takes at least three weeks, and sometimes up to 12 weeks, for a person to develop enough antibodies to be detectable in this type of test.
Combination, or fourth-generation, tests detect both HIV-1 antibodies and p24 antigens. The p24 antigen is part of the HIV virus and can be detected as early as two weeks after infection in some people, although for others it can take up to six weeks. The amount of p24 antigen in the blood is gradually reduced by antibodies, which makes it unsuitable for use in diagnosing HIV after the very early stages.
Nucleic acid tests detect the HIV virus itself in the blood. The test is expensive and usually only used in cases where high-risk exposure has occurred, or the person has symptoms of acute HIV infection. Nucleic acid tests can detect the HIV virus as early as one week after infection in some people, but it may take up to four weeks until detection is possible for others.
HIV test window period
The window period is the amount of time between when a person is first infected and when a test is able to accurately diagnose HIV infection: The following numbers are a guide, as the exact numbers may vary between tests and labs.
- Antibody tests: 21 to 84 days after infection
- Fourth generation tests: 13 to 42 days after infection
- Nucleic acid tests: seven to 28 days after infection
The first number for each test is the earliest possible time that an HIV infection can be detected with that test. However, each person responds differently to infection, so, in some cases, HIV may not be detectable until much later (indicated by the second number). If an early HIV test produces a negative result, it is advisable to have another test after the end of the window period.
Treatment of acute HIV infection
Acute HIV infection is treated with antiretroviral drugs (ARVs), which are drugs specially designed to treat retroviruses. People with HIV are prescribed a combination of antiretroviral drugs, which together are known as antiretroviral therapy (ART).
Antiretroviral therapy reduces the amount of virus (viral load) in the body. It does not cure HIV infection, but, taken correctly, it can slow progression of the condition from one stage to the next. For example, one recent study showed that a person diagnosed at age 20 who has appropriate treatment now has a life expectancy very close to that of a person without HIV.
Antiretroviral therapy should be started as soon as possible after diagnosis. It is very important to take antiretroviral medication correctly. Missing doses or stopping and restarting treatment can lead to drug resistance, which can reduce future treatment options.
Side-effects of ART may lead some people to consider stopping their medication. However, the long-term benefits of ART exceed the difficulties posed by some side-effects. It is very important not to stop taking ART without speaking with a doctor, who may be able to prescribe a more comfortable combination of antiretroviral drugs. More recent developments in ART mean that intolerable side-effects are fewer than in the past.
Side-effects associated with taking antiretroviral drugs include:
- Dry mouth
- Muscle pain
Doctors can generally tailor ART for a particular person to counter potential adverse effects, and a person may take various different antiretroviral drugs over the course of a lifetime.
More serious side-effects can emerge after taking antiretroviral drugs for a long time. These include:
- Chronic renal failure
- Liver damage
- Heart disease
- Hyperlipidemia, an excess of fats in the blood
- Lipodystrophy, metabolic changes in how the body uses and stores fat
People who have contracted HIV become more susceptible to other medical conditions, so they will benefit from lifestyle changes such as eating a healthy and balanced diet, practicing safe sex and reducing stress levels. HIV infection often has a large emotional and psychological impact, so counseling and social support should be available throughout treatment.
Post-exposure Prophylaxis (PEP)
PEP is a combination of antiretroviral drugs intended for use in emergency situations. When taken correctly, PEP can help to prevent HIV infection, but it is not 100 percent effective. Post-exposure Prophylaxis (PEP) must be started as soon as possible after, and within 72 hours of, potential exposure to HIV infection.
PEP must be taken exactly as directed for 28 days. The drugs may cause side-effects, such as:
Prevention of acute HIV infection
There are ways to minimize the risk of contracting HIV, or passing the infection on to other people:
- Practice safe sex: use condoms during all types of sexual contact and limit the number of partners
- Practice safe needle use: use only sterile needles and equipment if injecting substances. Safe needle use should also be observed by healthcare workers and tattooists
- Get diagnosed early, which can inform choices such as treatment and behavior toward other people
Anyone who is sexually active is recommended to get tested for HIV and other sexually transmitted diseases at least once a year. Any positive results should be disclosed to sexual partners so precautions can be taken. More frequent testing is recommended for anyone in a high risk group, such as someone who:
- Is in a relationship with a person who is HIV-positive
- Has multiple sexual partners
- Shares needles or drug equipment
Pre-exposure prophylaxis (PrEP)
Pre-exposure prophylaxis (PrEP) is another way of reducing the risk of acute HIV infection. PrEP is a combination of two medications that, taken daily, can lower a person’s chances of becoming infected with HIV.
PrEP is typically recommended for people who are considered to be at high risk of contracting HIV. This can include anyone who:
- Is in a relationship with a person who is HIV-positive
- Is considering getting pregnant with a person who is HIV-positive
- Has unprotected sex with people who are also at high risk of contracting HIV, such as people who inject drugs
- Shares needles or drug equipment
Taken as directed, PrEP can reduce the risk of becoming infected with HIV by:
- More than 90 percent during sex
- More than 70 percent when injecting drugs
PrEP should still be used alongside condoms as it does not provide protection against other STDs, such as gonorrhea.
Acute HIV infection FAQs
Q: When does acute HIV infection occur?
A: Acute HIV infection is the first stage of HIV infection. Some people may feel ill with flu-like symptoms two to four weeks after being infected with HIV, while other people who have contracted HIV develop no symptoms at all.
Q: How long do acute HIV infection symptoms last?
A: The symptoms of acute HIV infection, which can include flu-like symptoms, swollen lymph glands and mouth ulcers, generally last a few weeks. See the section on Symptoms of acute HIV infection.
Q: How is acute HIV infection treated?
A: Acute HIV infection should be treated with antiretroviral drugs (ARVs) as soon as possible after diagnosis. Antiretroviral therapy (ART) can help slow the progression of HIV by decades.
Other names for acute HIV infection
- Human immunodeficiency virus infection
AIDSinfo. “HIV-1” Accessed June 21, 2018. ↩
Centers for Disease Control and Prevention. “About HIV/AIDS.” January 2018. Accessed June 21, 2018. ↩ ↩ ↩
HIV.gov. “What Are HIV And AIDS?” May 2017. Accessed June 21, 2018. ↩
AIDSinfo. “Considerations for Antiretroviral Use in Special Patient Populations.” October 2017. Accessed June 21, 2018. ↩
Avert. “Symptoms and stages of HIV infection.” February 2017. Accessed June 21, 2018. ↩
American Family Physician. “Diagnosis and Initial Management of Acute HIV Infection.” May 2010. Accessed June 24, 2018. ↩
Centers for Disease Control and Prevention. “Opportunistic Infections.” May 2017. Accessed June 21, 2018. ↩
Centers for Disease Control and Prevention. “HIV Transmission.” January 2018. Accessed June 21, 2018. ↩ ↩
AIDSinfo. “The Basics of HIV Prevention.” May 2018. Accessed June 21, 2018. ↩
World Health Organization. “Breast is always best, even for HIV-positive mothers.” January 2010. Accessed June 24, 2018. ↩
AIDSinfo. “The Stages of HIV Infection.” August 2017. Accessed June 21, 2018. ↩
HIV.gov. “HIV Testing Overview.” May 2018. Accessed June 21, 2018. ↩ ↩ ↩
aidsmap. “p24 antigen.” June 2012. Accessed June 21, 2018. ↩
Centers for Disease Control and Prevention. “The Window Period.” Accessed June 21, 2018. ↩
The Lancet. “Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.” May 2017. Accessed July 17, 2018. ↩
HIV.gov. “HIV Treatment Overview.” May 2017. Accessed June 21, 2018. ↩ ↩
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Ending HIV. “5 Tips for Using PEP Effectively.” November 2015. Accessed June 21, 2018. ↩
Terrence Higgins Trust. “PEP.” April 2016. Accessed June 21, 2018. ↩
Centers for Disease Control and Prevention. “HIV Prevention.” March 2018. Accessed June 21, 2018. ↩
Centers for Disease Control and Prevention. “PrEP.” March 2018. Accessed June 21, 2018. ↩ ↩ ↩
Diagnosing AIDS-Related Lymphoma
In a healthy person, small glands called lymph nodes store lymphocytes—white blood cells that help the body fight infections. Lymphocytes travel throughout the body via a network of vessels called the lymphatic system.
Lymphoma occurs when lymphocytes become malignant, or cancerous. Malignant lymphocytes multiply, forming tumors in the lymph nodes and spreading to other parts of the lymphatic system. For instance, lymphoma often spreads to the spleen—an organ above the left side of the stomach that helps make lymphocytes—and bone marrow, the spongy material inside bone that makes new blood cells.
As lymphoma progresses, it can spread beyond the lymphatic system to organs such as the liver, lungs, or brain.
There are more than 60 types of lymphoma. Doctors classify these cancers according to the type of lymphocyte affected. These include B cells, which make antibodies that attack viruses, bacteria, and other pathogens; T cells, which kill viruses and signal B cells to make antibodies; and NK cells, which help fight cancer cells and viral infections. Most lymphomas begin in B cells.
These cancers are further divided into two large groups: non-Hodgkin lymphoma, the most common type, may affect B cells, T cells, or NK cells. Hodgkin lymphoma begins in a type of B cell called a Reed–Sternberg cell.
HIV Infection and Lymphoma
HIV weakens the immune system by attacking T cells, also called CD4 cells. As a result, people who have HIV are more vulnerable to infections and certain cancers.
When a person who has an HIV infection or AIDS develops lymphoma, it is called AIDS-related lymphoma. Most AIDS-related lymphomas are non-Hodgkin lymphomas, but some are Hodgkin lymphomas. The most common types of lymphomas in people who have HIV or AIDS are diffuse large B cell lymphoma, B cell immunoblastic lymphoma, and Burkitt’s lymphoma.
Lymphomas are usually more aggressive and more likely to spread beyond the lymph nodes in people who have HIV or AIDS. The cancer often spreads to areas outside of the lymph nodes, including the brain and gastrointestinal tract, by the time a person with HIV is diagnosed with lymphoma.
Treatment with a combination of medications to combat HIV infection decreases a person’s risk of developing lymphoma and other serious illnesses. This combination therapy is known as antiretroviral therapy.
AIDS-related lymphoma often causes prolonged swollen glands on either side of the neck above the collarbone, in the armpits, or in the groin. Other symptoms may include fatigue, weight loss, unexplained fevers, itching, and drenching night sweats.
Additional symptoms depend on the location of the lymphoma. For instance, lymphoma in the chest can cause shortness of breath, chest pain, or coughing. Some people with lymphoma have abdominal swelling, due either to an enlarged spleen or swollen lymph nodes in the abdominal cavity. Tumors in the brain or near the spinal cord can cause seizures, difficulty walking, confusion, or partial paralysis.
At NYU Langone, diagnosis of AIDS-related lymphoma begins with a physical exam to identify swollen lymph nodes. Doctors also ask about your symptoms and medical history. If you’re not sure whether you have HIV infection, the doctor orders blood tests.
Additional tests are used to diagnose AIDS-related lymphoma, identify the type of lymphoma present, and determine how fast it is growing. These tests can also indicate whether the condition has spread, how well it may respond to therapy, and whether it’s likely to return.
Blood Tests to Diagnose HIV
Doctors may use several blood tests to diagnose HIV infection and gauge the health of your immune system, especially if you haven’t already been diagnosed with HIV. A basic HIV blood test determines whether you have developed antibodies to HIV. People with AIDS-related lymphoma often have high levels of these antibodies in their blood at the time of diagnosis.
Blood tests also measure viral load, which reveals how many virus cells you have, and the number of CD4 cells. People with AIDS-related lymphoma who have not been taking antiretroviral medication often have an increased viral load and a lowered CD4 count. As the number of CD4 cells decreases, the immune system becomes progressively impaired.
Lymph Node Biopsy
A lymph node biopsy can confirm a diagnosis of AIDS-related lymphoma and identify the type you have. This procedure involves removing tissue from a swollen lymph node and evaluating it under a microscope. The tissue sample also may be used to look for genetic mutations associated with some non-Hodgkin lymphomas. This information can help the doctor select the most effective treatment.
Surgeons at NYU Langone usually remove an entire lymph node to perform a biopsy. Surgical biopsy is performed in the hospital using local anesthesia. Most people go home the same day.
Sometimes, a surgical biopsy is not possible because a swollen lymph node is difficult to reach without harming blood vessels or other structures. Your doctor may perform a needle biopsy, using fine needle aspiration or core needle biopsy, to obtain a tissue sample.
In fine needle aspiration, the doctor uses a small, thin needle to withdraw fluid and cells from an enlarged lymph node. In a core needle biopsy, the doctor uses a bigger needle to remove a larger portion of tissue. Both types of needle biopsy are performed as outpatient procedures using a local anesthetic.
If the lymph node is located deep within the body, your doctor may use an imaging technique to help guide the needle before inserting it. Depending on the location of the lymph node, the doctor may use a CT scan—a type of X-ray—or an ultrasound, in which sound waves produce images of structures in the body.
Bone Marrow Aspiration and Biopsy
Your doctor may recommend a bone marrow aspiration and biopsy to determine if lymphoma has spread to the bone marrow.
During a bone marrow aspiration, your doctor uses a needle to withdraw liquid and tissue from bone marrow in the back of the pelvis. To perform a biopsy, he or she removes a tiny piece of bone, about half the size of a matchstick, from the same area. New bone quickly regrows, replacing the piece that is removed. Tissue samples are evaluated under a microscope to look for lymphoma cells.
Both of these procedures require a local anesthetic and may be conducted in the doctor’s office or in the hospital as an outpatient procedure.
Doctors may perform a lumbar puncture, also known as a spinal tap. This test, performed on an outpatient basis in the hospital, can reveal whether lymphoma has spread to the cerebrospinal fluid, a liquid that cushions the spine and brain.
In this test, the doctor injects a local anesthetic into the skin in the lower back. Then, he or she inserts a hollow needle into the spinal canal to remove a small amount of cerebrospinal fluid. Doctors examine the fluid under a microscope to look for the presence of lymphoma cells.
Our doctors may also use imaging tests to determine how far the cancer has spread and how quickly it is growing.
A CT scan uses X-rays and a computer to create three-dimensional, cross-sectional images of the body. This test can help your doctor identify the location of a tumor and measure its size.
Before this scan, your doctor may give you contrast material, or dye, by injection or by mouth, as a liquid or a pill. The dye helps to highlight images of the tumor and surrounding blood vessels on the scan. It contains iodine, so it is not recommended for anyone with an allergy to iodine.
Your doctor may use a PET scan to look for smaller AIDS-related non-Hodgkin lymphoma tumors and to determine how active the disease is—that is, how quickly the cells are processing glucose, or sugar.
During a PET scan, the doctor injects a small amount of radioactive glucose into a vein. This substance collects in tumor cells, which are detected by a computer during the scan. The computer then creates three-dimensional images of cancer activity in the body.
Additional Blood Tests
If you’ve been diagnosed with AIDS-related lymphoma, your doctor may order additional blood tests to determine if you have anemia—a reduction in oxygen-carrying red blood cells—or a low number of platelets, which help the blood to clot. Another blood test measures the level of an enzyme called lactate dehydrogenase, which often increases as lymphoma advances.
Blood tests may also be used to look for infection with Epstein–Barr virus. This virus causes mononucleosis, commonly known as “mono,” and increases the risk of developing Hodgkin lymphoma in people who have HIV, as well as those who don’t.
Sept. 18, 2003 — Early HIV infection is centered in just a few upper-body lymph nodes. The finding suggests a radical AIDS therapy: Surgery.
The new discovery is surprising. And it’s still unexplained. Two teams of researchers find that the focal points of early HIV infection are the lymph nodes on both sides of the head and neck.
As infection progresses toward AIDS, lymph node infection follows a distinct pattern. The upper lymph nodes burn out. Then the infection moves to the lymph nodes around the lung. As these, too, burn out, the infection finally spreads to the lymph nodes around the bowel.
“Unexpectedly, HIV progression was evident by distinct anatomical correlates, suggesting that lymphoid tissues are engaged in a predictable sequence,” write C. David Pauza, PhD, and colleagues at the University of Maryland’s Institute of Human Virology in the Sept. 20 issue of The Lancet.
Johns Hopkins researchers David H. Schwartz, MD, and colleagues report similar findings in the same issue of The Lancet.
“The generally superficial location of these nodes makes them surgically accessible,” the researchers note.
They suggest that surgical removal be studied. Surgery would, of course, never get rid of all the HIV in the body. The virus would eventually reactivate. But the process might buy precious time, perhaps sparing patients from additional years of dealing with the harsh side effects and cost of anti-HIV drugs.
Lymph nodes are an important part of the immune system (your body’s natural defense system). They help your body recognize and fight germs, infections, and other foreign substances.
They are found throughout your body, including around the neck, armpit, groin, under the jaw and chin, behind the ears and on the back of the head. There is a chain of lymph nodes on either side of the front of the neck, both sides of the neck, and down each side of the back of the neck.
Some, but not all, people experience swollen and painful lymph nodes in the first few weeks after HIV infection. This may also be referred to as swollen glands or lymphadenopathy. The swelling may be experienced in any of your lymph nodes, and sometimes in more than one area.
In the absence of HIV treatment, a few people may continue to have swollen lymph nodes for years.
Painful lymph nodes may be caused by a wider range of infections, not just HIV. They are generally a sign that your immune system is fighting an infection. The soreness may go away within a couple of days, but the swelling may persist for a little longer.
Other infections that can lead to swollen lymph nodes include colds, influenza, ear infections, mononucleosis, tonsillitis and skin infections. They can also be a response to a malignancy or cancer.
More on HIV Symptoms at TheBody.com
To find out more about the symptoms of HIV infection, we recommend the following articles:
- What Are the Symptoms of HIV and AIDS?
- Acute HIV Infection
In addition, our Q&A experts sometimes address questions about symptoms in our “Ask the Experts” forums. Here are some of those questions and our experts’ responses:
- How to check for swollen nodes/glands
How do I perform a self-examination to check for any swollen glands?
- Lymph nodes and night sweats
I have had two separate lymph node biopsies; I also have night sweats. Now I have been told I need to take an HIV test.
- How do I know is my lymph nodes are swollen?
I have heard that swollen lymph glands can be an early sign of HIV infection but I’m not sure what these glands are or what they feel like. Please describe exactly what swollen glands feel like.
HIV Swollen Lymph Nodes Singapore | Shim Clinic
HIV Swollen Lymph Nodes Singapore. Lymph nodes are small organs where immune cells multiply in order to fight an infection. During an infection, the lymph nodes swell, and may be felt below the skin as small bumps. Swollen lymph nodes can occur during the early phase of HIV infection.
Lymph nodes are small organs attached to the lymphatic system, which gathers up excess fluid from the body’s tissues to return it to the circulation. Lymph nodes are immune organs. Inside of lymph nodes, the white blood cells, which are the cells that fight infection, multiply in response to an infection. This causes swollen lymph nodes, which are medically known as lymphadenitis. These can often be felt below the skin as small bumps, most commonly in the neck, armpit, and/or groin. Many people refer to them as “swollen glands” or “enlarged glands.”
In the early phase of HIV infection (known as acute HIV infection), the body generates a massive immune response to the virus. This can result in swollen lymph nodes throughout the body. In some cases, there may be some soreness or tenderness of the swollen lymph nodes, which some people refer to as “sore glands.” Often, other flu-like symptoms occur along with this lymphadenitis, including fever, rash, and headache. However, the swollen lymph nodes may be the only symptom of acute HIV infection. Symptoms begin 2 to 4 weeks after the exposure, and can last for a few weeks.
Later in the course of the infection, HIV damages the immune cells, so you may not feel swollen lymph nodes in response to an infection because there won’t be an effective immune response. If the acute HIV infection is detected and HIV is treated early, it can often be prevented from getting to this point.
- Lymph nodes are small organs where immune cells go to multiply, allowing them to respond to an infection. When this happens, they will swell.
- Swollen lymph nodes can often be felt below the skin as small bumps. They may be sore or tender.
- Swollen lymph nodes throughout the body may be a sign of the first phase of HIV infection, known as acute HIV infection. Other flu-like symptoms are also common.
- Having swollen lymph nodes doesn’t prove that you have HIV. You need an HIV test.
- If you have an exposure to HIV, you may be able to take HIV PEP, which is a regimen of medications that can decrease the chances of developing an HIV infection. It must be started within 72 hours of the exposure to be effective.
Having lymphadenitis and other HIV symptoms doesn’t prove that you have HIV. There are other possible causes of these symptoms, so you need an HIV test to find out whether HIV is the cause. To get a confidential HIV test, you can go to an STD clinic. Discuss any potential HIV symptoms with your doctor, as well as any possible exposures to HIV, such as a condom that slipped or broke during sex.
If you have an exposure to HIV, there is a medication regimen called HIV PEP that can help to prevent you from developing an HIV infection. However, it must be started within 72 hours of the exposure, so if you wait until you have HIV symptoms, then it will be too late. If you think that you may have been exposed to HIV, visit an STD clinic as soon as possible. Every hour counts, because the effectiveness of HIV PEP decreases over time.
Centers for Disease Control and Prevention. “Screening Recommendations Referenced in Treatment Guidelines and Original Recommendation Sources.” Centers for Disease Control and Prevention. Published 04 Jun 2015. Accessed 20 Jul 2016. http://www.cdc.gov/std/tg2015/screening-recommendations.htm
Centers for Disease Control and Prevention. “HIV/AIDS.” Centers for Disease Control and Prevention. Published 05 Jul 2016. Accessed 27 Jul 2016. http://www.cdc.gov/hiv/
Centers for Disease Control and Prevention. “HIV Basics – Testing.” Centers for Disease Control and Prevention. Published 12 Jul 2016. Accessed 20 Jul 2016. http://www.cdc.gov/hiv/basics/testing.html
|HIV Genital Sores|
Sexual risk (of HIV/STD/pregnancy), and what you can do before and after exposure.
| HIV PrEP (pre-exposure prophylaxis)
– Stop HIV infection before exposure
| STD vaccine:
– Hepatitis vaccine
– HPV vaccine
|STD / HIV exposure||
No condom / Condom broke / Condom slip
|0-72 hours|| HIV PEP (post-exposure prophylaxis)
– Stop HIV infection after exposure
| STD testing *
– Screening test
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Share on PinterestA person with HIV can lower their risk of developing shingles by maintaining their treatment.
People with HIV are more likely to experience shingles, and shingles-related complications, than the general population.
Shingles causes a painful, itchy rash. It develops from the herpes varicella-zoster virus, which is the same virus that causes chickenpox. This virus can lay dormant in the body for years without symptoms.
Anyone who has had chickenpox could develop shingles, which includes around 98 percent of adults in the United States.
The immune system usually suppresses the varicella-zoster virus and prevents outbreaks. However, if a person has a compromised immune system, they may experience shingles symptoms.
A person with HIV may have reduced immune system function if they:
- have not received treatment
- are in the earlier stages of treatment
- have stage 3 HIV
HIV specifically targets and destroys CD4 immune system cells. Having fewer CD4 cells and more HIV in the blood can make a person more susceptible to developing shingles.
Research suggests that people with detectable levels of HIV, measured by a high viral load and low CD4 levels, are more likely to experience shingles.
People may develop shingles shortly after starting to take antiretroviral medications. This indicates that the immune system is getting stronger and starting to respond to specific viruses and bacteria in the body.
The medical community sometimes refers to this as immune reconstitution inflammatory syndrome (IRIS). Around 20 percent of people may experience IRIS after starting antiretroviral therapy.
The best way to boost the immune system is to receive effective treatment for HIV. There are over 30 HIV medicines available in the U.S. Antiretroviral medication can reduce the viral load of HIV in the blood to undetectable levels, allowing the immune system to recover and CD4 counts to rise.
With treatment, a person with HIV can have the same quality of life as a person without HIV, including a reduced risk of catching viral and bacterial infections, such as shingles.
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Symptoms of HIV can vary between individuals however the first signs of infection generally appear within the first 1-2 months. Many, but not all, people will experience severe flu-like symptoms which is your body’s natural response to the virus. This is called the ‘seroconversion’ period.
It’s during this time that it’s crucial to identify if HIV is the cause, as your viral load is very high which greatly increases the risk of passing it on. And the only way to know for sure is by getting tested.
Symptom 1: Fever
The fever, usually one of the first symptoms of HIV, is often accompanied by other 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. As that happens, your immune system induces an inflammatory reaction.
Symptom 2: Fatigue and headache
The inflammatory response generated by your besieged immune system can cause you to feel tired and lethargic. Sometimes it can make you feel winded while walking or generally feel out of breath. Fatigue can be both an early and later symptom of HIV.
Symptom 3: Swollen lymph nodes, achy muscles and joint pain
Lymph nodes are part of your body’s immune system and protect your blood by getting rid of bacteria and viruses. They tend to get inflamed when there’s an infection. Many of them are located in your armpit, groin and neck which can result in aches and pains in these areas.
Symptom 4: Skin rash
Skin rashes can occur early or late in the course of HIV seroconversion. In some cases the rash can appear similar to boils with itchy, pink breakouts.
Symptom 5: Nausea, vomiting and diarrhoea
Many people experience digestive system problems as a symptom of the early stages of HIV. However, nausea, vomiting and diarrhoea can also appear in later stages of infection, usually as the result of an opportunistic infection.
It is important to stay hydrated. Diarrhoea that is unremitting and not responding to usual therapy might be an indication of HIV.
Symptom 6: Sore throat and dry cough
A severe, dry cough that can last for weeks to months without seeming to resolve (even with antibiotics and inhalers) is a typical symptom in very ill HIV patients.
Symptom 7: Night sweats
Many people will get night sweats during the early stages of HIV. These can be even more common later in infection and aren’t related to exercise or the temperature of the room.
With such a vast array of symptoms, HIV testing is vital to ensure a proper diagnosis. If you think you’ve been exposed to HIV, or have an active sex life with casual sex partners, regardless of whether you are showing symptoms of HIV or not, it’s important to get tested as soon as possible.
If you’re in Sydney, you can get a rapid HIV test and STI check-up at a. If you’re not in Sydney, you can still get a rapid HIV test and STI check-up using our ‘where to get tested’ tool here.
—Sean R. Hosein
- Whitley RJ. Chapter 180. Varicella-Zoster Virus Infections. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 18e. New York, NY: McGraw-Hill; 2012.
- Steiner I, Kennedy PG, Pachner AR. The neurotropic herpes viruses: herpes simplex and varicella-zoster. Lancet Neurology. 2007 Nov;6(11):1015-28.
- Grabar S, Tattevin P, Selinger-Leneman H, et al. Incidence of herpes zoster in HIV-infected adults in the combined antiretroviral therapy era: results from the FHDH-ANRS CO4 cohort. Clinical Infectious Diseases. 2015; in press.
- Mary-Krause M, Grabar S, Lièvre L et al. Cohort Profile: French hospital database on HIV (FHDH-ANRS CO4). International Journal of Epidemiology. 2014 Oct;43(5):1425-36.
- Berkowitz EM, Moyle G, Stellbrink HJ, et al. Safety and immunogenicity of an adjuvanted herpes zoster subunit candidate vaccine in HIV-infected adults: A phase 1/2a randomized, placebo-controlled study. Journal of Infectious Diseases. 2015; in press.
- Mullane KM, Winston DJ, Wertheim MS, et al. Safety and immunogenicity of heat-treated zoster vaccine (ZVHT) in immunocompromised adults. Journal of Infectious Diseases. 2013 Nov 1;208(9):1375-85.
- Meintjes G, Scriven J, Marais S. Management of the immune reconstitution inflammatory syndrome. Current HIV/AIDS Reports. 2012 Sep;9(3):238-50.
- Martin-Blondel G, Mars LT, Liblau RS. Pathogenesis of the immune reconstitution inflammatory syndrome in HIV-infected patients. Current Opinion in Infectious Diseases. 2012 Jun;25(3):312-20.
What Is It?
Published: April, 2019
The human immunodeficiency virus (HIV) weakens the body’s immune defenses by destroying CD4 (T-cell) lymphocytes, a type of white blood cell. T-cells normally help guard the body against attacks by bacteria, viruses and other germs.
When HIV destroys CD4 cells, the body becomes vulnerable to many different types of infections. These infections are called “opportunistic” because usually they only have the opportunity to invade the body when the immune defenses are weak. HIV infection also increases the risk of certain cancers, illnesses of the brain and nerves, body wasting, and death.
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HIV And Swollen Lymph Nodes
Many of the first symptoms you may notice or exhibit from HIV are similar to the flu. Symptoms such as fever and fatigue are common occurrences and so are swollen lymph nodes.. However, swollen lymph nodes might be a sign of more serious health concerns.
Let’s talk about swollen lymph nodes and their correlation with HIV.
What are Lymph Nodes?
Lymph nodes are part of the body’s lymphatic system. They are found in your neck, groin and armpits. Lymph nodes are shaped like beans and are about 3 cm long. These small but powerful organs are responsible for filtering lymph and produce strong and mature immune cells in our bodies.
Lymph nodes protect your immune system and blood by:
- Filtering excess proteins
- Removing excess fluids
- Producing antibodies for the body
- Creating specialized white blood cells
- Removing viruses and bacteria
How does HIV affect lymph nodes?
HIV/AIDS can cause swelling of the lymph nodes. The swelling occurs because the infection reaches the nodes through the body’s lymph fluid.
The lymph nodes on the neck are most often affected by HIV. Swollen lymph nodes can occur as soon as a few days after HIV infection. However, it is also possible not to experience any signs of HIV symptoms for several years after contracting the virus.
Healthy lymph nodes are not visible. When there is an infection, they can become swollen and present themselves as hard bean-sized lumps. As the infection progresses, lymph nodes in other areas of the body may swell as well.
In addition to swollen lymph nodes, non-specific HIV symptoms include:
- Rapid weight loss
When it comes to treating swollen lymph nodes you need to treat the underlying cause. Antibiotics will treat bacterial infections. Swelling resulting from viral infections requires some time to heal. But, HIV is different than these two causes.
Symptoms of HIV may be absent for months if not years while the virus is present in blood and other body tissues. Swollen lymph nodes from HIV have to be treated with antiretroviral medication. Antiretroviral therapy will reduce HIV symptoms while also preventing further transmission of HIV to others.
Looking Past Treatment
It’s important to remember that HIV is a chronic, ongoing condition. So you may not experience swollen lymph nodes all the time. Symptoms related to HIV will fluctuate throughout the body depending on a number of factors.
Medications for HIV help slow the breakdown of the immune system. When treating HIV it is very important to take all prescribed medications and treatments, even if your symptoms seem to be going away.
HIV that is untreated can weaken the immune system and leave you at risk for other infections. Symptoms are more likely to be present when you are sick since the virus affects the immune system.
Noticeable swollen lymph nodes indicate that your body is fighting an infection. If they are present for two to four weeks it is important to visit your healthcare provider.
The only way to know for sure is to get tested. myLAB Box offers at home testing that is discreet and easy to use. Take the first step and get tested for HIV today. Safe is sexy!
Signs and Symptoms
Many people don’t have any symptoms when they first become infected with HIV. Some have a flu-like illness, called HIV sero-conversion syndrome, a month or two after exposure to the virus. This illness may cause a variety of symptoms, including:
- Enlarged liver or spleen
- Enlarged or swollen lymph nodes
- Muscle pain
- Nausea and vomiting
- Neurologic symptoms
- Rash on the abdomen, arms and legs and face
- Sore throat
- Thrush, a common fungal infection of the mouth caused by Candida, a yeast-like fungus
These symptoms usually disappear in a week to a month and may be mistaken for other viral infections. During this period, people are very infectious and HIV is present in large quantities in genital fluids.
An infected person may not experience severe symptoms for eight to 10 years or more. This period — called the asymptomatic period — varies in length for each person. Some people may have symptoms within a few months and others may be symptom-free for years.
Children born with HIV usually have symptoms within two years of birth. Children may grow slowly or become sick frequently.
As the immune system weakens, other complications may occur. For many people, the first signs of infection are large lymph nodes or swollen glands that may be enlarged for more than three months. Other symptoms before the onset of AIDS include:
- Fevers and sweats
- Herpes infections that cause severe mouth, genital or anal sores
- Lack of energy
- Pelvic inflammatory disease in women that does not respond to treatment
- Persistent skin rashes or flaky skin
- Shingles, a painful nerve disease often accompanied by a rash or blisters
- Short-term memory loss
- Weight loss