Symptoms and Complications
Symptoms of HIV infection appear 2 to 12 weeks after exposure. At this point the virus begins rapidly taking over immune cells in the blood. The symptoms of this phase are flu-like and include:
- diarrhea
- fatigue or weakness
- fever
- headache
- joint pain
- night sweats
- rash
- swollen glands
- weight loss
- yeast infections (of the mouth or vagina) that last a long time or occur frequently
When the symptoms begin to appear, the person with HIV is very infectious. The symptoms usually go away within a week to a month, and the person will feel fine again. However, the symptoms may return from time to time. The symptoms of HIV are similar to symptoms of other diseases. The only way to know for sure whether you are HIV-positive is to be tested. After infection with HIV, it can take 3 months for antibodies to the virus to be detectable in the blood. On average, it takes about 22 days to develop antibodies. This is called seroconversion. After seroconversion occurs, the virus can be detected using a blood test.
After the initial symptoms go away, the body's immune system tries to control the virus. The immune system can keep the virus at bay for a while, but it can't completely get rid of it. Many people will feel fine for years before their immune system weakens and they develop AIDS. Without treatment, about half of HIV-positive people develop AIDS within 10 years of infection. Some people develop AIDS within a few years of infection. A few, called long-term non-progressors, do not develop AIDS until much later. Many factors affect the timeframe to develop AIDS, including medications and the person's general health and lifestyle.
AIDS is a term applied to advanced HIV disease. AIDS is defined as having HIV and an opportunistic infection normally associated with AIDS. These infections can be bacterial, fungal, viral, or parasitic. Examples of opportunistic infections include toxoplasmosis, pneumocystis pneumonia, cryptococcal meningitis, progressive multifocal leukoencephalopathy (PML), cryptosporidium, cytomegalovirus, and Mycobacterium avium complex (MAC). With the use of better medications to treat HIV, the risk of opportunistic infections has dropped over the years; however, people with AIDS will often need to take medications (such as antibiotics) to prevent opportunistic infections.
People who have AIDS are also more likely to develop cancer, especially cancers of the immune system (lymphomas). Another cancer common for people with AIDS is Kaposi's sarcoma. Women with AIDS are prone to developing cancers of the cervix. Gay men with HIV have higher rates of infection by human papillomavirus (HPV), a virus linked to anal cancer.
Children with AIDS tend to get common childhood infections like conjunctivitis, otitis media, and tonsillitis, but experience symptoms much worse than the infection usually causes.
Excessive weight loss or "wasting syndrome" is a problem for approximately 20% of people who have HIV infection. It is associated with an unexplained loss of 10% or more of normal body weight plus chronic diarrhea (30 days or more), or chronic weakness with fever (30 days or more).
Most people with AIDS die from the diseases that AIDS makes them more susceptible to. The virus occasionally infects the brain, causing a dementia that gets worse over time.