Acute HIV Infection

Acute HIV is the first stage of HIV. Without medical treatment, this acute infection can evolve into the second stage, and become chronic HIV. After years, chronic HIV can turn into AIDS, a serious medical condition in which the immune system is already heavily damaged. Because of this damage, people with AIDS are more subject to opportunistic infections. This means that they can develop conditions more frequently and with more severe symptoms than people with otherwise a healthy immune system would.

This article focuses on acute HIV, which is the stage after the moment of infection where the virus first damages the immune system and multiplies rapidly. During this stage, people are highly infectious and should get tested as soon as possible. Treatment should be started right away for the best possible outlook. Usually, this condition progresses to chronic HIV and later on to AIDS.

An acute HIV infection is the first stage of an infection with the Human Immunodeficiency Virus. This stage refers to the period after the actual moment of infection. It could take 2 to 4 weeks from the moment of infection for someone to develop an acute HIV infection.

During the acute stage, the human immunodeficiency virus multiplies rapidly and spreads throughout the body. As this stage is characterized by the rapid multiplication of HIV, there will be a high presence of the virus in the body and the risk of transmission to other people will be high. This acute stage can go by unnoticed, as the symptoms could easily be mistaken for a cold, mononucleosis (mono) or the flu. There are also cases where people don’t show any symptoms at all.

The virus is dangerous as it targets CD4 cells. These are a type of white blood cells that fight infection. HIV destroys these cells and spreads throughout the body. Without treatment, the human immunodeficiency virus will destroy more and more CD4 cells and will multiply itself further. The acute infection can progress into a chronic HIV infection, which may then progress into AIDS. More information on this progression can be found on our specific page about AIDS by clicking the link. 1 2

HIV is an STD, or sexually transmitted disease. This means that you can get the virus through unprotected sex with an infected person. It can also be transmitted by sharing medical equipment like syringes. A mother can also pass the virus along to her child while giving birth or while breastfeeding. 3

Early stage HIV symptoms are very common symptoms and could easily be confused with a cold, mononucleosis, or the flu. These symptoms are the result of the body fighting off the infection. The common acute HIV infection symptoms are:

• Mouth ulcers
• Red rash: an acute hiv infection rash presents itself as an area of the skin that is irritated, itchy, painful and red. 4
• Fever

Other symptoms may also be present such as: 5 6

• Aching muscles
• Joint pains
• Unintentional weight loss
• Loss of coordination
• Tiredness
• Headache
• Swollen lymph nodes (check our article about HIV swollen lymph nodes)
• Sore throat
• Diarrhea

HIV symptoms appear after 2 weeks in most cases. It’s important to know that these symptoms are also very common for other medical conditions and that some people may even have an acute HIV infection without any symptoms. It’s important to always know your HIV-status and to get tested if you think you’re at risk or if you participate in riskful behavior such as unprotected sex and sharing syringes.

The symptoms of an acute HIV infection can last anywhere from a few days to several weeks. After these symptoms, it’s possible that HIV doesn’t cause any symptoms for several years. That stage is called chronic HIV infection. Even when there are no symptoms, the infection is still present and still proceeds to damage the immune system.

The chronic infection can turn into AIDS after years of presence in the blood. It’s important to know that this progression can be slowed down or even prevented by early diagnosis and initiation of correct and early treatment. 6 7

As the infection can often be present without symptoms or with non-specific symptoms, it’s important to have bloodwork done if you think you could be at risk for an HIV-infection. An HIV test can come back positive from 10 to 90 days after a risk contact.

Acute HIV can be detected in various ways:

1. A nucleic acid amplification test (NAAT), which looks for the amount of HIV present in the blood. This is also known as an HIV viral load test. This test can already detect HIV within 10 to 33 days after exposure, which is sooner than other tests. The reason behind this is that the acute stage is characterized by a fast multiplication and a high presence of HIV. The body will start to make antibodies to fight the virus, but this process takes a few weeks, which is why the antibodies are only visible in the blood later on.
2. An antigen/antibody test, which looks for HIV antibodies and antigens in the blood. An antibody is a reaction from the immune system, while an antigen is the foreign substance causing the immune system to activate. This test can detect HIV within 18 to 90 days after exposure.
3. An HIV antibody test, which also searches for antibodies in the blood or oral fluid. These are rapid and self-tests, and can detect HIV 23 to 90 days after infection.

You should discuss your symptoms and possible risk factors with your doctor to find out which test is right for you. If you think that you’ve been exposed to HIV in the last 72 hours, you can talk to your doctor about taking PEP (post-exposure prophylaxis), which is an emergency medicine which you can take to prevent an HIV infection. If taken within 72 hours of exposure, PEP can be highly effective in preventing HIV. 8 9 10 11

Q: What is ARS?
A: ARS stands for Acute Retroviral Syndrome, which is seen in people with an acute HIV infection that develop symptoms.

Q: When do ARS symptoms start?
A: ARS symptoms usually start 2 to 6 weeks after infection with HIV.

Q: What is PreP?
A: PreP stands for pre-exposure prophylaxis. It’s a medication that some people use to prevent being infected by HIV.

Q: How soon do HIV symptoms disappear?
A: The symptoms of an acute HIV infection are different in each person, but people that do show symptoms often have these symptoms for a few days up to a few weeks. After this, people with HIV may not show symptoms for several years.

Q: Can you have HIV symptoms but test negative at 6 weeks?
A: As acute HIV symptoms are very general, they can also be symptoms of another condition. If you’ve tested negative at 6 weeks, you probably don’t have HIV. To be sure, you should test again after 3 months.