Symptoms of HIV/AIDS


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General information about symptoms of HIV/AIDS: The symptom information on this page attempts to provide a list of some possible symptoms of HIV/AIDS. This symptom information has been gathered from various sources, may not be fully accurate, and may not be the full list of symptoms of HIV/AIDS. Furthermore, symptoms of HIV/AIDS may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of symptoms and whether they are indeed symptoms of HIV/AIDS.

List of symptoms of HIV/AIDS: The list of symptoms mentioned in various sources for HIV/AIDS includes:

Symptoms of HIV/AIDS: Many children with HIV infection do not gain weight or grow normally. HIV-infected children frequently are slow to reach important milestones in motor skills and mental development such as crawling, walking and speaking. As the disease progresses, many children develop neurologic problems such as difficulty walking, poor school performance, seizures, and other symptoms of HIV encephalopathy.

Like adults with HIV infection, children with HIV develop life-threatening opportunistic infections (OIs), although the incidence of various OIs differs in adults and children. For example, toxoplasmosis is seen less frequently in HIV-infected children than in HIV-infected adults, while serious bacterial infections occur more commonly in children than in adults. Also, as children with HIV become sicker, they may suffer from chronic diarrhea due to opportunistic pathogens.

Pneumocystis carinii pneumonia (PCP) is the leading cause of death in HIV-infected children with AIDS. PCP, as well as cytomegalovirus (CMV) disease, usually are primary infections in children, whereas in adults these diseases result from the reactivation of latent infections.

A lung disease called lymphocytic interstitial pneumonitis (LIP), rarely seen in adults, also occurs frequently in HIV-infected children. This condition, like PCP, can make breathing progressively more difficult and often results in hospitalization.

Children with HIV suffer the usual childhood bacterial infections -- only more frequently and more severely than uninfected children. These bacterial infections can cause seizures, fever, pneumonia, recurrent colds, diarrhea, dehydration and other problems that often result in extended hospital stays and nutritional problems.

HIV-infected children frequently have severe candidiasis, a yeast infection that can cause unrelenting diaper rash and infections in the mouth and throat that make eating difficult.1

Many people do not have any symptoms when they first become infected with HIV. Some people, however, have a flu-like illness within a month or two after exposure to the virus. This illness may include fever, headache, tiredness, and enlarged lymph nodes (glands of the immune system easily felt in the neck and groin). These symptoms usually disappear within a week to a month and are often mistaken for those of another viral infection. During this period, people are very infectious, and HIV is present in large quantities in genital fluids.

More persistent or severe symptoms may not surface for a decade or more after HIV first enters the body in adults, or within two years in children born with HIV infection. This period of "asymptomatic" infection is highly individual. Some people may begin to have symptoms within a few months, while others may be symptom-free for more than 10 years.

Even during the asymptomatic period, the virus is actively multiplying, infecting, and killing cells of the immune system. HIV's effect is seen most obviously in a decline in the blood levels of CD4+ T cells (also called T4 cells) - the immune system's key infection fighters. At the beginning of its life in the human body, the virus disables or destroys these cells without causing symptoms.

As the immune system deteriorates, a variety of complications start to take over. For many people, their first sign of infection is large lymph nodes or "swollen glands" that may be enlarged for more than three months. Other symptoms often experienced months to years before the onset of AIDS include

  • lack of energy
  • weight loss
  • frequent fevers and sweats
  • persistent or frequent yeast infections (oral or vaginal)
  • persistent skin rashes or flaky skin
  • pelvic inflammatory disease in women that does not respond to treatment
  • short-term memory loss
Some people develop frequent and severe herpes infections that cause mouth, genital, or anal sores, or a painful nerve disease called shingles. Children may grow slowly or be sick a lot. 2

Symptoms of opportunistic infections common in people with AIDS include

  • coughing and shortness of breath
  • seizures and lack of coordination
  • difficult or painful swallowing
  • mental symptoms such as confusion and forgetfulness
  • severe and persistent diarrhea
  • fever
  • vision loss
  • nausea, abdominal cramps, and vomiting
  • weight loss and extreme fatigue
  • severe headaches
  • coma
Children with AIDS may get the same opportunistic infections as do adults with the disease. In addition, they also have severe forms of the bacterial infections all children may get, such as conjunctivitis (pink eye), ear infections, and tonsillitis.

People with AIDS are particularly prone to developing various cancers, especially those caused by viruses such as Kaposi's sarcoma and cervical cancer, or cancers of the immune system known as lymphomas. These cancers are usually more aggressive and difficult to treat in people with AIDS. Signs of Kaposi's sarcoma in light-skinned people are round brown, reddish, or purple spots that develop in the skin or in the mouth. In dark-skinned people, the spots are more pigmented.

During the course of HIV infection, most people experience a gradual decline in the number of CD4+ T cells, although some may have abrupt and dramatic drops in their CD4+ T-cell counts. A person with CD4+ T cells above 200 may experience some of the early symptoms of HIV disease. Others may have no symptoms even though their CD4+ T-cell count is below 200.

Many people are so debilitated by the symptoms of AIDS that they cannot hold steady employment or do household chores. Other people with AIDS may experience phases of intense life-threatening illness followed by phases in which they function normally.

A small number of people (fewer than 50) first infected with HIV 10 or more years ago have not developed symptoms of AIDS. Scientists are trying to determine what factors may account for their lack of progression to AIDS, such as particular characteristics of their immune systems or whether they were infected with a less aggressive strain of the virus, or if their genes may protect them from the effects of HIV. Scientists hope that understanding the body's natural method of control may lead to ideas for protective HIV vaccines and use of vaccines to prevent the disease from progressing. 2

Many manifestations of HIV disease are similar in men and women. Both men and women with HIV may have non-specific symptoms even early in disease, including low-grade fevers, night sweats, fatigue, and weight loss. Anti-HIV therapies, as well as treatments for other infections associated with HIV, appear to be similarly effective in men and women. Other conditions, however, occur in different frequencies in men and women. HIV-infected men, for instance, are eight times more likely than HIV-infected women to develop a skin cancer known as Kaposi's sarcoma. In some studies, women had higher rates of herpes simplex infections than men.

Data from several studies conducted by NIAID's Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA) found that HIV-infected women were also more likely than HIV-infected men to develop bacterial pneumonia. This finding may be explained by factors such as a delay in seeking care among HIV-infected women as compared to men, and/or less access to anti-HIV therapies or preventive therapies for Pneumocystis carinii pneumonia (PCP).3

Women also experience HIV-associated gynecologic problems, many of which occur in uninfected women but with less frequency or severity.

Vaginal yeast infections, common and easily treated in most women, often are particularly persistent and difficult to treat in HIV-infected women. Data from WIHS suggest that these infections are considerably more frequent in HIV-infected women. A drug called fluconazole is commonly used to treat yeast infections. A CPCRA study demonstrated that weekly doses of fluconazole can also safely prevent oropharyngeal and vaginal but not esophageal yeast infections, without resulting in resistance to the drug.

Other vaginal infections may occur more frequently and with greater severity in HIV-infected women, including bacterial vaginosis and common STDs such as gonorrhea, chlamydia, and trichomoniasis.

Severe herpes simplex virus ulcerations, which are sometimes unresponsive to therapy with the standard drug acyclovir, can severely compromise a woman's quality of life.

Idiopathic genital ulcers, with no evidence of an infectious organism or cancerous cells in the lesion are a unique manifestation of HIV disease. These ulcers, for which there is no proven treatment, are sometimes confused with those caused by herpes simplex virus.

Human papillomavirus (HPV) infections, which cause genital warts and can lead to cervical cancer, occur with increased frequency in HIV-infected women. A precancerous condition associated with HPV, called cervical dysplasia, is also more common and more severe in HIV-infected women, and more apt to recur after treatment.

Pelvic inflammatory disease (PID) appears to be more common and more aggressive in HIV-infected women than in uninfected women. PID may become a chronic and relapsing condition as a woman's immune system deteriorates.

Menstrual irregularities frequently are reported by HIV-infected women and are being actively studied by NIAID-supported scientists. Although menstrual irregularities were equally common in HIV-infected women and at-risk HIV-negative women in a WIHS survey, women with CD4+ T-cell counts below 50 per cubic millimeter (mm3) of blood were more likely to report no periods than were uninfected women, or HIV-infected women with higher CD4+ T-cell counts.3

Symptoms that could serve as warning signals of HIV infection may go ignored because many women do not perceive themselves at risk. Symptoms include recurrent yeast infections (vaginal candidiasis), pelvic inflammatory disease, abnormal changes or dysplasia (growth and presence of precancerous cells) in cervical tissue, genital ulcers, genital warts, and severe mucosal herpes infections may also accompany HIV infection in women.

It is possible for a person infected with HIV to show no signs of infection. For women, the most common symptoms of exposure to the HIV virus are frequent or severe vaginal infections, abnormal PAP smears, or pelvic infections (PID) that are difficult to treat.

Within a few weeks of having been infected, many people have flu-like symptoms. However, in some cases, symptoms do not show for many years. As the infection progresses, some symptoms can include 1) swollen lymph glands in the neck, underarm, or groin area, 2) recurrent fever including "night sweats," 3) rapid weight loss for no apparent reason, 4) constant tiredness, 5) diarrhea and decreased appetite, 6) white spots or unusual blemishes in the mouth. 4

Many people do not have any symptoms when they are first infected with HIV. It can take as little as a few weeks for minor flu-like symptoms to show up or as long as 10 years or more for more serious symptoms. Symptoms can include headache, chronic cough, diarrhea, swollen glands, lack of energy, loss of appetite and weight loss, frequent fevers and sweats, frequent yeast infections, skin rashes, pelvic and abdominal cramps, sores on certain parts of your body, and short-term memory loss. People age 50 and older may not recognize HIV symptoms in themselves because they think what they are feeling and experiencing is part of normal aging.5

More symptoms of HIV/AIDS: In addition to the above information, to get a full picture of the possible symptoms of this condition and its related conditions, it may be necessary to examine symptoms that may be caused by complications of HIV/AIDS, underlying causes of HIV/AIDS, associated conditions for HIV/AIDS, risk factors for HIV/AIDS, or other related conditions.

Medical articles on symptoms: These general reference articles may be of interest:



Footnotes:
1. excerpt from Backgrounder - HIV Infection in Infants and Children: NIAID
2. excerpt from HIV Infection and AIDS, An Overview, NIAID Fact Sheet: NIAID
3. excerpt from HIV Infection in Women, NIAID Fact Sheet: NIAID
4. excerpt from Women and HIV-AIDS: NWHIC
5. excerpt from HIV, AIDS, and Older People - Age Page - Health Information: NIA
Last revision: April 2, 2003

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