The progression of the HIV virus differs from person to person and response to treatments vary from person to person. But generally, there are four stages of HIV.
Stage 1: Acute or Primary Infection
When a person is infected, HIV enters the bloodstream and begins to duplicate. The body fights back with seroconversion, or the development of HIV positive antibodies. This takes about time, so an HIV test will not show that a person is HIV positive until 6-12 weeks after exposure.
However, as soon as a person becomes infected, he or she can still spread the virus to other people, even if the HIV test is negative. In fact, studies have shown that the likelihood of spreading the disease is higher during this time, which is dangerous because the infected person will not know that he or she is infected. This is one of the reasons why it is important to always use a condom.
Most people who are newly infected with HIV will experience “flu-like” symptoms for several days, such as fever, chills, night sweats, nausea, diarrhea, swollen lymph nodes, and rashes. Others may not experience any symptoms at all. If you have had an incident that you believe could have put you at risk for exposure to HIV, the best thing to do is consult a health professional and get tested.
Stage 2: Asymptomatic HIV Infection
After the primary stage of HIV, most infected people look and feel healthy for many years. One subtle symptom they may experience is swollen glands. However, the virus is never idle. Underneath, HIV actively replicates and slowly attacks the immune system. Even if the infected person feels fine, seeking medical care early on will increase his or her span and quality of life later on.
Stage 3: Symptomatic HIV Disease
Eventually the HIV infection weakens the immune system to the point that it progresses to the HIV disease. Infected people may begin to experience mild symptoms, even though their CD4 cell count is not yet low enough to warrant an AIDS diagnosis. The time it takes for the infection to become a disease differs for each person, but it generally ranges from five to seven years. Characteristic symptoms may include:
- Skin disorders
- Prolonged diarrhea
- Night sweats
- Thrush (a fungal infection, often in the mouth)
- Bacterial pneumonia
- Fatigue
- Joint pain
- Weight loss
- Mouth ulcers
- Fungal skin and nail infections
Symptoms usually begin to show after the virus has begun to seriously damage the immune system. To avoid this damage, it is best to start antiretroviral therapy as early as possible.
Stage 4: Diagnosis of AIDS (Acquired Immune Deficiency Syndrome)
The most advanced stage of the HIV continuum is an AIDS diagnosis, which is determined based on CD4 count. According to the Centers for Disease Control and Prevention (CDC), an HIV positive person is diagnosed with AIDS when his or her CD4, or T-cell, count is less than 200/mm3, or if he or she has an “AIDS-defining illness,” otherwise known as an “opportunistic infection.”
Opportunistic infections are infections that could not thrive in a person with a healthy immune system but can develop easily in the body of someone with a compromised immune system, such as someone with AIDS. Examples of opportunistic infections may include:
- Bacterial diseases such as pneumonia, tuberculosis, meningitis, and blood poisoning
- Parasitic diseases such as toxoplasmosis
- Fungal diseases such as thrush
- Persistent diarrhea
- Extreme fatigue
- Vision loss
- Cancers
Once a diagnosis of AIDS is made, a person always has AIDS, even though treatments can prolong a person’s life. However, it is not wise to let it go that far. If you have even an inkling that you may have been exposed to HIV, get tested as soon as possible to increase your chances of getting early treatment.