Within two to four weeks of HIV entering the body, 40% to 90% of people experience flu-like symptoms known as Acute Retroviral Syndrome (ARS). The flu-like symptoms are a sore throat, fever and body rash.

But sometimes HIV symptoms don’t appear for years—sometimes even a decade—after infection. Most HIV infections do not have any symptoms. A person infected with HIV can remain healthy and symptom-free for many years.

A person is diagnosed with AIDS when they have developed an AIDS-related condition or symptom, called an opportunistic infection or AIDS-related cancer. The diseases are called ‘opportunistic’ because they take advantage of a weakened immune system’s opportunity.
Someone can be diagnosed with AIDS even if they have not developed an opportunistic infection. AIDS can be diagnosed when the number of immune system cells (CD 4 cells) in an HIV positive person’s blood drops below a certain level.

A person who infects their sexual partner with HIV while knowing his/her HIV status could be charged with murder, attempted murder or assault under South African law. The Draft Sexual Offences Bill makes the intentional non-disclosure of HIV/AIDS by a person to their sexual partner a criminal offence.

List of symptoms

Fever

One of the first signs of an acute retroviral syndrome (ARS) can be a mild fever of about 102 degrees F.

If it occurs at all, the fever is often accompanied by other usually mild symptoms, such as fatigue, swollen lymph glands, and a sore throat.

At this point, the virus is moving into the bloodstream and starting to replicate in large numbers.

As that happens, there is an inflammatory reaction by the immune system.

Fatigue

The inflammatory response generated by your besieged immune system also can cause you to feel tired and lethargic. Fatigue can be both an early and later sign of HIV.

Achy muscles, joint pain, swollen lymph nodes

ARS  (acute retroviral syndrome) is often mistaken for the flu, mononucleosis, or another viral infection, even syphilis or hepatitis.

That’s not surprising: Many of the symptoms are the same, including pain in the joints and muscles and swollen lymph glands.

Lymph nodes are part of your body’s immune system and tend to get inflamed when there’s an infection. Many of them are located in your armpit, groin, and neck.

Sore throat and headache

As with other symptoms, sore throat and headache can often be recognised as ARS only in context.

If you’ve engaged recently in high-risk behaviour, an HIV test is a good idea. Get tested for your own sake and for others: HIV is most infectious in the earliest stage.

Keep in mind that the body hasn’t produced antibodies to HIV yet, so an antibody test may not pick it up. (It can take a few weeks to a few months for HIV antibodies to show in a blood test). Investigate other test options such as one that detects viral RNA, typically within nine days of infection.

Skin rash

Skin rashes can occur early or late in the course of HIV/AIDS.

Some can look like boils, with some itchy pink areas. The rashes can also appear on the trunk of the body. If [the rashes]aren’t easily explained or easily treated, you should think about having an HIV test.

Nausea, vomiting, diarrhoea

From 30% to 60% of people have short-term nausea, vomiting, or diarrhoea in the early stages of HIV. These symptoms can also appear due to antiretroviral therapy and later in the infection, usually due to an opportunistic infection.

Diarrhoea that is unremitting and not responding at all to standard therapy might be an indication. Or symptoms may be caused by an organism not usually seen in people with healthy immune systems.

Weight loss

Once called “AIDS wasting,” weight loss is a sign of more advanced illness and could be due in part to severe diarrhoea. Weight loss is a late presentation.

If you’re already losing weight, that means the immune system is usually relatively depleted.  The patient keeps on losing a lot of weight, even while eating as much as possible.  People are considered to have wasting syndrome if they lose 10% or more of their body weight and have had diarrhoea or weakness and fever for more than 30 days.

Dry cough

This symptom—an insidious cough that could be going on for weeks that doesn’t seem to resolve, is typical in very ill HIV patients.

Pneumonia

The cough and the weight loss may also presage a severe infection caused by a germ that wouldn’t bother you if your immune system worked correctly.

There are many various opportunistic infections, and each one can present differently, for example, Pneumocystis pneumonia (PCP), aka “AIDS pneumonia,” which eventually can land you in the hospital.

Other opportunistic infections include toxoplasmosis, a parasitic infection that affects the brain; a type of herpes virus called Cytomegalovirus; and yeast infections such as thrush.

Night sweats

About half of people get night sweats during the early stages of HIV infection. These can be even more common later in disease and aren’t related to exercise or the temperature inside the room. Similar to the hot flashes that menopausal women suffer, they’re also hard to dismiss, given that they soak your bedclothes and sheets.

Nail changes

Another sign of late HIV infection is nail changes, such as clubbing (thickening and curving of the nails), splitting of the nails, or discolouration (black or brown lines going either vertically or horizontally).

Often this is due to a fungal infection, such as candida. Patients with depleted immune systems will be more susceptible to fungal infections.

Yeast infections

Another fungal infection common in later stages is thrush, a mouth infection caused by Candida, a type of yeast.

It’s a prevalent fungus and the one that causes yeast infections in women. They tend to appear in the mouth or oesophagus, making it difficult to swallow.

Confusion or difficulty concentrating.

Cognitive problems could be a sign of HIV-related dementia, which usually occurs late in the disease course.

In addition to confusion and difficulty concentrating, AIDS-related dementia might also involve memory problems and behavioural issues such as anger or irritability.

It may even include motor changes: becoming clumsy, lack of coordination, and problems with tasks requiring fine motor skills such as writing by hand.

If HIV leads to AIDS, severe symptoms can develop and can ultimately lead to death. Signs and symptoms may include fever and rashes to lesions, soaking night sweats and blurred vision.

Kaposi’s sarcoma

Kaposi’s sarcoma is a cancerous tumour of the connective tissue and is often associated with AIDS. Cancer may also involve the skin, lungs, gastrointestinal tract, and other organs. The tumours most often appear as bluish-red or purple bumps on the skin. They are reddish-purple because they are rich in blood vessels.

The lesions may first appear on the feet or ankles, thighs, arms, hands, face, or other parts of the body. They also can appear on sites inside the body.

KS is considered an “AIDS-defining” illness. It means that when KS occurs in someone infected with HIV, that person officially has AIDS (and is not just HIV-positive).

Note:   You should not assume you have HIV just because you have any of these symptoms. Each of these symptoms can be caused by other illnesses. And some people who have HIV do not show any signs at all for ten years or more.