These Symptoms Could Mean You Are HIV Positive

Within a month or two of HIV entering the body,
40% to 90% of people experience flu- like
symptoms known as acute retroviral syndrome
(ARS).
But sometimes HIV symptoms don't appear for years,
sometimes even a decade, after infection.
"In the early stages of HIV infection, the most common
symptoms are none," says Michael Horberg, MD,
director of HIV/AIDS for Kaiser Permanente, in
Oakland, Calif. One in five people in the United States
with HIV doesn't know they have it, which is why it's
so important to get tested, especially if you have
unprotected s*x with more than one partner or use
intravenous drugs.
Here are some signs that you may be HIV-positive.

Fever

One of the first signs of ARS can be a mild fever, up to
about 102 degrees F. The fever, if it occurs at all, 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 blood stream
and starting to replicate in large numbers," says Carlos
Malvestutto, MD, instructor of infectious diseases and
immunology in the department of medicine at NYU
School of Medicine in New York City. "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. Ron, 54, a public relations executive in the
Midwest, started to worry about his health when he
suddenly got winded just walking. "Everything I did, I
got out of breath," he says. "Before that I had been
walking three miles a day." Ron had tested HIV
positive 25 years before feeling so tired; fatigue during
acute, or newly contracted, HIV might not be so
obvious.

Achy Muscles & Joint Pain

ARS 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 & Headache

As with other symptoms, sore throat and headache can
often be recognized as ARS only in context, Dr.
Horberg says. If you've engaged recently in high-risk
behavior, 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
monthsfor 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 Rashes

Skin rashes can occur early or late in the course of
HIV/AIDS. For Ron, this was another sign that he
might not have run-of-the-mill allergies or a cold.
"They were like boils, with some itchy pink areas on
my arms," Ron says. 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," Dr. Horberg says.

Nausea, Vomiting & Diarrhea

Anywhere from 30% to 60% of people have short-term
nausea, vomiting, or diarrhea in the early stages of
HIV, Dr. Malvestutto says. These symptoms can also
appear as a result of antiretroviral therapy and later in
the infection, usually as the result of an opportunistic
infection. "Diarrhea that is unremitting and not
responding at all to usual therapy might be an
indication," Dr. Horberg says. Or symptoms may be
caused by an organism not usually seen in people with
healthy immune systems, he adds.

Weight Loss

Once called "AIDS wasting," weight loss is a sign of
more advanced illness and could be due in part to
severe diarrhea. "If you're already losing weight, that
means the immune system is usually fairly depleted,"
Dr. Malvestutto says. "This is the patient who has lost a
lot of weight even if they continue to eat as much as
possible. This is late presentation. We still see a lot of
these." It has become less common, however, thanks to
antiretroviral therapy.
A person is considered to have wasting syndrome if
they lose 10% or more of their body weight and have
had diarrhea or weakness and fever for more than 30
days, according to the U.S. Department of Health and
Human Services.
Dry Cough
Have a bad cough that Benadryl, antibiotics, and
inhalers don't seem to fix? This symptom—an
"insidious cough that could be going on for weeks that
doesn't seem to resolve," Dr. Malvestutto says—is
typical in very ill HIV patients.

Night Sweats

About half of people get night sweats during the early
stages of HIV infection, Dr. Malvestutto says. These
can be even more common later in infection and aren't
related to exercise or the temperature of 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 are nail changes,
such as clubbing (thickening and curving of the nails),
splitting of the nails, or discoloration (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," Dr. Malvestutto says.

Yeast Infections

Another fungal infection that's common in later stages
is thrush, a mouth infection caused by Candida, a type
of yeast. "It's a very common fungus and the one that
causes yeast infections in women," Dr. Malvestutto
says. "They tend to appear in the mouth or esophagus,
making it difficult to swallow." Ron woke up one day
to find white patches on his tongue. He had thrush. For
him, "It was not bothersome other than I didn't like
having it." The infection was hard to get rid of, but
finally cleared up after Ron started taking drugs to
combat HIV.

Confusion or Difficulty Concentrating
Cognitive problems could be a sign of HIV-related
dementia, which usually occurs late in the course of the
disease. In addition to confusion and difficulty
concentrating, AIDS-related dementia might also
involve memory problems and behavioral 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.
Cold Sores or private part Herpes
Cold sores (oral herpes) and private part herpes can be a
sign of both ARS and late-stage HIV infection. Having
herpes can also be a risk factor for contracting HIV.
This is because private part herpes can cause ulcers that
make it easier for HIV to enter the body during s*x.
And people who have HIV tend to have more severe
herpes outbreaks more often because HIV weakens the
immune system.

Tingling & Weakness

Late HIV can also cause numbness and tingling in the
hands and feet. This is called peripheral neuropathy,
which also occurs in people with uncontrolled diabetes.
"This is when the nerves are actually damaged," Dr.
Malvestutto says. These symptoms can be treated with
over-the-counter pain relievers and antiseizure
medicines such as Neurontin (gabapentin).
Ménstrual Irregularities
Advanced HIV disease appears to increase the risk of
having ménstrual irregularities, such as fewer and
lighter periods. These changes, however, probably have
more to do with the weight loss and poor health of
women with late-stage infection rather than the
infection itself. Infection with HIV also has been
associated with earlier age of menopause (47 to 48
years for infected women compared to 49 to 51 years
for uninfected women).