Following exposure to the human immunodeficiency virus (HIV), about two-thirds of individuals will experience flu-like symptoms within the initial weeks of infection.

This response indicates that the body is actively responding to the virus. Known as acute retroviral syndrome, this early phase of HIV infection can be mild enough that some individuals may not even realize they are sick.

Symptoms such as fever or headache are often mistaken for common illnesses like the flu, mononucleosis, or tonsillitis. Generally, these initial signs only persist for a week or two as the immune system attempts to control and eliminate the virus from the body.

“It basically feels like a flu reaction since the initial HIV viral load is very high,” Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco stated.

In the first few weeks after exposure to HIV, it is important to be aware of symptoms even if you do not feel sick. If you have recently had sexual contact with a new partner or multiple partners, it is especially important to recognize these symptoms in order to get tested and take steps to minimize the impact of HIV on your health in both the short and long term.

If you suspect you have been exposed to HIV, be on the lookout for the following symptoms:

1. Fever :

The most common early symptom is a fever, typically 100.4ºF or higher. A study of 155 patients with acute HIV symptoms found that 66% experienced a fever.

After HIV infection, the virus rapidly circulates in the bloodstream and multiplies. Following seroconversion, the viral load is very high and a fever is the body’s natural response to battling the virus, according to Gandhi.

“The usual response to a pathogen is to mount a fever in order to try to recruit immune cells to kill the pathogen,” Gandhi stated.

2. Fatigue :

Fatigue which is a common symptom in various infections, including HIV, can range from mild to severe and can affect various aspects of an individual’s life, such as their quality of life, social relationships, productivity, physical activity, well-being, and healthcare-seeking behaviors. Studies have shown that fatigue can have a significant impact on individuals’ overall health and functioning.

“When one’s body is fighting infections, there’s a lot of chemicals that get released called cytokines,” said Dr. Philip Grant, an infectious diseases specialist at Stanford Medicine. While these chemicals help combat infections, that process can be exhausting, he stated.

Approximately two-thirds of individuals may experience flu-like symptoms within the first few weeks of an HIV infection.

3. Headache:

Following seroconversion, headaches may develop. A study discovered that more than half of HIV-positive individuals at a clinic reported experiencing headaches, which is the most common neurological issue related to HIV.

Grant explained that some individuals with acute HIV may develop meningitis or inflammation in the meninges due to the virus entering the cerebral-spinal fluid, leading to headaches. However, headaches can also result from the body’s response to the cytokines present in the system.

4. Swollen Lymph Nodes:

Lymph nodes in the armpit, groin, and neck regions may also swell. These nodes play a role in the immune system, and during the early stages of an infection, the body increases the production of immune cells.

“That’s why you get more cells there and why the lymph nodes are getting swollen,” Grant mentioned.

Grant explained that many individuals may observe swollen glands in their neck. He mentioned that individuals usually do not have just one swollen node but a cluster of swollen lymph nodes. Although lymph nodes can also swell in other areas such as the groin and armpits, they are not as easily noticeable as those in the neck.

5. Throat Pain:

A common early sign of HIV is a sore throat or tonsillitis. Tonsils in the back of the throat are lymphatic tissue that actively fights infections. When inflamed, swallowing can be uncomfortable or painful. Some individuals have mistakenly gone to the emergency room thinking they have tonsillitis or strep throat, only to be diagnosed with HIV.

6. Skin Rash:

A rash may suddenly appear and cause a section of the skin to feel itchy, red, and painful. This rash typically appears about three days after fever and is seen in around 50% of individuals with HIV. While these rashes can occur anywhere on the body, they are commonly found on the torso and face. They can be mistaken for rashes caused by other infections such as chickenpox or measles.

7. Muscle and Joint Discomfort:

About half of individuals with acute HIV experience muscle aches, which typically begin about a week after contracting the virus and feel similar to flu-induced aches. Cytokines play a role in promoting inflammation throughout the body.
“When cytokines are released, the body can feel very tired with muscle and joint aches, which makes the body ‘slow down’ as it tries to fight an infection,” Gandhi stated.

The main takeaway: “It’s a lot like the flu, it’s almost indistinguishable,” Grant elaborated.

If you are experiencing any of the initial symptoms of HIV and have engaged in sexual activity with multiple partners or someone with an unknown sexual history, it is crucial to consult a healthcare provider and undergo testing promptly.

Testing can be conducted at your regular doctor’s office, a local health department, a health clinic, or an HIV testing center listed in a national directory. The earlier you get tested, the sooner you can begin treatment if necessary. Antiretrovirals, when taken shortly after infection, can impede the replication of the virus, alleviate symptoms, and enhance long-term health outcomes.

While these early symptoms may not be readily apparent, recognizing them and taking swift action can safeguard your health and prevent the spread of the infection to others.