It is important to recognize symptoms of HIV as soon as possible since early diagnosis and treatment will prevent serious illness. Early treatment will also reduce your chances of transmitting the virus to others. Early symptoms of HIV develop in 50 to 90 percent of people who are infected, usually beginning two to four weeks after exposure to HIV. The initial group of signs and symptoms is referred to as primary or acute HIV.

Because the signs and symptoms of primary HIV may be similar to other common illnesses, such as mononucleosis, most people do not initially realize that they have HIV. However, HIV is highly contagious at this early stage because there are large amounts of the virus in the blood and other bodily fluids. Recognizing symptoms early, being tested for HIV, and starting HIV treatment as soon as possible can help to decrease the risk of transmitting HIV to another person.

Body-wide symptoms — The most common body-wide signs and symptoms of acute HIV include fever (temperature above 100.4ºF or 38ºC), sore throat, headache, and muscle and joint pain. These symptoms last approximately two weeks. During the second week of the illness, most people also have painless swelling of certain lymph nodes, including those in the armpits and in the neck. Although the lymph nodes decrease in size after the first few weeks, swelling can linger. Skin, mouth, genital symptoms — Many people also develop a rash of the skin about two to three days after fever. The rash usually affects the face, neck, and upper chest or may be more widespread. The rash usually lasts approximately five to eight days.

One characteristic feature of acute HIV is open sores or ulcers. These sores or ulcers can develop in the mouth, the esophagus (the tube that extends from the mouth to the stomach), the anus, or the penis. The ulcers are usually painful. However, only a small proportion of those with acute HIV develop these sores.

Digestive symptoms — Many people with acute HIV develop nausea and vomiting, diarrhea, lack of appetite, and weight loss.

Respiratory symptoms — A dry cough is usually the only respiratory symptom associated with primary HIV infection.

Symptoms of advanced HIV infection — If HIV is not treated, the virus will cause progressive weakening of the immune system, a process which occurs at different rates in different people. Once significant damage to the immune system has occurred, which typically takes at least several years, people with HIV can develop infections that are not usually seen in people with normal immunity. These “opportunistic infections” can cause serious disease in patients with advanced HIV. Depending on the opportunistic infection, symptoms may include shortness of breath, blurred vision, fevers, and weight loss.

One of the most common opportunistic infections is yeast infection of the mouth or esophagus. Yeast infections are caused by Candida, a fungal organism that is normally found on the skin and in the mouth, intestinal tract, and vagina in healthy individuals. Certain yeast infections can occur in people without HIV, (eg, vaginal yeast infections) although people with HIV are at a higher risk for this and other types of opportunistic infections. (See "Patient education: Vaginal yeast infection (Beyond the Basics)".)

●Candidiasis of the mouth, also known as thrush, causes cream-colored, slightly raised patches in the mouth, soreness, and easy bleeding

●Candidiasis of the esophagus may cause difficulty swallowing

However, with diagnosis and treatment of HIV, the immune system can improve. Then the risk of opportunistic infections goes down. While the immune system is recovering, certain medications can help prevent any opportunistic infections from occurring in the first place.

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