Signs and Symptoms of AIDS (Acquired Immunodeficiency Syndrome)
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Medically reviewed by Soma Mandal, MD
Acquired immunodeficiency syndrome (AIDS) is the third and final stage of human immunodeficiency virus (HIV). In the early stages of HIV, you typically experience flu-like symptoms and fatigue. But if HIV progresses to AIDS, more severe symptoms like rapid weight loss, extreme fatigue, and sores can occur.
When someone has HIV, their immune system (the body’s natural defense against germs and harmful cells) weakens. Without treatment, HIV can eventually turn into AIDS—though this happens many years after getting an HIV diagnosis. Getting the proper medical treatment for HIV can help stop this progression to AIDS.
Stage 1: Acute HIV
People with the first stage of HIV—known as the acute stage—may develop symptoms several weeks or months after exposure. Symptoms vary from person to person, but may last a few days or many weeks. But it's worth noting that not everyone will have symptoms during this stage. If you do develop symptoms during the acute stage, they may include:
Flu-like symptoms: Chills, fever, body aches, sore throat, headache, and fatigue
Swollen lymph nodes: Large or painful lymph nodes in the neck and under the arms
Rash: Non-itchy, red or pinkish, flat or slightly raised spots, that can occur on the chest and back
Painful mouth ulcers: Shallow sores on the gums, tongue, or lining of the cheeks
Night sweats: Excessive sweating during sleep, causing damp pajamas or bedding
Menstrual cycle changes: Worsening cramps, early-onset menopause, or heavy bleeding in people who have periods
Stage 2: Clinical Latent Infection
The clinical latent stage (chronic HIV infection without AIDS) can last for 10 or more years. During this time, the virus is active in your body but reproduces at low levels. If left untreated, the virus steadily harms the immune system and weakens your immune system response. During stage 2, it's common to experience the following symptoms:
Yeast infections: Overgrowth of yeast in the mouth or genital area
Oral hair leukoplakia: White, non-painful sores with a “hairy” appearance on your tongue
Herpes zoster (shingles): A painful, fluid-filled rash that causes blisters
Peripheral neuropathy: Nerve damage that can cause numbness, tingling, burning, or pain in the hands and feet
Bacillary angiomatosis: A bacterial infection that can cause sores, blood vessel tumors, flu-like symptoms, and bone pain
Cervical dysplasia: Abnormal cells on the cervix, or the opening of the uterus (womb).
Cervical carcinoma in situ: Stage 0 cervical cancer
Idiopathic thrombocytopenic purpura (ITP): Low platelet counts that cause problems with blood clotting, which can lead to excess bleeding or bruising
Stage 3: AIDS
AIDS is the most advanced and severe stage of HIV. Symptoms of AIDS occur due to the severe impact of the virus on your immune system. The most common AIDS symptoms include:
Rapid and severe weight Loss
Recurring fever
Chronic diarrhea, that lasts more than a week at a time
Extreme fatigue
Long-term swollen lymph nodes
Skin rash that appears as purple, red, or brown sores on the skin or inside the mouth, nose, or eyelids
Mouth or genital sores
White spots on the tongue or mouth
Mental health effects like stress, depression, and changes in memory
In addition to these symptoms, people with AIDS are also at an increased risk of experiencing recurring infections and certain cancers.
Opportunistic Infections
Opportunistic infections are infections that occur more often or are more severe in people who are immunocompromised (or, have weakened immune systems). These infections can sometimes become severe and life-threatening. People with AIDS are at a higher risk of experiencing the following types of infections:
Bacterial infections: Examples such as pneumonia or tuberculosis (TB), which can cause difficulty breathing, fever, and persistent cough
Yeast and fungal infections: Examples include mouth or genital yeast infections and histoplasmosis—a fungal infection that primarily affects the lungs
Cytomegalovirus (CMV): A virus that can lead to pneumonia, liver swelling, and retinitis (swelling of the retina in the eye)
Parasitic infections: Toxoplasmosis is an example of a parasitic infection that can affect the brain, causing headaches, confusion, and seizures
HIV-related encephalopathy: Infection in the brain that can increase the risk of dementia
Herpes simplex virus (HSV): Those with both herpes and AIDS may experience sores in the mouth or genitals
Cancers
People with AIDS are also more susceptible to some types of cancers. While this list is not exhaustive, some examples include:
Kaposi's sarcoma: A cancer that causes sores on the skin, mouth, or internal organs
Lymphoma: A type of blood cancer that originates in your lymphatic system (including your lymph nodes, spleen, and bone marrow) and causes symptoms like swollen lymph nodes, fatigue, and unintentional weight loss
Cervical cancer: A tumor that develops on the cervix—the entrance of the uterus from the vagina
When to Contact a Healthcare Provider
If you recently engaged in sex, shared needles, or exchanged bodily fluids (e.g., blood, semen, or vaginal fluid) with someone who has HIV or are experiencing symptoms of HIV, it's important to see your healthcare provider.
In the case you do not want to speak to your healthcare provider, you can test for HIV anonymously (without being identified). This resource from HIV.gov also provides an HIV testing and care locator database to help you find other local organizations that can offer confidential testing. Your local health department may also provide low-cost or free HIV self-test kits for home.
Receiving a diagnosis for HIV can be scary, but it is a good idea to talk to a healthcare provider that you trust about your diagnosis and any concerns or worries that you have. They can also help you get started on early treatment, such as antiretroviral therapy (ART), which can help prevent the progression of HIV to AIDS.
Experts also recommend routine HIV testing if you are sexually active or are at high risk for HIV. HIV risk increases for people who:
Have unprotected sex with a partner who has HIV/AIDS or an unknown HIV status
Are females who have sex with males
Are males who have sex with males
Share needles or syringes
Questions to Ask Your Provider
When discussing concerns about HIV/AIDS with a healthcare provider, here are some questions you might consider asking:
How often and where should I get tested for HIV?
How soon after exposure should I get an HIV test?
If my partner has HIV, would preventative measures are available for me?
How can I discuss my HIV status with my romantic or sexual partner?
Are there support groups or counseling services available for those with HIV?
A Quick Review
AIDS is the most advanced stage of HIV. HIV/AIDS damages the immune system, which can lead to symptoms such as fever, chronic diarrhea, unintentional weight loss, night sweats, opportunistic infections, depression, and certain cancers. Medical treatments such as antiretroviral therapy (ART) can help those with early stages of HIV prevent the progression to AIDS. Regular testing and monitoring are critical aspects in the management of HIV/AIDS.
Frequently Asked Questions
How long can AIDS symptoms last?
The first stage of HIV can cause symptoms that last a couple of days or weeks. The second stage can last for several years or a decade. Left untreated, the second stage of HIV can cause AIDS and lead to life-threatening infections and complications which can occur for one to three years.
What is the life expectancy for someone with AIDS?
Life expectancy for those who have AIDS, and who do not take HIV medication, is about three years. This drops to one year for those who are experiencing frequent opportunistic infections. Starting HIV medication soon after getting a diagnosis for HIV can help prevent the progression of HIV to AIDS.
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