Acute HIV Infection: Symptoms, Causes, Treatment & More - Healthline

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Key takeaways

Acute HIV infection is the first stage of HIV, occurring two to four weeks after contracting the virus, and is marked by rapid viral multiplication before the body develops antibodies.
Symptoms of acute HIV infection resemble those of the flu, and many people may not realize they have HIV during this stage, as standard antibody tests might not detect it.
Early treatment with antiretroviral drugs is crucial for individuals diagnosed with HIV, as it can minimize the virus’s impact on the immune system, prevent progression to stage 3 HIV, and improve long-term health outcomes.

Acute HIV infection is the initial stage of HIV, and it lasts until the body has created antibodies against the virus.

Acute HIV infection develops as early as 2 to 4 weeks after someone contracts HIV. It’s also known as primary HIV infection or acute retroviral syndrome. During this initial stage, the virus is multiplying at a rapid rate.

Unlike other viruses, which the body’s immune system can normally fight off, HIV can’t be eliminated by the immune system.

Over a long time, the virus attacks and destroys immune cells, leaving the immune system unable to fight off other diseases and infections. When this happens, it can lead to late stage HIV, known as AIDS or stage 3 HIV.

It’s possible to contract HIV from a person with an acute HIV infection because of the high rate of viral replication during this time.

However, most people with acute HIV infection don’t even know they’ve contracted the virus.

This is because the initial symptoms resolve on their own or may be mistaken for another illness such as the flu. Standard HIV antibody tests aren’t always able to detect this stage of HIV.

What are the symptoms of acute HIV infection?

Acute HIV infection symptoms are similar to those of the flu and other viral illnesses, so people may not suspect that they’ve contracted HIV.

In fact, the Centers for Disease Control and Prevention (CDC) estimates that of the nearly 1.2 million people in the United States living with HIV, about 14 percent of them don’t know they have the virus. Getting tested is the only way to know.

Symptoms of acute HIV infection can include:

rash
fever
chills
headache
fatigue
sore throat
night sweats
loss of appetite
ulcers that appear in or on the mouth, esophagus, or genitals
swollen lymph nodes
muscle aches
diarrhea

Not all symptoms may be present, and many people with acute HIV infection don’t have any symptoms.

However, if a person does experience symptoms, they may last for a few days or up to 4 weeks, then disappear even without treatment.

What causes acute HIV infection?

Acute HIV infection occurs 2 to 4 weeks after initial exposure to the virus. HIV is transmitted through:

contaminated blood transfusions, primarily before 1985
sharing syringes or needles with someone living with HIV
contact with blood, semen, vaginal fluids, or anal secretions containing HIV
pregnancy or breastfeeding if the mother has HIV

HIV isn’t transmitted through casual physical contact, such as hugging, kissing, holding hands, or sharing food utensils.

Saliva doesn’t transmit HIV.

Who is at risk for acute HIV infection?

HIV can affect people of any age, sex, race, or sexual orientation. However, behavioral factors may put certain groups at an increased risk for HIV. These include:

people who share needles and syringes
men who have sex with men

How is acute HIV infection diagnosed?

If a healthcare provider suspects that a person has HIV, they’ll perform a series of tests to check for the virus.

A standard HIV screening test won’t necessarily detect acute HIV infection.

Antibody test

Many HIV screening tests look for antibodies to HIV rather than the virus itself. Antibodies are proteins that recognize and destroy harmful substances, such as viruses and bacteria.

The presence of certain antibodies usually indicates a current infection. However, it can take several weeks after an initial transmission for HIV antibodies to appear.

If a person’s antibody test results are negative but their healthcare provider believes they may have HIV, they may be given a viral load test too.

The healthcare provider may also have them repeat the antibody test a few weeks later to see if any antibodies have developed.

Other tests

Some tests that may be able to detect signs of acute HIV infection include the:

HIV RNA viral load test
p24 antigen blood test
combined HIV antigen and antibody tests (also called 4th generation tests)

The p24 antigen blood test detects the p24 antigen, a protein that’s only found in people with HIV. An antigen is a foreign substance that causes an immune response in the body.

The 4th generation test is the most sensitive test, but it doesn’t always detect infections within the first 2 weeks.

People who take a 4th generation test or p24 antigen blood test will also need to confirm their HIV status with a viral load test.

Anyone who’s been exposed to HIV and may be experiencing acute HIV infection should get tested right away.

If a healthcare provider knows that someone has had possible recent exposure to HIV, they’ll use one of the tests capable of detecting acute HIV infection.

How is acute HIV infection treated?

Proper treatment is crucial for people diagnosed with HIV.

Healthcare providers and scientists agree that early treatment with antiretroviral drugs should be used by all HIV-positive people who are ready to start taking a daily medication.

Early treatment may minimize the virus’s effects on the immune system.

Newer antiretroviral medications are usually very well tolerated, but there’s always the possibility of side effects.

If a person thinks they’re experiencing a side effect of or an allergic reaction to their medication, they should immediately contact their healthcare provider.

In addition to medical treatment, healthcare providers may also suggest certain lifestyle adjustments, including:

eating a healthy and balanced diet to help strengthen the immune system
practicing sex with condoms or other barrier methods to help decrease the risk of transmitting HIV to others and contracting sexually transmitted infections (STIs)
reducing stress, which can also weaken the immune system
avoiding exposure to people with infections and viruses, since the immune system of those with HIV may have a harder time responding to the disease
exercising on a regular basis
staying active and maintaining hobbies
reducing or avoiding alcohol and injecting drugs
using clean needles when injecting drugs
stopping smoking

What is the outlook for someone with acute HIV infection?

There’s no cure for HIV, but treatment allows people with HIV to live long and healthy lives. The outlook is best for people who begin treatment before HIV has damaged their immune system.

Early diagnosis and the right treatment help prevent HIV progressing to AIDS.

Successful treatment improves both the life expectancy and quality of life of someone living with HIV. In most cases, HIV is considered a chronic condition and can be managed long term.

Treatment can also help someone living with HIV reach an undetectable viral load, at which point they’ll be unable to transmit HIV to sexual partners.

How can acute HIV infection be prevented?

Acute HIV infection can be prevented by avoiding exposure to the blood, semen, anal secretions, and vaginal fluid of a person living with HIV.

Below are some ways to reduce the risk of contracting HIV:

Reduce exposure before, during, and after sex. A variety of prevention methods are available including condoms (male or female), pre-exposure prophylaxis (PrEP), treatment as prevention (TasP), and post-exposure prophylaxis (PEP).
Avoid sharing needles. Never share or reuse needles when injecting drugs or getting a tattoo. Many cities have needle exchange programs that provide sterile needles.
Take precautions while handling blood. If handling blood, use latex gloves and other barriers.
Get tested for HIV and other STIs. Getting tested is the only way a person can know whether they have HIV or another STI. Those testing positive can then seek treatment that can eventually eliminate their risk of transmitting HIV to their sexual partners. Being tested for and receiving treatment for STIs reduces the risk of transmitting them to a sexual partner. The CDC recommends at least yearly testing for people who inject drugs or who have sex without a condom or other barrier method.

Where can someone with HIV find support?

Getting an HIV diagnosis can feel emotionally devastating for some people, so it’s important to find a strong support network to help deal with any resulting stress and anxiety.

There are many organizations and individuals dedicated to supporting people living with HIV, as well as many local and online communities that can offer support.

Speaking with a counselor or joining a support group allows people with HIV to discuss their concerns with others who can relate to what they’re going through.

Hotlines for HIV groups by state can be found at the Health Resources and Services Administration’s website.

Read this article in Spanish.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Acute HIV infection. (n.d.).https://clinicalinfo.hiv.gov/en/glossary/acute-hiv-infection
Global HIV Prevention and Treatment Clinical Trials Unit: FAQ. (n.d.).http://www.med.unc.edu/medicine/infdis/actu/faq
HIV/AIDS timeline. (n.d.).https://www.nycaidsmemorial.org/history?rq=timeline
HIV in the United States and dependent areas. (2020).http://www.cdc.gov/hiv/statistics/overview/ataglance.html
Hoenigl M, et al. (2016). Signs or symptoms of acute HIV infection in a cohort undergoing community-based screening.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4766914/
Mayo Clinic Staff. (2020). HIV/AIDS.http://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524
Post-exposure prophylaxis. (2019).http://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/post-exposure-prophylaxis
Pre-exposure prophylaxis. (2020).http://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis
Symptoms of HIV. (2020).http://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/symptoms-of-hiv
What are HIV and AIDS? (2020).http://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids
Which STD tests should I get? (2014).http://www.cdc.gov/std/prevention/screeningreccs.htm

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Medically reviewed by Cameron White, M.D., MPH — Written by The Healthline Editorial Team and Josh Robbins — Updated on December 1, 2020

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Key takeaways

What are the symptoms of acute HIV infection?

What causes acute HIV infection?

Who is at risk for acute HIV infection?

How is acute HIV infection diagnosed?

Antibody test

Other tests

How is acute HIV infection treated?

What is the outlook for someone with acute HIV infection?

How can acute HIV infection be prevented?

Where can someone with HIV find support?

How we reviewed this article:

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