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stages of hiv infection

By: Karen Terry

June 5, 2022

A Brief Guide to the Stages of HIV Infection

The U.S. has a significant history with HIV and AIDS due to the tragic epidemic that started in the early 1980s, and many people still think of that time when someone mentions HIV. The human immunodeficiency virus (HIV) destroys the body’s immune system, eventually leading to AIDS. Someone with AIDS (acquired immunodeficiency syndrome) typically has a life expectancy of about three years without treatment. 

Fortunately, researchers have discovered a treatment that slows the body’s progression through the stages of HIV, meaning that the numbers of severe cases are much lower today than they were 40 years ago. Antiretroviral therapy, or ART, describes an HIV treatment regimen that involves taking medications every day to help the immune system and reduce the risk of spread to other people.

HIV Overview

HIV attacks the cells of your body’s immune system, weakening its ability to fight off illness. HIV can eventually develop into AIDS. Though no cure currently exists, effective treatments allow people living with HIV to maintain a long, healthy life. 

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Where does HIV come from?

The virus originally came from chimpanzees in Central Africa. Some people speculate that humans contracted SIV (the simian version of the virus) from the blood of chimpanzees after hunting them for food in the late 1800s. HIV inched its way across Africa, eventually spreading to various parts of the world.

How can I determine if I have HIV?

You must get an HIV test to find out if you have the virus. The most common test detects antibodies, but it may take up to three months after infection for them to show up. If you believe you have had exposure to HIV, Rapid STD Testing offers a 10-panel STD test that can detect the virus.

What are the symptoms of HIV?

Flu-like symptoms can appear within two to four weeks after infection, including: 

  • Fever
  • Chills
  • Sore throat
  • Rash
  • Mouth ulcers
  • Night sweats
  • Body aches
  • Swollen lymph nodes 

These symptoms could last for a few days or weeks. Some people don’t experience any symptoms at this stage, though the virus continues to multiply in their bodies. While not a direct symptom of HIV, thinning hair is also common in patients due to conditions related to their compromised immune system.

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How does HIV spread?

HIV transmission happens through contact with certain bodily fluids, such as: 

  • Semen
  • Pre-seminal fluid
  • Blood
  • Rectal fluids
  • Vaginal fluids
  • Breast milk 

The most common ways that people contract HIV are:

  • Vaginal or anal sex with someone who has HIV without a condom or preventative medication
  • Using the same needles as someone with HIV

What are the stages of HIV?

Without treatment, HIV naturally progresses through different stages. If you get a rapid STD test early and receive treatment, you can slow the progression and avoid developing AIDS.

Stage 1: Acute HIV Infection

In the first stage of HIV infection, the virus is rapidly multiplying in the body. Some people will experience flu-like symptoms like fever, chills, and sore throat within days or weeks of exposure. However, some never feel sick in the earliest stage. 

In reaction to the virus replicating in the body, the immune system produces antibodies, which tests can detect three months after the initial infection. A person in this stage of HIV infection is highly contagious.

Stage 2: Chronic HIV Infection (Asymptomatic)

The second stage can be risky because there is no sign or symptom of an HIV infection. The virus continues to develop and hurt the immune system’s function but at a much slower pace. This stage can last for up ten years. 

A person in this stage may never know they have HIV, but they are still infectious. Treatment slows down the progression of HIV, and someone taking medication could live the rest of their life in this asymptomatic stage.

Stage 3: Chronic HIV Infection (Symptomatic)

Eventually, HIV causes a person’s immune system to stop working correctly, making them vulnerable to opportunistic infections. These severe illnesses can bring about symptoms like weight loss, fatigue, thrush, mouth ulcers, and diarrhea. 

Opportunistic infections earned the name because they take advantage of an infected person’s weakened immune system, spreading through bodily fluids, air, or contaminated foods. These infections include toxoplasmosis, pneumonia, Salmonella bacteria infection, and tuberculosis. Taking HIV medications can prevent damage to the immune system, helping your body resist illnesses.

Stage 4: Acquired Immunodeficiency Syndrome (AIDS)

The body’s immune system has taken a significant beating, and the HIV infection has developed into AIDS. Untreated HIV at this stage means numerous opportunistic infections and a rapid decline in health. 

Doctors test for AIDS by checking a person’s CD4 cell count, the primary infection-fighting cells in the immune system. They also take note of the viral load and opportunistic infections. Someone at this stage has a high amount of HIV in their blood, and they’re very contagious.

Rates of HIV Disease Progression

The rate of HIV progression depends on immune function and genetics. There are two main categories of progressors: 

  • Rapid progressors: HIV rapidly progresses to AIDS, taking only a few years versus the standard ten.
  • Long-term nonprogressors: the infected person shows no symptoms of HIV, and progression to AIDS can take over 12 years.

Test Markers of HIV Disease Progression

Running lab tests can reveal the progression of HIV by using specific test markers, giving doctors and researchers a better idea of how HIV develops in the body. These markers of HIV development correspond to low immune system cell count, viral load, and increased immune response.

CD4 cell count for T cells

CD4 cell count was the first marker doctors used to predict the rate of HIV progression to AIDS. CD4 cells, aka T cells, are white blood cells that find and eliminate invading germs. Measuring the number of these cells in the body allows doctors to determine a person’s risk of contracting opportunistic infections like pneumonia.

Plasma HIV viral load

Viral load is the amount of HIV in each millimeter of blood. At the beginning of an HIV infection, the viral load is very high. During the asymptomatic stage, the amount of HIV in the blood drops and stabilizes until AIDS starts to develop, at which point the viral load shoots up.

CD38 expression on CD8+ T cells

CD38 is a protein that appears on the surface of white blood, such as CD8+ T cells. A higher expression of CD38 on CD8+ cells indicates an imminent decline of CD4+ T cells at the beginning of an HIV infection. Later in the disease’s development, it can predict progression into AIDS.

The Basics of HIV Prevention

Since HIV only passes through specific bodily fluids, you can reduce your risk of infection by avoiding contact with those fluids or taking preventative medications.

Prevention of HIV Perinatal Transmission

A woman infected with HIV could pass the virus to her infant during pregnancy, labor and delivery, or breastfeeding, known as perinatal transmission. To prevent this type of infection, women should get tested for HIV before becoming pregnant, take HIV medications if they are infected, and use formula instead of breast milk.

Pre-Exposure Prophylaxis (PrEP)

PrEP is a medicine for people who don’t have HIV, but who want to prevent contracting it through sex or sharing needles. They must take the drug every day for it to be effective. The Centers for Disease Control (CDC) shows that PrEP reduces HIV infection through sex by 99% and injecting drugs by 74%.

Post-Exposure Prophylaxis (PEP)

PEP is for HIV exposure emergencies, and you should not substitute other prevention methods with it. You should use it as soon as possible after HIV exposure (within at least 72 hours). If you take it within those first three days, it can prevent HIV infection.

Protect Your Partners – Get Tested for HIV

Are you freaking out over potential exposure to HIV after reading this article? Give yourself peace of mind and try same-day STD testing. Visit a Rapid STD Testing center near you.


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By: Karen Terry
June 5, 2022

With a profound passion for making intricate medical information accessible to all, John possesses a unique ability to simplify complex concepts without sacrificing accuracy or depth. Armed with a comprehensive understanding of various healthcare fields, John is well-versed in the latest research and advancements. However, what truly sets him apart is his remarkable talent for distilling this wealth of knowledge into engaging, reader-friendly content.