What are the First Signs of an HIV Infection?

What are the first symptoms of an HIV infection? I am a 25-year-old woman who had unprotected sex in February, and in March I had tonsillitis. Could a symptom like that have been from HIV?


HIV, as you probably know, is the human immunodeficiency virus, the organism that causes AIDS (acquired immunodeficiency syndrome). AIDS typically develops 5-10 years after infection with HIV. But about two-thirds of people who become infected with HIV develop some early symptoms, usually two to four weeks after they were infected. This illness is termed "acute retroviral syndrome" or "primary HIV infection." The syndrome is similar to the flu. The most common symptoms of HIV are fever, sore throat, swollen lymph nodes and a rash. The rash usually consists of small raised or flat lesions scattered all over the body, sometimes on the palms and soles. Ulcers can also develop -- particularly in the mouth, but sometimes on the skin and genitals.

Because this syndrome closely resembles a variety of harmless viral illnesses, it is not usually recognized as HIV infection. And because it occurs so early after infection, typical lab tests do not help pinpoint the cause. The ELISA test, the most common HIV test, detects the body's own disease-fighting antibodies to HIV. Because it takes time for the immune system to create these antibodies, the ELISA test is typically negative during the acute retroviral syndrome.

Was your illness caused by HIV infection? I can't say for sure. It is possible, but don't forget that the usual causes of tonsillitis are very common. I recommend that you see your doctor and ask him or her how likely it is that HIV caused your specific symptoms. If your doctor thinks you may have been infected, then you can determine the next step. For patients in that situation, I see two options. The first is to wait about six months after the illness to get tested for HIV. By that time, antibodies will show up on the ELISA test if you were infected. The second option is to have a more sophisticated HIV test without waiting six months. One such test is called PCR (short for "polymerase chain reaction," a lab technique for detecting the genetic material of the virus itself). The PCR test will be positive even at the early stage of infection. One reason to take this approach is that it may be beneficial to treat HIV at this very early stage. A downside is that the PCR test may come up positive when in fact you are not infected. So if you do get a positive result, the test should be repeated and followed up later with a traditional HIV blood test.


by Harold Oster