What Are the 3 Stages of HIV?

Reviewed on 2/10/2022

Lab technician handling blood samples
The three stages of human immunodeficiency virus (HIV) include acute HIV infection, chronic HIV infection, and acquired immune deficiency syndrome (AIDS). Without treatment, HIV progresses to Stage 3 (AIDS).

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. People with untreated HIV infection don’t fight off infections or cancer as well as healthy people and can become sick easily. 

The three stages of HIV include acute HIV infection, chronic HIV infection, and acquired immune deficiency syndrome (AIDS).

Without treatment, human immunodeficiency virus (HIV) progresses through three stages. Progression to Stage 3 (AIDS) is not as common as it used to be because of the availability of antiretroviral therapy (ART) medications. 

Stage 1: Acute HIV Infection

  • There is a large amount of HIV in the blood
  • Patients are extremely contagious
  • Flu-like symptoms can occur, though not everyone will feel sick
  • Only antigen/antibody tests or nucleic acid tests (NATs) can diagnose acute infection

Stage 2: Chronic HIV Infection (asymptomatic HIV infection or clinical latency)

  • HIV is active but reproduces at very low levels
  • Symptoms may not occur during this phase
  • Without HIV medication, stage 2 can last a decade or longer in some patients
  • HIV can be transmitted in this phase
  • At the end of stage 2, the amount of HIV in the blood (the viral load) increases and the CD4 cell count decreases
  • Symptoms may occur as virus levels increase in the body, and the person progresses to stage 3
  • If HIV medications are taken as prescribed patients may not progress to stage 3

Stage 3: Acquired Immunodeficiency Syndrome (AIDS)

  • This is the most severe phase of HIV infection
  • AIDS damages the body’s immune system and patients can develop an increasing number of severe illnesses (called opportunistic infections)
  • AIDS is diagnosed when CD4 cell counts drop below 200 cells/mm or if patients develop certain opportunistic infections
  • People with AIDS may have a high viral load and be highly infectious
  • Without treatment, the life expectancy for AIDS patients is about three years
  • In the U.S., most people infected with HIV do not go on to develop AIDS because HIV medicines are available that can stop the progression of the disease

What Are Symptoms of HIV?

The first symptoms of HIV (human immunodeficiency virus) are called primary or acute HIV infection. These early symptoms usually occur two to four weeks after a person is infected with the virus.

Acute HIV infection symptoms last about 2 weeks and are usually mild. People often don’t realize they have HIV at this point. Early symptoms may include: 

After several years, if HIV is not treated, other symptoms can develop:

  • Lymph node swelling
    • Usually in the neck, armpit, or groin
  • Fever
  • Stomach pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Weight loss
  • Other infections (opportunistic infections)
    • Lung infections that can cause shortness of breath
    • Brain infections
    • Eye infections that cause trouble seeing and blurred vision
    • Candidiasis of the mouth (oral thrush) that can cause soreness and raised, white patches

How Is HIV Transmitted?

  • HIV (human immunodeficiency virus) infection is caused by exposure to the human immunodeficiency virus.
  • The virus is transmitted via blood or through sexual intercourse and exposure to other bodily fluids (such as semen or vaginal fluids) from a person with HIV.
  • HIV infection is NOT spread by casual contact.

What Is the Treatment for HIV?

HIV (human immunodeficiency virus) is treated with different combinations of antiretroviral medicines to help keep HIV infection controlled.

Early HIV infection is usually treated with one of the following antiretroviral therapy (ART) regimens: 

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Reviewed on 2/10/2022
References
Image Source: iStock Images

https://www.uptodate.com/contents/hiv-aids-the-basics?search=hiv&source=search_result&selectedTitle=4~150&usage_type=default&display_rank=4

https://www.uptodate.com/contents/symptoms-of-hiv-infection-beyond-the-basics?search=hiv&source=search_result&selectedTitle=11~150&usage_type=default&display_rank=11

https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids

https://www.uptodate.com/contents/acute-and-early-hiv-infection-treatment?search=hiv%20treatment&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.sfaf.org/collections/beta/life-expectancies-close-to-80-years-for-young-people-starting-hiv-meds-early/