HIV symptoms and progression

HIV often shows no clear symptoms at first. An early test is the only reliable way to make a diagnosis and enables timely treatment with a very good chance of success.
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🔬 Recognised early, easily treatable:
The earlier HIV is detected, the more effective the treatment and the better the long-term health protection.

🧍‍♂️ HIV affects everyone:
Regardless of gender, orientation or lifestyle - anyone can become infected.

📉 U = U:
Undetectable means not transmissible - successful therapy also protects partners.

📍 Test offers on site:
Many counselling centres and checkpoints offer free and anonymous HIV tests.

Hiv progression and symptoms

The course of an HIV infection can vary greatly and the symptoms are not always clear. Many people do not even realise that they are infected with HIV in the initial phase. Others experience flu-like symptoms or skin reactions that they do not initially associate with HIV.

Especially in men, typical HIV symptoms such as fever, night sweats or a skin rash are often unspecific and easily overlooked. This makes it all the more important to understand the course of HIV: from infection and Incubation period from the first signs to possible AIDS without treatment.

The good news:

With modern HIV therapy, the progression can be stopped. Those who act early stay healthy and do not pass on the virus.

In the following sections you will find detailed information on:

  • the first signs and the HIV Incubation period,
  • the question of how to recognise an HIV infection,
  • the course without and with treatment,
  • and the Aids symptoms

HIV incubation period and first symptoms of the body

Shortly after an infection with HIV, the so-called HIV Incubation period. This is the phase between transmission and the first signs of illness. This usually lasts two to four weeks. During this time, the virus multiplies particularly quickly in the body. As the graphic shows, the Viral load in the blood increases rapidly and reaches its peak around the third week.

Course of the viral load and symptoms of acute HIV infection: fever, skin rash, headache, joint pain, swelling of the lymph nodes
Acute HIV infection: symptoms last 7-10 days, high viral load in the blood

In this phase - the acute HIV infection - the first symptoms may appear. These are usually non-specific and are easily mistaken for a cold or flu. The symptoms can be Kind and intensity can vary greatly. Particularly critical: During this time, the Viral load in the body is very high and therefore also the risk of passing HIV on to others.

Typical symptoms in the early phase of an HIV infection are

  • Fever
  • Fatigue and tiredness
  • Night sweats
  • Diarrhoea
  • swollen Lymph nodes (especially in the throat)
  • Muscle pain
  • Sore throat or tonsillitis
  • Skin rash, mostly reddish and on the upper body

These symptoms usually last for 7 to 10 days and disappear on their own. During this acute phase, the Viral load is particularly high in certain body fluids - especially:

  • in the blood
  • in semen
  • in mucosal secretions

This makes HIV particularly easy to transmit during this period. Immune system already during the HIV Incubation period reacts to the infection, antibodies can only be reliably detected in the blood after around six weeks - for example with an HIV laboratory test. During this time, the virus already begins to damage parts of the immune system - especially the so-called Helper cells.

The clinical course without treatment

Without treatment, HIV infection progresses in several stages.

Graphic: Progression of HIV viral load in the blood in untreated infection - acute infection, chronic phase, AIDS.
From acute infection to chronic phase to AIDS

The chart shows how the Viral load in the blood changes over time - from a sudden increase in the acute phase to the transition to the AIDS stage. The progression can take many years.

Acute phase - Rapid virus replication

Shortly after infection, the Viral load in the blood rises sharply. This steep rise can be seen on the far left of the graph. During this acute infection phase, many people experience flu-like symptoms. The virus concentration in the blood, semen and other bodily fluids is particularly high at this time and so is the risk of infection.

Chronic infection – Latency phase without complaints

After a few weeks, the Viral load significantly. The infection enters the latency phase, as shown in the centre of the diagram. This phase can last several years. HIV is still active, but multiplies more slowly. Most people do not feel any symptoms during this time. Nevertheless, the Immune system slowly weakened. In the graph, additional infections or vaccination reactions (e.g. influenza, syphilis) lead to slight fluctuations in the Viral load.

Aids - severe immunodeficiency

Without treatment, the infection continues to progress. The right-hand side of the graphic shows how the Viral load rises again. In this phase, the transition to the AIDS stage occurs: the Immune system is so severely damaged that it can no longer defend itself against so-called opportunistic infections or certain types of cancer.

The course with modern HIV therapy

Thanks to modern medication, the course of HIV infection has changed fundamentally. The antiretroviral therapy (ART) suppresses the multiplication of the virus to such an extent that it is often no longer detectable in the blood. This protects health and prevents transmission during sex (U=U: Undetectable = Untransmittable).

Graphic: Course of the HIV viral load in the blood with treated infection - with and without therapy in comparison.
Comparison of progression with and without therapy

The graph above clearly shows the difference:
After the acute infection phase (left area) decreases the Viral load under therapy (green area) permanently to a very low level - usually below the detection limit. This means that the Immune system remains stable and the person concerned can live a healthy life.

Without therapy (medium range) remains the Viral load significantly higher and reacts strongly to stress: Flu, vaccination reactions or other illnesses can cause it to rise again and again. It is only when treatment with HIV medication begins that the amount of virus decreases and remains permanently stable - even if, for example, an influenza or vaccination is added.

Important: The medication must be taken daily and continuously. Regular medical check-ups ensure that the treatment remains successful and the Viral load is low.

Conclusion - Recognising HIV early, living well

HIV is easily treatable today. It is crucial that the infection is recognised in good time. If you get tested regularly and start treatment early, you can lead a long, healthy life with HIV - without restrictions in everyday life or during sex.

Modern therapy not only protects the Immune systembut lowers the Viral load in the blood to such an extent that HIV is no longer transmissible (U=U). This strengthens your own safety and protects others.

Graphic: HIV viral load and antibodies in the blood. Antibodies detectable from week 6 (laboratory test) or week 12 (rapid test).
Detection of HIV antibodies after 6 or 12 weeks

The graph shows how the amount of virus and antibody formation develop after an HIV infection:

  • Immediately after infection, the Viral load strongly.
  • A few weeks later, the body begins to produce antibodies against the virus.
  • An HIV laboratory test can usually reliably detect these antibodies from week 6.
  • The so-called diagnostic window for rapid tests is 12 weeks.

It is precisely during this time that many people feel healthy or experience unspecific symptoms that they do not take seriously: e.g. fever, tiredness or skin rash. Typical early signs of HIV infection can easily be overlooked or misinterpreted.

Take possible signs seriously and have an HIV test done so that you have clarity quickly and can act accordingly.

FAQ - frequently asked questions about HIV progression and symptoms

Many people have questions about HIV progression and symptoms - from infection and treatment to living with HIV. You will find the most important answers clearly summarised in our FAQ.

How can you reliably recognise an HIV infection?

An HIV infection can only be clearly determined by a test. Initial signs are often unspecific and are not sufficient for a reliable assessment. A laboratory test provides a reliable result from six weeks after a risk contact.

What symptoms can occur with an acute HIV infection?

Typical symptoms in the early phase can include fever, night sweats, fatigue, swollen Lymph nodes, sore throat, diarrhoea or a rash on the upper body. These symptoms usually disappear after a few days.

How long does it take for symptoms to appear after infection?

The first symptoms usually appear two to four weeks after infection. This period is known as the acute phase. It is not the same for everyone affected.

What distinguishes HIV from AIDS?

HIV is the virus that causes a chronic infection. Aids is the advanced stage of the disease, which can occur years later without treatment. Aids can be prevented with today's therapy.

How often should I be tested for HIV?

If you have regular sex with changing partners, a test every three to six months is recommended.

Does HIV therapy also protect others?

Yes, anyone who is successfully treated and Viral load below the detection limit can no longer transmit HIV during sex. This realisation is medically proven and is supported by U=U (not detectable = not transferable).

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