STAGESOFHIVINFECTION

HOWDOESHIVPROGRESSINYOURBODY?
Withouttreatment,HIVadvancesinstages,overwhelmingyourimmunesystemandgettingworseovertime.Thethree
stagesofHIVinfectionare:(1)acuteHIVinfection,(2)clinicallatency,and(3)AIDS(acquiredimmunodeficiencysyndrome).
However,theresgoodnews:byusingHIVmedicines(calledantiretroviraltherapyorART)consistently,youcanpreventHIV
fromprogressingtoAIDS.ARThelpscontrolthevirussothatyoucanlivealonger,healthierlifeandreducetheriskof
transmittingHIVtoothers.
ThesearethethreestagesofHIVinfection:

ACUTEHIVINFECTIONSTAGE
Within24weeksafterHIVinfection,many,butnotall,peopledevelopflulikesymptoms,oftendescribedastheworstflu
ever.Symptomscanincludefever,swollenglands,sorethroat,rash,muscleandjointachesandpains,andheadache.This
iscalledacuteretroviralsyndrome(ARS)orprimaryHIVinfection,anditsthebodysnaturalresponsetotheHIV
infection.
Duringthisearlyperiodofinfection,largeamountsofvirusarebeingproducedinyourbody.ThevirususesCD4countto
replicateanddestroysthemintheprocess.Becauseofthis,yourCD4cellscanfallrapidly.Eventuallyyourimmune
responsewillbegintobringthelevelofvirusinyourbodybackdowntoalevelcalledaviralsetpoint,whichisarelatively
stablelevelofvirusinyourbody.Atthispoint,yourCD4countbeginstoincrease,butitmaynotreturntopreinfectionlevels.
ItmaybeparticularlybeneficialtoyourhealthtobeginARTduringthisstage.
DuringtheacuteHIVinfectionstage,youareathighriskoftransmittingHIVtoyoursexualordrugusingpartnersbecause
thelevelsofHIVinyourbloodstreamareveryhigh.Forthisreason,itisveryimportanttotakestepstoreduceyourriskof
transmission(/hivaidsbasics/prevention/reduceyourrisk/sexualriskfactors/index.html).

CLINICALLATENCYSTAGE
AftertheacutestageofHIVinfection,thediseasemovesintoastagecalledtheclinicallatencystage.Latencymeansa
periodwhereavirusislivingordevelopinginapersonwithoutproducingsymptoms.Duringtheclinicallatencystage,
peoplewhoareinfectedwithHIVexperiencenosymptoms,oronlymildones.(Thisstageissometimes
calledasymptomaticHIVinfectionorchronicHIVinfection.)

Duringtheclinicallatencystage,theHIVviruscontinuestoreproduceatverylowlevels,althoughitisstillactive.Ifyoutake
ART,youmaylivewithclinicallatencyforseveraldecadesbecausetreatmenthelpskeepthevirusincheck.(Readmore
aboutHIVtreatment(/hivaidsbasics/justdiagnosedwithhivaids/treatmentoptions/overviewofhivtreatments/).)For
peoplewhoarenotonART,theclinicallatencystagelastsanaverageof10years,butsomepeoplemayprogressthrough
thisstagefaster.
PeopleinthissymptomfreestagearestillabletotransmitHIVtoothers,eveniftheyareonART,althoughARTgreatly
reducestheriskoftransmission.
IfyouhaveHIVandyouarenotonART,theneventuallyyourviralloadwillbegintoriseandyourCD4countwillbeginto
decline.Asthishappens,youmaybegintohaveconstitutionalsymptomsofHIVastheviruslevelsincreaseinyourbody.

AIDS
ThisisthestageofHIVinfectionthatoccurswhenyourimmunesystemisbadlydamagedandyoubecomevulnerableto
opportunisticinfections.WhenthenumberofyourCD4cellsfallsbelow200cellspercubicmillimeterofblood(200
cells/mm3),youareconsideredtohaveprogressedtoAIDS.(Insomeonewithahealthyimmunesystem,CD4countsare
between500and1,600cells/mm3.)YouarealsoconsideredtohaveprogressedtoAIDSifyoudeveloponeormore
opportunisticillnesses,regardlessofyourCD4count.
Withouttreatment,peoplewhoprogresstoAIDStypicallysurviveabout3years.Onceyouhaveadangerousopportunistic
illness,lifeexpectancywithouttreatmentfallstoabout1year.However,ifyouaretakingARTandmaintainalowviralload,
thenyoumayenjoyanearnormallifespan.YouwillmostlikelyneverprogresstoAIDS.

FACTORSAFFECTINGDISEASEPROGRESSION
PeoplelivingwithHIVmayprogressthroughthesestagesatdifferentrates,dependingonavarietyoffactors,includingtheir
geneticmakeup,howhealthytheywerebeforetheywereinfected,howsoonafterinfectiontheyarediagnosedandlinkedto
careandtreatment,whethertheyseetheirhealthcareproviderregularlyandtaketheirHIVmedicationsasdirected,and
differenthealthrelatedchoicestheymake,suchasdecisionstoeatahealthfuldiet(/hivaidsbasics/stayinghealthywith
hivaids/takingcareofyourself/nutritionandfoodsafety/),exercise(/hivaidsbasics/stayinghealthywithhivaids/taking
careofyourself/exercise/),andnotsmoke(/hivaidsbasics/stayinghealthywithhivaids/takingcareofyourself/smoking
tobaccouse/).

TimeBetweenHIVInfectionandAIDS
FactorsthatmayshortenthetimebetweenHIVandAIDS:

Olderage
HIVsubtype
Coinfectionwithotherviruses(liketuberculosisorhepatitisC)
Poornutrition
Severestress
Yourgeneticbackground
FactorsthatmaydelaythetimebetweenHIVandAIDS:
Takingantiretroviraltherapyconsistently
StayinginregularHIVcare
Closelyadheringtoyourdoctorsrecommendations
Eatinghealthfulfoods
Takingcareofyourself

Yourgeneticbackground
Bymakinghealthychoices,youhavesomecontrolovertheprogressionofHIVinfection.

Noteveryoneisdiagnosedearly.SomepeoplearediagnosedwithHIVandAIDSconcurrently,meaningthattheyhavebeen
livingwithHIVforalongtimeandthevirushasalreadydonedamagetotheirbodybythetimetheyfindouttheyareinfected.
Theseindividualsneedtoseekahealthcareproviderimmediatelyandbelinkedtocaresothattheycanstayashealthyas
possible,aslongaspossible.UsetheHIVTestingandServicesLocator(https://locator.aids.gov/)tofindanHIVprovider
nearyou.

RELATEDTOPICSONAIDS.GOV
Signs&Symptoms(/hivaidsbasics/hivaids101/signsandsymptoms/)
OverviewofHIVTreatments(https://aids.gov/hivaidsbasics/justdiagnosedwithhivaids/treatmentoptions/overviewof
hivtreatments/)
CD4Count(/hivaidsbasics/justdiagnosedwithhivaids/understandyourtestresults/cd4count/)
ViralLoad(/hivaidsbasics/justdiagnosedwithhivaids/understandyourtestresults/viralload/)
OpportunisticInfections(/hivaidsbasics/stayinghealthywithhivaids/potentialrelatedhealthproblems/opportunistic
infections/)
FindHIVCareandTreatment(/hivaidsbasics/justdiagnosedwithhivaids/findcareandtreatment/youandyour
provider/)

ADDITIONALRESOURCES
CDCHIVBasics(http://www.cdc.gov/hiv/basics/whatishiv.html)
NIHAIDSInfoStagesofHIVInfection(https://www.aidsinfo.nih.gov/educationmaterials/factsheets/19/46/thestages
ofhivinfection)
NationalInstituteofAllergyandInfectiousDiseasesHIV/AIDS:HowHIVCausesAIDS
(http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/howHIVCausesAIDS/Pages/cause.aspx)
NationalLibraryofMedicineTutorial:HIVandAIDS(https://www.nlm.nih.gov/medlineplus/hivaids.html)
Lastrevised:08/27/2015