What are the Early Stages of HIV Symptoms?

What are the Early Stages of HIV Symptoms?

What is HIV ARS?

HIV Acute Retroviral Syndrome (ARS) is the body’s early response to a HIV infection. HIV symptoms will take time to occur, at least two to six weeks for this is how long the body will take to mount an immune response that will give off these HIV symptoms.

What are the early symptoms of HIV infection?

HIV is a virus that attacks the body as a whole with nearly every organ system being affected. The severity and combination of the disease presentation may vary from person to person though. An abbreviated list is shown below.

General – Fever, Sweats, Lethargy, Malaise, swollen lymph nodes, weight loss

Skin – Rash, ulcers , Sore throat

Digestive – Nausea, Diarrhea, Loss of Appetite

Neurological – Headache

Musculo-Skeletal - Muscle aches, Joint aches

Who gets HIV ARS symptoms?

There is no method to ascertain who develops ARS symptoms and when they get it. It is widely thought that between 50-90% of people who are infected with HIV gets the HIV ARS symptoms.

When do HIV symptoms appear and how long do they last?

Most people report symptoms at about three weeks post exposure to the virus. The symptoms can occur anytime between two and six weeks post infection though. Usually, once developed, symptoms last two weeks but there have been reports of symptoms persisting up to ten weeks post infection.

‘Flu-like’ is not ‘Cold-like’

ARS has been described as mononucleosis-like symptoms. These usually result in a persistently high fever, horrible bodyaches and absolute lethargy.

This is not similar to when someone has the ‘flu’ which usually is interpreted as having a runny nose, sore throat or mild cough.

The HIV ARS Rash

The basic rule of thumb is that if you have to hunt for a spot of rash on your body, it is not an HIV rash. An HIV rash is a generalised red rash that looks similar to measles. It comes on two to three days after a fever and lasts for at least two weeks. It is usually up to 1cm in diameter and almost always appears at the upper chest and shoulder areas.

The HIV ARS Fever

The HIV ARS fever is a high-grade fever (>38.5 Celcius) and is associated with tiredness, muscle aches, and joint pains. It usually lasts more than two weeks but can be longer.

The HIV ARS Lymph Nodes

Enlarging lymph nodes usually are a sign of an active infection in the body. In thin individuals, a normal non-enlarged lymph node may be palpated at normal times. This is not a cause of concern.

HIV ARS lymph node enlargment is usually painful and are about 1cm in diameter. It can present in the neck, groin and underarms.

The HIV ARS Sore Throat and Mouth Ulcers

HIV ARS causes a really bad throat infection that lead to a painful swallowing because of the inflammation with pus noted from the tonsils at times. The tonsils can be enlarged with ulcers forming on them as well. These ulcers are usually five to ten millimeters around .

What other diseases have the same symptoms as HIV ARS (HIV Symptoms)?

HIV Acute Retroviral Syndrome can mimick a lot of other conditions because of the early nature of the infection. Illnesses such as Influenza, infectious mononucleosis, acute Hepatitis A or B, Parvovirus, Cytomegalovirus, Rubella and Toxoplasma infections must be ruled out first.


The only way to know for sure if you are infected with HIV or not is to get tested. Until that is done, try not to worry about your HIV symptoms.

If you have to worry, then worry if you fulfil the following criteria:

  • You have had a high risk exposure 2 to 6 weeks ago
  • You have a fever above 38.5⁰C that just does not go away
  • You have multiple small red spots covering your face, neck and upper chest
  • You have a really bad sore throat with ulcers in your mouth
  • You have been diagnosed with another STD like Gonorrhea or Chlamydia


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Comment on "What are the Early Stages of HIV Symptoms?"

  1. Jane

    Hi Doctor,
    Can a pregnant mother with HIV prevent the disease to her infant ?

    • Dr. Kaarthig

      Prevention of transmission is honestly difficult Jane. Here, our maternal and child care centers will extensively screen and counsel the mother before, during and after the pregnancy

  2. Gloria

    Hello Doctor,
    Does a woman having sex with another woman at risk of HIV ?

    • Dr. Kaarthig

      Yes, of course. If the partner is HIV positive, chances of transmission are there but is definitely less than a conventional relationship where there is penetrative sex.

  3. Dnn

    Good day doctor ,first forgive my English level , i find the sex worker at 19/12/2017 ,no protect oral sex ,and protect sexual , But when she lay and kiss me, when my penis (glans) and her vagina have contact with the case did not wear condom at that time ,I am not sure if there is no contact with vaginal fluid if there is infection Is HIV high risk? A week later, I found three red dots in my hand..I’m very worry ..hope doctor can reply me asap

    • Dr. Kaarthig

      It honestly does not sound high risk. When you say touching, I assume its just external contact. I doubt a significant amount of vaginal fluid would have made contact or entered your urethra to cause a significant infection.

      The rash on your hand may not be indicative of a HIV infection

  4. Noname

    Hello doctor ,if Vaginal fluid hit the penis is it high risk?But sexual with protected

  5. Pancracio

    Hi doctor,
    5 weeks ago I had a sexual encounter with a sex worker. Oral sex unprotected and vaginal/ anal sex protected. She was on the last phase of her period and some menstrual blood touch the base of my penis and hand (My Skin was complétela Healthy). After 3-4 days I started to feel muscle weakness on the legs and a week later a burning sensation of the skin (specially when I was thinking about the risks of the encounter). After that, on the third week I felt a lot of thirst and my mouth was very dry. On the four week I had huge back pain specially in the upper section and now (5th week) I’m starting to have some light sore throat. During the last 5 weeks I have been super stressed about the topic and not sure if my ‘symptoms‘ are originared due to the high Levels of Stress and Anxiety. 2 weeks ago I had a normal blood test and everything was ok. But it was not an hiv test to be clear. Should I be worried about it?

    • Dr. Kaarthig

      Its understandable to be worried. Its been five weeks, why don’t you just check for HIV? Its a simple rapid test anyways…

  6. Venoth

    Hi doctors i had a sex 2 months ago and i test hiv was negative.is that accurate

  7. sidd

    hi doctor i had test of hiv 1 rna pcr on 17th day of exposure and the test was negative do i have to retest??

    • Dr. Kaarthig

      Not necessary but if it’ll ease your anxiety, go ahead with rapid testing after day 28 or take an ELISA test

  8. Venoth

    Hiv ab ag p24 test. I test after 2 months and it show negative but protected sex…but i worry a bit …

    • Dr. Kaarthig

      You may continue worrying but the test result will stand true to your negative status. Do yourself a huge favour and try to let it go if all the proper testing has been conducted

  9. Venoth

    Should i get to tested again doctor…..

  10. Frey

    Hi Doctor, I had a rapid test on 17th day of exposure the result was negative. After that, I had high fever, sore throat, red needle like blood for on hand and some other symptoms on third week of exposure after the rapid test.

    On day 36, I did blood test on BP lab written in the report HIV Ag/Ab (CMIA). Result was non reactive.

    Do I need a retest?

    • Dr. Kaarthig

      If you are having symptoms, it is advisable to re-test. I would repeat testing at three months post exposure as well

      • Frey

        Hi Doctor,

        Is it mean that the test on day 17 and day 36 mean nothing at all? I need to wait three month post exposure for another test only can conclusive whether I was infected or not?

        • Dr. Kaarthig

          Like I said, if you are having symptoms, its advisable to re-test. I dont know if these symptoms are coming on after a new encounter you see. 4th generation testing is conclusive after 28 days post potential exposure

          • Frey

            Hi Doctor,

            My only exposure is on 19th Jan, after that i did had fever, sore thorat etc..

            I did a blood test on day 17, day 36 with result non reactive. And on 19th Apr another test with HIV Ab / Ag (CMIA) with result non reactive. Is the result convulsive?

          • Dr. Kaarthig

            To be concise, yes; is it conclusive

  11. Venoth

    Doctor what kind hiv test should i do to know my status and when should i do….

  12. D

    I visited a sex worker more than 3 months back and engaged in protected sex. Not long after, I had a case of itchy rashes which appeared on my arms and looked like insect bites based on appearance. These disappeared after a while and have now reappeared once more. Should I be concerned that this could be a symptom?

    • Dr. Kaarthig

      Are the symptoms still there? Are they insect bites? Do you have any other symptoms? From what you tell me now, it does not seem a cause of concern but with testing so easily done, why not just test for assurance sake?

  13. Jai

    Doctor.When can detect hiv after post potential exposure and what kind of test should be take….

    • Dr. Kaarthig

      4th generation rapid test kit 28 days post infection or PCR RNA testing 11 days post infection are the quickest, most conclusive testing means. Come in to see us and we can arrange for either

  14. Jai

    Doctors what is hiv 1 2 ab ag p24 means ???

    • Dr. Kaarthig

      ab is antibody
      ag is antigen
      p24 is a protein in the virus that we can use for testing
      hiv 1 & 2 are viruses

  15. Waxpyn

    Hi. Good Evening? Doctor, I had a sex with 9 different girl for last 6 months ago . It is can be infected with the HIV virus or not? Please reply

  16. Jai

    Doctor,what what type of test hiv 1 2 ab&ag p24 and when it can detect hiv after post potential exposure.is that 4th generation test?

  17. sidd

    Hi doctor my eosinophil count has been increased too much and i also have symptoms such as legs pain and feeling fatigue and tired and no other symptoms. Is this the sign of hiv??

    • Dr. Kaarthig

      HIV may mimick a lot of viral infections. These may or may not be associated with HIV. Without further history, its nearly impossible to attribute these things solely to HIV

  18. JTLF

    Hi doctor, i had unprotected sex a week ago. No any symptoms appearing but i just want to get my status cleared. How long should I wait before i get tested ?

    • Dr. Kaarthig

      Best to wait one month but if you’re in a hurry, at two weeks we can do simple screening tests for STIs

  19. Jessica

    My skin has suddenly dried up and have many skin rashes too. I consulted a skin specialist doctor and recommended skin cream but its not working. Is this early sign of HIV?? Where can I check this out?

  20. shan

    Hi doctor ,i had sex 3 months ago and i tested at nearby clinic. The test is hiv 1&2 ab ag p24 screen and the result is non reactive.is that acurate ….

    • Dr. Kaarthig

      I cannot comment on the accuracy of tests done in other centers but the theory is that it will be accurate, yes.

  21. Ray

    Good day dr. I am ray here. I eould like some comment for my expose. My expose was protected sex with my girl friends ( nvr see condom broke). My expose was 13 march the below is my question.
    1. Is peps will effect the acurracy of pcr rna if taking 1 days only?
    2. Is the hiv rna test on 23 march is good result.
    Thks dr.

    • Dr. Kaarthig

      1. No
      2. Its borderline – you did it at just over nine days when we know it to be accurate after a longer period of time

  22. roy

    Dr i was expose to protected sex with a girl with unknown status. I just done a combo test at 27days with the girl that i had protected sex was non reactive. And i was conduct a combo test again at 28days from the exposure also negative. Dr is my result conclusive?

  23. Sean

    Protected viginal sex with CSW in 17 Dec 2017, tested positive for Chlamydia after 3weeks (I don’t know how). Having syndrome since 3rd weeks post exposure such as sore throat for 1 months, rash skin (whole body redness skin, blanching and sometime itch), several swollen nodes at neck and extremely tiredness. Tested with Abbott Architect Combo at 3rd, 6th, 8th, 9th, 11th, 13th and 15th weeks, results show non-reactive. Rash skin and tender swollen neck node still persist until today. Is my test conclusive? Do I need to retest?

    • Dr. Kaarthig

      I would say the HIV testing is conclusive. You’d need to get worked up for other diseases to explain your symptoms

  24. Sean

    Dr. Kaarthig, thanks for the advice. Do you think my syndrome can be related to any other STD? I have taken high dose of antibiotic during windows period (amoxycilin 1000mg and clarithromycin 500mg twice a day for 2 weeks to cure H. Pylori; Doxycycline for 1week for Chlamydia), do you think this would impact my HIV test windows period? Would you recommend to retest at 6 months?

    • Dr. Kaarthig

      re-testing at six months is fine. Its not absolutely necessary but its perfectly okay to do it for completion sake. Your antibiotics would not have affected the HIV testing outcome

  25. Skv

    Hi doctor, i would like to check, i had an encounter with a csw on 4 may 2017 and had a fever on 22nd may but the fever went away on 23rd, no skin rashes or lymph nodes…and after that there is no fever, i dnt feel fatigue and im quite active. And it was a protected intercourse. Do i need to worry. Please advice

    • Dr. Kaarthig

      If this was a year ago and those are all the symptoms you’ve had, I dont see a need to be worried. Testing is simple enough. Please get yourself checked out. Come in to the clinic and we can go over these issues

  26. Graham

    Hi Doctor,

    Is an Ag/Ab 4th Generation (Roche/Cobas, by Quantum Diagnostics Malaysia) conclusive if taken at 5 weeks post-potential exposure?

    Many thanks in advance, and for this very helpful and insightful forum.

  27. Graham

    Hi Doctor,

    Sorry not sure my last post posted correctly. Would you say a negative DUO 4th Generation (Roche, Cobas) at 35 days is conclusive? Other party claims completely clean, but just wanting a bit of reassurance on the matter.

    Many thanks.

  28. Kane

    Hello doctor,
    Please advice if i need to go for check up. I had a unprotected oral sex without ejaculation with a sex worker within 1-2 minutes i asked her to stop as i was feeling uncomfortable.
    Is it possible that using her saliva hiv might have transmited to my urethor or if her mouth have sore is there a possiblitly that it might have transfer …and what should i do 72 hours hvt crossed yet where can i find pep? Or is there some test i can do.please advice i really worried

    • Dr. Kaarthig

      Testing at this early stage is likely going to be futile. If you’d like to get started on PEP, we have it here. Come on by.

  29. Sv

    Hi Doctor,
    I need some clarification and hopefully you can give me, I had an encounter with a spa worker protected with the use of lube as well on apr 18th….aft 2 weeks approxiamately 16 days i did a elisa duo test at kpj came negative…and then after 2 days, i had a sore throat changed to a runny nose and nasal congestion…to my knowledge i didnt had a fever and was still active…the runny nose changed to stuffy nose and still persist….during 4th week which was 27 days i took another duo (quantum diagnostic) came negative….rapid test at 6 weeks negative….and then took another duo elisa on 61 days negative….77 days rapid test negative….83 days rapid test negative….all my docs said i dnt have hiv concern…also….i contacted the lady and she said she dont have and shown me her test result which dated back march…so after all this test do I still have a HIV concern? Im pretty bit moving on…but the thinking is still there…may i know when is a 4th gen duo conclusive doctor…as there is no proper guideline….because im really confused…and since im gonna start monogamous rship soon…im quite concern whether can i proceed or need to test more….
    I really never thought i will put myself through this kind of situation and its ruining my life badly….
    Hopefully You can give me a clear pic.
    Also i stopped googling the window period and all other stuffs concerning HIV as its triggering irrational thoughts….also the encounter was very short which was less than 1 min. Again kindly pleasr advise doctor

    • Dr. Kaarthig

      Fourth generation tests are conclusive after 28 days. Based on your numerous test results, I don’t see why you’re worried about this encounter.

      • Sv

        Hi Doctor,
        I just had a clear picture…
        If duo is conclusive past 28 days…means 61 days duo already conclusive…am i correct to say that and i tested way pass the window period right?

  30. Reema

    If a 4th generation test is conclusive after 28 days. May I know why many sites and guidelines state 3 months test needed?

  31. Reema

    I see, doctor i tested at approxiamately 8.8 around 61/62 days with a 4th gen non reactive. The guy used a condom…didnt saw any breakage. Should i still need to worry and test at 3 months or can i resume my normal life….im concern because 3rd week had a cold like symptoms….and the stuffy nose still continue until today….should i be worried… no rash, fever or lymph enlargement though….so can i take it conclusive doctor? Also i did a rapid at 82 days negative as well

    • Dr. Kaarthig

      If your testing was done right and has been negative on two accounts, I see no cause for concern based on your experience

  32. AnxiousNow

    Hi Doctor,
    On 4 Jun 2018 I had a regular blood screening at a large lab. As part of the screening they also did Hiv ag/ab CMIA, which was non reactive. After a few days I began to fear if the needle was reused as when I was called, the needle was already unpacked and on the table. There wasn’t any patient attended to before me. I believe I came in a lot later on the morning. Since the anxiety was killing me, I went ahead and took the same ag/ ab hiv screening (cmia) 37 days later. The result came as non reactive. This time I did insist they open the needle in front of me.

    My question is, can I take this 37 days post last blood test (fear needle reuse) as conclusive? I did check with the lab and they did tell me this is a 4th generation test. However they said window period is 3 months.


  33. Mathew

    Dr Kaarthing,

    Dr i would like to know is the pcr rna test conclusive after 11 days post exposure regardless of the risk? i just conduct pcr rna viral loads test was undetectable at 12 days post exposure.

    • Dr. Kaarthig

      What do you mean by regardless of the risk? But yes, PCR testing is widely taken to be conclusive 11 days post potential exposure.

  34. Ali Zainal

    Hello Doctor,

    My penis has been continually been itching for a while now and it always happen after I wash it. It worries me that I might have stds or hiv. Is there other reason why it might itch?
    Also, I would like to know the price for the full stds and hiv testing? .

    • Dr. Kaarthig

      There are a few causes of it to itch including STIs. Come on by for a consult and we can discuss this further?

  35. Wilson

    Good day doctor, may I know HIV will transmitted through oral sex and protected vaginal sex? Are pep good enough in preventing HIV within 72 hour?

    • Dr. Kaarthig

      Through oral and protected vaginal sex, the risk is none to minimal in certain cases.
      PEP is shown to be up to 99% effective to prevent a HIV infection if taken within 72 hours. No worries there.
      Its best to test after 12 days of exposure using RNA PCR, or after 28 days of exposure using antigen testing.

  36. Tan

    hello Dr, will mouth ulcer increase the risk of transmitted HIV if there is a cunnilingus happen?

  37. Nelson

    Hi dr kaarthig.

    Dr i had pcr rna viral loads quantitative non dectable after 11 exposure. I had receiving oral sex. Can i knw is my result conclusive as i saw you had saying that 11 days will be conclusive for pcr rna test.

    • Dr. Kaarthig

      First of all, risk of transmission of HIV via oral sex is next to negligible. Secondly, the HIV RNA PCR test is widely recognized as conclusive after day 11 of exposure.

  38. Mark

    Hi dr kaarthing
    I would like to knw the accurate of hiv pcr rna viral loads test conclusive at 11 days post exposure? Even a oral sex?

  39. Yu

    Hi Dr, i had encountered with CSW approximately 22 days ago (15th August 2018)

    Protected vaginal sex and unprotected oral sex.

    I got mild fever for two weeks and chicken-pox like rash during the same time.

    I have done hiv 4th gen test but its only after a week of my exposure. My 3-4 rapid test all show negative.

    Now im going to do my another 4th gen test on 4th week.

    Can it be possible that ive got infected?

    Thanks Dr.

    • Dr. Kaarthig

      Keep up with your testing and your general health status. I’d be happy to see you to further explain this. Its difficult to evaluate your HIV status in this manner.

  40. Josh

    Hi Dr Kaarthig, the results came back negative. Exposure timeline 20/7 with hiv combo assay done at Gribbles Lab at 11/10 (83days).
    1) Can I move on from this exposure?
    2) Is a 6months test needed? I’ve read CDC guideline recommending as far to a year. What’s your recommendations and thoughts on this?
    3) Will hiv suddenly appear with no more exposure after 20/7?

    • Dr. Kaarthig

      1. Yes, there is no evidence of an infection
      2. It is not necessary but if you were keen to do it, no issues there
      3. Highly unlikely for something like this to happen

      If you have further questions, I would be happy to see you in person to go over these things in greater detail.

      Thank you.

  41. Josh

    Ok. Thanks a lot doctor. I will call in before coming over.

  42. Josh

    Hi Dr Kaarthig,

    I’ve just recently done another blood test at Gribbles Pathology Combo Assay test after the 90 days period with potential encounter on 20th July and test done on 4th of November (105 days).

    1) Is it 100% conclusive I do not hiv already?
    2) why are guidelines given 6 months to be 100% certain? Does it still apply in year 2018 with the above test done?

    Thanks & regards,

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