The Four Stages of HIV Infection

Primary, Asymptomatic, Symptomatic, and AIDS

Opportunistic infections occur in stage 3 of HIV - Y tambe, Wikipedia Commons

Infection with Human Immunodeficiency Virus (HIV) eventually leads to Acquired Immune Deficiency Syndrome (AIDS). This process typically takes several years and can be broken down into four stages: primary infection, asymptomatic, symptomatic, and AIDS. Knowing what stage of HIV infection an individual is in can help physicians design treatment plans.

In order to diagnose an individual as being in a specific stage of HIV, the World Health Organization (WHO) developed a set of criteria that can be used worldwide. The criteria rely on symptoms, instead of viral load test, since many developing countries do not have the facilities to perform these complicated tests.

Stage 1: Primary HIV Infection

The first stage of HIV infection is called primary infection. Primary infection begins shortly after an individual first becomes infected with HIV. This stage lasts for a few weeks. During this time period, individuals experience symptoms similar to the flu. Very few individuals seek treatment during this time, and those who do are usually misdiagnosed with a viral infection.

Often, if an HIV test is performed, it will come back negative, since antibodies are not yet being produced by the individual’s immune system. Those who believe they have been exposed to HIV should repeat the test again after six months.

Stage 2: Asymptomatic HIV

In the second stage, individuals are free from any symptoms of HIV. Levels of HIV in the blood are very low, but are detectable. If an HIV test is performed, it will come back positive. While the individual is asymptomatic, the HIV in their blood is reproducing constantly. This stage lasts about ten years, but can be much longer or shorter depending on the individual.

Stage 3: Symptomatic HIV

In the third stage, the immune system has become so damaged by HIV that symptoms begin to appear. Symptoms are typically mild at first, and then slowly become more severe. Opportunistic infections, infections that take advantage of the immune system’s vulnerable state, begin to occur. These infections affect almost all the systems of the body and include both infections and cancers. Some common opportunistic infections include tuberculosis, cytomegalovirus, and shingles.