What Is HIV?
HIV is a virus that attacks your immune system. If you don’t treat it, HIV typically goes through three stages. But if you keep the virus under control, you may live for decades without symptoms and never reach the final stage of the disease.
So, it’s important to get diagnosed for HIV early and to take your medicines as prescribed.
Stage 1: Acute HIV Infection
This is the first stage of an HIV infection. The moment you get HIV, the virus begins spreading. But it may not show up on tests. Symptoms start about two to four weeks after the virus enters your body and last about two weeks. Symptoms in this early stage are similar to those of the flu. They include:
- Fever
- Headache
- Rash
- Chills
- Night sweats
- Muscle and joint aches
- Sore throat
- Fatigue
- Swollen lymph nodes
- Mouth ulcers
- Upset stomach
Inside your body, the virus is making lots of copies of itself and spreading to all your cells. The virus attacks your infection-fighting immune cells called CD4 cells. It’s this interaction between the virus and your immune system that causes the symptoms.
At this stage, you have lots of HIV in your blood. As a result, it’s easy for you to spread the virus to another person. If you find out you have an acute HIV infection, start treatment right away to get the infection under control.
Stage 2: Chronic HIV Infection
This is when your HIV levels are very low or can’t be found by tests. You may not feel sick. And if medications keep your viral load (the amount of HIV in your blood) low enough, you can have sex without passing it on to your partners.
Other names for the chronic HIV stage include the asymptomatic stage and clinical latency.
Without treatment, this stage can last 10 years or longer before advancing to the final stage. With treatment, HIV can remain a chronic, or lifelong, condition.
Stage 3: Acquired Immunodeficiency Syndrome (AIDS)
This is the most serious stage of an HIV infection. The amount of HIV in the blood shoots up, and the amount of your infection-fighting immune cells drops. Doctors diagnose AIDS when these cells, called CD4 cells, drop below 200 per cubic millimeter of blood.
This damage to your immune system puts you at risk for other infections and illnesses. The high level of virus in your blood also makes it especially easy for you to pass the virus to another person. But this stage of HIV is much less common, thanks to better treatments. In the US, most people with HIV don’t get AIDS.
Symptoms of stage III HIV infection or AIDS include:
- Weight loss
- Chronic diarrhea
- Night sweats
- Fever
- Cough
- Mouth and skin problems
- Other infections
If you have AIDS, get treatment right away. Medicine can still get HIV back under control and help with other AIDS-related infections. Without treatment, people with AIDS often live for about three years.
Treatment Options for Different Stages of HIV
There’s no cure for AIDS and no vaccines to prevent HIV. But highly effective treatments, including antiretroviral therapy (ART), can help you live as long as you would have without HIV. The treatment depends on the exact stage of HIV you have.
“For newly diagnosed infections, we have a limited number of preferred treatment regimens that have been specifically studied for this scenario,” says Francisco Marco Canosa, MD, an infectious disease specialist at Cleveland Clinic in Avon, Ohio. “These options are highly effective at controlling the virus and have a high barrier to resistance. They are preferred early on because we want a regimen that is highly likely to be effective.”
No matter what stage of HIV you have, take ART medications. ART is a mix of two or more medicines that lower HIV in the blood and prevent medicine-resistant HIV strains. Staying on ART keeps your immune system strong and lowers the risk of getting an infection. It also lowers your chances of giving the virus to others. ART must be taken as prescribed. Don’t miss or skip doses.
“For patients who are well controlled on treatment, current options include daily oral regimens, one containing only two antiretroviral drugs per pill, which differs from the traditional three-drug combinations used for many years,” Canosa says.
There’s also a long-acting shot that you can get every four or eight weeks, depending on your situation. If you have treatment experience (have taken antiretroviral or ARV medication or currently take it) or a history of resistance, you may need more personalized plans. This could mean combining oral medications with shots.
If you have HIV, you may also want to take supplements and use alternative therapies to manage your symptoms. Check with your doctor to make sure these don’t interfere with prescribed medicines. Little research supports taking supplements to control HIV. But these vitamins and supplements have limited evidence:
- Acetyl-L-carnitine to ease nerve pain and numbness (neuropathy)
- Probiotics to help with diarrhea
- Vitamins A, D, E, C, and B, as well as minerals, such as zinc, iron, and selenium, which can help if you don’t get enough
- Whey protein and amino acids to help you gain weight
Always check with your doctor before adding any new supplements to your diet. There are some supplements you should avoid completely, including:
- Garlic supplements and St. John’s wort, both of which can affect how well some HIV medications work (eating garlic in food is OK)
- Red yeast rice extract, which you shouldn’t use if you take a statin or a protease inhibitor
A healthy lifestyle helps manage HIV, especially:
- Avoiding raw meat, raw eggs, and raw seafood such as sushi, sashimi, and oysters
- Eating nutritious foods, such as whole grains, lean protein, fruit, and vegetables
- Getting vaccinated for common infections
- Practicing handwashing after playing with pets or emptying litter boxes
Don’t forget about your mental health, either.
“HIV is a life-changing diagnosis, but you don’t have to carry the burden alone,” Canosa says. “When you feel ready, consider sharing your diagnosis with trusted loved ones — people who will love and support you unconditionally. And if you’re struggling to cope, don’t hesitate to seek help early. Prioritizing your mental health is essential to living well with HIV.”
How Can You Prevent HIV from Progressing?
If you’re diagnosed with any stage of HIV, start ART treatment as soon as possible to lower the viral load (how much of the virus is in your blood) to an undetectable level.
HIV gets worse if left untreated.
“Frequent screening and early detection are essential to prevent progression to advanced stages, including symptomatic disease such as AIDS,” Canosa says.
To make sure HIV doesn’t advance to later stages, stick to your prescribed medication schedule. If you don’t, you risk developing resistance to HIV medicines, which makes them ineffective.
To prevent HIV from progressing, be sure to:
- Use pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
- Don’t share needles.
- Use condoms correctly when you have sex.
- Get vaccinated for common infections, such as the flu and pneumonia.
- Try to lower your stress levels.
- Avoid drinking alcohol, smoking, and using drugs.
- Get regular exercise.
“Find a health care practice with providers you feel comfortable with,” Canosa says. “They will become your lifelong partners in maintaining your health. It might take some time to find someone you truly ‘click’ with, but it’s worth the effort.”
Takeaways
There’s no cure for HIV and AIDS, but you can take steps to prevent or lower your risk of infection. If you are at any stage of HIV, see your doctor to start ART. Be sure to take those medicines exactly as prescribed and don’t skip a treatment. Follow best practices — such as staying up-to-date on vaccines, avoiding alcohol and drugs, and getting regular exercise — to prevent HIV from advancing.
FAQs About the Stages of HIV
Here are some commonly asked questions about the stages of HIV.
How does HIV progress over time?
HIV typically advances in three stages, going from acute HIV infection to chronic HIV infection and then AIDS. This can take months or years. HIV treatment can prevent or slow its advance.
Can you survive stage 3 HIV (AIDS)?
Improved treatments have reduced deaths from AIDS across the globe. In fact, in the US, most people with HIV don’t get AIDS. But if left untreated, HIV progresses to AIDS in about 8-10 years. AIDS seriously damages the immune system, which can cause opportunistic infections. Opportunistic infections are diseases most people wouldn’t get if they had a healthy, working immune system.
How long you can live with AIDS depends on the person. Some people live for many years, while others may get sick and die soon after an AIDS diagnosis. Without treatment, people with this stage of HIV usually live for about three years.
How can you recognize the different stages of HIV?
Each stage of HIV comes with different symptoms.
Stage 1 HIV. This stage is also called an acute HIV infection. It develops over a few weeks and has flu-like symptoms like headache, fever, and rash.
Stage 2 HIV. The second stage of HIV is called a chronic HIV infection or asymptomatic HIV (clinical latency). That means you might not have any symptoms. If you take ART, you might have stage II HIV for many years. But if it goes untreated, it’ll usually turn into AIDS in about 10 years.
Stage 3 HIV (AIDS). The last stage of HIV is called AIDS. It seriously harms your immune system, which makes it hard to fight off infections.
