Updated 10 December 2014

Symptoms of HIV/Aids

The symptoms of HIV infection include the following: fever and nights sweats, swollen glands, diarrhoea, aching muscles and tiredness.

The majority of people will have some symptoms about three weeks after they have been infected with HIV. These symptoms are similar to those of glandular fever:

•    Fever and night sweats
•    Aching muscles and tiredness
•    Sore throat
•    Swollen glands
•    Diarrhoea
•    Skin rash and ulceration of the inside surface of the mouth and genitals
•    Headache, sore eyes and sensitivity to light

These early symptoms are called the HIV seroconversion illness. This is because the illness coincides with the start of the production of antibodies to the virus. (Antibodies are blood proteins made by the immune system that recognise and attach to organisms invading the body.)

HIV antibodies become detectable in the blood during the course of the illness. The usual HIV test (rapid test or ELISA) detects these antibodies. The seroconversion illness is usually brief, lasting a week or two.

Thereafter most people remain symptom-free for a long time, on average ten years. Then symptoms associated with the advance of HIV disease, roughly in order of appearance, may include:

•    Unexplained weight loss (more than 10% of body weight)
•    Swelling of glands in the neck, armpit or groin
•    Easy bruising
•    Recurring and unusual skin rashes, often itchy
•    A thick, white coating of the tongue or mouth (oral thrush) or vagina (vaginal thrush) which is severe and recurs
•    Ongoing vaginal discharge and pain in the lower abdomen
•    Sinus fullness and drainage
•    Recurrent herpes
•    Shingles
•    Persistent sore throat
•    Recurring fevers lasting more than 10 days without an obvious cause
•    Night sweats or chills
•    Persistent cough and/or shortness of breath
•    Persistent severe diarrhoea (longer than a month)
•    Changes in vision
•    Pain, loss of control and strength of muscles, paralysis
•    Discoloured or purplish growths on the skin or inside the mouth or nose
•    Difficulty with concentration, inability to perform mental tasks that have been done in the past, confusion, personality change
Symptoms are slightly different in children. Common symptoms include:

•    Persistent oral thrush
•    Recurrent bacterial infections, such as ear infections
•    Recurrent gastro-enteritis
•    Swollen salivary glands (parotitis)
•    Swollen lymph nodes in the neck, armpits or groin
•    Enlargement of the liver and spleen
•    Failure to grow or reach normal points in development at the right time (such as talking, walking)


Estimates published in the annual "UNAIDS Report on the Global HIV/AIDS Epidemic" in 2009 estimate that about 33.4 million adults and children were infected with HIV around the world in 2008. Africa south of the Sahara desert accounts for 22.4 million of these infections. A recent HIV prevalence survey by the Human Sciences Research Council (HSRC) conducted in 2008 estimated that 10.9% of South Africans (5.2 million people) over the age of two years are currently living with HIV/Aids. Also this study clearly demonstrated that young women in South Africa in the age group 25-29 continue to be at greatest risk for HIV infection.

This data is also supported by the annual Department of Health Antenatal clinic (ANC) surveys that showed about 29.3% of pregnant women in South Africa were HIV positive in 2008.

For more details of the global epidemic, please refer to the UNAIDS Global Report.

(Reviewed by Dr Diana Hardie, clinical virologist, National Health Laboratory Service and University of Cape Town, July 2010, Additional review by Dr Avron Urison, 2013)


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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