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Acute HIV Infection

What Is Acute HIV Infection?

Acute HIV infection, also known as primary HIV infection or acute retroviral syndrome, is a condition that occurs within the first two to four weeks after someone is infected with the human immunodeficiency virus. It is the primary stage of infection and lasts until the body has created antibodies against HIV. During this stage of infection, the virus is duplicating at a rapid rate. Unlike other viruses, the body's immune system is unable to fight off HIV, and the infection can live in cells for long periods of time. Over time, the virus attacks and destroys immune cells, leaving the immune system unable to fight off other diseases and infections. When this happens, HIV infection can lead to the development of acquired immune deficiency syndrome, or AIDS.

Acute HIV is highly contagious. However, most people with acute HIV do not yet know that they are infected. This is possibly due to the fact that most of the population is not tested for HIV on a regular basis, or because standard HIV antibody tests may not be able to detect this stage of infection.

What Causes an Acute HIV Infection?

Acute HIV infection occurs within two to four weeks after initial exposure to the virus. HIV is spread through:

  • contaminated blood transfusions
  • contact with contaminated blood or fluids
  • contaminated syringes or needles
  • oral, anal, or vaginal sexual contact
  • passing of the virus from mother to fetus during pregnancy
  • breastfeeding

HIV is not spread through casual contact, such as hugging, holding hands, or sharing food utensils with an infected person.

Who Is at Risk for an Acute HIV Infection?

Acute HIV infection does not always develop into a symptomatic HIV infection or AIDS. In some people, an HIV infection may remain quiet for years or decades. Others may never develop advanced HIV disease or AIDS.

It is important to note that HIV can affect people of any age, race or sexual orientation. However, certain groups may be at higher risk for HIV. These include:

  • intravenous drug users
  • men who have sex with men
  • African Americans

What are the Symptoms of an Acute HIV Infection?

Many people with acute HIV have no symptoms. If you do have acute HIV symptoms, they may last for a few days or up to four weeks.

Most people with acute HIV symptoms do not know they are caused by HIV. This is because acute HIV symptoms are similar to those of the flu and other viral illnesses. They may include:

  • rash
  • decreased appetite
  • fever
  • headache
  • fatigue
  • malaise, or a general "unwell" feeling
  • sore throat
  • night sweats
  • ulcers that appear in the mouth, esophagus, or genitals
  • swollen lymph nodes
  • muscle aches

The Centers for Disease for Disease Control and Prevention (CDC)  estimate that 20 percent of people living with HIV have no idea they are infected. The only way to know if you have HIV is to be tested. (CDC,2012)

Diagnosing an Acute HIV Infection

If acute HIV infection is suspected, your doctor will perform a series of tests to look for the virus.

A standard HIV screening test will not necessarily detect acute HIV. Many HIV screening tests look for antibodies to HIV rather than the virus itself. It can take several months after an initial infection for those antibodies to appear.

Some tests that may be able to detect signs of an acute HIV infection include:

  • HIV RNA viral load
  • p24 antigen blood test
  • CD4 count
  • blood differential
  • HIV ELISA and Western blot tests may or may not be able to detect acute HIV

Treating an Acute HIV Infection

Proper treatment is crucial for individuals who are infected with HIV. If you have been diagnosed with HIV, it is important to learn as much as you can about the virus.

Doctors and scientists continue to debate whether early, aggressive treatment should be used for all people with HIV. Early treatment may minimize the effects of the virus on your system. However, HIV medications can have serious side effects when used for long-term treatment. It is important to discuss all treatment options and potential side effects with your doctor to determine which treatments are right for you.

In addition to medical treatment, your doctor might also recommend the following healthy behaviors:

  • eating a healthy, balanced diet to help strengthen your immune system
  • practicing safe sex to avoid passing the virus to others and to reduce your risk of STDs
  • avoiding stress, which can also weaken your immune system
  • avoiding exposure to individuals with infectious illnesses, since you may have a harder time fighting off disease
  • exercising on a regular basis
  • avoiding situations that may cause depression
  • staying active and maintaining your hobbies


Over time, HIV can suppress your immune system. This can leave you more susceptible to infection, cancer, and other illnesses.

In some people, HIV infection will eventually lead to AIDS. This risk may be reduced with timely medical treatment.


HIV is a chronic, life-long condition. It can be treated, but there is no cure.

With proper treatment, people with HIV can live long, full lives.


HIV can be prevented by avoiding exposure to potentially infectious fluids. These include blood, semen, and breast milk. You can also reduce your HIV risk by making healthier choices.

  • Always practice safer sex, unless you are in a monogomous relationship and both you and your partner have tested HIV negative for at least six months.
  • Avoid intravenous drugs. If you can’t stop using, you can reduce your risk for HIV drug by never sharing or reusing needles. Many cities have needle exchange programs. 
  • Practice universal precautions. Always assume that blood might be infectious. Protect yourself by using latex gloves and other barriers.
  • Get tested for HIV. If you test negative, you can take preventative steps to stay that way. If you are HIV positive, getting tested can help you find treatment and reduce the risk of spreading the infection to others. The CDC recommends yearly testing for sexually active people with multiple partners, people who use intravenous drugs, and those who have had sex with an HIV-infected person. The CDC recommends getting retested if you or your partner have had one or more sexual partners since your last HIV test.

If you have HIV, you will not be able to donate blood, sperm, or organs. This is to help prevent the spread of HIV to others. However, HIV cannot be spread through casual contact. It should not affect the way you go about the activities of daily life.

Content licensed from:

Written by: Elly Dock and Elizabeth Boskey, PhD
Published on: Jul 16, 2012
Medically reviewed : George Krucik, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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