Becoming HIV antibody positive

Most people who become infected with HIV do not immediately notice that they have been infected. Some have a short illness soon after they become infected. This is called 'seroconversion illness' because it coincides with the time that blood tests for HIV antibodies will become positive. The illness may take the form of a sore throat, a fever or a rash, or rarely more severe illness.

Asymptomatic HIV infection

Initially any damage caused by HIV has no outward effect. This is called asymptomatic infection, which may last for several months or years.

Sometimes people with asymptomatic HIV infection may have swollen lymph nodes, which is called persistent generalised lymphadenopathy, but this is not a sign of damage in itself.

People who have HIV and feel well may have signs of immune damage detectable by laboratory tests; for example, their CD4 cell count may be below normal levels. The use of viral load tests has also demonstrated that HIV is actively replicating inside the bodies of asymptomatic people from the moment of infection onwards. At no time is the virus truly latent.

Symptomatic HIV infection

The more time passes, the more likely it is that the damage will become more severe and opportunistic infections or tumours may develop. However, individuals have their own characteristic responses to HIV, which may or may not lead to symptomatic disease.

HIV can also have direct effects upon the body. For instance, the virus can also attack immune cells in the brain, which can lead to HIV-associated dementia.

It is important to understand that apart from the so-called `wasting syndrome' and HIV-associated dementia, the symptoms of AIDS and of symptomatic HIV disease are caused by particular opportunistic infections and tumours, and not directly by HIV itself. Therefore, there is a wide range of possible symptoms and it serves no particular function to answer the question: what are the symptoms of AIDS? Particular symptoms are associated with particular opportunistic infections.

An AIDS diagnosis

Before coming to a diagnosis of AIDS, doctors look at a variety of symptoms and tests. There is no single test for AIDS.

Doctors would be looking for one of the opportunistic infections or cancers in the presence of underlying immune deficiency. They might, for instance, do tests to try to seek a positive diagnosis of Pneumocystis pneumonia (PCP), an AIDS-defining illness.