Dr. MJ Bazos MD,
HIV: What is Acute
What is acute HIV syndrome?
HIV syndrome is a name for the early stage of
HIV infection, when you first get infected with the HIV virus. (HIV stands for
human immunodeficiency virus.) These are some of the symptoms of acute HIV
- A fever
- A tired feeling
- Swollen lymph nodes
- Swollen tonsils (also called tonsillitis)
- A sore throat
- Joint and muscle aches
- A rash
The symptoms of acute HIV
syndrome usually last for about 14 days after HIV exposure. They could last for
just a few days, or they could last for several months.
You might not realize your illness is acute HIV
infection. For one thing, the person you caught HIV from may not even look sick.
And the signs and symptoms of HIV infection may look just like mononucleosis
(mono), tonsillitis or the flu.
How can my doctor tell that I have
acute HIV infection?
When HIV enters your body, it moves inside white
blood cells called "CD4 lymphocytes." HIV takes over the CD4 cells and makes
billions of virus pieces each day. The virus pieces spread through your body.
Your body tries to defend itself against HIV by
making the following:
- Antibodies (these hook on to the virus and keep
it from making virus pieces).
- Special cells called macrophages and natural
killer T-cells. These cells help you to get rid of some of the virus pieces. If
antibodies against HIV show up in your blood, you know your body is trying to
protect you from the HIV infection you have picked up. However, it's usually
several months before your body makes enough antibodies to measure.
So at the time you have acute
HIV syndrome, you probably won't have enough HIV antibodies in your blood to
measure, and this test can't give you a diagnosis.
However, when you have acute HIV syndrome, you
do have a high level of HIV RNA in your blood. A test can measure the amount of
HIV RNA in your blood. (RNA is the short name for "ribonucleic acid." RNA is
made when the virus is active.) This test tells your doctor that you're feeling
sick because you have acute HIV syndrome.
What happens after a person gets HIV
After acute HIV infection, your body works hard
to attack the virus. With your body fighting, the virus can't make so many virus
pieces. Even though you still have HIV infection, you'll begin to look well and
feel well again. The usual blood tests will be normal.
However, during this time, the virus pieces are
still attacking your lymph nodes. Lymph nodes are the centers of your body's
immune system. The virus may also attack your brain tissue and slowly cause
Over 10 to 15 years, HIV would kill so many CD4
cells that your body could no longer fight off infections. At this point, you
have AIDS (acquired immunodeficiency syndrome). Once you have AIDS, you can
easily get many serious infections.
Does it help me to find out I have
HIV at an early stage?
Yes. Right now, there is no cure for HIV
infection. Your body can make antibodies and killer T-cells to slow down the
progress of HIV, but they can't get rid of the virus. In fact, the very act of
going after HIV may wear out your immune system in a short time.
However, treatment with HIV medicines (usually
at least 3 at once) can hold down the virus and keep your body's immune system
strong for a longer time. That's why the U.S. Centers for Disease Control and
Prevention (CDC) recommends early treatment of people with acute HIV syndrome.
How is HIV treated?
HIV treatment must last for a long time (maybe
forever). A kind of medicine called reverse transcriptase inhibitors stops the
virus from taking over the CD4 lymphocytes--but this medicine can't work if the
CD4 takeover has already happened. To get help from these medicines, you have to
start taking them at an early stage. You might take 2 of these medicines at the
Another kind of medicine, called protease
inhibitors, works later in the life cycle of HIV. It stops the infected CD4
cells from making more virus pieces.
If you have HIV, you'll probably have to take
many pills and liquids several times a day. Side effects are common. You might
have nausea, bloating, diarrhea and headaches. You might notice mood changes or
have serious reactions to the medicines. Some of these medicines can cause
Because you have to keep taking these medicines
for such a long time, it's important to find a medicine plan you (and your body)
can get along with.
Remember that it's not good to just stop taking
any of your medicines, or to take fewer pills every day. It's important to take
some of your medicines with food and to take some medicines between meals. If
you don't follow the doctor's directions, the virus may become resistant to the
What's in the future?
Combination drug therapy has changed HIV disease
from the leading killer of young adults to a chronic illness that can be
controlled for decades. However, even though you can take HIV medicines and feel
OK, you could still give the virus to others through unsafe sex or blood
exchanges. The medicines don't kill the virus--they just keep your immune system
strong enough to stop AIDS or slow it down.
New medicines are being developed and tested
that can be taken less often and that are more powerful in holding back the
virus. However, it may be a few years before these new drugs become