What are the clinical manifestations and symptoms after HIV infection?

Dec 03, 2025 Source: Cainiu Health

Dr. Liu Wenmin

Introduction

In general, AIDS is an infectious disease caused by the human immunodeficiency virus (HIV), and its manifestations vary at different stages after infection. Main symptoms include acute fever and rash, generalized lymphadenopathy, oral mucosal lesions, opportunistic infections, and ulcerative skin lesions. Since AIDS symptoms lack specificity, individuals with high-risk behaviors should undergo regular testing.

Generally, AIDS is an infectious disease caused by the human immunodeficiency virus (HIV), and its manifestations vary at different stages after infection. These mainly include acute fever with rash, generalized lymphadenopathy, oral mucosal lesions, opportunistic infections, and skin ulcerative lesions. A detailed analysis is as follows:

1. Acute fever with rash: Two to four weeks after infection, mild to moderate fever commonly occurs, with body temperature ranging from 37.5°C to 39°C, lasting for 1–2 weeks, accompanied by chills and sweating. One to two days after the onset of fever, red maculopapular rashes appear, mostly on the face and trunk. The rash is typically non-pruritic and resolves spontaneously within 5–8 days.

2. Generalized lymphadenopathy: Enlarged lymph nodes in areas such as the neck and axilla may appear during the acute phase, with a diameter exceeding 1 cm. The nodes are soft in texture and slightly tender upon palpation. In the AIDS stage, persistent enlargement can develop in multiple sites, presenting smooth surfaces and mobility; these show little response to conventional treatments.

3. Oral mucosal lesions: Oral candidiasis is common, characterized by white plaques on the mucosa that are difficult to wipe off. After removal, a red underlying surface becomes visible, often associated with painful swallowing. Some patients develop hairy leukoplakia on the tongue, which serves as an important clue for early diagnosis.

4. Opportunistic infection symptoms: Due to impaired immunity, Pneumocystis pneumonia frequently develops, manifesting as progressive dyspnea and dry cough. When tuberculosis coexists, persistent cough and night sweats occur, significantly affecting respiratory function and overall health status.

5. Skin ulcerative lesions: Herpes zoster is common in the AIDS stage, presenting as clusters of vesicles distributed along nerve pathways, causing severe pain. After rupture, these form eroded surfaces. Herpes simplex may also occur, where vesicles on the lips or genitalia break open and develop into shallow ulcers that heal slowly.

The symptoms of AIDS lack specificity. Individuals with high-risk behaviors should undergo regular testing. Once diagnosed, patients should follow medical advice for standardized treatment, maintain healthy sleep patterns and balanced nutrition, avoid staying up late and excessive fatigue, thereby delaying disease progression.

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What does it mean to test positive for HIV?

A positive HIV test indicates the detection of markers related to HIV infection in the body, suggesting a possible HIV infection. A confirmatory test is required for definitive diagnosis. A positive result does not mean that the person has developed AIDS; it only indicates the presence of viral infection. Individuals with a positive result or a history of high-risk exposure should seek medical evaluation promptly.

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What are the symptoms of HIV infection?

After HIV infection, symptoms such as persistent low-grade fever, night sweats, painless lymphadenopathy, trunk maculopapular rash, and oral mucosal leukoplakia may occur, typically appearing 2–4 weeks after infection. In later stages, multiple organ systems may be affected. If there is a history of high-risk exposure and any of the above symptoms develop, prompt HIV testing and medical evaluation are recommended.

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How to check for early symptoms of AIDS

In general, early symptoms of HIV infection often resemble flu-like symptoms such as fever and rash. Definitive diagnosis relies on professional testing, with commonly used methods including HIV antigen/antibody combination testing, HIV nucleic acid testing, HIV antibody testing, viral load testing, and CD4+ T-lymphocyte count testing.

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What to do about small red spots in the early stage of AIDS

Small red spots may appear in the early stage of HIV infection. It is important to promptly undergo proper testing for diagnosis, avoid self-medication, maintain good skin care, adjust lifestyle habits, and monitor changes in symptoms. These red spots are often rashes caused by viral infection—should not be ignored, but there's no need for excessive panic. If accompanied by symptoms such as fever, fatigue, swollen lymph nodes, or if there is a history of high-risk exposure, immediate medical evaluation and testing are recommended.