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Dr Sean Cummings  
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London, United Kingdom

Specialties: STD/STI HIV prevention

Interests: Hepatitis C, Men's Health, HIV Prevention

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HIV seroconversion symptoms

Jun 30, 2010 - 56 comments

What are the symptoms of HIV?

This is a common question we receive here at Freedom Health.

According to this article on emedicine ( http://emedicine.medscape.com/article/211873-overview ) , it is thought around 70% of people who contract HIV will develop symptoms when they are seroconverting. Seroconversion is the period between exposure to the HIV virus and the completion of the initial response of your immune system. It lasts about two to three months, though the symptoms will last for a shorter period. Seroconversion is also known as acute HIV infection.

The symptoms of an HIV infection are often described as ‘flu-like,’ the most common are fever and chills, swollen glands, a sore throat (with or without ulcers), anaemia and rash, particularly on the upper body.  Symptoms can also include headaches, fatigue, night sweats and weight loss and an individual recently infected with HIV may also feel nauseous, experience diarrhoea, have swollen and tender joints or a painful or stiff neck.
Many of the symptoms will disappear without the need for medical treatment.

These symptoms may be the signs of a recently acquired HIV infection, but not all HIV tests will be able to detect whether an individual is HIV positive during the period of acute HIV infection. If you have any of these symptoms and have had a risky sexual exposure you should get tested for HIV.

See our HIV testing page ( http://www.freedomhealth.co.uk/sexual-health/hiv-testing/125/ ) and also our information on novel testing methods for more information ( http://freedomhealth-co-uk.blogspot.com/2010/06/std-sti-hiv-and-hepatitis-b-and-c.html )

What happens during seroconversion?

The article (http://emedicine.medscape.com/article/211873-overview ) also gives a rough timeline of the different stages of HIV infection.

Day 0: A person is infected with the HIV virus.

From day 8: The amount of virus in the blood more than doubles every day and the CD4 cell count begins to drop as the viral load (amount of virus in the body) increases. CD4 cells are the immune cells that the HIV virus depletes over time, eventually resulting in the need for anti-retroviral medication. At this stage of the seroconversion a HIV RNA PCR test would be able to detect HIV, however traditional antibody tests would come back negative.

Week 2 - 4: The viral load peaks and can be as high as millions of copies per microlitre of blood, making the individual their most infectious. Despite the high amount of HIV virus within the body, antibody tests may still return a negative result. For this reason the sooner an HIV infection is diagnosed, the less chance there is of it unwittingly being passed on.

Week 10 – 24: The viral load will drop to its lowest point and traditional HIV antibody tests will become positive for HIV.

What happens after seroconversion?

The immune system continues its battle against the HIV virus but the depletion of CD4 cells, or T-cells as they are also known, continues as the virus replicates. This stage is known as chronic HIV infection and can continue for many years without the need for medication until it eventually would develop into AIDS. AIDS (Acquired immunodeficiency syndrome) is defined by a CD4 cell count of less than 200 per microlitre of blood.
The interval between seroconversion and AIDS is an average of ten years, with the CD4 count being depleted at an average rate of 50 cells per year. The speed at which the disease progresses relates to the HIV viral load - the higher the viral load the faster the progression.

Many people first become aware they are HIV positive after contracting an opportunistic infection brought on by having a low CD4 T-cell count. A low CD4 cell count leads to a serious state of immunodeficiency which puts the individual at great risk of contracting opportunistic infection, further damaging their immune system. For this reason it is agreed that the earlier a person infected with HIV knows that they are HIV positive, the better it will be for their health.

However, it is not just a weakened immune system that can cause illness; it is possible that the HIV virus itself can have a direct effect on the body, such as causing organ dysfunction.

Some symptoms that may reflect a deteriorating immune system include herpes lesions, shingles and anaemia, caused by the virus damaging the body’s marrow.

Within the chronic infection stage are a number of other stages which are based on the CD4 T-cell count. A count of more than 500 is considered the ‘early stage,’ between 200 – 500 is an ‘intermediate stage’ and a CD4 T-cell count of less than 200 is considered an ‘advanced’ stage of infection.




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by johnross80, Jun 30, 2010
Is it possible to have the ARS flu-like symptoms (fatigue, fever, aches,etc) 34-58 hours following a potential exposure/encounter with an escort?
Feeling very stupid and scared!
Hoping that its a simple community aquired viral infection!

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by Dr Sean CummingsBlank, Jun 30, 2010
Ah! Now you're being very naughty - this is the Blog part - the questions go the Forum - bad, very bad!

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by tom7636, Jun 30, 2010
Hi Sean,

A comment on the above article, it seems to imply that antibody tests can take up to 24 weeks to become positive?

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by Dr Sean CummingsBlank, Jun 30, 2010
Hi Tom

No, antibodies will form in very quick time - certainly the vast majority of people becoming HIV positive by antibody test by 6 weeks using modern antibody tests (greater than 99% of people).

The immune response is recognition, reaction, and ultimately reaching the "set point" - ie the HIV viral load which stabilises after a period of acute infection. The immune response referred to above is the entire initial sequence. Antibody formation is simply part of that.

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by Argentina2010, Jun 30, 2010
Hi there, don't want to beat around the bush..i suffered (still suffer) peripheral neuropathy from about 3 weeks after i had sex, a weird tingling sensation in my foot which is ALWAYS there. The GUM clinic told me I shouldn't be suffering that symptom of HIV for a few years.....not weeks, is that correct? I got an 80 day negative ELISA test...i do suffer health anxiety i suppose, but will the 4 days upto 12 weeks (84days) really make that much of a difference?
I'm 20, healthy, not a drug user, no chemotherapy or anything.

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by Dr Sean CummingsBlank, Jul 01, 2010
Peripheral neuropathy, if that is indeed what you have, is a feature of late stage HIV +/- a treatment side effect.



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by Argentina2010, Jul 01, 2010
Erm i don't know how to take that response,..should I be worried? Even though i have an 80 day negative....

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by Vance2335, Jul 01, 2010
Argentina2010 read what the Dr said...late stage. That means you would have had HIV for a while (years) and your 80 day test shows that you don't have HIV for years.

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by Argentina2010, Jul 01, 2010
thanks for the clarification :)

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by Dr Sean CummingsBlank, Jul 02, 2010
Hi Argentina2010 and thanks Vance2335,

Yes, late stage = after many years - not after a few weeks - simply not posible. If indeed you have peripheral neuropathy then it is not related to HIV from this event.

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by shuramatongo, Jul 07, 2010


I had  protected sexual encounter with a man living with HIV and on treatment since 2005. I realised the next day that the condom was broken, im not sure how and when it broke. I immediately went for an HIV test the same day and i was negative and began a course on PEP i.e non occupational Post exposure prophylaxis the same day which im still on. Iam taking combination therapy of zidovudine, lamivudine and nevirapine. I understand Nevirapine is not the best but that was the best option availble.Today, i have began my third week on this PEP course. Im so worried to death. What are my chances of testing positive on completing the course?



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by worriedguy278, Jul 12, 2010
i believe that one must first consider whether there has been a risky exposure, before looking at symptoms, not the other way round.

maybe dr cummings can expand on what are risky sexual exposures? or, looking at it from another angle, why are some exposures (anal or vaginal sex) considered risky, and others (kissing, handjobs) not? it seems rather arbitrary to lay people.

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by littleone81, Oct 19, 2010
six weeks ago I had unprotected sex with an ex intravenous drug sddict I didnt know about this until afterwards. I have swollen glands, im aching all over and have bad headaches and severe mouth ulcers. Does this sound like seroconversion? I have two little babies and im worried sick. Please help.

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by mindfreak1, Nov 20, 2010
dear people, i have tested Elisa 80 days after my expousure.... NEGATIVE....is that conclusive test ( i am helthy 20 year old guy, taking no drugs, or kortikosterids, or anything..... )??? i am scared because of simptoms i had 3 and a hlaf weeks after expousure....

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by mindfreak1, Nov 20, 2010
dear people, i have tested Elisa 80 days after my expousure.... NEGATIVE....is that conclusive test ( i am helthy 20 year old guy, taking no drugs, or kortikosterids, or anything..... )??? i am scared because of simptoms i had 3 and a hlaf weeks after expousure....

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by mindfreak1, Nov 20, 2010
sorry for cometing two times...

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by lastfault, Nov 21, 2010
Hi doctor,

what is ELISHA test with electro chemical lumnisence. It is accurate as normal elisha. I got non reactive(0.18) with this test after 94 days of my exposer. I am healthy , overweight indian.
my test was reliable or not.

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by Sam198810, Nov 21, 2010
Hi I had protected sex on 13 but though after 2 or 3 days I am having sore throat and light fever and headache problem are these symptoms of HIV infection please help me out I am really very tressfull about it thank you

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by ShoNuff190, Nov 24, 2010
When will you (people) ever learn. HIV does not discriminate...its infects and kills. Wise up and put on a condom and if you are negative be committed to one HIV negative partner.

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by brianna124, Dec 13, 2010
Hello I am 19 years old and I had unprotective sex in may of 2010 and I got test in june, july and august, august being the 3rd month. I was told from his peers that he may be hiv positive. All three test came out negative. Since before we had sex I have had involuntary muscle movements on my body all over. I noticed it happeneing in my arm in the middle of a basketball game then it spread to my whole body. Later symtoms that I currently have now are a little bit of swollen lymph nodes in the neck and one side of the groin. I have green streaks on my tongue from time to time. I don't cough and NEVER had a fever for years and was told that fever is one of the common signs of hiv. Also when I spit its it sometimes comes out green not all the time though. I have not gone down in weight at all still 190 lbs and I feel stronger then ever. Can you please give me some advice about which symptoms are related to hiv or not please especially with spit and green tongue cause from what doctors have told me and readings they aren't .?

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by brianna124, Dec 13, 2010
Hello I am 19 years old and I had unprotective sex in may of 2010 and I got test in june, july and august, august being the 3rd month. I was told from his peers that he may be hiv positive. All three test came out negative. Since before we had sex I have had involuntary muscle movements on my body all over. I noticed it happeneing in my arm in the middle of a basketball game then it spread to my whole body. Later symtoms that I currently have now are a little bit of swollen lymph nodes in the neck and one side of the groin. I have green streaks on my tongue from time to time. I don't cough and NEVER had a fever for years and was told that fever is one of the common signs of hiv. Also when I spit its it sometimes comes out green not all the time though. I have not gone down in weight at all still 190 lbs and I feel stronger then ever. Can you please give me some advice about which symptoms are related to hiv or not please especially with spit and green tongue cause from what doctors have told me and readings they aren't .?

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by jp575, Jan 24, 2011
hi doctor,

i have recently had sex with a friend of mine, i dont knw her for so long, after 4 days having protected sex with her i had fever and its goes away in a week, but i always see my body get heated up and cools down for about a month,in mid of it i was also having sore throat and flu which last about a week ,ten everythg was ok till this last 10 days i am having some needle piercing sensation on foot with pain when walking and buring sensation sometimes, its comes and goes, during night time i dont have it at all am i am having good sleep, i am really worried, i dont have any swollen lymph nodes or rashes, and till now i dont have any diarehea or vomit as well, i am totally worried,i have done my test after 14 days which turns out to be negative, i am worried to go and do another test as i am wooried of the result

thanks,
jp

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by helpme125, Jan 29, 2011
Hi Doctor,

Please help, I am so much scared and troubled. 7 weeks back I had an unsafe encounter where my anus was fingered and nothing else. 10-12 days later, I started having hoarse voice, heavy tongue and cold. Went to the clinic, who diagnosed strep throat and gave me antibiotics for 10 days, which I took. The symptoms improved but the hoarse voice in the evening thing kept on happening for another 4 weeks and the tongue heaviness though reduced is still present in a minor way. Also after the antibiotics were over, for a couple of nights I had a lot of pain due to acid reflux.

From 3 weeks after the unsafe encounter, till now (which is 4 weeks period), I have lost weight, around 8 lbs. I went for a Elisa-WB test 6 weeks after and it came negative. But the last week, I have had chills, feverish (less than 98.5F) and have had diarrhea (mostly the urge immediately or a bit after eating). Also I am belching a lot immediately after I take any food or drink.  The last 2 weeks, I am finding it hard to sleep, and when I do, I wake up early. I am a High BP patient, and am on medication, but the last one month, I have seen lower BP than I have seen myself have. I have no headaches, body aches.

Please tell me if these point to possible HIV infection. I am anxious and scared. Do I go for immediate PCR test?

Please help.

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by I20loko, Feb 17, 2011
Please help: On November  23 2010 I performed  unprotected oral sex on a guy I met online,On December 14 2010 I had the flu.I think some semen got on my mouth but  tried spiting it out,
This flu lastested for about 2 weeks,I had fever,swollen groin limp nodes.,sore throat for the first few days afterwards it was kind of a dry cough with chest pain,at times in the morning I would cough and spit some blood.
I blamed this on the cold  weather as I might have gotten wet.
or possibly could have walked outside in the cold mornings with no coat

On January 3rd 2011 I met with him again,,gave him oral sex and no semen got in my mouth..

January 27 2011 I got tested with ELISA test It came back negative.
I have no other symptoms,that I am aware of. I have always had severe dry skin so with the cold temperature It always itches,Ive also read that stress causes the skin to itch. I have been really scared,very stressed
Is it possible that this test was ACCURATE for the first encounter being that it had been exactly 2 months or 60 days after a possible exposure?????
It is February 17,I am counting the days to go back and get tested,I am scared but at least I will know and stop worrying so much.
Thanks.

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by Thofu, Mar 01, 2011
How risky is oral sex to he or she that performs it On a woman? Drs are never clear on wat in the large spectrum of sexual manoeuvres is risky

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by been_there123, Mar 29, 2011
Quote from Dr Cummings

"Week 2 - 4: The viral load peaks and can be as high as millions of copies per microlitre of blood, making the individual their most infectious."

A. This being true I asume you would feel really sick, your body would be going crazy trying to fight off the invasion. I am sure this cannot be mistaken. Rash seams like a very good indication that there is something seriously wrong.

B. If you had oral contact during this time, is the 'low risk' of transmission statement still true?



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by Vance2335, Mar 29, 2011
THIS IS NOT A FORUM TO ASK QUESTIONS. PLEASE DIRECT ALL QUESTIONS TO THE FREE FORUM OR PAY TO ASK THE EXPERTS.

THANK YOU

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by heavenhelpme789, Mar 27, 2012
7 weeks ago, I was date raped by a total stranger. 4 weeks ago my shoulders and arms started to ache and now my upper back and back of my neck hurt. I dropped 8lbs since, I have weakness in my upper body and my arms and hands are shaky. My right side hurts under my rib cage. Last night I woke up at 3am in a pool of sweat and again tonight. I have taken ELISA TEST  at 14 days which was negative and I took a 6 week one last week, in which I still have not gotten the results back, I was hoping that today I would have gotten it but I didn't, and having the night sweats starting, I do believe at this point that I am positive. And some days it feels like my belly swells.
I have 3 children and I feel like I failed them. I have no body to talk to. I feel like i'm walking in a fog and I can't make my way out...I feel like this is a nightmare
In my heart I know something is wrong, but does it sound like I may be infected to you Dr.?

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by paranoiafreak, Apr 13, 2012
could it be possible that peripheral neuropathy appears after 6 months of being infected?

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by nathan02, May 13, 2012
Hello doc, I had an unprotected sex, as my penis went in I realised I had made a mistake so I retreat within 10secs of invading, 2weeks later I s tested nagative what are my chances of remaining negative! Since it was only ten secs, and I didn't *** but had some foul smile frm the vaginal!


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by neudryhaid, May 23, 2012
Doc could elevated platelet at 555 000 14 weeks post infection and elevated liver enzymes at 9 months? I am having many symptoms since i felt the first symptom 8 weeks post possible infection.

Low grade fever and chills for almost 3 months then, 2 episodes of urticaria. then neuropathy,persistent burningand tingling  feet hands, legs, arms , upper back neck head.. persistent dry mouth, white tongue and white patches which seems to be OHL at the side of tongue.

Dry hands and feet, peeling hands and feet.

burning worsens at dawn. Could not go back to sleep.

It has been 9 months post possible infection and i still am having many symptoms except for the fever.

The symptoms did bnot come all together but one after the other .

Can this be hiv? can this be possible hiv early in the infection.?

I feel my symptoms are unusual.

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by neudryhaid, May 23, 2012
Liver enzyme was at 39.4 in november but 174 in may


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by munna986, Jun 21, 2012
hi dr., can acute HIV be symmetrical rashes on limbs but no fever and no lymphadenopathy.... i m so scared as i have insertive anal sex for around 10 seconds 2 months back ....  rashes is disturbing me.plz reply. i am so scared

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by bidy, Jul 02, 2012
hi dear i had a deep kiss with a HIV partner and also suck her breast unkwowinggly but no sex, i ran for text immediately i noticed her being positive and i tested negative but am having symptoms like fever, sore throat, sleepless night, shortness of breath, loss of weight. Pls am scared, i need ur help.

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by needhelp214, Aug 06, 2012
Pleasee help i had unprotected sex nd 2 weeks later i had flu like symptoms fever chills night sweats headaches that only lasted 3 day i since had 2 antibodies test came out negative but i am soo scared that i stay awake at night researching the internet for hiv symptoms pleasee help me put my mind to rest im on 17 nd dnt knw if i should believe da tests.

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by wolffang, Sep 24, 2012
Hi doc, just a question,
me and my partner tested negative after 2 days we had oral..... Let say if she is in a seroconversion state which could not be detected by hiv test kit, is there a possibility i could get hiv as well?

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by sunny21101985, Nov 14, 2012
Hi! Same like you, I am also nervous and cannot sleep. I had unprotected sex with a girl two weeks ago. I do not know anything about her but she said that she had a hiv test a week before we had sex. I have chest conjution problem from a long time. 10 days after I had this intercourse with her, I am getting very short breath, cold and pain in my collar bone, chest and upper back. I am also taking medicines for anxiety from 2 years but I am not sure what can cause this. I visited my doctor and he prescribed medicines for three weeks.  My lips are getting blue and felling my body very light. Is it because of the low oxygen level and can it happen due to the unprotected sex with in 10 days. Please help. what should I do?

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by Sherman1913, Jan 01, 2013
Hello doctor

Can you have headaches for 1 week without Any other symptom and be considered ARS. I have no fever, sore throat , nothing. Only headaches. I had a very risky exposure. Unprotected sex with an exotic dancer and this is killing me. Please advise. It's been almost three week now. Can I get tested soon?

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by sammy8313, Feb 07, 2013
Iam so severely anxious and can't sleep at night my test is in a month . I've been having all sorts of random infections and really worried that this is the end , HIV or aids would kill me. Iam sure we all feel terrible in here if I get chance again I will never practice unsafe sex EVER  . Been on a emotional loose end since I was forced and manipulated to have an abortion , then I just went off on one slept with three four people cos I hated myself hope  its negative as worry is killing me day to day and realise to let go of bad feeling  I bless you all x

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by bobbimike, Mar 10, 2013
I recently had a sex attempt..had on a condom..really not much penetration as I noticed the female had started mensing during. i got some blood on the condom and some on my hand..I washed immeditatly..but it is a week later and I am sick..sneezing, coughing, sore throat..kinda worried do you think it could be hiv

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by Jigson, Mar 17, 2013
Jesus some people are stupid. This is an informative journal. NOT THE PLACE FOR QUESTIONS. I realize many of you are worried. I am as well. It would probably be nice for you to actually get your questions answered, so please ask them in the FORUM THREADS and not this ABANDONED JOURNAL.

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by Jigson, Mar 17, 2013
I meant no one personally by the way, and I also included myself. This answer however is directed @bobbymike: If you had an open sore/scratch/lesion anywhere that the blood made contact there is a slim possibility. Go get tested just to be safe!

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by scaredddhelp, Apr 01, 2013
Can hiv symptoms occur after 5 days of unprotected oral ( given and received) with a sex worker?  symptoms such as extreme fatigue, weakness and severe leg pain.

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by kaka316, Jun 01, 2013
I DR. Sean . can seroconversion can take place after 90 days .. i got tested negative for hiv on 93 days .

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by kaka316, Jun 01, 2013
i got some fever 99 or above as it's my 17th week is it hiv related or not a white hairy tongue also ... please tell .


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by ddorsey, Jul 01, 2013
How long for mouth ulcers to occur in an HIV positive person?

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by rocky364, Jul 19, 2013
Hello, i have been suffering from ill health, it began with sever cough and runny nose with extreme sputum in cough and in nose, for first four day i did not go to hospital on the fourth day evening i visited the clinic, where the doctor treated with antibiotic in junction and gave not to effective but bit reduced the illness. thereafter   in between i had bit fever of 102, then i had sever and extreme sinus attack where i had to go 3 to four hours in the morning in my eyes, it used to be so extreme and somtimes felt like  my eyes balls will come out or get blast, and on and off later on, then i visited another physician he just give me tables for 5 days to take morning and evening1. for cold, antibiotic, nosal drops , and liquid medicin to take stem, and gave tablet for fever as well only in case of high tempeture....then on the same morning i started to for the first time it self after taking steam i felt more better, then i continue it till four days, it *** down but still am suffering from light sputum cough and nose running block, by today it been 8 to 9 days,, what kind of illness,,, is this i read it somewhere cough and cold fever is also a symtom of hiv and other sever illness....please help out to figure it out exactly what is it....

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by aadinick, Aug 04, 2013
Hi,
I was sexually exposed with a HIV positive man on 12 th July,2013. Two days after I was suffering from fever, Headache, and diarrhea. on 22th July I did DNA PCR test and it came negative. How much I can trust on this report??  

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by respect_my_mind, Dec 30, 2013
OMG I'm ******* going crazy and too scared to get tested on November 22 I had unprotected drunk and mollyed out sex with a man I did not know he had a bump on the shaft of his penis I did not pay it any mind I gave oral and we had sex the next day I had stomach pains and was ******** water all day two weeks later and as I type now I've experienced diarrhea a mild headache and green tounge also my stomach feels wired my boyfriend who i had sex with two nights after this "one night stand" is expirenceing common symptoms I'm worrying myself half to death I can't deal or live with being HIV and knowing I killed my boyfriend of 8years that I love to death along with myself for a one night thing :'( :-/ :-(

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by xiaolan, Mar 11, 2014
I have some symptoms mentioned above , but did not have a fever, some experts say no have a fever is the most convincing evidence that not acute symptoms,is  this view  right?

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by Niligirl, Mar 17, 2014
Hi,  I had unprotected sex about 7 months ago, I have lots of swollen lymph nodes on my neck and under my jaw since 4 months ago, I lost 8 lbs in 3 months without any exercise or diet!
I also have Diarhea
And I considered that my bf has swollen lymph nodes in his neck too,
I'm afraid to get tested for HIV
Can these all be symptoms of HIV?  

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by Alex1664, Mar 28, 2014
Hello I have read that HIV lymphadenopathy is symmetrical. I only ask because I have a large swollen lymph node on one side does HIV lymphadenopathy pertain to the Acute HIV infection stage?

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by JimmyTyler21, May 15, 2014
Hey guys.. After Male to Male sex.. I drink his Sperm.. Then 2 weeks i have a little swollen gland that only 1 night.. Just a little its not really that hurt.. Then 2 months ago theres a big wierd thing on my back.. I think its pimple.. I red that rash is also a symptoms..  

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by ali018018, Jul 02, 2014
Hello I have unprotected sex with girl.1 month no symptoms and  2nd month I got muscle aches that last for one month.3 month I got mild fever on evening and white tongue and cold feet I have also pain on my back side when I pressing. I test on 3 weak after negative .then I check after 86 days antibofy test negative.my symptoms not gone away last symptoms now lasying 2 months what is my problem.plz help me


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by Hivfree2014, Jul 12, 2014
Is a oraquick test taken 93 days after a high risk event conclusive? I tested negative and do I need more testing?

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by Collin79, 2 hours
some of the symptoms you think its of HIV are not tress can cause numerous symptoms look like hiv dont worry all you people get tested at 3months mark and be free

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