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The Stages of HIV Infection

Series of test tubes containing varying amounts of HIV particles and CD4 cells to depict the course of HIV infection.

HIV infection

Without treatment, HIV infection advances in stages, getting worse over time. HIV gradually destroys the immune system and eventually causes acquired immunodeficiency syndrome (AIDS).

There is no cure for HIV, but treatment with HIV medicines (called antiretroviral therapy or ART) can slow or prevent HIV from advancing from one stage to the next. HIV medicines help people with HIV live longer, healthier lives. One of the main goals of ART is to reduce a person’s viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative partner through sex.


There are three stages of HIV infection:

    1. Acute HIV Infection
      Acute HIV infection is the earliest stage of HIV infection, and it generally develops within 2 to 4 weeks after infection with HIV. During this time, some people have flu-like symptoms, such as fever, headache, and rash. In the acute stage of infection, HIV multiplies rapidly and spreads throughout the body. The virus attacks and destroys the infection-fighting CD4 cells (CD4 T lymphocyte) of the immune system. During the acute HIV infection stage, the level of HIV in the blood is very high, which greatly increases the risk of HIV transmission. A person may experience significant health benefits if they start ART during this stage.


    1. Chronic HIV Infection
      The second stage of HIV infection is chronic HIV infection (also called asymptomatic HIV infection or clinical latency). During this stage, HIV continues to multiply in the body but at very low levels. People with chronic HIV infection may not have any HIV-related symptoms. Without ART, chronic HIV infection usually advances to AIDS in 10 years or longer, though in some people it may advance faster. People who are taking ART may be in this stage for several decades. While it is still possible to transmit HIV to others during this stage, people who take ART exactly as prescribed and maintain an undetectable viral load have effectively no risk of transmitting HIV to an HIV-negative partner through sex.


  1. AIDS
    AIDS is the final, most severe stage of HIV infection. Because HIV has severely damaged the immune system, the body cannot fight off opportunistic infections. (Opportunistic infections are infections and infection-related cancers that occur more frequently or are more severe in people with weakened immune systems than in people with healthy immune systems.) People with HIV are diagnosed with AIDS if they have a CD4 count of less than 200 cells/mm3 or if they have certain opportunistic infections. Once a person is diagnosed with AIDS, they can have a high viral load and are able to transmit HIV to others very easily. Without treatment, people with AIDS typically survive about 3 years.

Source: NIH

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