This article first appeared in HIV Update, a publication of aidsmap.com, here.
In the very first few weeks after infection with HIV, some people feel unwell. Commonly reported symptoms at this time include fever, sore throat, tiredness, a skin rash, aching muscles and joints, swollen lymph glands and headaches.
These symptoms are the result of the immune system’s production of antibodies to HIV in order to mount a defence against HIV. This is known as seroconversion.
The symptoms usually clear up after a while. They are very similar to those of other, much more commonly reported illnesses, including the flu and glandular fever. For these reasons, doctors often fail to suggest an HIV test to people who have these symptoms.
Now a new study has found that a few people have an even wider variety of symptoms and health problems around the time of their seroconversion. The study comes from Switzerland where, since 2002, doctors have been recording information on people who were diagnosed with HIV very early, within six months of their infection.
While most people did have the symptoms mentioned in the first paragraph – like fever and sore throat – the range of other symptoms reported is quite surprising. And many of them were serious enough to require hospital treatment.
There was a long list of unusual illnesses seen. Many involved the gastrointestinal system (including tonsillitis, gall-bladder inflammation and what was at first thought to be appendicitis). Others were connected with the central nervous system (including temporary paralysis of part of the face and psychiatric problems), but symptoms also involved the eyes, the lungs, the kidneys and genitals, and the skin.
Most previous studies of the symptoms of early HIV infection have been conducted with gay men in the United States or Europe, where HIV subtype B is most commonly found. People who had unusual symptoms in this study were more likely to be heterosexual and to have a different subtype. This is interesting because some subtypes which are more often found in other parts of the world, such as D and A/E, seem to be more virulent than subtype B.
The study is a reminder that HIV can present in a wide variety of different ways and can cause a significant illness soon after infection.