TellTale Signs You HIV Infection

Dry Cough

A dry cough was the first sign Ron had that something was wrong. He at first dismissed it as bad allergies.

But it went on for a year and a half—and kept getting worse. Benadryl, antibiotics, and inhalers didn't fix the problem. Neither did allergists.

This symptom—an "insidious cough that could be going on for weeks that doesn't seem to resolve," Dr. Malvestutto says—is typical in very ill HIV patients.

Pneumonia

The cough and the weight loss may also presage a serious infection caused by a germ that wouldn't bother you if your immune system was working properly.

"There are many different opportunistic infections and each one can present differently," Dr. Malvestutto says. In Ron's case, it was Pneumocystis pneumonia (PCP), aka "AIDS pneumonia," which eventually landed him in the hospital.


Other opportunistic infections include toxoplasmosis, a parasitic infection that affects the brain; a type of herpes virus called cytomegalovirus; and yeast infections such as thrush.

Night Sweats

About half of people get night sweats during the early stages of HIV infection, Dr. Malvestutto says.

These can be even more common later in infection and aren't related to exercise or the temperature of the room.

Similar to the hot flashes that menopausal women suffer, they're also hard to dismiss, given that they soak your bedclothes and sheets.

Nail Changes

Another sign of late HIV infection are nail changes, such as clubbing (thickening and curving of the nails), splitting of the nails, or discoloration (black or brown lines going either vertically or horizontally).

Often this is due to a fungal infection, such as candida. "Patients with depleted immune systems will be more susceptible to fungal infections," Dr. Malvestutto says.

Yeast Infections

Another fungal infection that's common in later stages is thrush, a mouth infection caused by Candida, a type of yeast.

"It's a very common fungus and the one that causes yeast infections in women," Dr. Malvestutto says. "They tend to appear in the mouth or esophagus, making it difficult to swallow."

Ron woke up one day to find white patches on his tongue. He had thrush. For him, "It was not bothersome other than I didn't like having it." The infection was hard to get rid of, but finally cleared up after Ron started taking drugs to combat HIV.

Confusion or difficulty concentrating

Cognitive problems could be a sign of HIV-related dementia, which usually occurs late in the course of the disease.

In addition to confusion and difficulty concentrating, AIDS-related dementia might also involve memory problems and behavioral issues such as anger or irritability.

It may even include motor changes: becoming clumsy, lack of coordination, and problems with tasks requiring fine motor skills such as writing by hand.

Cold sores or genital herpes

Cold sores (oral herpes) and genital herpes can be a sign of both ARS and late-stage HIV infection.

And having herpes can also be a risk factor for contracting HIV. This is because genital herpes can cause ulcers that make it easier for HIV to enter the body during sex. And people who have HIV tend to have more severe herpes outbreaks more often because HIV weakens the immune system.

Tingling and weakness

Late HIV can also cause numbness and tingling in the hands and feet. This is called peripheral neuropathy, which also occurs in people with uncontrolled diabetes.

"This is when the nerves are actually damaged," Dr. Malvestutto says. These symptoms can be treated with over-the-counter pain relievers and antiseizure medicines such as Neurontin (gabapentin).

Menstrual irregularities

Advanced HIV disease appears to increase the risk of having menstrual irregularities, such as fewer and lighter periods.

These changes, however, probably have more to do with the weight loss and poor health of women with late-stage infection rather than the infection itself.

Infection with HIV also has been associated with earlier age of menopause (47 to 48 years for infected women compared to 49 to 51 years for uninfected women).

Conclusion

These days, the news about HIV/AIDS is mostly good. We're hearing about "functional" cures, better drugs, fewer side effects and longer lives, although there are still shadows here and there.

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