Asymptomatic HIV infection

After the period of primary infection most people feel and look well for a number of years. They are known as asymptomatic, which means they have no symptoms.

The length of time people stay asymptomatic varies tremendously. In the UK the average length of time from becoming infected to developing late stage HIV, or AIDS, is around 10 years. Some people become sick within two to three years of being infected, while a few per cent of people who were infected in the 1980s are still well, have normal CD4 counts, and don’t have to take treatment. These people are sometimes known as long-term slow progressors or non-progressors.

How long will I stay asymptomatic?

The time you stay asymptomatic varies for all sorts of reasons:

• You may have got infected with more than one kind of HIV at once (referred to as dual infection).
• You may have HIV that reproduces particularly fast or slowly.
• Some people have a genetic variation that means HIV finds it difficult to infect their cells.
• Your body may have mounted a particularly strong defence against HIV when you were first infected.
• You may have other infections which also damage the immune system, such as herpes or tuberculosis (TB). This is one reason why it is particularly important to stay healthy if you have HIV.

Stress, fatigue, depression and some recreational drugs can all run down the immune system, which is why it is important to stay well and happy. And poor diet also plays a part: this may be the reason why people in developing countries tend to develop AIDS faster.

What is happening to my body?

During this period HIV will still be actively reproducing and destroying your T-cells, and other T-cells will be trying to fight it. You may get slight symptoms such as night sweats and aching muscles to show this is happening, and some people experience weight loss.

It is important to keep visiting your clinic every three to six months to have your CD4 count and viral load monitored, so your doctors and you can decide if and when to start treatment.

Late stage HIV, or AIDS

After a period of time, often up to 10 years after becoming infected with HIV, your immune system will become so weakened that the body becomes susceptible to serious illnesses. 

Once your CD4 count falls below 200, AIDS-related illnesses may appear. Many of these infections, though serious, are treatable to some degree, and others often improve if you start HIV treatment and your CD4 count goes up.