....itchy pink areas on my arms,” Ron says. The rashes can also appear on the trunk of the body. “If [the rashes] aren’t easily explained or easily treated, you should think about having an HIV test,” Dr. Horberg says.
Nausea, Vomiting & Diarrhea
Anywhere from 30% to 60% of people have short-term nausea, vomiting, or diarrhea in the early stages of HIV, Dr. Malvestutto says. These symptoms can also appear as a result of antiretroviral therapy and later in the infection, usually as the result of an opportunistic infection. ”Diarrhea that is unremitting and not responding at all to usual therapy might be an indication,” Dr. Horberg says. Or symptoms may be caused by an organism not usually seen in people with healthy immune systems, he adds.
Once called “AIDS wasting,” weight loss is a sign of more advanced illness and could be due in part to severe diarrhea. ”If you’re already losing weight, that means the immune system is usually fairly depleted,” Dr. Malvestutto says. “This is the patient who has lost a lot of weight even if they continue to eat as much as possible. This is late presentation. We still see a lot of these.” It has become less common, however, thanks to antiretroviral therapy.
A person is considered to have wasting syndrome if they lose 10% or more of their body weight and have had diarrhea or weakness and fever for more than 30 days, according to the U.S. Department of Health and Human Services.
Have a bad cough that Benadryl, antibiotics, and inhalers don’t seem to fix? 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.
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.
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.
Another fungal infection that’s common in later stages is thrush, a mouth infection caused by....