Chronic HIV Infection: What to Know

Medically Reviewed by Laura J. Martin, MD on April 18, 2022
4 min read

HIV is the virus that causes AIDS. The illness known as HIV/AIDS happens in three stages: acute HIV infection, chronic HIV infection, and AIDS.

But the phrase “chronic HIV infection” isn’t simply the second stage of HIV/AIDS. It also describes the illness as a whole: There’s no cure for HIV infection. So in a sense, it’s a chronic infection no matter what stage you’re in.

However, the right diagnosis and treatment in the early stages of HIV/AIDS can often keep you from getting to the third and final stage, where it causes the most damage. It also helps stop transmission of the virus to others.

The first possible symptoms of HIV infection may develop within 2-4 weeks after you’re exposed to the virus. You might notice flu-like symptoms such as fever, headache, and rashes. Or you could have no symptoms at all.

In this first stage of HIV/AIDS (acute HIV infection) the virus reproduces itself very quickly and spreads all over your body. This makes the virus especially easy to transmit to others through sexual contact. The virus starts to destroy infection-fighting cells in your immune system called CD4 T cells, or sometimes just “T cells.”

Once you reach the second stage of HIV/AIDS -- chronic HIV infection -- the virus has started to reproduce at a far slower pace. Even without treatment, many people in this stage don’t notice any HIV-related symptoms for 10 years or more. That’s why some doctors also call it “asymptomatic HIV infection” or “clinical latency.”

Still, in some cases, you might get mild infections with symptoms like:

Whether you have symptoms or not, without treatment, HIV continues to take a relentless toll on your immune system. Your HIV levels go slowly up and your CD4 levels go slowly down until the illness progresses to the most serious stage: AIDS.

Treatment during these early stages of the illness can have huge health benefits, especially with an approach known as antiretroviral therapy, or ART.

If you don’t treat chronic HIV infection, your illness is likely to progress to the third and final stage, AIDS. This usually happens after 10 or more years of chronic HIV infection, though it sometimes happens sooner.

At this point, serious damage to your immune system makes it harder for your body to fight off certain infections and cancers. These “opportunistic” infections and cancers often happen in people with a weakened immune response.

This is very serious. People with AIDS who don’t get treatment typically survive about 3 years. And with AIDS, you’re also more likely to have a high viral load that spreads more easily to sexual partners.

It’s important to keep in mind that there is no cure for HIV/AIDS. Once you have the virus, you’ll need treatment to keep its worst effects at bay. That said, treatment of chronic HIV infection works very well, especially if you start it early.

Treatment involves antiretroviral therapy, or ART. This is a combination of medicines that helps stop HIV from making copies of itself. That gives your body a chance to raise the levels of CD4 cells that help fight off opportunistic infections.

Properly followed, the right prescription of antiretroviral therapy can bring your HIV viral load down so low that it can’t be detected by current blood tests. This not only makes you healthier, it also makes you less likely to pass the virus on to a sexual partner. Someone with an undetectable viral load has almost no chance of passing the virus to a partner.

This undetectable viral load is the goal of ART. Maintain it, and you and your doctors may be able to keep AIDS at bay for decades. This effectively keeps you in this second stage of HIV/AIDS, chronic HIV infection, almost indefinitely.

In fact, most people in the U.S. with HIV who get ART treatment will never develop AIDS.

Your doctor can tell by doing a blood test of your CD4 immune cells. A count of less than 200 cells/mm3 means you have AIDS. Certain opportunistic infections may also be enough to diagnose this third stage of the illness.

But only your doctor can tell you your stage for certain. That’s why it’s important to check in regularly with your medical team about your general health and treatment if you have HIV/AIDS.

Regular checkups can ensure that you get the right treatment at the right time and that you don’t put your sexual partners at risk.

As more and more people with HIV live into old age, doctors have found that chronic HIV infection might raise your risk for other illnesses like heart disease, high blood pressure, and peripheral neuropathy.

The increases aren’t generally huge and scientists aren’t yet sure why they happen. But research continues to provide information to help us get to the bottom of these issues.