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Acute Retroviral Syndrome - Symptoms, Diagnosis, and Treatment

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Acute retroviral syndrome (ARS) is the initial phase of the HIV (human immunodeficiency virus) infection. Let us learn more about this condition in detail.

Medically reviewed by

Dr. Shah Sushma Kant

Published At December 8, 2022
Reviewed AtJanuary 25, 2023


Acute retroviral syndrome (ARS) represents the initial, acute stage of an HIV (human immunodeficiency virus) infection. The symptoms of ARS resemble the symptoms of influenza, show up within several weeks of exposure to the infectious virus, and generally last from a few days to a few weeks. This article describes the symptoms, causes, diagnosis, and treatment options for acute retroviral syndrome (ARS).

What Is an Acute Retroviral Syndrome?

HIV (human immunodeficiency virus) is a type of virus that affects the immune system and proceeds through three stages. First, after getting infected with HIV, the person develops various symptoms resembling influenza or the flu. These symptoms indicate the initial stage of HIV infection, which is called acute retroviral syndrome (ARS), primary HIV infection, or acute HIV infection. This acute, initial stage develops as early as two to four weeks after exposure to HIV. During this stage, the virus multiplies at a rapid rate.

Unlike other viruses, the body’s immune system cannot fight off and eliminate HIV. The immune system gets weakened as the virus continues to attack and destroy the immune cells over a long period. This makes the immune system unable to fight off other infections and diseases. This leads to late-stage HIV, known as AIDS (acquired immunodeficiency syndrome). The chances of contracting HIV from an infected person are high, especially when they are in the ARS stage. However, the initial symptoms disappear on their own and are often mistaken for flu-like illnesses. Therefore, it is difficult to know whether the person has contracted HIV.

The available standard HIV antibody test may not always detect this stage of HIV.

What Are the Symptoms of Acute Retroviral Syndrome (ARS)?

The symptoms of ARS are similar to the flu and other viral illnesses. Therefore people may not know that they have contracted HIV. In addition, some individuals may not have any symptoms at all.

Symptoms of ARS may include-

  • Fever and chills.

  • Skin rash.

  • Fatigue.

  • Headaches.

  • Sore throat.

  • Loss of appetite.

  • Unexplained weight loss.

  • Ulcers in the mouth, food pipe, or genitals.

  • Muscle aches.

  • Swollen lymph nodes.

  • Diarrhea.

All the symptoms may not be present, and these are nonspecific, which means these can occur due to other illnesses and infections. If the person suspects they may have had exposure to HIV and have these symptoms, HIV testing should be done as soon as possible.

How Long Do the ARS Symptoms Last?

The center for disease control and prevention (CDC) states that the symptoms of ARS may last a few days to several weeks. At this point, the multiplication of the virus may slow down, and people start feeling better as the immune system gradually takes over the HIV infection.

One symptom that may persist for longer is lymphadenopathy or swelling of the lymph nodes. This painful condition may continue for three months or longer. Persistent generalized lymphadenopathy (PGL) is common in many people with HIV infection.

How Is Acute Retroviral Syndrome Transmitted?

Acute HIV infection is transmitted through-

  • Contaminated blood transfusions.

  • Breastfeeding mother infected with HIV.

  • Sharing syringes or needles with infected people.

  • Contact with infected people's blood, vaginal fluids, semen, and anal secretions.

HIV does not spread through physical contacts, such as hugging and holding hands. It also does not spread through kissing or sharing food because saliva does not transmit HIV.

How Is ARS Diagnosed?

The healthcare provider may recommend a series of tests if they suspect HIV in a person.

However, the standard HIV screening test would not necessarily detect an acute HIV infection.

Antibody Test: Most HIV screening tests look for antibodies to HIV rather than the virus. Antibodies are proteins that identify and destroy foreign substances such as viruses and bacteria. Therefore, the presence of antibodies indicates a current infection. However, in the case of an HIV infection, the antibodies may take several weeks to appear after the initial contract with the virus. If the antibody test is negative, but the healthcare provider suspects that the person may still have HIV infection, they may order a viral load test. They may also have the person get tested for the antibody test after a few weeks to check whether the antibodies have developed.

Other Tests: Some other tests that may detect signs of ARS include-

  • HIV RNA (ribonucleic acid) viral load test.

  • P24 antigen blood test.

  • Combined HIV antigen and an antibody test (4th generation test).

  • The p24 antigen test is a blood test that checks for the presence of the antigen p24, which is only found in people with an HIV infection. An antigen represents a foreign substance that induces an immune response in the body.

  • The combined HIV antigen and antibody test (4th generation test) is the most sensitive test, but it is not always able to detect the infection within the first two weeks.

  • People taking the p24 antigen blood test or the 4th generation test will also need to confirm the status of their HIV infection by the viral load test.

How Is ARS Treated?

It is crucial for people infected with HIV to have the proper treatment. Healthcare providers believe that early treatment with antiretroviral therapy (ART) proves to be beneficial for all HIV-positive patients. This is because early treatment helps with minimizing the virus's effects on the immune system. ART involves a combination of various HIV drugs belonging to several classes.

In addition to the medical treatment, the healthcare provider might also suggest specific lifestyle adjustments, which may include-

  • Healthy and balanced diet intake for strengthening the immune system.

  • Practicing sexual intercourse with condoms and other barrier methods helps reduce the chances of HIV transmission to other people and avoids sexually transmitted infections (STIs).

  • Avoid exposure to people with other infections and illnesses because HIV-infected people already have a lowered immunity, making them prone to acquiring infections quickly.

  • Proper sterilization and disinfection of syringes and needles whenever used.

  • Stop smoking and reduce or avoid alcohol.


Acute retroviral syndrome (ARS) or acute HIV infection is the initial stage of the HIV (human immunodeficiency virus) infection. Not everyone has symptoms of ARS, but those who do can expect the symptoms to last for a few days to several weeks. The symptoms are mild and usually resemble the flu. Early diagnosis and management of ARS are essential because it allows people to have a healthy and average life expectancy.

Frequently Asked Questions


What Causes Acute Retroviral Syndrome?

Acute retroviral syndrome (ARS) occurs after a person has been infected with the human immunodeficiency virus (HIV). HIV attacks the immune system and causes acquired immunodeficiency syndrome (AIDS) if left untreated. After a person is infected with HIV, the virus rapidly replicates and spreads throughout the body. This initial phase of HIV infection is known as the acute phase, and it can last for several weeks to several months.


What Is the Treatment for Acute Viral Syndrome?

The treatment of acute viral syndrome depends on the specific virus that is causing the illness. In most cases, the symptoms of acute viral syndrome are treated with self-care measures and symptom relief. Some common measures that can help alleviate symptoms include:
 - Getting Plenty of Rest- Fatigue is a common symptom of acute viral syndrome, and getting plenty of rest can help you feel better.
 - Staying Hydrated- Dehydration can worsen symptoms, so drink plenty of water and stay hydrated.
 - Using Over-The-Counter Pain Relievers- Over-the-counter pain relievers, such as Acetaminophen or Ibuprofen, can help relieve headaches, muscle aches, and joint pain.
 - Soothing a Sore Throat- A sore throat can be relieved with lozenges, gargling with salt water, or taking over-the-counter pain relievers.


How Long Do Acute Viral Infection Symptoms Last?

Yes, the symptoms of acute retroviral syndrome (ARS) can come and go. Some individuals may experience symptoms for a few days, while others may have symptoms for several weeks. Additionally, the symptoms can appear suddenly and then resolve, only to return later. This pattern of symptoms can make it difficult to diagnose ARS. Early diagnosis and treatment with antiretroviral therapy (ART) can effectively suppress the virus and prevent the development of AIDS (acquired immunodeficiency syndrome).


How Long After ARS Symptoms Does the Infection Test Positive?

The timing of a positive HIV test after the onset of the acute retroviral syndrome (ARS) symptoms vary depending on the individual and the specific test used. Generally, it can take several weeks to several months for a person to test positive for HIV after they have been infected. During this time, the virus is actively replicating and spreading throughout the body, and the person may experience symptoms of ARS.


How Long Does Acute Viral Infection Fever Last?

The duration of fever during acute retroviral syndrome can vary from person to person. Some individuals may experience a fever for just a few days, while others may have a fever for several weeks. The exact duration of fever during ARS depends on several factors, including the individual's immune response, the severity of their symptoms, and overall health.


When Do People Experience Acute Viral Infection?

Acute retroviral syndrome (ARS) occurs in the early stages of HIV infection, typically within two to four weeks after exposure to the virus. ARS is a cluster of symptoms that occur as the body's immune system responds to the presence of the virus. Not everyone who is infected with HIV will experience ARS symptoms. However, those who do experience ARS symptoms typically do so within a few weeks after exposure to the virus.


Is Shortness of Breath a Symptom of Acute Viral Infection?

Shortness of breath is not a common symptom of acute retroviral syndrome (ARS). Typically, the symptoms of ARS include-
 - Fever.
 - Fatigue.
 - Muscle aches and joint pain.
 - Headache.
 - Sore throat.
 - Rash.
 - Swollen lymph nodes.


What Happens During Acute Viral Infection?

During acute retroviral syndrome (ARS), the body responds to the presence of the human immunodeficiency virus (HIV). During ARS, the virus is actively replicating and spreading throughout the body, and the person's immune system is mounting a response to the infection. As a result, the person may experience symptoms of ARS.


Is Acute Viral Infection Contagious?

Yes, individuals with acute retroviral syndrome (ARS) can be contagious and can transmit the human immunodeficiency virus (HIV) to others. HIV spreads through sharing needles or other injection equipment, sexual contact, or from a mother to her baby during pregnancy, childbirth, or breastfeeding. Precautions to prevent the transmission of HIV, especially in an early stage when the virus is actively replicating, and the person is highly contagious, are necessary.


How Painful Is Acute Viral Infection?

ARS, or acute retroviral syndrome, can cause a range of symptoms, and the level of discomfort and pain can vary from person to person. Some individuals may experience mild symptoms, while others may have more severe symptoms. Muscle aches, joint pain, and headache can be painful for some people. Additionally, the sore throat and swollen lymph nodes can also be uncomfortable.


How Long Is the Acute Stage of HIV?

The acute stage of HIV infection can last for two to four weeks after the person is infected with the virus. In this stage, the virus replicates rapidly, spreading throughout the body, and the person's immune system mounting a response to the infection. As a result, the person may experience a cluster of symptoms, such as fever, fatigue, muscle aches, joint pain, headache, sore throat, rash, and swollen lymph nodes.


How Long Does Acute HIV Last?

No, acute HIV, also known as acute retroviral syndrome (ARS), does not go away on its own. ARS is the initial stage of HIV infection, and it occurs within two to four weeks of getting infected with the virus. However, after the acute stage of HIV, the virus does not go away and may continue to replicate at low levels and damage the person's immune system over time, leading to the development of AIDS if left untreated.


Can Acute Viral Infections Occur Without Fever?

Yes, acute respiratory syndrome can occur without a fever. Fever is a common symptom of ARS, but it is not always present. Other symptoms of ARS include cough, shortness of breath, muscle pain, headache, and sore throat. In some cases, ARS may present with mild symptoms, such as a runny nose, cough, and fatigue, which can be mistaken for a cold or the flu.


What Time Does It Take to Treat AVI?

The duration of acute viral infections can vary depending on the type of virus and the individual's immune system. Most acute viral infections generally last for some days or for a week or two. However, some acute viral infections can lead to more serious and prolonged illnesses, such as pneumonia, encephalitis, or myocarditis. In these cases, the illness may last several weeks or even months and can have long-term health consequences.


How Long Can Acute Retroviral Syndrome Stay?

Acute retroviral syndrome (ARS) is a cluster of symptoms that occur early in HIV infection. ARS typically lasts for a few weeks, although the symptoms can vary in duration and intensity. It occurs after a person has been infected with the HIV virus.
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Dr. Shah Sushma Kant
Dr. Shah Sushma Kant

HIV/AIDS specialist


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