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Acute Retroviral Syndrome - Symptoms, Diagnosis, and Treatment

Published on Dec 08, 2022 and last reviewed on Jan 25, 2023   -  4 min read


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


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-

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.

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Last reviewed at:
25 Jan 2023  -  4 min read




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