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Sore Throat and HIV: Is It an Early Symptom?

Medically reviewed by Barry S. Zingman, M.D. — Written by Chelsea Alvarado, M.D.
Posted on August 28, 2023
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Of the 1.2 million people living with human immunodeficiency virus (HIV) in the United States, 13 percent don’t know they have it. Although some symptoms of the condition are well known, others may be less of a red flag, delaying necessary diagnosis and treatment. One symptom that some people wonder about is sore throat, including whether it could be an early sign of HIV.

Read on to discover the most common early symptoms of HIV, particularly a sore throat.

Recognizing Early Symptoms of HIV

Acute HIV infection is the earliest stage of infection. During this period, 50 percent to 90 percent of people with HIV have flu-like symptoms that may last a few days to several weeks. The exact percentage of people who experience symptoms may be even lower due to research limitations. Symptoms typically develop within two to four weeks of infection and result from the body’s initial reaction to the virus.

The exact prevalence of symptoms (how widespread they are) in acute HIV isn’t known. However, available research points to a handful of symptoms that occur most often. These symptoms, from most to least common, are:

  • Fever
  • Fatigue
  • Muscle aches and joint pain
  • Swollen lymph nodes
  • Headache
  • Sore throat
  • Rash

Other possible symptoms include:

  • Painful mouth sores
  • Genital ulcers
  • Weight loss
  • Aseptic meningitis (inflammation of the lining around the spinal cord, usually caused by viruses)
  • Pain in the back of the eyes
  • Depression
  • Belly pain
  • Cough
  • Diarrhea
  • Night sweats

Although sore throat is commonly reported, acute HIV symptoms and their severity vary widely, and some people have no symptoms at all. Additionally, early symptoms of HIV, including sore throat, are nonspecific, meaning they also occur in many other conditions.

Is It Acute HIV or Another Condition?

Knowing about the other conditions that can cause sore throat may help you and your provider differentiate them from acute HIV. Viral infections cause sore throat in 50 percent to 80 percent of cases. The most common of these viruses are:

  • Rhinovirus (causes the common cold)
  • Orthomyxovirus (causes influenza)
  • Adenovirus
  • Coronavirus
  • Parainfluenza

These viruses, unlike HIV, are usually cleared by a person’s immune system without causing long-term issues. HIV is among the less common viruses that cause sore throat, along with herpesvirus, Epstein-Barr virus (which causes mononucleosis), and coxsackievirus.

Bacterial infections can also cause sore throats. These less common infections are typically more serious and may develop after a viral infection.

The most common bacterial cause of sore throat is Group A strep, which accounts for 5 percent to 36 percent of acute pharyngitis (sore throat) cases, according to StatPearls, a medical education library. Other common, noninfectious causes of sore throat include allergies, dry indoor air, outdoor air pollution, throat muscle strain, and gastroesophageal reflux disease. These factors can affect people in the general population, as well as those with HIV.

“I went to my doctor because I don’t feel well — I’ve got strep throat,” one myHIVteam member wrote.

“Acid reflux is driving me crazy, hurting my throat,” another member said.

It can be challenging to tell the difference between the illnesses that cause a sore throat, which is why it’s crucial to seek advice from a health care provider for long-lasting or severe symptoms. According to the American Academy of Otolaryngology-Head and Neck Surgery, the following problems warrant a doctor visit:

  • A severe sore throat lasting more than a week
  • Trouble swallowing, breathing, or opening your mouth
  • Joint pain
  • Rash
  • Earache
  • Body temperature over 101 F
  • Bloody saliva or phlegm
  • Recurrent sore throats
  • Lump in the neck
  • Hoarseness for more than two weeks
  • Swelling of the face or neck

Any of these symptoms could indicate disease more severe than a common cold, such as a bacterial infection or acute HIV infection.

Getting Tested

Having undiagnosed — and therefore untreated — HIV allows the virus to continue replicating, causing more harm to the affected person and increasing the risk of transmitting the virus. Research shows that starting antiretroviral treatment (ART) early in the course of HIV lowers the risk of AIDS and other serious health problems, so early HIV diagnosis is crucial.

Although other viruses more commonly cause sore throat than HIV does, people with sore throat or other symptoms of acute HIV should get tested. This advice is especially important for those who also have possible HIV exposure. Risk factors for HIV include:

  • Having anal or vaginal sex without a condom or medicines to prevent or treat HIV with someone whose status is unknown or who has HIV that’s not controlled by their own ART
  • Having multiple sexual partners since the last HIV test
  • Sharing needles, syringes, or other drug injection devices
  • History of sex work
  • Being diagnosed with or treated for another sexually transmitted infection
  • Being diagnosed with or treated for hepatitis or tuberculosis

The Centers for Disease Control and Prevention (CDC) recommends that people with any of the above risk factors be tested once a year. Given that many people with HIV have no symptoms, the CDC also recommends that everyone between ages 13 and 64 get tested at least once. People at older ages should be tested as well.

Several options exist for HIV testing. According to the CDC, there’s no way to detect the virus just after infection. However, one test that should be considered for people suspected to have recent exposure or acute HIV symptoms is the nucleic acid test (NAT). NATs measure the amount of virus in the blood and can detect HIV 10 to 33 days following exposure.

Antibody and antigen/antibody tests are also available. Antibodies are produced by the immune system in response to HIV, and antigens are parts of the virus that trigger the immune system. Antibody tests may take 23 to 90 days to detect HIV, while antigen/antibody tests can take 18 to 90 days.

If you’re looking to get tested for HIV, talk with your doctor about which type is best for you and how regularly you should be tested.

Educating Yourself

Because of significant historical and current stigma around HIV, getting tested may feel daunting. However, HIV and AIDS health care providers are committed to helping people feel comfortable and supported when seeking HIV-related care.

If someone you love has HIV or is concerned they may have HIV, it’s important to show your support for their health journey. HIV testing is quick, confidential, and free in some places. HIV treatment is also highly effective at helping people live longer.

Anyone looking to get tested or treated should feel comfortable doing so. Educating yourself about HIV can help reduce the stigma and support those living with HIV.

Find Your Team

On myHIVteam, the social network for people with HIV and their loved ones, more than 37,000 members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Are you living with HIV or concerned that you may have acquired it? What early symptoms of HIV do you have? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on August 28, 2023
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    Barry S. Zingman, M.D. specializes in HIV/AIDS medicine and general infectious disease. Review provided by VeriMed Healthcare Network. Learn more about him here.
    Chelsea Alvarado, M.D. earned her Bachelor of Science in biochemistry from Temple University in Philadelphia, Pennsylvania, and her Doctor of Medicine from the University of Maryland School of Medicine in Baltimore, Maryland. Learn more about her here.

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