Table of ContentsView AllTable of ContentsLymphadenopathyHIV LymphadenopathySymptomsCould It Be HIV?Treatment
Table of ContentsView All
View All
Table of Contents
Lymphadenopathy
HIV Lymphadenopathy
Symptoms
Could It Be HIV?
Treatment
In those withhuman immunodeficiency virus (HIV), swollenlymph nodesare not only a common occurrence, but one that can occur at anystage of infection.Lymph nodes on the side of the neck, under the jaw, or in the armpits or groin are most often involved.
Any type of infection can cause swollen lymph nodes, also known aslymphadenopathy. But in some cases of HIV, the swelling can be extremely painful and the nodes can get as large as a walnut.
This article describes the cause of swollen lymph nodes in HIV, including when it is more likely to occur. It also explains how lymphadenopathy is treated in people who are infected.
Common Signs and Symptoms of HIV
What Is Lymphadenopathy?
Coronation Dental Specialty Group / Wikimedia Commons
Lymphadenopathy is not a disease but rather a symptom of a disease.
Lymphadenopathy is common when the body is fighting infections like colds, flu, orstrep throat. However, it can occur withautoimmune diseases, cancer, and even use of certain medications.
The location of the swollen lymph nodes can tell a lot about the type of disease you have. Lymph node locations include:
Lymphadenopathy can also be generalized, meaning that there are swollen lymph nodes throughout the body. This is common with systemic diseases that affect the body as a whole, like HIV.
When Do Lymph Nodes Swell in HIV?
Lymph nodes can swell during theacute or chronicstage of HIV and mean entirely different things based on when the symptom occurs.
Acute HIV Infection
Lymphadenopathy is common during theacute phase of HIVinfection—occurring soon after infection when the immune system is actively fighting the virus. The acute phase is also called acute seroconversion or acute retroviral syndrome and affects roughly 70% of newly infected individuals.
Swollen lymph nodes can occur wherever there are lymph nodes in the body—the front or sides of the neck, behind your ears, under your chin, in your armpits, and in the groin area.
Swollen lymph nodes often look like round bumps that can be about the size of a pea or larger, depending on the extent of infection.
Enlarged lymph nodes can be tender and painful. They may also feel rubbery, moveable, and squishy. If there is redness, warmth, or tenderness that may be a sign of inflammation and infection.
Lymphadenopathy in HIV is unique in that the swollen lymph nodes are found throughout the body as opposed to one or two more localized areas which occurs with conditions like the flu, herpes infections, staph infections, or solid tumor cancers.
Widespread lymphadenopathy with nodes larger than 2 centimeters (roughly 1 inch) and lasting for more than three months, is a condition called persistent generalized lymphadenopathy (PGL).
HIV Symptoms
Advanced HIV Infection
As people enter advanced HIV infection, PGL may resolve, but for some people, it may last for months. When lymph node swelling resolves, it does not mean the virus is inactive; the virus continues to replicate and gradually depletes the immune system.
Taking antiviral medications exactly as prescribed is the only way to slow down or stop the progression of HIV.
Advanced HIV infection is the second stage of HIV infection and is a chronic phase. It is also called asymptomatic HIV infection or clinical latency. During this stage, HIV continues to multiply in the body but at very low levels.
Opportunistic infections are more common in those with chronic or untreated HIV because the virus depletes the immune system, making it difficult to fight off diseases.
Different opportunistic infections (OIs) may present with lymphadenopathy including:
Antiretroviral therapy(ART)is commonly used to treat HIV and helps decrease opportunistic infections. By reducing the amount of HIV in the body, the immune system can stay strong and fight off infections better.
It is important to note that some people may develop OIs and PGL despite ART. This is more common in those who:
Guide to Antiviral Drugs
Immune Reconstitution Inflammatory Syndrome (IRIS)
Immune reconstitution inflammatory syndrome (IRIS) is the worsening of symptoms of previously controlled disease or the unmasking of unsuspected disease after starting ART.Little is known about why IRIS develops but researchers hypothesize that the condition has a paradoxical inflammatory component that results in:
IRIS often resolves on its own. Taking corticosteroids like prednisone for one to two weeks may lead to a quicker resolution of IRIS symptoms.
Uncommon Signs and Symptoms of Early HIV
Are My Swollen Lymph Nodes Due to HIV?
Verywell / Colleen Tighe
During acute HIV infection, swollen lymph nodes most often occur in two or more sites in the body. The cervical lymph nodes are commonly affected as well as the axillary and inguinal lymph nodes.
In this stage, lymphadenopathy is self-limiting and will usually resolve on its own within weeks or months.The swelling may be mild and relatively painless.
With that said, some people may experience visible, unsightly swelling with severe pain.
Lymphadenopathy and accompanying symptoms of acute HIV infection can last anywhere from a few days to several weeks.Not everyone newly infected with HIV develops lymphadenopathy or realizes that they have it. It is not uncommon for people to think they have a cold or flu and miss theearly signs of HIV infection.
For some people, lymphadenopathy doesn’t occur untilHIV is advancedand the immune system is fullycompromised. This is whenopportunistic infections (OIs)liketuberculosisortoxoplasmosiscan develop. In such cases, lymphadenopathy is the result of the OI rather than HIV itself.
Other Causes of Swollen Lymph Nodes
A range of infections other than HIV can also cause swollen lymph nodes, such as:
Although lymphadenopathy can occur for any number of reasons, PGL is a stronger indication that HIV is involved.
How to Tell If an HIV Infection Is Recent
Diagnosis
Contact your health care provider if:
Your healthcare provider will take a medical history and may ask if you are experiencing any associated symptoms, such as:
They may also ask about:
The physical exam will consist of:
A biopsy of the lymph node may also be taken, called fine-needle aspiration cytology (FNAC), to identify the type of virus.
As a rule of thumb, you should gettested for HIVif the following occurs:
The U.S. Preventive Services Task Force recommends that all people ages 15 to 65 who reside in the United States be tested for HIV as part of a routine medical visit, whether they experience swollen glands or not.
What Happens If My HIV Test Is Positive?
Treating Swollen Lymph Nodes
If left untreated, HIV lymphadenopathy can resolve on its own within weeks or months. With that said, HIV should never beneverleft untreated.
In the end, the one surefire way to resolve swollen lymph nodes due to HIV is to startantiretroviral therapy. This is the daily use of two or more drugs able to bring the virus under control.
Antiretroviral drugs don’t “cure” HIV but suppress the virus to levels where it can do little harm to the body. By reducing the viral burden in the body, also known as theviral load, your lymph nodes will no longer be overtaxed and can return to their normal size.
Antiretroviral therapy can also extend lifeexpectancyto near-normal levels and dramatically reduce the risk of HIV-associated and non-HIV-associated diseases.Moreover, if the viral load remains undetectable, your odds of infecting someone else arereduced to zero.
Until lymphadenopathy symptoms are fully resolved, an over-the-counternonsteroidal anti-inflammatory drug (NSAID)like Advil (ibuprofen) orAleve (naproxen)can provide short-term pain relief.
How to Live Long and Well With HIV
Summary
Swollen lymph nodes are common in many different medical conditions, including HIV. Lymphadenopathy associated with HIV tends to occur in more than one part of the body, such as the neck, groin, and armpits.
Lymphadenopathy can occur at any stage of HIV. Contact your healthcare provider if you have had swollen lymph nodes for several weeks or if you are experiencing any associated symptoms.
16 Sources
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