Human Immunodeficiency Virus (HIV) Infection: When To Call A Doctor

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When To Call a Doctor

Known HIV infection

If you are infected with HIV or caring for someone who is, call 911 or other emergency services immediately if any of the following conditions develop:

• Seizures
• Loss of consciousness
• New weakness in an arm, a leg, or one side of the body
• New inability to move a body part (paralysis)
• New inability to stand or walk

Call your doctor if any of the following conditions develop:

• Fever higher than
• Fever higher than for 24 hours
• Shortness of breath
• Cough that produces mucus or sputum
• New changes in balance or sensation (numbness, tingling, or pain)
• Ongoing diarrhea
• Unusual bleeding, such as from the nose or gums, blood in the urine or stool, or easy bruising
• Ongoing headache
• Changes in vision
• Rapid, unexplained weight loss
• Night sweats
• Fatigue
• Swelling of lymph nodes in the neck, armpits, or groin
• Unusual sores on the skin or in the mouth
• Increased outbreaks of cold sores
• Severe numbness or pain in the hands and feet
• Personality changes or decline in mental ability, such as confusion, disorientation, or an inability to do mental tasks that the person has done in the past
• Sores, bumps, rashes, blisters, or warts that appear on or around the genital or anal areas

Suspected or known exposure to HIV and symptoms are present

Many people have a flu-like illness 3 to 6 weeks after they are first infected with HIV, but symptoms can occur within a few days of infection. Symptoms of acute retroviral syndrome (such as nausea and headache), which are the first signs of HIV infection, are often mistaken for symptoms of another viral infection.

Call your doctor to determine whether HIV testing is needed if you suspect you have been exposed to HIV, particularly if you engage in high-risk behavior and develop any of the following symptoms:

• Abdominal cramps, nausea, or vomiting
• Diarrhea
• Enlarged lymph nodes in the neck, armpits, and groin
• Fever
• Headache
• Muscle aches and joint pain
• Skin rash
• Sore throat
• Weight loss
• Yeast infection of the mouth (thrush)

Initial symptoms of HIV infection may be mild to severe and usually disappear on their own after 2 to 3 weeks.

Suspected or known exposure to HIV but symptoms are not present

If you have not been tested for HIV, call your doctor if:

• You suspect that you have been exposed to HIV.
• You have engaged in high-risk behavior and are concerned that you were exposed to HIV.
• Your sex partner engages in high-risk behavior.
• Your sex partner may have been exposed to HIV.
• Your sex partner has HIV.
• You develop any of the symptoms listed above.

Getting tested for HIV can be scary, but the condition is treatable so it is important to get tested if you think you have been exposed. Early detection and monitoring of HIV will help your doctor determine whether the disease is progressing and when to start treatment.

Watchful Waiting

Until you know the results of your test:

• Avoid sexual contact with others. If you do have sex, practice safe sex.
• Do not share needles, syringes, cookers, cotton, cocaine spoons, or eyedroppers.

If you do not have symptoms of HIV even though you have tested positive for the virus, you and your doctor may simply continue to watch for symptoms to occur. If you do not show any signs of disease and your CD4+ cell count is more than 350 cells per microliter (mcL), you may not require treatment. But during this time you still need regular checkups with a doctor to monitor your viral load and CD4+ cell counts—these tests measure the amount of HIV in your blood and detect how well your immune system is working.

Who To See

Health professionals who can diagnose and may treat HIV include:

• Family medicine doctors.
• Internists.
• Infectious disease specialists.
• Nurse practitioners.
• Physician assistants (PAs).

HIV can also be diagnosed and treated at an HIV care clinic.

Complications of HIV may require treatment by the following health professionals:

• Cardiologist
• Dermatologist
• Gastroenterologist
• Infectious disease specialist
• Oncologist
• Ophthalmologist
• Orthopedist
• Pulmonologist

If you do not have a health professional

Public health clinics and other organizations provide low-cost, confidential testing and counseling about HIV and high-risk behavior. If you have questions about the testing procedure, ask your doctor to explain the procedure to you.

If you do not have a doctor, contact one of the following for information on HIV testing in your area:

• Your county or state health department
• Local AIDS organization
• Centers for Disease Control and Prevention (CDC) 24-hour information hotline: 1-800-232-4636 (1-800-CDC-INFO) or see the CDC National HIV Testing Resources Web site: www.hivtest.org
• National Association of People with AIDS (NAPWA) hotline: (240) 247-0880 or see the NAPWA Web site: www.napwa.org
• U.S. National Institutes of Health (NIH) toll-free HIV hotline: 1-800-448-0440 or see the NIH AIDS Web site at www.aidsinfo.nih.gov

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Last updated:	May 08, 2008
Author:	Maria G. Essig, MS, ELS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Peter Shalit, MD, PhD - Internal Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer