There are about 600 lymph nodes throughout the body. Some of these lymph nodes are in deep tissue, but others can more easily be located in clusters closer to the skin in the armpit, groin, and neck areas.
The lymph nodes are part of the lymphatic system, which helps the body fight infection. The lymph nodes filter the lymphatic fluid, which is a clear fluid that carries infection-fighting cells, and stores white blood cells.
A lymph node is considered swollen if it measures about half an inch wide. Lymph nodes can become swollen due to many different types of infections. Among these, swollen lymph nodes can be an early symptom of HIV infection. The lymph nodes in the neck, groin, or armpits are most often affected.
When to see a doctor: Symptoms and causes
People should see a doctor:
Swollen lymph nodes may be an early symptom of HIV. However, there may also be other causes behind the swelling.
- if their lymph nodes have been swollen for more than 2 weeks
- if their lymph nodes are hard or seem to be growing rapidly
- if the skin over the nodes is red and inflamed
People should also see a doctor if they have swollen lymph nodes and are also experiencing any of the following symptoms:
When attempting to diagnose the cause of swollen lymph nodes, a doctor will perform a physical exam and ask questions about symptoms, recent travel history, and recent contact with animals. It is important to remember that although swollen lymph nodes are a symptom of early HIV infection, there are also many other causes of swollen lymph nodes.
Doctors may also require blood or tissue samples to help them make a diagnosis. Fluid from the lymph node may also be extracted and placed into a culture to analyze what class of bacteria may grow, if any. Swollen lymph nodes may also be the result of a viral illness.
If a person has swollen lymph nodes and it is possible that they have recently been exposed to HIV, they should speak to a doctor about what testing options are available.
Other causes of swollen lymph nodes
The lymph nodes usually become swollen due to a rapid increase in number of the white blood cells that build up in the nodes in order to fight an infection.
Common infections that are associated with swollen lymph nodes include the common cold, measles, strep throat, ear infections, and tooth infections. Less common infections, such as tuberculosis, syphilis, and toxoplasmosis can also cause the lymph nodes to swell.
Other early symptoms of HIV infection
Early symptoms of HIV infection include:
- rash that is not easily explained by other factors, such as medication or allergies
- sore throat
- fatigue, caused by the inflammatory response generated by the overworked immune system
- aches and pains in the muscles and joints
- new or serious headache
- diarrhea, vomiting, nausea, and lack of appetite
- night sweats - these can be a side effect of a fever caused by infection
A doctor will take into account a patient's full history when treating swollen lymph nodes. If the cause is HIV, antiretrovirals may be prescribed.
When treating swollen lymph nodes, doctors will take into account the person's age, medical history, how sick they are, and how well they tolerate certain medicines.
If the underlying cause of the swollen lymph nodes is HIV, antiretroviral drugs are typically used to manage the infection. Antiretrovirals cannot cure HIV, but the drugs are able reduce the amount of HIV in the bloodstream, also known as the viral load.
The goal of antiretrovirals is to reduce the viral load to undetectable levels.
People with HIV whose viral loads are at undetectable levels are known to stay healthier for longer and are less likely to transmit the virus to other people. However, having an undetectable viral load does not mean that the person is completely free of the virus.
Outlook for HIV
There are three main stages of HIV infection: acute infection, chronic infection, and AIDS.
During the first stage of the disease, acute HIV infection, the amount of HIV in the blood reaches very high levels, as the body is not yet able to mount an immune response.
The second stage of infection is chronic HIV infection. HIV continues to multiply in the blood during this stage, but at lower levels than in acute infection. People at this stage of infection may not present symptoms, but they can still transmit the virus.
If a person with HIV does not receive treatment then they will usually progress to the final stage of infection, which is AIDS. This usually happens within 10 years.
By this stage, a person's immune system has been so badly damaged by HIV that their body is unable to fight infections that a healthy immune system might be able to. People who have been diagnosed with AIDS but do not receive treatment will typically die within 3 years.
However, studies have found that people who take their antiretrovirals to manage HIV infection can expect to live well into their 60s and 70s. Their life expectancy is still around 13 years shorter on average than people who do not have HIV.
People with HIV are at an increased risk of lymphoma and other types of cancer. AIDS-related lymphoma occurs when cancer cells form in the lymphatic system of people who have AIDS.
Symptoms of AIDS-related lymphoma include:
- weight loss
- night sweats
- swollen lymph nodes
- a feeling of fullness below the ribs
The condition can be diagnosed from a physical exam and by using blood tests to count the numbers of red blood cells, white blood cells, and platelets in the blood.
Rarely, AIDS-related lymphoma can occur outside of the lymph nodes, in the bone marrow, liver, brain, and stomach.