HIV is a viral infection that affects the body’s immune system. Swollen lymph nodes often occur when the immune system attacks pathogens, such as a virus, to prevent an infection.

The cause of swollen lymph nodes is typically infection.

Swollen lymph nodes can be an early symptom of HIV, and they can also occur in the later stages due to an opportunistic infection.

Antiretroviral therapy is a treatment that can slow or stop the progression of HIV and keep the immune system strong enough to fight off infections. This reduces or eliminates any complications related to HIV and helps ensure that the person can live a long and healthy life.

This article looks at the link between swollen lymph nodes and HIV, as well as treatments and the outlook for people with the condition.

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A lymph node is a small, bean-shaped mass of tissue. They are part of the lymphatic system, which helps the body fight infections.

There are an estimated 800 lymph nodes throughout the body. Some are in deep tissues, and others are in clusters close to the skin’s surface.

Swollen lymph nodes are a sign that the body is fighting off an infection. They feel like tender, painful lumps, and a person may notice them:

  • in both sides of the neck
  • underneath the chin
  • in the armpits
  • in the groin

Swollen lymph nodes can be an early symptom of an HIV infection.

When the body first senses the virus and combats it, the person may experience flu-like symptoms, or what doctors call seroconversion illness. The person may also be able to feel swollen lymph nodes throughout the areas listed above.

The flu-like symptoms usually appear within 2–4 weeks of exposure to the virus and last for several days or weeks.

Specific symptoms include:

  • fever
  • fatigue
  • rash
  • muscle aches
  • night sweats
  • sore throat
  • swollen lymph nodes in the throat, groin, or armpits
  • sores or ulcers around the mouth or genitals
  • nausea, with or without vomiting

However, not everybody experiences these types of symptoms.

HIV enters white blood cells called CD4 cells and damages or destroys them. If the person does not receive effective treatment, the damage continues until the immune system is too weak to fight off infections.

If the number of CD4 cells drops below 200 cells per cubic milliliter or 200 cells per microliter, a doctor diagnoses stage 3 HIV. This is the most advanced stage.

A person with stage 3 HIV may develop various infections and illnesses due to damage to the immune system. These infections can lead to swollen lymph nodes.

In some people, swollen or large lymph nodes are among the first signs of a stage 3 HIV infection, and they may be enlarged for more than 3 months.

Other symptoms that can indicate stage 3 HIV include:

  • rapid weight loss
  • unexplained extreme tiredness
  • recurring fevers
  • profuse night sweats
  • persistent swelling of lymph nodes in the armpits, groin, or neck
  • diarrhea lasting more than a week
  • pneumonia
  • sores in the genitals, mouth, or anus
  • discolored areas on the skin or inside the nose, mouth, or eyelids
  • memory loss, depression, or other neurologic conditions

Stage 3 HIV may not develop for a decade or more after the initial infection. If a person receives effective treatment, HIV likely will not progress to this stage.

Learn more about the stages and timeline of HIV.

Swollen lymph nodes can result from a wide range of infections, and they can represent one symptom of early HIV.

It is impossible to diagnose HIV by its symptoms alone. The only way to be sure involves testing.

Anyone who wants to know their status or suspects a recent exposure to the virus should take a test or contact a healthcare professional for advice.

Visit HIV.gov to find out how to get tested in the United States.

Meanwhile, if a person has swollen lymph nodes, it is best to contact a doctor if any of the following occur:

  • The nodes are getting bigger.
  • They have been swollen for 2 weeks or more.
  • They feel hard.
  • They do not move when pressed.
  • They accompany night sweats or a very high fever and have lasted longer than 3 or 4 days.
  • There are no other symptoms of illness.

To diagnose the cause of swollen lymph nodes, a doctor performs a physical exam and asks about symptoms and recent activities.

They may also send off a blood or tissue sample for testing. In some cases, doctors extract a sample of the lymph node for further testing. They may also recommend an ultrasound or CT scan.

HIV and AIDS resources

For more in-depth information and resources on HIV and AIDS, visit our dedicated hub.

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Swollen lymph nodes can result from most viral or bacterial infections, including the following common ones:

Less common causes include tuberculosis, syphilis, and toxoplasmosis.

Swollen lymph nodes can also result from cancer, such as leukemia or lymphoma, which is cancer of the immune cells.

Also, if a person does not receive treatment for HIV, they can become more susceptible to other infections and diseases, and these can result in swollen lymph nodes.

Read more about other causes of swollen lymph nodes.

First, the doctor determines the cause and recommends a course of action, taking into account the person’s age, medical history, current health status, and how well they can tolerate certain medications.

If the underlying cause of swollen lymph nodes is HIV, a person can undergo antiretroviral therapy to manage the infection.

Antiretrovirals do not cure HIV. Instead, they reduce the amount of HIV in the body, called the “viral load,” to very low levels. The goal of this treatment is to make the viral load undetectable. This means the person has fewer than 200 copies of the virus per milliliter of blood.

Once the medication achieves this, the virus cannot affect the person’s overall health, and it cannot transfer to others. Some refer to this as “untransmittable equals undetectable” or “U=U.”

Even when the viral load is undetectable, HIV remains in the body, so it is crucial to continue taking the medication and having levels tested regularly.

In the past, HIV often led to life threatening complications. However, if a person has access to current treatments, their life expectancy is now comparable to that of a person without HIV.

Taking antiretroviral drugs as prescribed can reduce the virus to undetectable levels. When this happens, the virus can no longer damage the immune system or transfer to others.

The following are some questions people frequently ask about HIV and swollen lymph nodes.

When do signs of HIV start showing?

While many people experience flu-like symptoms within 2–6 weeks of infection with HIV, some people experience very mild symptoms or no symptoms at all.

What do HIV lymph nodes feel like?

Swollen lymph nodes due to HIV typically feel larger than usual and may be painful.

Swollen lymph nodes can be an early sign of an HIV infection. They may accompany flu-like symptoms.

If a person believes they may have come into contact with HIV, they should contact a healthcare professional right away for testing. HIV is manageable with medications.

Other infections, such as mononucleosis, can also cause swollen lymph nodes. If an individual has any concerns about swollen lymph nodes or other symptoms, it is best to contact a healthcare professional.

Read this article in Spanish.