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20 of 24 Keep in mind that the body hasn't produced antibodies to HIV yet so an antibody test may not pick it up. (It can take a few weeks to a few monthsfor HIV antibodies to show in a blood test). Investigate other test options such as one that detects viral RNA, typically within nine days of infection. Skin rash Skin rashes can occur early or late in the course of HIV/AIDS. For Ron, this was another sign that he might not have run-of- the-mill allergies or a cold. "They were like boils, with some itchy pink areas on my arms," Ron says. The rashes can also appear on the trunk of the body. "If [the rashes] aren't easily explained or easily treated, you should think about having an HIV test," Dr. Horberg says. Nausea, vomiting, diarrhea Anywhere from 30% to 60% of people have short-term nausea, vomiting, or diarrhea in the early stages of HIV, Dr. Malvestutto says. These symptoms can also appear as a result of antiretroviral therapy and later in the infection, usually as the result of an opportunistic infection. "Diarrhea that is unremitting and not responding at all to usual therapy might be an indication," Dr. Horberg says. Or symptoms may be caused by an organism not usually seen in people with healthy immune systems, he adds. Weight loss Once called "AIDS wasting," weight loss is a sign of more advanced illness and could be due in part to severe diarrhea. "If you're already losing weight, that means the immune system is usually fairly depleted," Dr. Malvestutto says. "This is the patient who has lost a lot of weight even if they continue to eat as much as possible. This is late presentation. We still see a lot of these." It has become less common, however, thanks to antiretroviral therapy. A person is considered to have wasting syndrome if they lose 10% or more of their body weight and have had diarrhea or weakness and fever for more than 30 days, according to the U.S. Department of Health and Human Services. Dry cough A dry cough was the ﬁrst sign Ron had that something was wrong. He at ﬁrst dismissed it as bad allergies. But it went on for a year and a half—and kept getting worse. Benadryl, antibiotics, and inhalers didn't ﬁx the problem. Neither did allergists. This symptom—an "insidious cough that could be going on for weeks that doesn't seem to resolve," Dr. Malvestutto says—is typical in very ill HIV patients. Pneumonia The cough and the weight loss may also presage a serious infection caused by a germ that wouldn't bother you if your immune system was working properly.

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