The sicker people are after becoming infected with HIV, the faster they’ll progress to AIDS, new research confirms in the August 1 issue of the Journal of Acquired Immune Deficiency Syndromes. The number of symptoms experienced during primary HIV infection, Colleen Kelly, MD, and her colleagues report, can mean a higher viral load set point—a well-established marker of more rapid disease progression.

The University of California, San Francisco (UCSF), study involved 177 newly infected people. The volunteers reported their symptoms, including fatigue, fever, night sweats, and rash. The researchers found that each additional symptom was associated with a higher HIV spike after infection, which was predictive of the more stable viral load that is maintained for months or years if treatment is not started.

The researchers note that the small study involved mostly gay men. They do say, however, that these results mirror those of a more diverse group of patients.