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Primary HIV Infection

Primary HIV infection is an acute contagious disease caused by the human immunodeficiency virus (HIV). It is characterized by non-specific signs and symptoms which develop after an individual is exposed to the virus and can manifest until he/she develops antibodies. The diagnosis of the disease can be missed or mistaken due to the flu-like symptoms and inability of laboratory tests to detect specific antibodies to the virus.


Presentation

Primary HIV infection, also known as an acute retroviral syndrome or acute HIV infection occurs within three to four weeks [1] after a person is infected with the human immunodeficiency virus and can last for up to three months until the HIV-specific antibodies develop [2].

A few patients with this infection are asymptomatic but a majority of them develop flu-like signs during this period [3]. These are usually non-specific [2] and include fatiguability, fever, myalgia, sore throat, and skin rash [4] with constitutional symptoms like malaise, anorexia, loss of weight, diarrhea, and tender lymphadenopathy, typically in the inguinal region. A headache, neck stiffness, encephalitis, aseptic meningitis and cranial nerve V or VII involvement can also be the presenting manifestations in some patients. Other neurological features include demyelinating polyneuropathy and mononeuropathy leading to wrist drop or foot drop.

A characteristic maculopapular rash on the proximal aspect of the extremities and trunk is noticed. Oral thrush, hairy leukoplakia, and aphthous ulcers may be seen on oropharyngeal examination. In addition, orogenital lesions due to herpes simplex or reactivation of herpes zoster with vesiculation can occur.

Generalized Lymphadenopathy
  • Persistent Generalized Lymphadenopathy (PGL) There is loss of normal lymph node architecture as the immune system fails with emergence from latency of HIV infection. It is marked by development of generalized lymphadenopathy.[library.med.utah.edu]
  • Findings: Acute Retroviral Syndrome Fever (low-grade Fever over 102 with rigors suggests occult infection Fatigue (70-90%) Erythematous Maculopapular Rash (40-80%) Face and Trunk Extremities involving palms and soles Headache (32-70%) Generalized Lymphadenopathy[fpnotebook.com]
Fever
  • Herein is a report of an adult case of primary HIV infection with cytomegalovirus coinfection causing cough, fever, and lymphocytic alveolitis. Primary HIV infection has not been previously reported as a cause of lymphocytic alveolitis.[ncbi.nlm.nih.gov]
  • A male homosexual presented with a skin rash, pharyngitis, fever and lymphadenopathy. The clinical symptoms were suggestive of an acute primary HIV infection. The diagnosis was confirmed serologically.[ncbi.nlm.nih.gov]
  • The patient developed a severe dilated cardiomyopathy and initially presented with global heartfailure and fever. The left ventricular function partially recovered. One week after discharge the patient was readmitted in a septic shock and died.[ncbi.nlm.nih.gov]
  • We report the case of a patient with extensive multiple organ involvement (fever, rhabdomyolysis, myocarditis, pancreatitis, bilateral renal infarcts, acute renal failure and anemia) in the setting of documented HIV seroconversion as an unusual form of[ncbi.nlm.nih.gov]
  • […] possible to recognize when you've recently contracted HIV from signs and symptoms such as fever, rash, or swollen lymph nodes.[archive.org]
Fatigue
  • Meningoencephalitis has been described as a fairly common presenting condition in PHI, with nuchal rigidity, fatigue, photophobia and headache; therefore, PHI should be considered in the differential diagnosis of aseptic meningitis.[ncbi.nlm.nih.gov]
  • […] or muscle pain, swollen lymph nodes, diarrhea, fatigue, night sweats, nausea and vomiting, headache, or genital sores.[archive.org]
  • These are usually non-specific and include fatiguability, fever, myalgia, sore throat, and skin rash with constitutional symptoms like malaise, anorexia, loss of weight, diarrhea, and tender lymphadenopathy, typically in the inguinal region.[symptoma.com]
  • […] believe that rash and fevers are the strongest predictors of primary HIV infection, especially when occurring in combination with one or more of the following symptoms: Loss of appetite Joint pain Sore throat Muscle pain Swollen lymph nodes Diarrhea Fatigue[thebody.com]
  • Clinical findings Fever, severe fatigue, sore throat, lymphadenopathy, anorexia, nausea, vomiting, and a maculopapular rash; less commonly, diarrhoea, lightning-like pain, major weight loss, abdominal cramping, palmoplantar desquamation, myalgia, arthralgia[medical-dictionary.thefreedictionary.com]
Lymphadenopathy
  • A male homosexual presented with a skin rash, pharyngitis, fever and lymphadenopathy. The clinical symptoms were suggestive of an acute primary HIV infection. The diagnosis was confirmed serologically.[ncbi.nlm.nih.gov]
  • These are usually non-specific and include fatiguability, fever, myalgia, sore throat, and skin rash with constitutional symptoms like malaise, anorexia, loss of weight, diarrhea, and tender lymphadenopathy, typically in the inguinal region.[symptoma.com]
  • Acute HIV is characterized by fever, sore throat, headache, skin rash and swollen glands (lymphadenopathy). CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE Last Editorial Review: 1/24/2017[medicinenet.com]
  • Acute HIV is characterized by fever , sore throat , headache , skin rash and swollen glands (lymphadenopathy). CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE Last Editorial Review: 1/24/2017[medicinenet.com]
  • At the emergency room, she had a temperature of 38 C, tender submandibular lymphadenopathy, disorientation, and drowsiness, with intact strength and reflexes.[thebodypro.com]
Weight Loss
  • Symptoms include rash and/or fevers, possibly in combination with one or more of the following symptoms: malaise (which is a general feeling of weakness, discomfort, and fatigue), loss of appetite, weight loss, a sore throat, sores in the mouth, joint[archive.org]
  • Clinical findings Fever, severe fatigue, sore throat, lymphadenopathy, anorexia, nausea, vomiting, and a maculopapular rash; less commonly, diarrhoea, lightning-like pain, major weight loss, abdominal cramping, palmoplantar desquamation, myalgia, arthralgia[medical-dictionary.thefreedictionary.com]
  • loss (70%) Wasting Syndrome Unexplained weight loss of 10% usual body weight V.[fpnotebook.com]
  • The common signs and symptoms associated with Acute HIV Infection include: Fever Fatigue and lethargy Loss of appetite Swollen lymph nodes (lymphadenopathy) Sore throat Weight loss Dry cough Muscle aches and muscle stiffness Headache Malaise (feeling[dovemed.com]
Infectious Mononucleosis
  • The appearance of primary HIV infection ranges from an asymptomatic presentation to a symptomatic illness resembling infectious mononucleosis.[ncbi.nlm.nih.gov]
  • Primary HIV infection normally shows an asymptomatic presentation or symptoms resembling infectious mononucleosis. However, severe unusual presentations have been reported.[ncbi.nlm.nih.gov]
  • A constellation of symptoms that most closely resembles those of acute infectious mononucleosis characterizes the syndrome. On rare occasions, opportunistic infections present simultaneously with primary HIV infection.[ncbi.nlm.nih.gov]
  • Primary infection with the human immunodeficiency virus (HIV-1) has been associated with a self-limited illness resembling acute infectious mononucleosis. Pulmonary manifestations have been notably absent in published reports.[ncbi.nlm.nih.gov]
Sore Throat
  • Topics hiv , aids , primary , infection , symptoms , test , fever , rash , lymph , nodes , fatigue , nausea , vomiting , sore , throat , mouth , genital , joint , muscle , pain , headache , night , sweat , diarrhea , loss , appetite , weight It's sometimes[archive.org]
  • Acute HIV is characterized by fever, sore throat, headache, skin rash and swollen glands (lymphadenopathy). CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE Last Editorial Review: 1/24/2017[medicinenet.com]
  • Acute HIV is characterized by fever , sore throat , headache , skin rash and swollen glands (lymphadenopathy). CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE Last Editorial Review: 1/24/2017[medicinenet.com]
  • These are usually non-specific and include fatiguability, fever, myalgia, sore throat, and skin rash with constitutional symptoms like malaise, anorexia, loss of weight, diarrhea, and tender lymphadenopathy, typically in the inguinal region.[symptoma.com]
  • Patient 1 * A 43-year-old woman presented to the emergency room with confusion, stiff neck, fever, headache, and sore throat that had lasted for over 2 weeks.[thebodypro.com]
Pharyngitis
  • A male homosexual presented with a skin rash, pharyngitis, fever and lymphadenopathy. The clinical symptoms were suggestive of an acute primary HIV infection. The diagnosis was confirmed serologically.[ncbi.nlm.nih.gov]
  • CASE DESCRIPTION: A 42-year-old Caucasian man was treated with amoxicillin-clavulanate for pharyngitis. He did not improve, and a rash developed.[archive-ouverte.unige.ch]
  • The relative frequency of symptoms has been reported as follows [ 11 ] : Main symptoms of primary HIV infection Fever 80% Rash 51% Oral Ulcers 37% Arthralgia 54% Pharyngitis 44% Loss of appetite 54% Loss of more than 2.5 kg in weight 32% Malaise 68% Myalgia[patient.info]
  • Patients with the syndrome may have fever, fatigue, rash, pharyngitis or other symptoms. Primary HIV infection should be considered in any patient with possible HIV exposure who presents with fever of unknown cause.[aafp.org]
Cough
  • Herein is a report of an adult case of primary HIV infection with cytomegalovirus coinfection causing cough, fever, and lymphocytic alveolitis. Primary HIV infection has not been previously reported as a cause of lymphocytic alveolitis.[ncbi.nlm.nih.gov]
  • During that week, he developed flu-like symptoms of fever, chills, cough, and persistent diarrhea. Three days before admission, he developed a stiff neck, headaches, confusion, and vivid nightmares.[thebodypro.com]
  • Symptoms can include: weight loss chronic diarrhoea night sweats fever persistent cough mouth and skin problems regular infections serious illness or disease. What is AIDS? It’s important to understand the difference between HIV and AIDS.[avert.org]
  • The common signs and symptoms associated with Acute HIV Infection include: Fever Fatigue and lethargy Loss of appetite Swollen lymph nodes (lymphadenopathy) Sore throat Weight loss Dry cough Muscle aches and muscle stiffness Headache Malaise (feeling[dovemed.com]
Diarrhea
  • Topics hiv , aids , primary , infection , symptoms , test , fever , rash , lymph , nodes , fatigue , nausea , vomiting , sore , throat , mouth , genital , joint , muscle , pain , headache , night , sweat , diarrhea , loss , appetite , weight It's sometimes[archive.org]
  • These are usually non-specific and include fatiguability, fever, myalgia, sore throat, and skin rash with constitutional symptoms like malaise, anorexia, loss of weight, diarrhea, and tender lymphadenopathy, typically in the inguinal region.[symptoma.com]
  • Patient 2 ** A 31-year-old bisexual man presented to the emergency department complaining of progressive headaches, confusion, myalgia, vivid nightmares, and diarrhea.[thebodypro.com]
  • […] researchers believe that rash and fevers are the strongest predictors of primary HIV infection, especially when occurring in combination with one or more of the following symptoms: Loss of appetite Joint pain Sore throat Muscle pain Swollen lymph nodes Diarrhea[thebody.com]
  • People usually notice swollen lymph nodes, fever, headache, nausea, and/or diarrhea, as well as a sore throat. Other symptoms include vomiting, joint pain (arthralgias), and sensitivity to light (photophobia).[skinsight.com]
Vomiting
  • Topics hiv , aids , primary , infection , symptoms , test , fever , rash , lymph , nodes , fatigue , nausea , vomiting , sore , throat , mouth , genital , joint , muscle , pain , headache , night , sweat , diarrhea , loss , appetite , weight It's sometimes[archive.org]
  • […] and fevers are the strongest predictors of primary HIV infection, especially when occurring in combination with one or more of the following symptoms: Loss of appetite Joint pain Sore throat Muscle pain Swollen lymph nodes Diarrhea Fatigue Nausea and vomiting[thebody.com]
  • Other symptoms include vomiting, joint pain (arthralgias), and sensitivity to light (photophobia). Men may notice open sores (ulcers) in the mouth or on the penis.[skinsight.com]
  • A less common presentation is a predominantly gastrointestinal disease, including abdominal pain, nausea, vomiting, diarrhoea, hepatitis and even gastrointestinal haemorrhage.[patient.info]
Nausea
  • Topics hiv , aids , primary , infection , symptoms , test , fever , rash , lymph , nodes , fatigue , nausea , vomiting , sore , throat , mouth , genital , joint , muscle , pain , headache , night , sweat , diarrhea , loss , appetite , weight It's sometimes[archive.org]
  • A less common presentation is a predominantly gastrointestinal disease, including abdominal pain, nausea, vomiting, diarrhoea, hepatitis and even gastrointestinal haemorrhage.[patient.info]
  • […] that rash and fevers are the strongest predictors of primary HIV infection, especially when occurring in combination with one or more of the following symptoms: Loss of appetite Joint pain Sore throat Muscle pain Swollen lymph nodes Diarrhea Fatigue Nausea[thebody.com]
  • People usually notice swollen lymph nodes, fever, headache, nausea, and/or diarrhea, as well as a sore throat. Other symptoms include vomiting, joint pain (arthralgias), and sensitivity to light (photophobia).[skinsight.com]
Loss of Appetite
  • Topics hiv , aids , primary , infection , symptoms , test , fever , rash , lymph , nodes , fatigue , nausea , vomiting , sore , throat , mouth , genital , joint , muscle , pain , headache , night , sweat , diarrhea , loss , appetite , weight It's sometimes[archive.org]
  • Some researchers believe that rash and fevers are the strongest predictors of primary HIV infection, especially when occurring in combination with one or more of the following symptoms: Loss of appetite Joint pain Sore throat Muscle pain Swollen lymph[thebody.com]
  • The relative frequency of symptoms has been reported as follows [ 11 ] : Main symptoms of primary HIV infection Fever 80% Rash 51% Oral Ulcers 37% Arthralgia 54% Pharyngitis 44% Loss of appetite 54% Loss of more than 2.5 kg in weight 32% Malaise 68% Myalgia[patient.info]
  • Symptoms of acute HIV infection can include: rash fever chills headache fatigue sore throat night sweats loss of appetite ulcers that appear in the mouth, esophagus, or genitals swollen lymph nodes muscle aches diarrhea Not all symptoms may be present[healthline.com]
Perianal Ulcer
  • Consider the diagnosis in patients presenting with a blotchy rash on the trunk or oral or perianal ulcers. Bear in mind commensural infections which can occur when the CD4 count drops rapidly - eg, oral candidiasis, shingles.[patient.info]
Left Ventricular Dysfunction
  • Current hypotheses concerning the etiology of left ventricular dysfunction in HIV infection are discussed.[ncbi.nlm.nih.gov]
Photophobia
  • Meningoencephalitis has been described as a fairly common presenting condition in PHI, with nuchal rigidity, fatigue, photophobia and headache; therefore, PHI should be considered in the differential diagnosis of aseptic meningitis.[ncbi.nlm.nih.gov]
  • Other symptoms include vomiting, joint pain (arthralgias), and sensitivity to light (photophobia). Men may notice open sores (ulcers) in the mouth or on the penis.[skinsight.com]
  • Fever, severe fatigue, sore throat, lymphadenopathy, anorexia, nausea, vomiting, and a maculopapular rash; less commonly, diarrhoea, lightning-like pain, major weight loss, abdominal cramping, palmoplantar desquamation, myalgia, arthralgia, headache, photophobia[medical-dictionary.thefreedictionary.com]
  • […] present in a variety of ways: from a mild flu like illness to a more severe constellation of complaints, including fever, fatigue, sore throat, anorexia, headaches, myalgias or arthralgias, nausea, cervical adenopathy, diarrhea, or rash. [16], [17] Photophobia[sjkdt.org]
Myalgia
  • These are usually non-specific and include fatiguability, fever, myalgia, sore throat, and skin rash with constitutional symptoms like malaise, anorexia, loss of weight, diarrhea, and tender lymphadenopathy, typically in the inguinal region.[symptoma.com]
  • It is associated with fevers, sweats, malaise, lethargy, anorexia, nausea, myalgia, arthralgia, headaches, sore throat, diarrhoea, generalised lymphadenopathy, a macular erythematous truncal eruption and thrombocytopenia.[patient.info]
  • Patient 2 ** A 31-year-old bisexual man presented to the emergency department complaining of progressive headaches, confusion, myalgia, vivid nightmares, and diarrhea.[thebodypro.com]
  • […] performed Survived [15] 42 M Myalgias, Abdominal pain, and diarrhea 63800 1480 No urine drug screen performed Survived [16] 20 M Myalgias, fever, pharyngitis, and LN 11016 462 Acute HIV/CMV coinfection Survived [17] 51 M Myalgias, emesis, and fever 32720[omicsonline.org]
Arthralgia
  • In addition, p24 antigen positivity identified recent fever, night sweats, and arthralgias as symptoms that may be predictive of recent HIV infection.[jamanetwork.com]
  • It is associated with fevers, sweats, malaise, lethargy, anorexia, nausea, myalgia, arthralgia, headaches, sore throat, diarrhoea, generalised lymphadenopathy, a macular erythematous truncal eruption and thrombocytopenia.[patient.info]
  • Other symptoms include vomiting, joint pain (arthralgias), and sensitivity to light (photophobia). Men may notice open sores (ulcers) in the mouth or on the penis.[skinsight.com]
  • Clinical findings Fever, severe fatigue, sore throat, lymphadenopathy, anorexia, nausea, vomiting, and a maculopapular rash; less commonly, diarrhoea, lightning-like pain, major weight loss, abdominal cramping, palmoplantar desquamation, myalgia, arthralgia[medical-dictionary.thefreedictionary.com]
Night Sweats
  • Night sweats were reported by 9% of the p24 antigenemic, but only 1% of the control subjects (AOR, 9.1; 95% CI, 1.7-47.6; P .009).[jamanetwork.com]
  • Topics hiv , aids , primary , infection , symptoms , test , fever , rash , lymph , nodes , fatigue , nausea , vomiting , sore , throat , mouth , genital , joint , muscle , pain , headache , night , sweat , diarrhea , loss , appetite , weight It's sometimes[archive.org]
  • Flu-like symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, or mouth ulcers. If you have these symptoms, that doesn't mean you have HIV.[wwwn.cdc.gov]
  • Flu-like symptoms can include: Fever Chills Rash Night sweats Muscle aches Sore throat Fatigue Swollen lymph nodes Mouth ulcers These symptoms can last anywhere from a few days to several weeks.[aids.gov]
  • Symptoms can include: weight loss chronic diarrhoea night sweats fever persistent cough mouth and skin problems regular infections serious illness or disease. What is AIDS? It’s important to understand the difference between HIV and AIDS.[avert.org]
Maculopapular Rash
  • On admission she presented with fever, a maculopapular rash, and moderate enlargement of nuchal lymph nodes. At that time the anti-HIV 1,2 enzyme immunoassay was negative.[ncbi.nlm.nih.gov]
  • A characteristic maculopapular rash on the proximal aspect of the extremities and trunk is noticed. Oral thrush, hairy leukoplakia, and aphthous ulcers may be seen on oropharyngeal examination.[symptoma.com]
  • rash on his trunk.[bmj.com]
  • Clinical findings Fever, severe fatigue, sore throat, lymphadenopathy, anorexia, nausea, vomiting, and a maculopapular rash; less commonly, diarrhoea, lightning-like pain, major weight loss, abdominal cramping, palmoplantar desquamation, myalgia, arthralgia[medical-dictionary.thefreedictionary.com]
Alopecia
  • Simultaneous primary infection with HIV and CMV leading to severe pancytopenia, hepatitis, nephritis, perimyocarditis, myositis, and alopecia totalis. Klin Wochenschr 1990;68 (4):237-40. 23. Ragnaud JM, Tahbaz A, Buisson M, et al.[sjkdt.org]
Exanthema
  • We describe here the clinical and histopathological picture of the exanthema. Biopsy from a papular skin lesion revealed a possibly characteristic pattern.[ncbi.nlm.nih.gov]
Headache
  • Meningoencephalitis has been described as a fairly common presenting condition in PHI, with nuchal rigidity, fatigue, photophobia and headache; therefore, PHI should be considered in the differential diagnosis of aseptic meningitis.[ncbi.nlm.nih.gov]
  • Topics hiv , aids , primary , infection , symptoms , test , fever , rash , lymph , nodes , fatigue , nausea , vomiting , sore , throat , mouth , genital , joint , muscle , pain , headache , night , sweat , diarrhea , loss , appetite , weight It's sometimes[archive.org]
  • Acute HIV is characterized by fever, sore throat, headache, skin rash and swollen glands (lymphadenopathy). CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE Last Editorial Review: 1/24/2017[medicinenet.com]
  • Acute HIV is characterized by fever , sore throat , headache , skin rash and swollen glands (lymphadenopathy). CONTINUE SCROLLING OR CLICK HERE FOR RELATED ARTICLE Last Editorial Review: 1/24/2017[medicinenet.com]
  • A headache, neck stiffness, encephalitis, aseptic meningitis and cranial nerve V or VII involvement can also be the presenting manifestations in some patients.[symptoma.com]
Peripheral Neuropathy
  • BACKGROUND: Peripheral neuropathy (PN) is a frequent complication of chronic HIV infection.[ncbi.nlm.nih.gov]
  • neuropathy, all symptoms remit, and reappear as AIDS after a latency of up to several years.[medical-dictionary.thefreedictionary.com]
  • Laboratory data often reveal thrombocytopenia, lymphopenia, and elevated hepatic transaminase levels. [17] Neurological complications such as aseptic meningitis, peripheral neuropathy, Guillian-Barre syndrome and facial nerve palsies as well as opportunistic[sjkdt.org]
  • Neuropathy Facial palsy Guillain-Barre Syndrome Brachial Neuritis Cognitive Impairment Psychosis Malaise Anorexia Weight loss (70%) Wasting Syndrome Unexplained weight loss of 10% usual body weight V.[fpnotebook.com]
  • neuropathy Myelopathy Dermatological symptoms Erythematous maculopapular rash Mucocutaneous ulceration The rash is a symmetrical maculopapular erythematous exanthem that involves face, palms and soles as well as trunk and limbs.[dermnetnz.org]
Lethargy
  • It is associated with fevers, sweats, malaise, lethargy, anorexia, nausea, myalgia, arthralgia, headaches, sore throat, diarrhoea, generalised lymphadenopathy, a macular erythematous truncal eruption and thrombocytopenia.[patient.info]
  • The common signs and symptoms associated with Acute HIV Infection include: Fever Fatigue and lethargy Loss of appetite Swollen lymph nodes (lymphadenopathy) Sore throat Weight loss Dry cough Muscle aches and muscle stiffness Headache Malaise (feeling[dovemed.com]
Neck Stiffness
  • A headache, neck stiffness, encephalitis, aseptic meningitis and cranial nerve V or VII involvement can also be the presenting manifestations in some patients.[symptoma.com]
Foot Drop
  • Other neurological features include demyelinating polyneuropathy and mononeuropathy leading to wrist drop or foot drop. A characteristic maculopapular rash on the proximal aspect of the extremities and trunk is noticed.[symptoma.com]

Workup

The diagnosis of primary HIV infection can be challenging. A high index of suspicion in those at risk e.g. intravenous drug users, sex workers, men who have sex with men, transgender individuals and those indulging in unprotected intercourse with multiple sexual partners, is essential to diagnose the condition. A detailed history and thorough physical, oropharyngeal, and neurological examination will provide clues to the presence of the infection. Oral candidiasis, hairy leukoplakia, herpes lesions and aphthous ulcers can be diagnosed clinically. Scrapings from oral ulcers for detection of fungal hyphae and a Tzanck test can also be performed to confirm candidal and herpetic infection respectively.

A complete blood count may indicate anemia and thrombocytopenia while a rapid viral load test typically shows an elevated level of HIV along with a decrease in CD4 count. Enzyme-linked immunoglobulin M (IgM) assays help to detect HIV within 23 to 25 days after the initial infection [1] [5] [6] and p24 antigen can be detected within 20 to 30 days [1]. If the initial test is negative, then a second test can be ordered within three months [7].

Testing for drug resistant strains is recommended if HIV infection is detected [8]. In patients with persistent lymphadenopathy, serology tests for cytomegalovirus and Epstein-Barr virus should be performed. If liver transaminases are elevated, hepatitis A, B, and C infection should be ruled out with serological tests.

Gliosis
  • CONCLUSIONS: Early in HIV infection, increases of Cho/Cr and MI/Cr in treatment-naive participants suggest progressive inflammation and gliosis in the frontal white matter and parietal gray matter, which is attenuated after initiation of ART.[ncbi.nlm.nih.gov]

Treatment

  • Primary end points were (1) viral set point, defined as the plasma viral load 36 wk after randomization in the no treatment arm and 36 wk after treatment interruption in the treatment arms, and (2) the total time that patients were off therapy, defined[ncbi.nlm.nih.gov]
  • Early treatment had a modest positive effect on the quality of the CD4 T-cell response.[ncbi.nlm.nih.gov]
  • And to investigate whether treatment initiation time, treatment duration and follow-up time after treatment interruption would affect these post-treatment immunovirological outcomes.[ncbi.nlm.nih.gov]
  • HIV-1 RNA and CD4 lymphocytes in patients with transient treatment were compared to those in untreated patients.[ncbi.nlm.nih.gov]
  • Most guidelines recommend antiretroviral treatment in patients who are symptomatic, although the indication for treatment remains inconclusive in asymptomatic patients.[ncbi.nlm.nih.gov]

Prognosis

  • Those with more prolonged illness tend to have a poorer prognosis [ 10 ].[patient.info]
  • Those with more prolonged illness tend to have a poorer prognosis [ 10 ] .[patient.info]
  • AIDS Transmission AIDS Treatment AIDS Prognosis History of AIDS AIDS Stigma[news-medical.net]
  • Expectations (prognosis) There is no cure for HIV infection or AIDS. However, appropriate treatment can dramatically improve the length and quality of life for persons infected with HIV, and can delay the onset of AIDS.[ufhealth.org]
  • […] levels may be elevated Baseline labs prior to starting medications Serum Creatinine Serum Glucose Lipid profile (affected by Protease Inhibitor s) Urinalysis HIV Staging labs CD4 Count Best marker of HIV-related immunosuppression, infection duration and prognosis[fpnotebook.com]

Etiology

  • Current hypotheses concerning the etiology of left ventricular dysfunction in HIV infection are discussed.[ncbi.nlm.nih.gov]
  • The lack of an alternative etiology, despite extensive investigations, suggests that this ulcer was directly caused by primary HIV infection.[archive-ouverte.unige.ch]
  • Infectious etiologies of rhabdomyolysis: 3 case reports and review. Clin Infect Dis 1996;22(4):642-9. 27. Holt S, Moore K. Pathogenesis of renal failure in rhabdomyolysis: The role of myoglobin. Exp Nephrol 2000;8(2):72-6.[sjkdt.org]
  • Luck RP, Verbin S (2008) Rhabdomyolysis: a review of clinical presentation, etiology, diagnosis, and management. Pediatr Emerg Care 24: 262-268. Singh U, Scheld WM (1996) Infectious etiologies of rhabdomyolysis: three case reports and review.[omicsonline.org]
  • (Etiology) HIV infection is caused by the human immunodeficiency virus (HIV), a virus that gradually destroys the immune system. Acute HIV Infection occurs 2-4 weeks after infection with the virus.[dovemed.com]

Epidemiology

  • @gmail.com. 3 INSERM, U1018, Epidemiology of HIV and STI, CESP; University Paris-Sud, Le Kremlin-Bicêtre, France. remonie.seng@inserm.fr. 4 Department of Public Health and Epidemiology, Bicêtre Hospital, AP-HP, Le Kremlin Bicêtre, France. remonie.seng[ncbi.nlm.nih.gov]
  • Michael Greiner, fellow for infectious diseases and hospital epidemiology • Dr. med.[en.infektiologie.usz.ch]
  • Author information 1 Department of Infectious Disease Epidemiology, Imperial College London, St.[ncbi.nlm.nih.gov]
  • Objective: To further define the clinical and epidemiologic presentation of primary HIV infection. Design: Descriptive cohort study. Setting: University research clinic.[annals.org]
  • However, the case also illustrates a very important epidemiological aspect: Sexually transmitted diseases are clearly known to increase both susceptibility and infectivity for HIV.[infekt.ch]
Sex distribution
Age distribution

Pathophysiology

  • The aetiology, pathophysiology, diagnosis, and treatment of ADEM is reviewed, and the sparse existing literature on ADEM and HIV infection is discussed.[ncbi.nlm.nih.gov]
  • Acute rhabdomyolysis and renal failure in HIV-infected patients: risk factors, presentation, and pathophysiology. AIDS Patient Care STDS 2000;14(10):541-8. 6. Hare CB, Vu MP, Grunfeld C, Lampiris HW.[sjkdt.org]
  • Joshi MK, Liu HH (2000) Acute rhabdomyolysis and renal failure in HIV-infected patients: risk factors, presentation, and pathophysiology. AIDS Patient Care STDS 14: 541-548.[omicsonline.org]

Prevention

  • The lack of association between SBR and viral load among MSM supports use of treatment-as-prevention as part of diversified prevention strategies.[ncbi.nlm.nih.gov]
  • BACKGROUND: Risk-reduction counselling is a standard preventive intervention, but behaviour change is difficult to sustain over the duration of HIV infection.[ncbi.nlm.nih.gov]
  • PURPOSE OF REVIEW: This review will discuss the role of antiretroviral therapy to treat primary HIV infection (PHI) as a strategy to prevent onward viral transmission.[ncbi.nlm.nih.gov]
  • These findings can inform behavioral interventions in communities of at-risk MSM and secondary prevention efforts among those already living with HIV.[ncbi.nlm.nih.gov]
  • When primary prevention for HIV infection is less than 100% effective, secondary prevention should incorporate undiagnosed HIV-positive individuals into counseling, testing, and treatment programs to reduce transmission to partners.[grantome.com]

References

Article

  1. Fiebig EW, Wright DJ, Rawal BD, et al. Dynamics of HIV viremia and antibody seroconversion in plasma donors: implications for diagnosis and staging of primary HIV infection. AIDS. 2003; 17:1871–9.
  2. Cohen MS, Shaw GM, McMichael AJ, Haynes BF. Acute HIV-1 infection. N Engl J Med 2011; 364:1943 –54.
  3. Pilcher CD, Eron JJ Jr, Galvin S, Gay C, Cohen MS. Acute HIV revisited: new opportunities for treatment and prevention. J Clin Invest. 2004 Apr; 113(7):937-45.
  4. Zetola NM, Pilcher CD. Diagnosis and management of acute HIV infection. Infect Dis Clin North Am. 2007 Mar; 21(1):19-48, vii.
  5. Robb ML. Viral dynamics and immune response in acute infection and their impact on viral set-point. In: AIDS Vaccine 2012 Conference. Boston, United States of America, 11 September 2012
  6. Busch MP, Lee LL, Satten GA, et al. Time course of detection of viral and serologic markers preceding human immunodeficiency virus type 1 seroconversion: implications for screening of blood and tissue donors. Transfusion. 1995; 35 :91 –7
  7. South African National AIDS Council. HIV Counselling and Testing (HCT) Policy Guidelines, 2010. http://www.sanac.org.za/resources/doc_download/2-department-of-health-hct-policy-guidelines . Accessed 19 April 2017.
  8. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. January 10, 2011; 1-174. Available at http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf. Accessed: April 20, 2017.

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Last updated: 2018-06-22 01:36