Overcoming the challenge of diagnosis of early HIV infection: a stepping stone to optimal patient management

Abstract

Prompt identification of individuals during the highly infectious acute or early stage of HIV infection has implications for both patient management and public health interventions. The studies on natural history of HIV infection over the last three decades have uncovered several clinical features and virological markers to diagnose early infection. However, the brevity of the acute symptomatic phase combined with the difficulty in identifying non-specific signs and symptoms poses diagnosis of early HIV infection as a remaining challenge. Furthermore, underestimation of risky behavior in the absence of detailed patient history and possible concurrent sexually transmitted infections render the diagnosis of recent infection difficult. Herein, we focus on the multifaceted clinical manifestations and the best usage of technological advancements to detect early HIV infection. Early diagnosis of HIV infection contributes to further improving patient outcomes and preventing transmission.

Keywords:

• antiretroviral therapy
• early HIV diagnosis
• early HIV Infection
• HIV transmission
• immunoassays
• primary HIV Infection

Acknowledgements

The authors acknowledge Angie Massicotte for coordination and assistance and Kishanda Vyboh and Alexandra Averback for a critical reading.

Financial & competing interests disclosure

This work was supported by the Fonds de la Recherche Québec-Santé (FRQ-S): Thérapie cellulaire and Réseau SIDA/Maladies infectieuses, Canadian Institutes of Health Research (grants MOP 103230 and CTN 257), the Canadian Foundation for AIDS Research (CANFAR; grant 023-512), and the Canadian HIV Cure Enterprise Team Grant HIG-133050 from the CIHR in partnership with CANFAR. JP Routy is the holder of Louis Lowenstein Chair in Hematology & Oncology, McGill University. W Cao is supported by CTN postdoctoral fellowship award and V Mehraj is supported by FRQ-S postdoctoral fellowship award. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Notes