Diagnosing acute HIV infection

Abstract

Individuals with acute HIV infection (AHI) pose a greater transmission risk than most chronically HIV-infected patients and prevention efforts targeting these individuals are important for reducing the spread of HIV infection. Rapid and accurate diagnosis of AHI is crucial. Since symptoms of AHI are nonspecific, its diagnosis requires a high index of suspicion and appropriate HIV laboratory tests. However, even 30 years after the start of the HIV epidemic, laboratory tools remain imperfect and only a few individuals with AHI are identified. We review the clinical presentation of the acute retroviral syndrome, the laboratory markers and their detection methods, and propose an algorithm for the laboratory diagnosis of AHI.

Keywords::

• acute HIV infection
• diagnosis
• primary infection
• retroviral syndrome

Acknowledgements

The authors thank Laurent Kaiser and Rosemary Sudan for their help in the preparation of the manuscript.

Financial & competing interests disclosure

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

AHI: Acute HIV infection; EIA: Enzyme immunoassay.

AHI: Acute HIV infection; EIA: Enzyme immunoassay; ER: Emergency room.

EIA: Enzyme immunoassay.