Year: 2004
Type: review
Abstract: Review series Acute HIV infectionThe natural history of HIV infection encompasses an acute/primary phase that lasts months, followed by an early/clinically latent phase that typically lasts 3-10 years, and ultimately by the immune collapse characterized by AIDS."Acute" HIV infection best describes the interval during which HIV can be detected in blood serum and plasma before the formation of antibodies routinely used to diagnose infection.During this time, high levels of viremia and shedding at mucosal sites can be demonstrated, because HIV replication is unrestrained by immune responses.Approximately 30 days after infection, early virus-specific immune responses are mounted, with subsequent reduction of viremia.After 4-6 months, viral and host factors combine to determine a new pseudo-steady state of viremia (or virologic "set point") for each patient, heralding the beginning of the long clinical latency experienced by patients infected by HIV.Recognition of acute HIV infection is important for several reasons.First, acute HIV provides a unique view of HIV transmission and pathogenesis, including early host-virus interactions that require further study.Second, prevention strategies directed at subjects with acute HIV infection may have great impact.Third, very early recognition may allow for HIV treatment that could alter the natural history of disease, or even eliminate infection. Acute HIV revisited: new possibilities for early detectionDespite infection of nearly 60 million individuals worldwide with HIV, fewer than 1,000 cases have been diagnosed in the first month of infection, primarily because of a lack of a specific and recognizable acute retroviral syndrome.About half of people with acute HIV infection develop headache, fever, myalgias, anorexia, rash, and/or diarrhea (1-3) after an incubation period of around 14 days (1, 4-6).Symptoms are generally minor and last days to weeks (1).Genital or oral ulcers may be present, and coinfections with other sexually transmitted pathogens (e.g., herpes simplex virus, gonorrhea, syphilis, hepatitis viruses) are common (2, 7-9).The latter observation suggests common cotransmission of HIV and other sexually transmitted disease (STD) pathogens.
DOI: 10.1172/jci21540
Institution: University of North Carolina at Chapel Hill
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: bronze
Funders: U.S. Department of Health and Human Services, North Carolina Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources
OpenAlex ID: W2142118075