Primary (Acute) HIV

Incubation period:    9-30 days from time of transmission

• Symptom duration 1-3 weeks
• Diagnosis Important:  patient highly infectious up to 4 months

Signs & Symptoms

 

Mononucleosis-like syndrome (usual presentation)

• Very Common:  Fever, malaise, fatigue
• Very Common:  Generalized Adenopathy (posterior cervical, occipital, axillary, epitrochlear)
• Common:  Rash (generalized maculopapular), Pharyngitis, Arthralgias/Myalgias, Headache
• Less Common:  Diarrhea, Oral/Genital Ulcers, Nausea/Vomiting

Aseptic Meningitis (Not often seen)

• Headache,Fever
• Facial Palsy (often bilateral) may occur up to 3 wks after the above

Diagnosis:     HIV RNA (Viral Load) extremely high (>100,000 copies/mL

• HIV-antibody (EIA) usually negative (“Window Period”)
• Lower Viral Loads (e.g. 20,000) suggest long-standing HIV
• Extremely-low V.L  (e.g. 250) suggests false-positive

HIV-Antibody Seroconversion after moment of infection:

• 1 month:  50%
• 3 months:  95%
• 6 months:  >99%

Monospot may be false-positive in Primary HIV

See postings Sore Throat – 2 [pictures of rash], and Sore Throat – 1.