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.

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