PRIMARY HIV (ACUTE HIV)
Onset 9-30 days from time of transmission; Duration 1-3 wks- Dx important because highly infectious
- Mono-like Syndrome: Fever, malaise, adenopathy, sore throat, rash, myalgias/arthralgias, headache
- Aseptic Meningitis: Headache, Fever, Facial Palsy
- HIV-antibody (EIA) usually negative (“Window Period”)
- EIA Seroconverts:
- 50% by 1 mo., 95% by 3 mos, >99% by 6 mos
- 4th Generation EIA + p24 Antigen can convert by 18 days (viral load still best test)
See also Primary HIV and HIV Rashes.
SCREENING
Screen all persons 13-64 y.o. at least once- Opt-out; no counseling or consent forms
ASYMPTOMATIC PERIOD — CLINICAL CLUES
1. Unusual Lymphadenopathy • Posterior Cervical • Posterior Auricular • Epitrochlear • Sub-occipital • Axillary • NOT inguinal 2. Certain Symptoms • Recurrent Fevers/Sweats • Weight Loss • Chronic Diarrhea 3. Certain Medical Conditions • Recurrent Staph infections, Vaginal Yeast, bacterial sinusitis/pneumonia • Active TB • Non-Hodgkin Lymphoma • Invasive Cervical CA • Herpes Zoster (shingles) if <50 y.o. 4. Oral Lesions • Thrush • Hairy Leukoplakia • Kaposi’s • Severe Gingivitis Pictures: HIV — Oral Lesions 5. Unusual Rashes • Seborrheic Derm (severe) • Eosinophilic Folliculitis (very itchy) • Kaposi’s Sarcoma • Other unusual rashes Pictures: HIV — Rashes 6. Subtle Incidental Laboratory Findings That Warrant HIV Testing- Lymphopenia on CBC: Abs Lymphys <1,000 (ballpark guide)
- Thrombocytopenia: Platelet count <100,000
- Elevated Globulins (>4.0) see Calculating Serum Globulins
- HDL Cholesterol <25 [ballpark guide]
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