Acute HIV-1 Infection: A Call to Action
Authors: Mathias Lichterfeld, Eric S. Rosenberg
Journal: Annals of Internal Medicine (2013)

Ideas and OpinionsSeptember 17, 2013Acute HIV-1 Infection: A Call to ActionMathias Lichterfeld, MD, PhD and Eric S. Rosenberg, MDMathias Lichterfeld, MD, PhDFrom Massachusetts General Hospital, Boston, Massachusetts.Search for more papers by this author and Eric S. Rosenberg, MDFrom Massachusetts General Hospital, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-6-201309170-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail An estimated 50 000 persons in the United States are newly infected with HIV-1 each year, but the diagnosis of acute infection is infrequently considered and rarely made. Commonly encountered infectious syndromes, such as Epstein–Barr virus mononucleosis, influenza, or streptococcal pharyngitis, mimic the classic presentation of acute HIV-1 infection and often confound the diagnosis. Before the advent of fourth-generation combination HIV-1 antigen and antibody testing, results of standard screening tests were typically negative in patients with acute infection because of the absence of detectable HIV-1 antibody characteristic of this period.When Should Acute HIV-1 Be Considered, and How Is the Diagnosis ...References1. Kahn JO and Walker BD. Acute human immunodeficiency virus type 1 infection. N Engl J Med. 1998;339:33-9. [PMID: 9647878] CrossrefMedlineGoogle Scholar2. Schacker T, Collier AC, Hughes J, Shea T, and Corey L. Clinical and epidemiologic features of primary HIV infection. Ann Intern Med. 1996;125:257-64 LinkGoogle Scholar3. Hecht FM, Busch MP, Rawal B, Webb M, Rosenberg E, Swanson M, et al. Use of laboratory tests and clinical symptoms for identification of primary HIV infection. AIDS. 2002;16:1119-29. [PMID: 12004270] CrossrefMedlineGoogle Scholar4. Le T, Wright EJ, Smith DM, He W, Catano G, Okulicz JF, et al. 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Grijsen ML, Steingrover R, Wit FW, Jurriaans S, Verbon A, Brinkman K, et al. Primo-SHM Study Group. No treatment versus 24 or 60 weeks of antiretroviral treatment during primary HIV infection: the randomized Primo-SHM trial. PLoS Med. 2012;9:1001196. [PMID: 22479156] CrossrefMedlineGoogle Scholar9. Hogan CM, Degruttola V, Sun X, Fiscus SA, Del Rio C, Hare CB, et al. A5217 Study Team. The setpoint study (ACTG A5217): effect of immediate versus deferred antiretroviral therapy on virologic set point in recently HIV-1-infected individuals. J Infect Dis. 2012;205:87-96. [PMID: 22180621] CrossrefMedlineGoogle Scholar10. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. HPTN 052 Study Team. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493-505. [PMID: 21767103] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Mathias Lichterfeld, MD, PhD; Eric S. Rosenberg, MDAffiliations: From Massachusetts General Hospital, Boston, Massachusetts.Grant Support: Dr. Lichterfeld is supported by grants AI098487 and AI093203 from the National Institutes of Health. Dr. Rosenberg is supported by grant AI071915 from the National Institutes of Health.Disclosures: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0403.Corresponding Author: Eric S. Rosenberg, MD, Massachusetts General Hospital, Infectious Disease Division, Gray J-504, 55 Fruit Street, Boston, MA 02114; e-mail, [email protected].Current Author Addresses: Drs. Lichterfeld and Rosenberg: Massachusetts General Hospital, Infectious Disease Division, Gray J-504, 55 Fruit Street, Boston, MA 02114.Author Contributions: Conception and design: E.S. Rosenberg.Drafting of the article: M. Lichterfeld, E.S. Rosenberg.Critical revision of the article for important intellectual content: E.S. Rosenberg.Final approval of the article: M. Lichterfeld, E.S. Rosenberg. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics September 17, 2013Volume 159, Issue 6Page: 425-427KeywordsAdverse reactionsAntigensAntiretroviral therapyAntiretroviralsBlood cellsClinical trialsEpstein-Barr virusFeversHIVHIV-1Nucleic acidsResearch laboratoriesSigns and symptomsStreptococcal infectionsStreptococcal pharyngitisT cellsViral loadViral transmission and infectionViremia ePublished: 17 September 2013 Issue Published: September 17, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...