Clinical presentation and diagnosis of primary HIV-1 infection

Abstract

More numerous and severe primary HIV-1 infection symptoms predict more rapid disease progression. Pooled HIV-1 RNA screening and fourth generation HIV-1 enzyme immunoassay antibody tests with sensitive p24 antigen detection are beginning to be implemented in routine HIV-1 testing algorithms, but further research is needed to define optimal strategies for increasing detection of primary HIV-1 infection.

Short Communication: New HIV Infections at Southern New England Academic Institutions: Implications for Prevention

“…Acute infection was defined as a negative enzyme-linked immunosorbent assay (ELISA) and detectable RNA at presentation, or positive ELISA and indeterminate Western blot. 16 Recent, nonacute HIV infection was defined as seroconversion within 6 months as evidenced by a current positive ELISA and negative, 6 month prior ELISA, or patient-reported clinical syndrome consistent with acute retroviral syndrome in the prior 6 months 15,16 (including fever, lymphadenopathy, pharyngitis, rash, myalgias, and/or arthralgias [17][18][19][20]. PHI was defined as acute or recent infection.…”

Early Treatment in HIV Patients: A Cost–Utility Analysis from the Italian Perspective

“…As outlined in the guidelines of the Italian Ministry of Health, the earlier start of the therapy is not only justified by a better prognosis linked to a better tolerability of regimens, immune reconstitution and a reduced incidence of AIDS-and non-AIDS-related events [15][16][17], as demonstrated in this study, it is also justified by a sound effectiveness of resource allocation.…”

“…The guidelines of the Italian Ministry of Health indicate that an earlier start to therapy involves a better diagnosis for the single patient, linked to a better tolerability of regimens, immune reconstitution and a reduced incidence of AIDS-and non-AIDS-related events [15][16][17].…”

HIV-1 RNA testing of pooled dried blood spots is feasible to diagnose acute HIV infection in resource limited settings

“…4,5,21,22 Patients treated during acute infection are also ideal candidates for curative interventions as early therapy prevents immune damage and limits seeding of reservoirs. 23,24 According to the 2012 Human Science Research Council South African National HIV Prevalence, Incidence and Behaviour Survey, the overall HIV incidence in 2 -49-year-old individuals was 1.07%. However, as the epidemic is generalised, it is difficult to define risk groups, apart from a higher incidence among young black female survey participants.…”