Acute and early HIV infection: Pathogenesis and epidemiology
- Paul E Sax, MD
Paul E Sax, MD
- Clinical Director, Division of Infectious Diseases
- Brigham and Women's Hospital
- Professor of Medicine
- Harvard Medical School
In 1985, the first description of acute human immunodeficiency virus (HIV) infection, a "mononucleosis-like" illness, was published based upon the clinical records of 12 men with documented seroconversion to HIV during the preceding six months; 11 of these individuals experienced a remarkably similar illness . Since that time, larger studies have described the clinical and laboratory features of acute and early HIV infection.
With the advent of more specific diagnostic testing, particularly HIV RNA detection, and more active drug regimens, early aggressive therapy during early HIV infection has become an option. (See "Techniques and interpretation of HIV-1 RNA quantitation" and "Selecting antiretroviral regimens for the treatment-naïve HIV-infected patient".)
The pathogenesis and epidemiology of acute and early HIV will be reviewed here. The clinical manifestations, diagnosis, and treatment of early HIV infection are discussed separately. (See "Acute and early HIV infection: Clinical manifestations and diagnosis" and "Acute and early HIV infection: Treatment".)
Different terms, including acute, recent, primary, and early HIV infection, have been used in the literature to refer to variable intervals following initial infection with the virus. In this topic, we use the term "early HIV infection" to refer to the approximate six-month period following HIV acquisition. We use the term "acute HIV infection" to refer to symptomatic early infection, as this reflects common usage in clinical care.
HIV has several targets including dendritic cells, macrophages, and CD4+ T cells.
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