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Abstract:
The following cases illustrate the complexities involved in recognizing and correctly diagnosing primary HIV infection (PHI). Extensive lab work, but also thorough history taking, is required. Patient 1 was not recognized as suffering from PHI until after she was discharged from the hospital. Patient 2 was recognized with PHI, and his symptoms spontaneously resolved. Patient 3 required extensive hospitalization because of pulmonary complications. Viral loads declined sharply without medication for both patients 1 and 2, upon resolution of symptoms. However, patient 3 maintained a high viral load and was started on triple-drug antiretroviral therapy. None of the patients were started on antiretroviral therapy during the acute retroviral syndrome phase of PHI, which is currently recommended in US treatment guidelines.