Acute HIV seroconversion illness presenting as African viral haemorrhagic fever

Both human immunodeficiency virus type 1 (HIV-1) and African viral haemorrhagic fever (VHF) viruses cause similar symptoms in acutely infected individuals and must be included in the differential diagnosis in areas where HIV-1 and VHF viruses both occur.

To determine the cause of an acute illness in a patient at risk of exposure to both HIV-1 and African VHF viruses.

Serological examination revealed the presence of high levels of the p24 core antigen of HIV-1 in the absence of antibodies to HIV-1 in a specimen collected during the acute stage of the infection. On follow-up, the antigen enzyme-linked immunosorbent assay (ELISA) became negative while the antibody ELISA and confirmatory Western blot for HIV-1 became positive.

Acute HIV seroconversion illness may have protean manifestations and, in the more severe forms, may cause diagnostic dilemmas, particularly in regions where African VHFs occur.