[Primary HIV infection: an update]

Acute HIV infection is a frequently symptomatic event. Presenting as a mononucleosis-like disease with fever, lymphadenopathy, myalgias, rash and headache, it is insufficiently identified. Since acute HIV infection is associated with high viral loads it is important to diagnose patients with this entity, in order to prevent transmission. An evolution towards AIDS can happen more rapidly according to length and severity of the symptoms, but it is still controversial whether very early therapy during acute seroconversion is beneficial on the long-run. Randomised controlled trials of early short-term antiretroviral treatment versus deferred therapy are both ethically justifiable and necessary.