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[Acute retroviral syndrome].
L Thompson1, A Schönfeldt, M Salcedo
1Servicio de Urgencia, Clínica Santa María, Santiago, Chile.
Revista Medica De Chile
|January 1, 1991
Summary
Early HIV infection may present as a mononucleosis-like illness. Testing for HIV p24 antigen is crucial for diagnosing acute retroviral syndrome in high-risk individuals, even with negative antibody tests.
Area of Science:
- Virology
- Immunology
- Infectious Diseases
Background:
- Acute retroviral syndrome (ARS) is the earliest stage of HIV infection.
- ARS symptoms can mimic other viral illnesses, complicating early diagnosis.
- Accurate diagnosis of ARS is vital for patient management and public health.
Observation:
- A 37-year-old male presented with a 20-day febrile illness including headache, anorexia, lymphadenopathy, and splenomegaly.
- During the acute phase, p24 antigen was detected, but HIV antibodies were negative.
- The patient recovered and later tested positive for HIV antibodies.
Findings:
- A retrospective diagnosis of acute retroviral syndrome was established.
- The case highlights the diagnostic challenge in differentiating ARS from infectious mononucleosis, CMV, measles, rubella, toxoplasmosis, and influenza.
- Positive HIV antigenemia (p24) preceded seroconversion.
Implications:
- Investigate HIV antigenemia in patients with mononucleosis-like syndromes, especially those in high-risk groups for AIDS.
- Consider ARS even if serological tests for Epstein-Barr virus (EBV) are positive.
- Early diagnosis of HIV infection through antigen testing can improve patient outcomes and prevent transmission.