Acute HIV infection: diagnosis and management in the emergency department

Acute human immunodeficiency virus (HIV) infection, also known as primary HIV infection, is the initial phase of infection, spanning from inoculation to the establishment of CD4 count and viral load set points. This phase is marked by dynamic changes in viral replication and host immune responses and contains 2 important clinical events: acute retroviral syndrome and seroconversion. Acute HIV infection is challenging to diagnose, but with recent improvements in diagnostic testing and a heightened awareness of acute HIV, the emergency physician is well positioned to make this diagnosis and initiate important interventions for the individual patient and public health.