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Primary HIV Infection: Clinical Presentation, Testing, and Treatment
Aurélia Henn1,2, Clara Flateau1, Sébastien Gallien3,4
1Service d'immunologie clinique et maladies infectieuses, CHU Henri Mondor, APHP, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Creteil, France.
Current Infectious Disease Reports
|September 9, 2017
Summary
Primary HIV infection (PHI) often presents as flu-like symptoms. Early antiretroviral treatment (ART) during PHI is crucial for preventing transmission and improving long-term health outcomes.
Area of Science:
- Infectious Diseases
- Virology
- Immunology
Background:
- Primary HIV infection (PHI) is the earliest stage of HIV infection.
- PHI often manifests with non-specific, flu-like symptoms, mimicking acute retroviral syndrome in 65-95% of cases.
- Symptomatic PHI is linked to accelerated clinical and immunological disease progression.
Purpose of the Study:
- To present current data on the clinical presentation, diagnosis, and treatment of primary HIV infection (PHI).
Main Methods:
- This review synthesizes current literature on PHI.
- Data on diagnostic accuracy and treatment efficacy were analyzed.
Main Results:
- Point-of-care tests show lower sensitivity for PHI detection compared to fourth-generation immunoassays, particularly with tenofovir prophylaxis.
- Early initiation of antiretroviral treatment (ART) during PHI significantly reduces HIV transmission and limits viral and immunological reservoir establishment.
- Recommended ART regimens include tenofovir/emtricitabine combined with darunavir/ritonavir or dolutegravir.
Conclusions:
- Starting ART during PHI offers substantial clinical, virological, immunological, and public health advantages.
- Early ART in PHI may enhance opportunities for future functional HIV cure by minimizing reservoir formation.
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