REVIEW – April 2009

Primary HIV infection: a case report


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Primary HIV infection (PHI) occurs in 40–90% of recently infected individuals as a transient symptomatic illness, often as a mononucleosis-like syndrome. The most common symptoms include fever, maculopapular rash, oral ulcers and lymphadenopathy. The symptomatic phase of PHI lasts from 7 to 10 days and diagnosis is based on detection of HIV replication in the absence of HIV antibodies (not yet present at an early stage). The decision to initiate antiretroviral treatment depends on the condition of the patient.  This case describes a 30-year-old man with PHI. The patient presented a 5-day history of fever and signs of intestinal infection. Despite appropriate treatment, he developed a mononucleosis-like syndrome. The serological markers for the HIV antigen were positive and PHI was suspected (HIV RNA viral load was >1000000 copies/ml). He admitted having unprotected sex with an occasional partner 1 month earlier.
In conclusion, at present testing for HIV infection should be recommended for all adults seeking medical attendance.