Viral infections in HIV disease

DEFINITION/OVERVIEW Acute HIV infection, also known as acute retroviral syndrome (ARS) and seroconversion illness, is the period from the initial infection with HIV to complete seroconversion. It is often subclinical and asymptomatic, and therefore may escape diagnosis. Symptomatic ARS is a transient illness that is associated with robust HIV replication followed by an expansive immunologic response to the virus.1 The estimated incidence of symptomatic primary HIV infection ranges from 25% to 75%.2,3 ARS has been described in all populations at risk for HIV infection: Homosexual men, heterosexual men and women, recipients of contaminated blood, recipients of organs from infected donors, and those acquiring HIV from accidental occupational exposure and contaminated body fluids.4 Acute HIV infection is a period of extreme infectiousness, and the occurrence and severity of symptoms during ARS may correlate with the severity of clinical decline. It has been shown that early identification and treatment of patients with ARS may preserve immune function. Therefore, timely recognition of the ARS is imperative for patients and for public health as it allows for early initiation of antiviral therapy and prevention of subsequent transmission.