Fact Sheet Number 103
- WHAT IS ACUTE HIV INFECTION?
- TESTING FOR ACUTE HIV INFECTION
- RISK OF INFECTING OTHERS
- TREATING ACUTE HIV INFECTION
- PROS AND CONS OF TREATING ACUTE HIV
- THE BOTTOM LINE
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PrintHIV INFECTION?
The amount of HIV in the blood gets very high within a few days
or weeks after HIV infection. Some people get a flu-like illness.
This first stage of HIV disease is called “acute infection.”
About half of the people who get infected don’t notice anything.
Symptoms generally occur within 2 to 4 weeks. The most common
symptoms are fever, fatigue, and rash. Others include headache,
swollen lymph glands, sore throat, feeling achy, nausea, vomiting,
diarrhea, and night sweats.
It is very easy to overlook the signs of acute HIV infection.
They can be caused by several different illnesses. If you have
any of these symptoms and if there is any chance that you were
recently exposed to HIV, talk to your doctor about getting tested
for HIV.
HIV INFECTION
The normal HIV blood test will come back negative for someone
who was infected very recently. The test looks for antibodies
produced by the immune system to fight HIV. It can take two months
for these antibodies to be produced. See fact
sheet 102 for more information.
However, the viral load test
(see fact sheet 413) measures the virus itself. Before the
immune system produces antibodies to fight it, HIV multiplies
rapidly. Therefore, this test will show a high viral load during
acute infection.
A negative HIV antibody test and a very high viral load indicate
recent HIV infection, most likely within the past two months.
If both tests are positive, then HIV infection probably occurred
a few months or longer before the tests.
RISK OF INFECTING OTHERS
The number of HIV particles in the blood is much higher during
acute HIV infection than later on. Exposure to the blood of someone
in the acute phase of infection is more likely to result in infection
than exposure to someone with long-term infection. One research
study estimated that the risk of infection is approximately 20
times higher during acute infection.
HIV INFECTION
At first, the immune system produces white blood cells that recognize
and kill HIV-infected cells. This is called an “HIV-specific
response.” Over time, most people lose this response. Unless
they use antiviral medications, their HIV disease will progress.
Guidelines for using HIV medications recommend waiting until
the immune system shows signs of damage. However, starting anti-HIV
drugs during acute infection might protect the HIV-specific immune
response.
Preliminary research suggests that treatment during acute infection
might protect the immune system enough so that it can control
HIV without drugs. Researchers have studied people who start treatment
during acute infection and then stop taking antiviral drugs. In
a few cases, their immune systems controlled HIV without medications.
OF TREATING ACUTE HIV
Starting antiviral medications is a major decision. Anyone thinking
about taking anti-HIV drugs should carefully consider the benefits
and disadvantages.
Taking antiviral drugs changes your daily life. Missing doses
of drugs makes it easier for the virus to develop resistance to
medications, which limits future treatment options. Fact
Sheet 416 has more information about the importance of taking
anti-HIV medications correctly.
The medications are very strong. They have side effects that
can be difficult to live with for a long time, and they can be
very expensive.
Early treatment can protect the immune system from damage by
HIV. Immune damage shows up as lower T-cell counts and higher
viral loads. These are associated with higher rates of disease.
Older people (over 40 years old) have weaker immune systems. They
do not respond as well as younger people to antiviral drugs.
However, not everyone with HIV gets sick right away. Someone
with a T-cell count over 350 and a viral load under 20,000, even
if they don’t take antiviral drugs, has about a 50/50 chance of
staying healthy for 6 to 9 years. Fact
Sheet 412 has more information on T-cell
tests, and Fact Sheet 413
has information on the viral load.
The most important benefit of early treatment is the possibility
of discontinuing antiviral medications after a period of controlling
HIV. However, research on this topic is in very early stages.
It’s not easy to identify people with acute HIV infection. Some
people have no symptoms. If symptoms do occur, several diseases
like the flu might cause them.
If you think you might be in the acute stage of HIV infection,
tell your doctor and get tested. There may be a real advantage
to starting antiviral treatment during acute HIV infection.
Taking anti-HIV medications is a major commitment. Discuss
the pros and cons of treatment with your doctor and consider them
carefully before making any decisions.
Revised August 5, 2002
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New Mexico AIDS Education and Training Center
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