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Acute Hiv Infection

Overview

An infection caused by the human immunodeficiency virus (HIV) that gradually destroys the immune system.

Primary or acute HIV infection is a condition that occurs 2 to 4 weeks after infection by the HIV virus. The virus, called human immunodeficiency virus or HIV, is spread by intimate sexual contact, injection drug use in which contaminated needles and syringes are used, contaminated blood transfusions and blood products, through the placenta from the mother to the fetus, and rarely through breastfeeding.

Acute HIV infection can resemble infectious mononucleosis, flu, or other virual syndromes. Typical symptoms include fever, headache, fatigue, and swollen lymph nodes. People may also experience aching muscles and a rash that occurs anywhere on the body and may change locations. These symptoms may last from a few days to 4 weeks, and then subside.

After an infection with HIV, antibodies to the virus can be detected in the blood. This is called seroconversion. HIV seroconversion (converting from HIV negative to HIV positive) usually occurs within 3 months of exposure, but on rare occasions may occur up to a year after exposure.

Following the acute infection, there may be no further evidence of illness for the next decade.

Acute HIV infection can, but does not always, progress to early symptomatic HIV infection and to advanced HIV disease (AIDS).

It cannot be assumed that all people infected with HIV will inevitably progress to AIDS, but time has shown that the vast majority do. To date there are a small number of people who have unquestionably tested positive for HIV, but no longer test positive and have absolutely no signs of disease. These numbers are extremely small, but they provide evidence that the human body may be capable of eliminating the disease. These people are being carefully watched and studied.

HIV has spread throughout the United States and other countries. Higher concentrations of the disease are found in large metropolitan centers, inner cities, and among certain populations with high-risk behaviors.


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Causes

Primary or acute HIV infection is a condition that occurs 2 to 4 weeks after infection by the HIV virus. The virus, called HumanImmunodeficiency Virus or HIV, is spread by intimate sexual contact, IV drug use where contaminated "paraphernalia"(needles and syringes) is used, contaminated blood transfusions and blood products, through the placenta from the mother tothe fetus, and rarely through breast feeding.Acute HIV infection can resemble infectious mononucleosis or other viral flu syndromes. Typical symptoms include fever,headache, fatigue, and swollen lymph nodes . People may also experience aching muscles (myalgia) and a rash that occursanywhere on the body and may change locations (transient, generalized rash). These symptoms may last from a few days to twoweeks, and then subside.After an infection with HIV, antibodies to the virus can be detected in the blood. This is called seroconversion. HIVseroconversion (converting from HIV negative to HIV positive) usually occurs within 3 months of exposure, but on rareoccasions may occur up to a year after exposure.Following the acute infection there may be no further evidence of illness for the next 2 to 5 years. After 5 years, approximatelyone-fourth of the infected people will have progressed to the next stage of illness, known as ARC or AIDS-Related Complex.Acute HIV infection can, but does not always, progress to chronic symptomatic HIV infection and advanced HIV diseases orAIDS . In a study of people infected with the virus from 1977 through 1980, some have no signs or symptoms of HIV infection(asymptomatic HIV infection) , and some have only enlarged lymph nodes (generalized lymphadenopathy) . It cannot beassumed that all people infected with HIV will inevitably progress to AIDS, but time has shown that the vast majority do. Todate there are a small number of people who have unquestionably tested positive for AIDS but no longer test positive and haveabsolutely no signs of disease. These numbers are extremely small but provide evidence that the human body may be capable ofeliminating the disease. These people are being carefully watched and studied.HIV has spread throughout the U.S. and other countries. Higher concentrations of the disease are found in large metropolitancenters, inner city areas, and among certain high-risk populations such as IV drug users, bisexual and homosexual men, andhemophiliacs. The HIV infection rate is increasing more quickly among blacks and Hispanics than among Caucasians. The rateamong women is also increasing rapidly.It is estimated that 1 out of every 200 people carries the HIV virus (not all exhibit symptoms).


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Signs & Symptoms

At the time of diagnosis with the HIV infection, many people have not experienced symptoms.

Acute HIV infection can appear like infectious mononucleosis, flu, or other viral illnesses.

Any of the following symptoms can occur:

Decreased appetite
Fatigue
Fever
Headache
Malaise
Swollen lymph glands
Muscle stiffness or aching
Rash
Sore throat
Ulcers of the mouth and esophagus
These symptoms can last from a few days to 4 weeks, and then subside.

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Prevention

For a comprehensive discussion see the prevention section in AIDS .Safer sex behaviors may reduce the risk of acquiring the infection. There is a risk of acquiring the infection even if "safe sex" ispracticed. Abstinence is the only sure way to prevent sexual transmission of the HIV virus.General guidelines:- Do not have sexual intercourse with persons known or suspected to be infected with AIDS, numerous partners, any personwho has multiple partners, or people who use IV drugs.- Do not use intravenous drugs. If IV drugs are used, do not share needles or syringes.- People with AIDS or who have had positive antibody tests may pass the disease on to others and should not donate blood,plasma, body organs, or sperm. Do not exchange body fluids (including saliva) during sexual activity.

HIV is a long-term medical condition that can be treated but not yet cured. There are effective means of preventing complications and delaying (but not preventing) progression to AIDS. At the present time, not all cases of HIV have progressed to AIDS, but time has shown that the vast majority do.


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Treatments
Self-care and Education Psychotherapy

People with HIV infection need to be educated about the disease and its treatment so they can be active partners in making decisions with their health care provider.

There is still controversy about whether aggressive early treatment of HIV infection with HIV medications will slow the progression of disease. You should discuss this option with your health care provider.

Follow these healthy practices in the early stages of HIV infection:

Avoid exposure to people with acute infectious illnesses.
Avoid settings and situations that could lead to depression. Maintain positive social contacts, hobbies, interests, and pets.
Eat a nutritious diet with enough calories.
Get enough exercise, but don't wear yourself out.
Keep stress to a minimum.
Practice safer sex. The disease is highly transmissible, especially in the first months after infection.

You can often reduce the stress of illness by joining a support group where members share common experiences and problems. See AIDS - support group.

 

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