eMedicine Specialties > Infectious Diseases > HIV

Early Symptomatic HIV Infection: Follow-up

Author: Robert J Carpenter, DO, Fellow in Infectious Diseases, Infectious Diseases Clinic, Naval Medical Center San Diego
Coauthor(s): Braden R Hale, MD, MPH, Assistant Clinical Professor, Department of Internal Medicine, University of California at San Diego; Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Naval Medical Center at San Diego; Kirk M Chan-Tack, MD, Fellow, Division of Infectious Disease, University of Maryland School of Medicine; John Bartlett, MD, Chief of Division of Infectious Diseases, Chief of HIV Care Service, Professor, Department of Internal Medicine, Johns Hopkins University School of Medicine
Contributor Information and Disclosures

Updated: Jun 9, 2009

Follow-up

Further Inpatient Care

Most of the conditions involved in early symptomatic human immunodeficiency virus (HIV) infection can be treated in an outpatient setting. Decisions for inpatient care are made on a case-by-case basis. Patients infected with HIV should be cared for by providers with expertise in HIV infection because this has been shown to decrease patient morbidity and to extend patient lifespan.

Inpatient & Outpatient Medications

See Medication.

Prognosis

Early symptomatic HIV infection encompasses several diseases. Patients classified under this term are a heterogeneous group, with widely varying clinical problems and prognoses. Generally, HIV infection carries an excellent prognosis in most patients who are cared for by a provider who is experienced in HIV medicine.

Patient Education

  • Counsel patients extensively about the course of HIV illness, therapeutic options, health maintenance issues (eg, immunizations, abstinence, safer-sex practices, informing sexual partners about HIV diagnosis), and the range of conditions that can occur at each stage on the HIV continuum. Close follow-up care with providers who have expertise in treating patients infected with HIV is essential.
  • For excellent patient education resources, visit eMedicine's Immune System Center, Sexually Transmitted Diseases Center, and Teeth and Mouth Center. Also, see eMedicine's patient education articles HIV/AIDS, Rapid Oral HIV Test, Oral Herpes, and Canker Sores.

Miscellaneous

Medicolegal Pitfalls

  • Failure to identify patients who are at risk for human immunodeficiency virus (HIV) infection: One of the goals of this article is to remind clinicians that the numerous conditions discussed may be harbingers of HIV infection. A high index of clinical awareness is essential. A growing body of literature supports routine testing for HIV.
 


More on Early Symptomatic HIV Infection

Overview: Early Symptomatic HIV Infection
Differential Diagnoses & Workup: Early Symptomatic HIV Infection
Treatment & Medication: Early Symptomatic HIV Infection
Follow-up: Early Symptomatic HIV Infection
References
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References

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  2. Zetola NM, Pilcher CD. Diagnosis and management of acute HIV infection. Infect Dis Clin North Am. Mar 2007;21(1):19-48, vii. [Medline].

  3. Truong HM, Grant RM, McFarland W, Kellogg T, Kent C, Louie B. Routine surveillance for the detection of acute and recent HIV infections and transmission of antiretroviral resistance. AIDS. Nov 14 2006;20(17):2193-7. [Medline].

  4. Pilcher CD, Fiscus SA, Nguyen TQ, Foust E, Wolf L, Williams D. Detection of acute infections during HIV testing in North Carolina. N Engl J Med. May 5 2005;352(18):1873-83. [Medline].

  5. Bettaieb A, Fromont P, Louache F, et al. Presence of cross-reactive antibody between human immunodeficiency virus (HIV) and platelet glycoproteins in HIV-related immune thrombocytopenic purpura. Blood. Jul 1 1992;80(1):162-9. [Medline].

  6. Mylonakis E, Paliou M, Lally M, et al. Laboratory testing for infection with the human immunodeficiency virus: established and novel approaches. Am J Med. Nov 2000;109(7):568-76. [Medline].

  7. Streeck H, Jessen H, Alter G, Teigen N, Waring MT, Jessen A. Immunological and virological impact of highly active antiretroviral therapy initiated during acute HIV-1 infection. J Infect Dis. Sep 15 2006;194(6):734-9. [Medline].

  8. Hecht FM, Wang L, Collier A, Little S, Markowitz M, Margolick J. A multicenter observational study of the potential benefits of initiating combination antiretroviral therapy during acute HIV infection. J Infect Dis. Sep 15 2006;194(6):725-33. [Medline].

  9. Fidler S, Fox J, Touloumi G, Pantazis N, Porter K, Babiker A. Slower CD4 cell decline following cessation of a 3 month course of HAART in primary HIV infection: findings from an observational cohort. AIDS. Jun 19 2007;21(10):1283-91. [Medline].

  10. Strategies for Management of Antiretroviral Therapy (SMART) Study Group, Emery S, Neuhaus JA, Phillips AN, Babiker A, Cohen CJ, et al. Major clinical outcomes in antiretroviral therapy (ART)-naive participants and in those not receiving ART at baseline in the SMART study. J Infect Dis. Apr 15 2008;197(8):1133-44. [Medline].

  11. US Department of Health and Human Services. National Institutes of Health. NIH News. Starting Antiretroviral Therapy Earlier Yields Better Clinical Outcomes. June 8, 2009. [Full Text].

  12. Aberg JA, Gallant JE, Anderson J, et al. Primary care guidelines for the management of persons infected with human immunodeficiency virus: recommendations of the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. Sep 1 2004;39(5):609-29. [Medline].

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Further Reading

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Keywords

early symptomatic HIV infection, acute HIV infection, acute retroviral syndrome, HIV seroconversion illness, HIV seroconversion syndrome, immune reconstitution inflammatory syndrome, human immunodeficiency virus, HIV, viral infection, immunologic impairment, immunocompromise, pre-acquired immune deficiency syndrome, pre-AIDS, thrush, oral hairy leukoplakia, herpes simplex virus, HSV, varicella-zoster virus, VZV, shingles, herpes zoster, thrombocytopenia, acute inflammatory demyelinating polyneuropathy, mononeuritis multiplex, myopathy, persistent generalized lymphadenopathy, PGL, oral lesions, anemia, aseptic meningitis, aphthous ulcers

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Contributor Information and Disclosures

Author

Robert J Carpenter, DO, Fellow in Infectious Diseases, Infectious Diseases Clinic, Naval Medical Center San Diego
Robert J Carpenter, DO is a member of the following medical societies: American College of Osteopathic Internists, American College of Physicians, American Osteopathic Association, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Coauthor(s)

Braden R Hale, MD, MPH, Assistant Clinical Professor, Department of Internal Medicine, University of California at San Diego; Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Naval Medical Center at San Diego
Braden R Hale, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, Armed Forces Infectious Diseases Society, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Kirk M Chan-Tack, MD, Fellow, Division of Infectious Disease, University of Maryland School of Medicine
Kirk M Chan-Tack, MD is a member of the following medical societies: American College of Physicians, American Medical Association, Christian Medical & Dental Society, Physicians for Social Responsibility, and Southern Medical Association
Disclosure: Nothing to disclose.

John Bartlett, MD, Chief of Division of Infectious Diseases, Chief of HIV Care Service, Professor, Department of Internal Medicine, Johns Hopkins University School of Medicine
John Bartlett, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Clinical Pharmacology, American College of Physicians, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, American Thoracic Society, American Venereal Disease Association, Association of American Physicians, Infectious Diseases Society of America, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Medical Editor

Fred A Lopez, MD, Associate Professor and Vice Chair, Department of Medicine, Assistant Dean for Student Affairs, Louisiana State University School of Medicine
Fred A Lopez, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, Infectious Diseases Society of America, and Louisiana State Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Joseph F John Jr, MD, FACP, FIDSA, FSHEA, Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center
Disclosure: BioMerieux Honoraria Review panel membership; Cubist Honoraria Review panel membership; Pfizer Honoraria Speaking and teaching; Merck Stock dividends stock holdings

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Ronald A Greenfield, MD, Professor, Department of Internal Medicine, Section of Infectious Diseases, University of Oklahoma College of Medicine
Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology
Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Wyeth Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubist  Speaking and teaching

 
 
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