How to recognize and treat acute HIV syndrome

The diagnosis of acute human immunodeficiency virus (HIV) syndrome requires a high index of suspicion and proper laboratory testing. Patients with the syndrome may have fever, fatigue, rash, pharyngitis or other symptoms. Pri mary HIV infection should be considered in any patient with possible HIV ex posure who presents with fever of unknown cause. The diagnosis is based on a positive HIV-1 RNA level (more than 50,000 copies per mt) in the absence of a positive enzyme-linked immunosorbent antibody assay (ELISA) and confir matory Western blot antibody test for HIV. Early diagnosis permits patient education as well as treatment that may delay disease progression. Triple-c ombination antiretroviral therapy should be started immediately and continu ed indefinitely. Compliance with medication regimens is essential to maximi ze benefit and discourage the development of viral resistance.