Primary HIV infection (PHI) is the clinical syndrome associated with the development of HIV antibodies.
PHI occurs in 80% of individuals 2 to 4 weeks after HIV infection. Therefore suspect if high-risk exposure within 2 months and if clinical symptoms include any of the following:
Rarer presentations include aseptic meningitis, weight loss or an AIDS-defining infection such as PJP.
Serological HIV antibody test 4th generation or combo test (HIV Ab with page 24 Ag)
If initial test negative & you suspect PHI it is essential to bring back in 7 days for a repeat test.
Note: a second negative HIV test at one week confidently excludes that particular clinical presentation as a seroconversion illness, a 3 month window period test is still needed to exclude asymptomatic seroconversion.
Secondary syphilis, other acute viral infections (EBV/ CMV/ HSV)
Patients may rarely require admission for symptom control, discuss with a senior doctor.
Some symptoms associated with seroconversion may need HIV treatment.
Abstain from all sex until results are known (consider highly infections).
These guidelines are based on review of current literature, current recommendations of the United States Centers for Disease Control and Prevention, World Health Organization, the British Association for Sexual Health and HIV and local expert opinion.
They are written primarily for use by Adelaide Sexual Health Centre staff and some flexibility is required in applying them to certain private practice situations.
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