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Diagnosis of Acute HIV Infection: It's Time To Get Moving!

Timothy Flanigan, MD; and Karen T. Tashima, MD
[+] Article, Author, and Disclosure Information

Drs. Flanigan and Tashima: Brown University School of Medicine; Providence, RI 02906

Grant Support: In part by the Lifespan/Tufts/Brown Center for AIDS Research (NIH P30-A142853) and AIEDRP (NIH AI 41534).

Requests for Single Reprints: Karen T. Tashima, MD, Miriam Hospital/Brown University, 164 Summit Avenue, Providence, RI 02906.

Current Author Addresses: Drs. Flanigan and Tashima: Miriam Hospital/Brown University, 164 Summit Avenue, Providence, RI 02906.

Ann Intern Med. 2001;134(1):75-77. doi:10.7326/0003-4819-134-1-200101020-00017
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Despite dramatic advances in the treatment of HIV infection and the resultant decrease in deaths from AIDS, new HIV infections continue to occur among Americans at a relatively steady rate of 40 000 to 45 000 per year (1). More than 90% of cases of acute HIV infection go undiagnosed despite the fact that more than 50% of persons with the disease are symptomatic (2). Although many of these symptomatic patients seek medical attention at emergency departments, urgent care centers, and primary care offices, they often receive the true but highly misleading diagnosis of “viral syndrome” and are told to go home, take aspirin and plenty of fluids, and call if the symptoms do not resolve. Usually, the symptoms do resolve. Acute infection occasionally has severe sequelae, which may include neurologic syndromes (such as meningitis or myelopathies) or opportunistic infections caused by profound decreases in CD4 cell count (such as Pneumocystis carinii pneumonia [3] or Candida esophagitis).

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