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treating acute infection
May 14, 2003

Dr., I had a one-time high-risk exposure 2 weeks ago. Since then I've had just about every symptom. Some have gone away (cough, sore throat, mouth sores fading, mild night sweats) some are still present (diarhea, weight loss/increased metabolism, enlarged lymph nodes in my armpits). In short, I've self diagnosed myself, because there is simply no other explanation--I know I have it. Is a psoitive PCR test a sure sign of HIV? Also, could you give me some advice as to starting treatment in the acute infection stage, or waiting (maybe for a new drug) until later. I have gotten the impression from people at the tseting clinics that there's no advantage to treating the acute stage. Thank you for your time.

Response from Dr. Young

Thank you for your question.

Firstly, it is essential for a number of reasons to establish if you do have HIV infection. Having a number of symptoms is not sufficient to know if you're infected. As such, getting tested (both a HIV antibody test and viral load, or PCR) is the only way to establish the diagnosis of acute HIV infection. Persons who have acute infection will have a negative or indeterminate antibody test and a positive viral load.

I'm not sure which testing clinics you're talking to, but in most major treatment centers (including ours and others in Colorado), persons with acute HIV infection are counseled about the possible benefits of initiation of treatment and are uniformly offered therapy.

While it is not absolutely concrete, nor mandatory, there is an increasing body of scientific evidence of long-term benefit to the immune system if therapy is started within the first weeks of infection.

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