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Primary HIV Infection

April 2004


What Is Primary HIV Infection?

Primary HIV infection is the period of a few weeks or months after a person becomes infected with HIV. During this time a person may have symptoms that resemble the flu or mono (mononucleosis). During primary HIV infection a person will not test positive using standard HIV antibody tests (ELISA) even though he or she is infected.


How Do I Know if I Have Primary HIV Infection?

Most people (up to 90%) with primary HIV infection have symptoms, usually 2 to 6 weeks after becoming infected with HIV. These symptoms are generally referred to as "acute retroviral syndrome."


What Are the Most Common Symptoms of Primary HIV Infection?

Primary HIV infection can have a variety of different symptoms. Some researchers believe that rash and fevers are the strongest predictors of primary HIV infection, especially when occurring in combination with one or more of the following symptoms:


Does Everyone Have These Symptoms?

Some people will become infected with HIV and have no symptoms. However, most people do have symptoms.


How Severe Will the Symptoms Be?

Some people have symptoms so severe that they go to the emergency room. Others will have mild symptoms.


If I Think I'm Experiencing Primary HIV Infection, What Should I Do?

Primary HIV infection is a medical emergency. You should seek prompt medical attention from a doctor who specializes in treating HIV. If you don't have a private doctor or medical insurance, you should seek prompt attention from a local public health clinic. Ask to see a doctor who specializes in HIV or infectious diseases. Tell the doctor if you have had unsafe sex or shared needles so he or she may be alerted to run the appropriate blood tests.


How Will My Doctor Determine If I Have Primary HIV Infection?

A doctor can check your blood for certain proteins that are produced by HIV. The test for these proteins is called the p24 antigen test. Also, a doctor can check for HIV in the blood by doing a viral load test.


Are These Tests Easy to Get? Are the Results Reliable?

A p24 antigen test is cheap and easy to get but is not completely reliable. The test may fail to detect up to 25% of persons who are infected with HIV. A viral load test is more expensive but more reliable. There is a small chance (less than 3%) that a viral load test may give you a false positive.


What Happens If My Doctor Says I Have Primary HIV Infection?

Your doctor may discuss the possibility of starting HIV medications immediately. Treating HIV during this period will not cure you. Some research indicated that treatment during this window of time might help your immune system stay intact and better equipped to fight HIV. Some people treated during this period were even able to control HIV later without drugs. However, the effects did not last in these small studies and no overall benefits could be demonstrated for the patients. The verdict is still out on treatment during primary HIV infection. More research in this area is needed. Given that most HIV medications have side effects and toxicities, you and your doctor should decide when is the best time to start taking medications to fight HIV.


How Is Primary HIV Infection Treated?

Usually with 3 HIV drugs, the same way a person who has been infected a long time is treated.


What Are the Risks of This Treatment?

You may have side effects. Also, you may develop resistance to the drugs if you do not take them at the right times and in the correct doses. Even though treatment during primary HIV infection may preserve your immune system, it has not been proven to help you live longer.


What About Sex During Primary HIV Infection?

You are extremely infectious during primary HIV infection. Sex and any other behaviors that place other people at risk for HIV infection should be avoided during this time. You may be infectious even before your symptoms begin. If possible, you should notify sexual partners and others who you might have exposed so that they may get immediate medical attention.


Where Can I Call for More Information, or for a Referral to a Physician Who Specializes in HIV?

You can call The Center for AIDS at (713) 527-8219 or toll free at (888) 341-1788.




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