Characteristics of Acute HIV-1 Infection

To elucidate early events in HIV-1 infection that may underlie pathogenesis, investigators recruited volunteers in East Africa and Thailand who were at high risk for HIV-1 infection. Participants underwent twice-weekly HIV-1 RNA testing (NAT) on finger stick samples. Those with positive HIV-1 RNA underwent additional testing and evaluation twice weekly for 4 weeks.

Among 2276 initially HIV-negative participants, 112 had acute HIV-1 infection, of whom 50 had two or more enzyme immunoassay–negative/HIV-1 NAT–reactive samples and a sample before HIV infection, and had not started antiretroviral therapy during acute infection. Among these 50 patients, median time between the last negative sample and the first positive NAT was 4 days; peak viremi…