Primary HIV Infection: Expect the Unexpected

Typical manifestations of primary HIV infection (PHI) include a flu- or mononucleosis-like syndrome, including fever, pharyngitis, rash, or oral ulcers. To determine how frequently patients present with atypical findings, investigators in Switzerland analyzed clinical manifestations in patients with PHI who enrolled in a prospective cohort.

Typical manifestations of acute retroviral syndrome (ARS) were defined as fever plus ≥1 of 17 symptoms or signs (determined by review of the PHI literature) or, in the absence of fever, ≥2 findings. Atypical ARS was defined as lack of any symptoms or signs, presence of a single symptom or sign, unusual clinical manifestations, or occurrence of an opportunistic condition.

Of 290 participants, 271 (93%) were…