RT Journal Article
SR Electronic
T1 Primary HIV infection: a medical and public health emergency requiring rapid specialist management
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 180
OP 183
DO 10.7861/clinmedicine.16-2-180
VO 16
IS 2
A1 Sarah Fidler
A1 Julie Fox
YR 2016
UL http://www.rcpjournals.org/content/16/2/180.abstract
AB Primary HIV infection (PHI) refers to the first six months following HIV acquisition and represents a unique opportunity for expedited diagnosis, and consideration of rapid antiretroviral therapy (ART) initiation to improve immune function, reduce the size of the viral reservoir and limit the risk of onward viral transmission. Failure to diagnose and rapidly treat individuals with PHI has significant individual and public health implications. The Strategic Timing of AntiRetroviral Treatment trial recently identified a clinical benefit of immediate ART over deferral of treatment according to CD4 count threshold, and has led to rapid changes in World Health Organization and specialist national guidelines. For all individuals living with HIV, the offer of immediate therapy irrespective of CD4 count is now recommended. This paper summarises the presentation and management of PHI, incorporating current research and guideline changes and discusses the role of PHI in onward transmission.