Acute Infection by HIV - Acute Retroviral Syndrome

Acute HIV infection, also called acute retroviral syndrome is a flu-like frame, which appears 2 to 4 weeks after the patient has been infected with HIV.


Not all newly infected with HIV patients have an acute stage, and many of which have the form nonspecifically with symptoms similar to those of any one of several common respiratory viruses to humans.


Since the mid-1980s we know that new patients infected with HIV may develop a similar picture to the flu or mononucleosis after the first contact with the virus.

Acute HIV infection is an entirely different picture of AIDS. This acute infection usually occurs between two to four weeks after infection and is caused by the rapid multiplication of the virus in the body. While AIDS is an immunodeficiency above, the result of years of destruction of the immune system by HIV infection, acute retroviral syndrome is caused by the rapid multiplication of HIV in the early days of contamination.

It is believed that the majority of individuals infected by HIV present some sort of acute infection during the first weeks, however, due to the fact that many had apparently common respiratory symptoms, similar to a cold, this acute retroviral syndrome can pass more or less unnoticed.

In general, when directly questioned, the newly diagnosed patient with HIV can remember an infectious syndrome that occurred 2 or 3 weeks after a risky behavior. Many even report having sought medical care to help control the symptoms. When the patient is not aware of having had a risk behavior, he usually sees the symptoms of the acute phase only as a stronger flu.


The HIV virus is the causative agent of serious disease called acquired immunodeficiency syndrome, better known as AIDS or AIDS abbreviations.

AIDS is a disease that arises due to the relevant part of the destruction of our immune system by the virus, mainly the defense cells called CD4 + T lymphocytes. As this process occurs slowly and gradually, usually the symptoms of AIDS comes only after a few years of HIV infection.

The HIV virus is unable to multiply yourself. To survive in an organism, HIV invades the CD4 + T lymphocytes, changes the normal operation thereof, and then inject their genetic material, making these cells are transformed into "zombie" HIV virus producer. Over time, these zombies lymphocytes die, causing their CD4 + cell count full fall. The patient infected by HIV becomes susceptible to a variety of infections because the majority of their CD4 + cells or destroyed or are destroyed, serving only as a "factory" virus.

When HIV enters comes into contact with our bodies for the first time, he finds a rich medium in CD4 + T lymphocytes and poor in specific antibodies against itself. As a result, in the first weeks of infection, HIV multiplies rapidly in, causing great destruction of CD4 + T lymphocytes. In the acute phase period, the patient has a high virus load in blood and a low CD4 + T lymphocyte count.

Over the days, however, the immune system can fight back using specific antibodies against HIV and other immune cells, such as T-CD8 + cytotoxic lymphocytes. As a result, tumbles viral load and number of CD4 + T lymphocytes starts to increase. At this time the patient stops feeling the symptoms of acute HIV infection.

In general, the above acute infection of HIV takes 7 to 14 days to disappear. Patients who have more difficulty in controlling this initial viral multiplication, presenting symptoms for more than 14 days, are those who will develop AIDS earlier, usually within the first 3 years after contamination.


The risk of an infected person transmitting HIV to a partner or partner is directly proportional to the viral load in the blood. In males, for example, the amount of virus in semen increases as the amount of virus in the blood rises.

As the phase of acute HIV infection is a period of high viral load, contaminated patient is highly contagious at this time. In general, the peak infectivity occurs between the 5th and 6th day of symptoms of acute retroviral syndrome. In patients without symptoms of acute infection, the peak infectivity usually around the 20th day after contamination.


Studies show that about 90% of newly infected patients with HIV will experience some kind of viral infection symptoms. Because the symptoms are very unspecific, in some cases it is difficult to know whether the patient had was really an acute HIV infection or just a common virus whatsoever.

In general, the symptoms appear between 2nd and 4th weeks after the contamination, but may take up to a few months to appear. The most common signs and symptoms of acute retroviral syndrome are fever (between 38°C and 40°C), fatigue, muscle pain, red spots on the skin (rash), enlarged lymph nodes, sore throat and diarrhea. The next table shows the results of scientific work in 2008 followed about 380 patients with acute HIV infection.

The rash acute phase of HIV usually mainly affect the upper body and face. The members, including the palms and soles of the feet may also be affected. Lesions are usually multiple, reddish, small (about 1 cm in diameter) and oval. Some of them may have some relief. Itching is unusual. The rash appears, in general, on the 2nd or 3rd day of symptoms and lasts about 5 days.

Pharyngitis may be just like a viral pharyngitis, with intense pain and redness. Usually, there is pus in the tonsils, but this is not a rule.

The palpable lymph nodes are usually painless and occur more often in the neck. Other sites, however, are also possible, such as the neck, armpits and groin area (groin). In general, the lymph nodes appear later, only in the last days of symptoms.

Other signs and symptoms may be present are anemia, weight loss (up to 5 kg), loss of appetite, nausea and vomiting.

Two signs are not very common, but which also appear, they speak much in favor of acute retroviral syndrome are painful oral ulcers (may also occur on the genitalia or anus) and oral candidiasis.

In most cases, the symptoms last 7 to 10 days and disappear spontaneously. After the acute stage, the patient enters the latent phase of the disease, a symptom-free period that can last several years.

Patients with symptoms of acute phase for more than 14 days, or have a very aggressive table, with several of the symptoms described above, usually have worse prognosis with increased risk of having a short latent phase and evolve early to AIDS.


The most modern HIV tests, such as ELISA 4th generation are already able to detect the virus in its acute phase. The viral counts can also be performed, and usually have high values (> 100,000 copies/ml). A + T-CD4 lymphocyte count usually shows low values during the acute phase. In common blood count, anemia may be the values of lymphocytes and leukocytes tend to be low.



Until recently, treatment with antiretroviral cocktail was only offered to patients with clinical and laboratory criteria of HIV immunodeficiency. The latest approach, however, indicates treatment for ALL HIV patients who want to treat, regardless of the disease stage and its immune status.

Patients with acute HIV infection who begin treatment with antiretroviral cocktails have a lower risk of contamination of partners and increased free period of symptoms, decreasing the chance of progression to AIDS.