Recognizing Acute HIV Syndrome

Recognizing Acute HIV Syndrome

When Flu Symptoms May Not Be the Flu

Across the country, a very dangerous scenario takes place each day. In emergency departments and family practice offices people are presenting with such symptoms as fever, head ache, muscle and joint aches, sore throat, rash and diarrhea. In response to these symptoms, physicians diagnose the flu and send the patient on their way. In the majority of cases, their diagnosis proves correct. But unfortunately, a number of those people with these vague, indistinct symptoms have a much more serious illness than the flu. For some, these symptoms signal the acute stages of HIV infection.

What is Acute HIV Syndrome?

Acute HIV syndrome was initially described as a flu or mononucleosis-like illness affecting gay men. Since those early years of HIV, acute HIV syndrome can now be identified in 30-50% of newly HIV infected individuals during seroconversion. During the initial period of infection, HIV replication is very rapid. As the level of HIV in the blood rises, it begins to attack the immune system, catching it off guard so to speak, and weakening it to the point of causing symptoms. Because of its similarity to common illnesses such as influenza or mononucleosis, the diagnosis of acute HIV syndrome is often missed and the patient is sent home unaware that they have a serious illness that can do great harm to themselves and others. Medical professionals have a responsibility to properly identify this syndrome for two very important reasons.

Why is Identifying Acute HIV Important?

* First and foremost, an early diagnosis of HIV provides the first opportunity to appropriately counsel patients in regard to preventing the spread of the disease. Being unaware of an HIV infection increases the possibility of an infected person unknowingly spreading the disease to others by way of unsafe sexual practices or the sharing of needles. In addition, an early diagnosis allows early medical intervention that has been shown to be a positive influence on the course of HIV throughout a person's lifetime.

* Secondly, acute HIV syndrome represents a brief opportunity to control the dissemination of HIV throughout the body. This early spread of the virus greatly affects the course of the disease and sets immune system damage into motion. One school of thought is that early intervention with antiretroviral medications can limit the initial spread of HIV, thus allowing the body's immune system to stay healthier longer and therefore remaining better able to fight the disease.

How is acute HIV syndrome diagnosed?

Simply put, without testing there is no diagnosis. Medical professionals must recognize the symptoms of acute HIV and be aware of the possibility of HIV infection in anyone who presents with vague symptomology and known risks to HIV exposure. For instance, the wife of a known injectable drug user presents to the Emergency Room with a rash, fever, diarrhea and fatigue. Recognizing the patient's potential exposure to HIV by way of unprotected sex with her husband, the medical provider should counsel and test the patient for HIV before a diagnosis of flu or another common illness is made.

What Needs to be Done?

]Some estimates show that a third of all HIV infected persons are unaware of their infection. Its not hard to see what a huge impact this fact can have on HIV transmission and the health of those infected. All one has to do is look to Africa to see the potential effects of being unaware. Steps must be taken to diagnose HIV as quickly as possible. These steps include:

* The medical community has to make a concerted effort to train its members how to recognize acute HIV syndrome and what to do once it is diagnosed.

* Emergency Rooms across the country must turn their back on conventional thinking and allow for rapid HIV testing in their departments.

* Family practice and primary care physicians must build referral resources that provide HIV testing and counseling.

We have the ability to fight HIV, we just need to know it's there.