Acute human immunodeficiency virus infection

Shao-Tsung Huang¹, Hsin-Chun Lee^1,2, Kung-Hung Liu¹, Nan-Yao Lee¹, Wen-Chien Ko^1,2
1Division of Infectious Diseases, Department of Internal Medicine and ²Department of Medicine, National Cheng Kung University, Tainan, Taiwan

Received: March 15, 2004 Revised: June 1, 2004 Accepted: June 10, 2004

Corresponding author: Wen-Chien Ko, Department of Internal Medicine, National Cheng Kung University Hospital, No. 138, Sheng Li Road, Tainan 704, Taiwan. E-mail:

Human immunodeficiency virus type 1 (HIV-1) infection has a broad spectrum of clinical manifestations, ranging from asymptomatic seroconversion to a severe symptomatic illness resembling infectious mononucleosis or other medical conditions including hepatitis, meningoencephalitis, or pneumonitis. Without clinical alertness, the illness is usually misdiagnosed or even not considered. Here we report 3 cases of acute HIV-1 infection with either a negative HIV-1 antibody assay or an indeterminate Western blot result, but high plasma levels of HIV-1 RNA. The initial presentations included fever, skin rash, sore throat, neck lymphadenopathy, cough and headache. One patient presented with infectious mononucleosis-like illness, 1 with aseptic meningitis, and 1 with acute tonsillitis. Physicians should be alert to the possibility of acute HIV-1 infection, especially in cases with unexplained fever, lymphadenopathy or rash.

Key words: Acute disease, case reports, HIV infections, HIV seronegativity, signs and symptoms

J Microbiol Immunol Infect 2005;38:65-68.