People who develop symptoms two to four weeks after they contract the STD may experience a primary HIV infection. Scientists refer to this medical condition as an acute retroviral syndrome, as well.

After the individual develops antibodies against the virus, the syndrome may abate. The physiopathology behind this initial state is the virus's rapid multiplication. Our immune system usually fights other types of infections that we acquire throughout our lives, like the common flu, for example.

However, we cannot fight HIV only using our immune system. Therefore, as time goes by, the virus destroys more and more of our immune cells, leaving us with incapacity to fight against other pathogens. This state describes the late-stage of the disease called AIDS. The challenging part of having an acute HIV infection is that you are not always aware of it. Therefore, people who contracted the virus can spread it to other people. Its symptoms may be absent or may look like they belong to another infection.

Acute versus chronic HIV infection

The status of the disease has to do with its progression. What characterizes an acute HIV infection is the rapid viral multiplication, in contrast with a chronic one, that levels of viral load decrease. However, as it progresses, its capacity increases again. Therefore, there is a destruction of immune cells that may finally lead to the final stage of the disease called AIDS. The damage that indicates an immunity insufficiency has to do with CD4 cells. The only way to prevent absolute destruction is receiving antiretroviral treatment. The three stages of HIV infection are the following:

  • Acute HIV infection - increased HIV levels
  • Chronic HIV infection - decreased HIV levels
  • AIDS - increased HIV levels

Symptoms of acute HIV infection

The reason why patients do not suspect directly they contracted HIV is because of the disease's general symptoms that resemble those of the flu, or of another infection. An estimated 15% of all people living with HIV in the US are unaware of their infection. The only method to know whether you contracted the disease is to get tested. The symptoms of acute HIV infection are general, and they might present with a headache, fever and chills, and rash. Others might appear to have a sore throat or generalized fatigue. The following are some additional symptoms an individual with HIV might present with:

  • decreased appetite
  • night sweats
  • sores in the oral cavity, or genital area
  • lymphadenopathy
  • pain in the muscles
  • changes in bowel habits with diarrhea

It is not mandatory to have all the symptoms. Some people may experience a few or none at all. The symptoms, if present, may last for up to four weeks. However, they decline without any treatment. The fact that the signs disappear on their own without causing any severe disturbances makes it hard to diagnose on time.

To recognize an acute retroviral treatment, you need to have a high index of suspicion, meaning that the individual must have some risk factors linked to his current condition. The most common symptoms are fever, followed by a rash, headache, and swollen lymph nodes.

What is the cause of acute HIV infection?

Responsible for retroviral syndrome is acquiring the virus that causes HIV infection. The symptomatology, if present, takes place from a few days to four weeks after contracting the virus. It lasts around 14 days on average. The routes of transmission of the virus are the following:

  • Through blood transfusions, especially the ones that took place during the eighties
  • Sharing needles for injectable drugs
  • Having unprotected anal or vaginal sex and having contact with contaminated blood, anal or genital secretions
  • Having a mother with HIV during pregnancy or breastfeeding

It is necessary to keep in mind that you cannot contract HIV through saliva. Therefore, you cannot acquire the infection through kissing. Hugging, holding hands, or practicing other physical activities, doesn't put you at high risk. But who should get a regular screening?

Which groups are at risk and require regular screening?

You can contract HIV at any age, regardless of your socioeconomic background, race, gender, or sexual orientation. However, there are a few habits and behaviors that put you at higher risk than an average person. Generally, having unprotected sex predisposes you not only for contracting HIV but other STDs, as well. However, people that belong in high-risk groups are drug users that share needles or syringes, as well as men who have sex with men (MSM).

But why is the MSM group vulnerable to an HIV infection? The answer is multifaceted. Men who have sex with men do not show any genetic predisposition towards HIV. Many biological, cultural, and social factors put MSM at higher risk when compared with heterosexual individuals. Gay men and men who have sex with men are 27 times more likely to contract HIV. On top of that, unprotected anal sex has a higher vulnerability than the vaginal one. The reason is anatomical. The walls of the anus are thinner and more vulnerable to trauma. When an injury occurs, it becomes the entry point for HIV to enter the body. Besides, gay men and men who have sex with men might have multiple sex partners, a behavior that is common among this group.

Legal reasons in every country, as well as discrimination and homophobia against gays and men who have sex with men, make it even harder for this social group to receive screening and sexual education.

How to diagnose acute HIV infection?

To diagnose HIV infection, your doctor will ask questions regarding your medical history, recent sexual behaviors, and sexual orientation, to identify whether you belong in a high-risk group. After evaluating the data, you should get tested for the virus. Regular screening tests will not identify an acute HIV infection because they detect the antibodies in your body. Due to the time required for these proteins to form, they might not appear during retroviral syndrome. You can get tested alone at home through a rapid STD kit that provides you with results in less than half an hour. Alternatively, you can visit a lab. You may undergo a p24 antigen blood test, a CD4 count and HIV RNA viral load test, or HIV antigen or antibodies tests.

Treatment of acute HIV infection

The cornerstone of HIV treatment is antiretroviral therapy. Also, the sooner the diagnosis and intervention, the better the outcome. These oral drugs will minimize the negative effects of the virus to the cells of your immune system. The treatment is long-term but may also cause some adverse effects. Talk with your healthcare provider about side effects and the correct timing to commence the treatment.

Other lifestyle interventions are also crucial for people with HIV infection. Eating healthy and having regular exercise is essential for everybody, healthy or not. Also, people with HIV are prone to other STDs, as well. Therefore, they should practice sex with condoms to protect themselves and their sexual partners. Finally, if you have HIV, you should stop smoking and reduce your alcohol consumption. Avoid sharing needles or syringes with other people, and try to reduce your stress levels, which worsen your immune system, even more.