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Acute (Primary) HIV Infection

Thread: Acute (Primary) HIV Infection

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  1. usmlemate said:

    Acute (Primary) HIV Infection

    A 27-year-old previously healthy man presents to an urgent care center with fever, sore throat, swollen lymph nodes, severe fatigue, and a rash. His symptoms have been present for approximately 48 hours and his history reveals unprotected receptive anal intercourse with another man 12 days prior to the onset of his symptoms. He had a negative HIV antibody test approximately 6 months ago. His physical examination shows a temperature of 39.0C, non-exudative pharyngitis, cervical and axillary lymphadenopathy, and a generalized morbilliform rash (Figure 1). All laboratory tests are pending. The diagnosis of acute (primary) HIV infection is suspected.

    Which one of the following statement is TRUE regarding acute HIV infection?

    A. Less than 5% of persons who acquire HIV develop an acute clinical illness.

    B. More than 80% of patients with acute HIV present with aseptic meningitis.

    C. Patients recently infected with HIV typically have plasma HIV RNA levels greater than 50,000 copies/ml within 4 weeks of acquiring HIV.

    D. An HIV RNA level of 2,400 copies/ml combined with a negative HIV antibody test would be diagnostic of acute HIV infection.
     
  2. usmlemate said:

    Re: Acute (Primary) HIV Infection

    Quote Originally Posted by usmlemate
    A 27-year-old previously healthy man presents to an urgent care center with fever, sore throat, swollen lymph nodes, severe fatigue, and a rash. His symptoms have been present for approximately 48 hours and his history reveals unprotected receptive anal intercourse with another man 12 days prior to the onset of his symptoms. He had a negative HIV antibody test approximately 6 months ago. His physical examination shows a temperature of 39.0C, non-exudative pharyngitis, cervical and axillary lymphadenopathy, and a generalized morbilliform rash (Figure 1). All laboratory tests are pending. The diagnosis of acute (primary) HIV infection is suspected.

    Which one of the following statement is TRUE regarding acute HIV infection?

    A. Less than 5% of persons who acquire HIV develop an acute clinical illness.

    B. More than 80% of patients with acute HIV present with aseptic meningitis.

    C. Patients recently infected with HIV typically have plasma HIV RNA levels greater than 50,000 copies/ml within 4 weeks of acquiring HIV.

    D. An HIV RNA level of 2,400 copies/ml combined with a negative HIV antibody test would be diagnostic of acute HIV infection.

    The correct answer is C. Persons who become infected with HIV can develop detectable viremia within 4-11 days of the time of acquiring HIV. The early viremia is generally poorly controlled, with the plasma HV RNA typically increasing to a level greater than 100,000 copies/ml within 14-21 days of the initial infection.


    Answer A is incorrect. Among persons acutely infected with HIV, it is estimated that between 40-90% will develop an acute symptomatic illness.

    Answer B is incorrect. Although persons with acute HIV can develop aseptic meningitis, this occurs in less than 30% of patients presenting with acute HIV infection.

    Answer D is incorrect. Although a positive HIV RNA level combined with a negative antibody test suggests a diagnosis of acute HIV infection, the HIV RNA levels are almost always significantly greater than 2,400 copies/ml (typically greater than 100,000 copies/ml). In a person presenting with symptoms that could represent acute HIV, an HIV RNA level less than 10,000 copies/ml would be most consistent with a false-positive HIV RNA level, but would require close follow-up.
     
  3. aiden.rojer said:
    Less than 5% of persons who acquire HIV develop an acute clinical illness.
    This one is true in my opinion.Some times we may also get the illness from the clinical spots and hospitals but usually it happens in less developed countries.
    aiden.rojer
     
  4. offdan said:
    C is correct
     
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