Many diagnosed infected people do not pay much attention to the acute manifestations of HIV infection because they are not very important for guiding the timing of treatment and judging the quality of life and length of life in the future, which are the most important concerns of infected people, and doctors base their treatment mainly on viral load and CD4+ T lymphocyte count.
Those who really care about the performance of the acute phase are those who have a history of high-risk behavior or exposure. Many people want to determine whether they are infected with HIV by analyzing the performance of the acute phase, and once discomfort occurs after high-risk or exposure, it will greatly increase the likelihood of infection and increase the psychological burden of many people.
So what are the symptoms that usually occur after HIV infection? What laboratory tests are available to detect HIV infection as early as possible?
The 2015 edition of the HIV treatment guidelines describes the symptoms of the acute phase, “usually occurring 2 to 4 weeks after the initial HIV infection. Some infected individuals develop clinical symptoms resulting from HIV viremia and acute damage to the immune system. Most patients have mild clinical symptoms that persist for 1 to 3 weeks and then resolve. Clinical manifestations are most commonly fever, which may be accompanied by sore throat, night sweats, nausea, vomiting, diarrhea, rash, joint pain, swollen lymph nodes, and neurological symptoms.”
Here are some points that need to be understood: 1. Time: 2 to 4 weeks after exposure, symptoms are produced after virus replication and need time, too early the amount of virus is too small and there will be no symptoms, too late there are already enough antibodies and symptoms should not occur again. Last 1 to 3 weeks, the body produces antibodies, the symptoms will gradually ease and disappear.
2, symptoms: these symptoms are really nothing special, many diseases, especially a variety of viral infections, will have the above symptoms, such as influenza, upper respiratory tract infections, the common cold can have, a person will have about 1 to 2 times a year cold, and an unprotected sex with the infected person, the probability of infection ranging from one percent to one thousandth, simply based on the symptoms themselves to analyze, is the cold or HIV The probability is about the same, the probability of cold should be greater, and it is difficult for the doctor to give a tendency conclusion based on the symptoms. In other words, even if there are symptoms or even “typical” symptoms after high-risk exposure, it is difficult for doctors to assume that these symptoms are caused by HIV infection.
3. Not all people have acute symptoms, and the article points out that “some infected people” have clinical symptoms, which means that HIV infection cannot be ruled out even if there are no acute symptoms after high-risk or exposure. Some statistics say that about 10% of infected people do not have acute symptoms, and our clinical statistics show that the proportion of people who do not have acute symptoms is even higher, of course, perhaps because it has been too long to recall, or some people are “big-hearted” and have acute symptoms but do not care. If the acute symptoms persist for a long time, the disease may progress more quickly in the future.
4. In relation to testing, the guidelines mention that “HIV-RNA and P24 antigen can be detected in the blood during this period, while HIV antibodies appear only a few weeks after infection, and CD4+ T-lymphocyte count may decrease transiently. Some patients may have mild leukopenia and thrombocytopenia or abnormal liver function.” In other words, theoretically, RNA and P24 antigen should already be detectable when symptoms appear in the acute phase. For people who are particularly worried about symptoms after high risk and cannot wait until 6 weeks for testing, P24 antigen can be tested to assist in diagnosis, while RNA testing can be diagnosed early, but it is expensive and takes a long time to test. It is better to be patient and wait for 6 weeks for antibody testing.