clinical features of the seroconversion illness

Last edited 02/2018

Clinical features of primary HIV infection (PHI) are present in over 60% of patients.

  • in majority, acute illness develops within 1-4 weeks after initial infection and the symptoms persist for 2-4 weeks post exposure
  • symptoms are thought to correlate with peak viremia (1,2)

Clinical features of PHI usually resemble mononucleosis or influenza-like illness.  Two studies have reported an HIV prevalence of 3.9% & 1.3% in patients presenting with monnucleosis type symptoms

  • most prevalent symptoms are:
    • fever
    • fatigue
    • myalgias/arthralgias
    • rash (typically an erythematous maculopapular exanthem)
    • sore throat
    • lymphadenopathy
    • oral, genital or perianal ulcers (1,3)

In addition patients may also present with less common features:

  • headache or meningitis
  • cranial nerve palsies
  • diarrhoea
  • weight loss (3)            

A patient may have acute conditions associated with immunosupression due to an acute drop in CD4 count such as.

  • oral candidiasis
  • shingles
  • other conditions associated with immunodeficiency (3)

Reference: