Fast Five Quiz: HIV Recognition and Diagnosis

Michael Stuart Bronze, MD


November 29, 2018

According to the CDC, a person with HIV must have an AIDS-defining condition or a CD4+ T-cell count < 200/µL to be diagnosed with AIDS; however, some opportunistic infections develop when CD4+ T-cell counts are > 200 cells/µL, and some people with CD4 counts < 200 cells/µL may remain relatively healthy.

Seroconversion may take a few weeks, and up to several months. At this point, the viral load is typically very high, and the CD4+ T-cell count drops precipitously. With the appearance of anti-HIV antibodies and CD8+ T-cell responses, the viral load drops to a steady state and the CD4+ T-cell count returns to levels within the reference range, although slightly lower than before infection. Symptoms during this time may include fever, flulike illness, lymphadenopathy, and rash. These manifestations develop in approximately half of all people infected with HIV.

No firm evidence has shown that the initiation of therapy early in the asymptomatic period is effective. However, very late initiation is known to result in a less effective response to therapy and a lower level of immune reconstitution. Thus, many experts suggest theoretical benefits of early initiation of treatment, which has lead to the recommendation for initiation of treatment regardless of CD4 cell count.

For more on the phases of HIV, read here.


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