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Recognising acute HIV infection.

BACKGROUND
Early diagnosis and appropriate management of acute or primary human immunodeficiency virus (HIV) infection may significantly alter the long term course of the disease and help reduce further transmission.


OBJECTIVE
General practitioners are the doctors most likely to see a person with acute or primary HIV infection. This article aims to assist GPs in the early diagnosis and management of these patients.


DISCUSSION
The symptoms of acute HIV infection include headache, fever, malaise and rash. Good history taking including assessing possible HIV transmission risk and careful examination can alert GPs to the illness. Appropriate investigations require knowledge of the time course of serological and virological markers and expert laboratory advice may be needed. Management may include general supportive measures for physical, psychological and social issues and some clinicians advocate the use of antiretrovirals. Postexposure prophylaxis is becoming more widely available in Australia. Most patients can be cared for by their own GP with the support and advice of a more HIV experienced colleague.