Acute Retroviral Syndrome

What Is Acute Retroviral Syndrome?

Acute retroviral syndrome is a primary infection associated with HIV infection. Acute retroviral syndrome develops within two to four weeks after the onset of HIV infection. Acute retroviral syndrome extended till the body creates an antibody against HIV.

Our immune system usually fights against infectious micro-organisms. In Acute retroviral syndrome, the HIV virus multiplying at a rapid rate and our immune system unable to check their growth or kill them. Therefore, HIV virus is living for sustained period.

In the progression of HIV, the immune system becomes impaired and unable to fight against other infectious diseases due to HIV virus destroys the immune system. In this stage, the HIV virus infection turns to AIDS.

Acute retroviral syndrome is a contagious infection, but most of the time, affected individuals are unaware of their infection. The possible reason of this is they are not going for routine HIV tests or standard HIV antibody tests do not efficiently identify the early stage of infection^1,2.

Symptoms

Acute retroviral syndrome symptoms are developed almost 75% of the HIV-infected individuals. But the symptoms are quite similar to flu and other viral infections.

Therefore, in Acute retroviral syndrome stage, it is difficult to guess that patient has HIV infection. It has been estimated that almost 1.2 million HIV-infected people oblivious about their infection at acute retroviral syndrome stage. The symptoms of acute retroviral syndrome are as follows:

• Fever
• Chills
• Rash
• Headache
• Night sweats
• Fatigue
• Sore throat
• Ulcers that appear in the mouth, esophagus, or genitals
• Loss of appetite
• Swollen lymph nodes
• Muscle aches

But in some cases, Acute retroviral syndrome symptoms is asymptomatic^1,2,3.

Pathophysiology

In acute retroviral syndrome, CD4 cells are get affected due to responsible virus replication. During the replication CD4 cells become damaged and the CD4 cells count is dropped down rapidly. The lowering immune response causes viral replication.

After a certain period, a standard number of virus present in affected individual’s body, which is termed as ‘viral set point’. Gradually, the CD4 count begins to increase after ‘viral set point’ arises. However, the CD4 count is not become normalized as similar as a pre-infection stage.

The acute retroviral syndrome has a tendency to transmit the infection to other via sexual transmission, blood contact and through placental barrier, mother transmits the infectious agent to fetus^2,4.

Diagnosis

A series of tests require conducting for assessing the Acute Retroviral Syndrome. Some tests are conducted to screen the HIV antibodies, which may not detect HIV virus. The specification of antibodies can assist to judge the type of infection even though virus identification is not possible.

However, the diagnosis of Acute Retroviral Syndrome is not provided frequent result. It takes several months to detect the antibodies for a specific infection. Therefore, there is a risk of delayed diagnosis.

The lists of acute Acute Retroviral Syndrome diagnostic tests are:

• HIV RNA viral load
• blood differential
• CD4 count
• p24 antigen blood test
• HIV ELISA and Western blot tests^1,2

Treatment

The aim of the treatment for Acute Retroviral Syndrome is to control the viral replication and restrict the immune system impairment. However, experts are always debating about the treatment approach for Acute Retroviral Syndrome, because the side effects of Acute Retroviral Syndrome treatment is maximum.

Therefore, the risk of severe adverse effects is increased with aggressive treatment. The treatment course for Acute Retroviral Syndrome is prolonged. Detail discussion about the possible treatment and their side effects discussion between patient and clinician are very important before initiating the treatment.

However, the symptoms associated with Acute Retroviral Syndrome are disappeared and the disease is progressed and there is no cure for HIV infection. Certain life style adjustment is important in addition to medication and other therapeutic approaches.

Life style management

• A balanced healthy diet with proper amount nutrition intake can help to delay immune system impairment.
• Transmitting infection can be controlled by safe sexual intercourse.
• Distressing is important to avoid immune system weakness.
• Measure need to take to prevent other infections because of damage immune system unable to fight against causative organism.
• Routine exercise is important to keep the body active
• To provide a steady life it is important to stay lively, keep passionate about your hobbies.
• Medications
• Zidovudine, stavudine or abacavir are nucleoside reverse transcriptase inhibitors can be prescribed for Acute Retroviral Syndrome affected patients.
• Didanosine, lamivudine or zalcitabine are nonthymidine NRTI category drugs can be recommended for Acute Retroviral Syndrome affected patients.
• Indinavir, nelfinavir, ritonavir, saquinavir or amprenavir are protease inhibitors can be prescribed for Acute Retroviral Syndrome affected patients. But patients may not tolerate these drugs due to its side effects. Some experts may prescribe nevirapine, delavirdine or efavirenz are nonnucleoside reverse transcriptase inhibitors and may prescribe for patients affected with Acute Retroviral Syndrome^1,2,5.

References

1. What Is Acute HIV Infection? Retrieve from http://www.healthline.com/health/acute-hiv-infection#overview1
2. BARBARA LEE PERLMUTTER, JORDAN B. GLASER, SAMWEL O. OYUGI; How to Recognize and Treat Acute HIV Syndrome. Am Fam Physician. 1999 Aug 1;60(2):535-542. Retrieve from http://www.aafp.org/afp/1999/0801/p535.html
3. Stages of HIV infection; AIDS* Gov. Retrieve from https://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/hiv-in-your-body/stages-of-hiv/
4. Acute Retroviral Syndrome: A Challenge for Primary Care. AIDS Reader; Retrieve from http://www.theaidsreader.com/articles/acute-retroviral-syndrome-challenge-primary-care
5. Robert J Carpenter. Early Symptomatic HIV Infection. Retrieve from http://reference.medscape.com/article/211873-overview