Today, a protective HIV vaccine remains a distant goal. In the face of continued high rates of transmission, increasing importance has been given to the study of acute HIV and forward transmission during this early, undiagnosed period of infection.
The relationship between levels of viraemia and transmission has been well documented, and the high levels of circulating virus observed during acute infection clearly pose serious challenges to prevention of new infections. Implementation of programs that aid early diagnosis is critical with regard to an individual's decision on treatment as well as to public health issues surrounding transmission, viral load reduction and education in risk reduction.
Because of the non-specific nature of the symptoms of acute HIV infection, the most important step in its diagnosis is to include it in the differential diagnosis.
More than an important diagnosis, acute HIV infection has received much attention in the research community due to increasing evidence suggesting the early events in HIV infection determine the long-term outcome of disease:
- The significant association between the severity and duration of the acute infection syndrome and the speed of HIV-1 disease progression.
- The reduction of peak viraemia by more than 1,000-fold during this initial phase of infection, indicating the initial ability of host immunity to control viral replication.
- The strong predictive value of the initial viral setpoint for the subsequent speed of disease progression, demonstrating that the events that determine long-term disease outcome occur during this initial window.
