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J Infect Dis. 2015 Nov 1;212(9):1351-60. doi: 10.1093/infdis/jiv430. Epub 2015 Aug 26.

Programmatic Implications of Acute and Early HIV Infection.

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  • 1South African Centre for Epidemiological Modelling and Analysis, University of Stellenbosch, South Africa.
  • 2International Association of Providers of AIDS Care, Washington D.C.
  • 3World Health Organization Vietnam Country Office, Hanoi.
  • 4Rwanda Biomedical Center, Kigali.
  • 5British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
  • 6Wits Reproductive Health Institute, University of the Witwatersrand, Johannesburg, South Africa.


Human immunodeficiency virus (HIV) infection includes acute, early, chronic, and late stages. Acute HIV infection lasts approximately 3 weeks and early HIV infection, which includes acute HIV infection, lasts approximately 7 weeks. Many testing and blood screening algorithms detect HIV antibodies about 3 weeks after HIV infection. Incidence estimates are based on results of modeling, cohort studies, surveillance, and/or assays. Viral load is the key modifiable risk factor for HIV transmission and peaks during acute and early HIV infection. Empirical evidence characterizing the impact of acute and early HIV infection on the spread of the HIV epidemic are limited. Time trends of HIV prevalence collected from concentrated and generalized epidemics suggest that acute and early HIV infection may have a limited role in population HIV transmission. Collectively, these data suggest that acute and early HIV infection is relatively short and does not currently require fundamentally different programmatic approaches to manage the HIV/AIDS epidemic in most settings. Research and surveillance will inform which epidemic contexts and phases may require tailored strategies for these stages of HIV infection.


HIV incidence; HIV testing; acute HIV infection; blood safety; early HIV infection; national strategic plan; recent HIV infection

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