Update on antiretroviral treatment during primary HIV infection

Expert Rev Anti Infect Ther. 2014 Jul;12(7):793-807. doi: 10.1586/14787210.2014.913981. Epub 2014 May 7.


Primary HIV-1 infection covers a period of around 12 weeks in which the virus disseminates from the initial site of infection into different tissues and organs. In this phase, viremia is very high and transmission of HIV is an important issue. Most guidelines recommend antiretroviral treatment in patients who are symptomatic, although the indication for treatment remains inconclusive in asymptomatic patients. In this article the authors review the main virological and immunological events during this early phase of infection, and discuss the arguments for and against antiretroviral treatment. Recommendations of different guidelines, the issue of the HIV transmission and transmission of resistance to antiretroviral drugs, as well as recently available information opening perspectives for functional cure in patients treated in very early steps of HIV infection are also discussed.

Keywords: Fiebig phases; HIV guidelines; HIV infection; acute retroviral syndrome; antiretroviral treatment; eradication; functional cure; primary HIV infection; therapeutic vaccines; transmitted drug resistance.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use*
  • Anti-Retroviral Agents / administration & dosage
  • Anti-Retroviral Agents / therapeutic use*
  • Drug Resistance, Viral / genetics
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Seropositivity
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • HIV-1 / pathogenicity
  • Humans
  • Viral Load
  • Viremia


  • Anti-HIV Agents
  • Anti-Retroviral Agents