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2635 pages added, reviewed or updated during the last month (last updated: 16/4/2021)

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natural history and prognosis of HIV infection

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Once the transmission of HIV occurs through exposure to HIV-containing fluids, the host’s cells transfer the virus to the local immune system, including t-cells, macrophages and dendritic cells.

The natural history of HIV infection may be characterised by:

  • acute human immunodeficiency virus (HIV) infection/primary HIV infection/acute retroviral syndrome
    • is the period just after initial HIV infection
    • presentation is often clinically indistinguishable from infectious mononucleosis
    • more than 60% of patients experience a flu-like illness at the time of infection
    • risk of onward transmission is particularly high during primary HIV infection due to high viral load but are often unaware they have HIV and may even test antibody negative
  • asymptomatic stage
    • begins when the symptoms of primary HIV infection subside (if they occur at all)
    • usually no overt clinical signs or symptoms of HIV infection during this stage and the  individual may be well for many years
  • symptomatic stage
    • results from progressive immunosuppression due to untreated HIV infection
  • symptomatic, AIDS defining
    • AIDS defining infections and malignancies are present (1,2)


  • various studies have reported the dramatic decreases in mortality among individuals infected with human immunodeficiency virus (HIV) since the widespread introduction of highly active antiretroviral therapy (HAART) in industrialized countries
    • in industrialized countries, persons infected sexually with HIV now appear to experience mortality rates similar to those of the general population in the first 5 years following infection, though a mortality excess remains as duration of HIV infection lengthens
    • individuals exposed to HIV through intravenous drug use had a higher excess risk of death than persons infected sexually with HIV (3)


Last edited 02/2018 and last reviewed 05/2018