Henn Aurélia, Flateau Clara, Gallien Sébastien
Service d'immunologie clinique et maladies infectieuses, CHU Henri Mondor, APHP, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Creteil, France.
Faculté de médecine, Université Paris-Est Créteil, Créteil, France.
Curr Infect Dis Rep. 2017 Sep 7;19(10):37. doi: 10.1007/s11908-017-0588-3.
The purpose of this review was to provide current data on clinical presentation, diagnosis, and treatment of primary HIV infection (PHI).
In 65 to 95% of cases, PHI causes acute retroviral syndrome presenting with unspecific flu-like symptoms. Symptomatic PHI was associated with a faster clinical and immunological progression of HIV infection. Point-of-care tests remain less sensitive than fourth-generation immunoassays (IA) in PHI, especially after tenofovir-based prophylaxis use. Early antiretroviral treatment (ART) started during PHI prevents HIV transmission and decreases viral and immunological reservoir constitution. Recommended ART regimens in PHI are combinations of tenofovir and emtricitabine with either darunavir/ritonavir, or dolutegravir. Starting ART the earliest is highly recommended for clinical, virological, immunological, and public health benefits. Reducing HIV reservoir constitution in PHI may optimize potential opportunities for future functional cure.
本综述旨在提供关于原发性HIV感染（PHI）临床表现、诊断和治疗的最新数据。
在65%至95%的病例中，PHI会引发急性逆转录病毒综合征，表现为非特异性流感样症状。有症状的PHI与HIV感染更快的临床和免疫进展相关。即时检测在PHI中的敏感性仍低于第四代免疫测定（IA），尤其是在使用基于替诺福韦的预防措施后。在PHI期间开始早期抗逆转录病毒治疗（ART）可预防HIV传播并减少病毒和免疫储存库的形成。PHI中推荐的ART方案是替诺福韦和恩曲他滨与达芦那韦/利托那韦或多替拉韦的组合。强烈建议尽早开始ART，以获得临床、病毒学、免疫学和公共卫生方面的益处。减少PHI中的HIV储存库形成可能会优化未来功能性治愈的潜在机会。
