[Acute primary phase as an indicator of HIV-1 infection. The general symptoms and polymorphic exanthema with mouth mucosal involvement 2 to 6 weeks before seroconversion].

The initial symptoms of an HIV-1 infection were observed in four patients. The following were characteristic for the acute primary phase: (a) initial maculopapular exanthema, especially of the trunk, with occasional transition into a papulovesical appearance; (b) involvement of the oral mucosa, often of aphthous character; and (c) general malaise with fever and lymphadenopathy. The observed cutaneous changes had, on one hand, features of a Coxsackie or mononucleosis exanthema, on the other of secondary syphilis. In three patients seroconversion occurred within 2-6 weeks, the fourth failed to return for follow-up. The listed acute primary symptoms can be used as the earliest indicators of an HIV-1 infection having occurred.