Abstract
The human immunodeficiency virus, type 1 (HIV-1), which is a retro-virus of the human T-cell leukemia/lymphoma line, is the causative agent of the acquired immunodeficiency syndrome (AIDS). Because the potential exists in HIV spectrum disease for patients to remain free of clinical symptoms for a prolonged period and because appropriate patient management can delay the onset of frank AIDS, it might be useful to view HIV as a chronic disease. Most patients with primary HIV infection develop an acute mononucleosis-like syndrome approximately 3 to 6 weeks after initial infection. This period is associated with a high level of viremia. The virus becomes disseminated during this early stage of infection, which suggests that the subsequent course of infection might be influenced by the seeding of the virus. Detectable viremia tends to decline in the weeks after the acute syndrome subsides. This change is temporally associated with the emergence of an HIV-specific immune response, which occurs 4 to 12 weeks after the onset of acute infection. It seems likely that viral replication is not completely curtailed because it remains detectable in lymph nodes during the quiescent stages of HIV infection.