HIV/AIDS

Definition & Clinical Manifestations

  • Acute HIV: mono-like syndrome → rash, lymphadenopathy, fever, oral ulcers, pharyngitis, myalgias, diarrhea. Presents ~2–6 wk after infxn.
  • AIDS: HIV + CD4 <200/mm3 or AIDS-defining opportunistic infection (OI) or malignancy

Epidemiology

  • ~1 million Americans living w/ HIV (1 in 8 unaware); ~36 million worldwide
  • Highest at risk are men who have sex with men (MSM) and African Americans
  • Routes: sexual (risk is 0.1–1% per sex act w/o ARV), IVDU, transfusions, needlesticks (0.3%), vertical (15–40% w/o ARV)

Prophylaxis (NEJM 2015;373:2237; Lancet 2016;387:53; J Infect Dis 2018;218:16)