Treatment of Acute HIV Infection: Immediate Antiretroviral Therapy
Acute HIV infection requires prompt clinical action at the point of diagnosis — including when the diagnosis is established by HIV RNA testing before serologic confirmation can be obtained.
Treatment Approach
Immediate initiation of antiretroviral therapy (ART) is recommended — ideally the same day as diagnosis — without waiting for serologic confirmation. Preferred options include specific fixed-dose combination regimens; alternatives are also defined within the protocol.
Full regimen details, preferred agents, alternatives, and renal function considerations are available in the structured protocol.
Treatment Goals
The primary target is suppression of plasma HIV RNA to below detectable levels. Response to therapy is assessed with a viral load test at 4 weeks after ART initiation.
References
- Clinicians should recommend immediate ART initiation to all patients diagnosed with acute HIV infection.
- If a diagnosis of acute infection is made based on HIV RNA testing, clinicians should recommend ART initiation without waiting for serologic confirmation.
- TAF/FTC/BIC is available as a single-tablet formulation, taken once daily.
- Administer as 2 tablets once daily.
- TAF/FTC/DRV/COBI is available as a single-tablet formulation, taken once daily.
- TAF/FTC should not be used in patients with CrCl <30 mL/min; re-evaluate after baseline laboratory testing results are available.
- The clinicians should implement treatment to suppress the patient’s plasma HIV RNA to below detectable levels.
- Clinicians should obtain a viral load test 4 weeks after ART initiation to assess the response to therapy.
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