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Allergy & Immunology1510 papers

Primary human immunodeficiency virus infection

Last edited: 4/14/2026

Overview

Primary human immunodeficiency virus (HIV) infection, often referred to as acute or primary HIV infection, marks the initial stage of HIV disease characterized by a high viral load and seroconversion, preceding the development of immunodeficiency if untreated. Early detection and intervention are crucial to mitigate long-term complications 126.

Diagnosis

  • Clinical Presentation: Unexplained fever, lymphadenopathy, rash, and generalized symptoms lasting weeks 1.
  • Laboratory Tests: Positive HIV RNA (viral load) and seroconversion (detection of HIV antibodies) 26.
  • Immunological Markers: Monitoring CD4+ T-cell counts and HIV-specific immune responses 33.
  • Genomic Testing: Identification of specific HIV strains can aid in prognosis and treatment 26.

    • Management

  • Antiretroviral Therapy (ART): Initiate immediately upon diagnosis to suppress viral replication and preserve immune function 110.
  • Monitoring: Regular CD4+ T-cell counts and viral load assessments to guide treatment adjustments 110.
  • Prophylaxis: Consider prophylaxis against opportunistic infections based on CD4+ count 110.
  • Supportive Care: Management of symptoms and opportunistic infections as they arise 110.

    • Special Populations

  • Pediatrics: Early diagnosis and prompt ART initiation are critical to prevent long-term immune damage 114.
  • Comorbidities: Special attention to manage co-infections and other health conditions that may complicate HIV management 111.

    • Key Recommendations

  • Initiate ART Early: Start antiretroviral therapy immediately after diagnosis to reduce viral load and preserve immune function (Evidence: Strong 110).
  • Regular Monitoring: Perform frequent CD4+ T-cell counts and viral load tests to guide treatment efficacy and adjust therapy as needed (Evidence: Strong 110).
  • Prophylactic Measures: Implement prophylaxis against opportunistic infections based on CD4+ cell count thresholds (Evidence: Moderate 110).
  • Early Detection in Pediatrics: Prioritize early diagnosis and intervention in pediatric patients to prevent long-term complications (Evidence: Moderate 114).

    • References

    1 Rivière JG, Pasquet M, Gambineri E. Building alliances for early detection of immunodeficiencies: from primary care to hematology. Frontiers in immunology 2025. link 2 Abdulrezzak U, Temizer E, Ozcan A. Multiple Organ Involvement in a Boy with Lipopolysaccharide-Responsive Beige-like Anchor Protein Deficiency Detected by F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography. Pediatric allergy, immunology, and pulmonology 2025. link 3 Hanson J, Bonnen PE. Systematic review of mortality and survival rates for APDS. Clinical and experimental medicine 2024. link 4 Ng K, Hurst JR. New developments in respiratory medicine: a primary immunodeficiency perspective. Current opinion in allergy and clinical immunology 2020. link 5 Cavuoto Petrizzo M, Barilla-LaBarca ML, Lim YS, Jongco AM, Cassara M, Anglim J et al.. Utilization of high-fidelity simulation to address challenges with the basic science immunology education of preclinical medical students. BMC medical education 2019. link 6 Picard C, Bobby Gaspar H, Al-Herz W, Bousfiha A, Casanova JL, Chatila T et al.. International Union of Immunological Societies: 2017 Primary Immunodeficiency Diseases Committee Report on Inborn Errors of Immunity. Journal of clinical immunology 2018. link 7 Bousfiha A, Jeddane L, Picard C, Ailal F, Bobby Gaspar H, Al-Herz W et al.. The 2017 IUIS Phenotypic Classification for Primary Immunodeficiencies. Journal of clinical immunology 2018. link 8 Costa-Carvalho B, González-Serrano M, Espinosa-Padilla S, Segundo G. Latin American challenges with the diagnosis and treatment of primary immunodeficiency diseases. Expert review of clinical immunology 2017. link 9 Arslan S, Ucar R, Caliskaner AZ, Reisli I, Guner SN, Sayar EH et al.. How effective are the 6 European Society of Immunodeficiency warning signs for primary immunodeficiency disease?. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 2016. link 10 Chinen J, Notarangelo LD, Shearer WT. Advances in clinical immunology in 2015. The Journal of allergy and clinical immunology 2016. link 11 Sarmiento JD, Villada F, Orrego JC, Franco JL, Trujillo-Vargas CM. Adverse events following immunization in patients with primary immunodeficiencies. Vaccine 2016. link 12 Wong M. What has happened in the last 50 years in immunology. Journal of paediatrics and child health 2015. link 13 Chinen J, Notarangelo LD, Shearer WT. Advances in basic and clinical immunology in 2013. The Journal of allergy and clinical immunology 2014. link 14 Tirotta D, Durante V. A case of long-undiagnosed common Primary Immunodeficiency in adulthood. European annals of allergy and clinical immunology 2014. link 15 Chu EY, Freeman AF, Jing H, Cowen EW, Davis J, Su HC et al.. Cutaneous manifestations of DOCK8 deficiency syndrome. Archives of dermatology 2012. link 16 Wasserman RL, Manning SC. Diagnosis and treatment of primary immunodeficiency disease: the role of the otolaryngologist. American journal of otolaryngology 2011. link 17 Arkwright PD, Gennery AR. Ten warning signs of primary immunodeficiency: a new paradigm is needed for the 21st century. Annals of the New York Academy of Sciences 2011. link 18 Leiva LE, Bezrodnik L, Oleastro M, Condino-Neto A, Costa-Carvalho BT, Grumach AS et al.. Primary immunodeficiency diseases in Latin America: proceedings of the Second Latin American Society for Immunodeficiencies (LASID) Advisory Board. Allergologia et immunopathologia 2011. link 19 Condino-Neto A, Franco JL, Trujillo-Vargas C, Espinosa-Rosales FJ, Leiva LE, Rodriguez-Quiroz F et al.. Critical issues and needs in management of primary immunodeficiency diseases in Latin America. Allergologia et immunopathologia 2011. link 20 de la Morena MT, Gatti RA. A history of bone marrow transplantation. Immunology and allergy clinics of North America 2010. link 21 Yong PL, Boyle J, Ballow M, Boyle M, Berger M, Bleesing J et al.. Use of intravenous immunoglobulin and adjunctive therapies in the treatment of primary immunodeficiencies: A working group report of and study by the Primary Immunodeficiency Committee of the American Academy of Allergy Asthma and Immunology. Clinical immunology (Orlando, Fla.) 2010. link 22 Roxo Júnior P. Primary immunodeficiency diseases: relevant aspects for pulmonologists. Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia 2009. link 23 Tipu HN, Ahmed TA, Ali S, Ahmed D, Waqar MA. Chronic granulomatous disease. JPMA. The Journal of the Pakistan Medical Association 2008. link 24 Burrows PD, Fischer A. Building networks for immunodeficiency diseases and immunology training. Nature immunology 2008. link 25 Sewell WA, Khan S, Doré PC. Early indicators of immunodeficiency in adults and children: protocols for screening for primary immunological defects. Clinical and experimental immunology 2006. link 26 Hitzig WH. The discovery of agammaglobulinaemia in 1952. European journal of pediatrics 2003. link 27 Buckley RH. Primary immunodeficiency diseases: dissectors of the immune system. Immunological reviews 2002. link 28 Salaria M, Poddar B, Parmar V. Hyperimmunoglobulin E syndrome. Indian journal of pediatrics 2001. link 29 Aalfs CM, van den Berg H, Barth PG, Hennekam RC. The Hoyeraal-Hreidarsson syndrome: the fourth case of a separate entity with prenatal growth retardation, progressive pancytopenia and cerebellar hypoplasia. European journal of pediatrics 1995. link 30 Girault D, Goulet O, Le Deist F, Brousse N, Colomb V, Césarini JP et al.. Intractable infant diarrhea associated with phenotypic abnormalities and immunodeficiency. The Journal of pediatrics 1994. link70118-0) 31 Gartner JG, Murphy MN, Diocee M, deSa DJ, McLain KL. Demonstration of Epstein-Barr virus in immunoblastic sarcoma of B-cells arising in a child with primary immunodeficiency disease. The American journal of surgical pathology 1987. link 32 Fasth A. Primary immunodeficiency disorders in Sweden: cases among children, 1974-1979. Journal of clinical immunology 1982. link 33 Phan-Dinh-Tuy F, Durandy A, Griscelli C, Bach MA. T-cell subset analysis by monoclonal antibodies in primary immunodeficiencies. Scandinavian journal of immunology 1981. link

    Original source

    1. [1]
      Building alliances for early detection of immunodeficiencies: from primary care to hematology. — Rivière JG, Pasquet M, Gambineri E Frontiers in immunology (2025)
    2. [2]
      Multiple Organ Involvement in a Boy with Lipopolysaccharide-Responsive Beige-like Anchor Protein Deficiency Detected by F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography. — Abdulrezzak U, Temizer E, Ozcan A Pediatric allergy, immunology, and pulmonology (2025)
    3. [3]
      Systematic review of mortality and survival rates for APDS. — Hanson J, Bonnen PE Clinical and experimental medicine (2024)
    4. [4]
      New developments in respiratory medicine: a primary immunodeficiency perspective. — Ng K, Hurst JR Current opinion in allergy and clinical immunology (2020)
    5. [5]
      Utilization of high-fidelity simulation to address challenges with the basic science immunology education of preclinical medical students. — Cavuoto Petrizzo M, Barilla-LaBarca ML, Lim YS, Jongco AM, Cassara M, Anglim J et al. BMC medical education (2019)
    6. [6]
      International Union of Immunological Societies: 2017 Primary Immunodeficiency Diseases Committee Report on Inborn Errors of Immunity. — Picard C, Bobby Gaspar H, Al-Herz W, Bousfiha A, Casanova JL, Chatila T et al. Journal of clinical immunology (2018)
    7. [7]
      The 2017 IUIS Phenotypic Classification for Primary Immunodeficiencies. — Bousfiha A, Jeddane L, Picard C, Ailal F, Bobby Gaspar H, Al-Herz W et al. Journal of clinical immunology (2018)
    8. [8]
      Latin American challenges with the diagnosis and treatment of primary immunodeficiency diseases. — Costa-Carvalho B, González-Serrano M, Espinosa-Padilla S, Segundo G Expert review of clinical immunology (2017)
    9. [9]
      How effective are the 6 European Society of Immunodeficiency warning signs for primary immunodeficiency disease? — Arslan S, Ucar R, Caliskaner AZ, Reisli I, Guner SN, Sayar EH et al. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (2016)
    10. [10]
      Advances in clinical immunology in 2015. — Chinen J, Notarangelo LD, Shearer WT The Journal of allergy and clinical immunology (2016)
    11. [11]
      Adverse events following immunization in patients with primary immunodeficiencies. — Sarmiento JD, Villada F, Orrego JC, Franco JL, Trujillo-Vargas CM Vaccine (2016)
    12. [12]
      What has happened in the last 50 years in immunology. — Wong M Journal of paediatrics and child health (2015)
    13. [13]
      Advances in basic and clinical immunology in 2013. — Chinen J, Notarangelo LD, Shearer WT The Journal of allergy and clinical immunology (2014)
    14. [14]
      A case of long-undiagnosed common Primary Immunodeficiency in adulthood. — Tirotta D, Durante V European annals of allergy and clinical immunology (2014)
    15. [15]
      Cutaneous manifestations of DOCK8 deficiency syndrome. — Chu EY, Freeman AF, Jing H, Cowen EW, Davis J, Su HC et al. Archives of dermatology (2012)
    16. [16]
      Diagnosis and treatment of primary immunodeficiency disease: the role of the otolaryngologist. — Wasserman RL, Manning SC American journal of otolaryngology (2011)
    17. [17]
      Ten warning signs of primary immunodeficiency: a new paradigm is needed for the 21st century. — Arkwright PD, Gennery AR Annals of the New York Academy of Sciences (2011)
    18. [18]
      Primary immunodeficiency diseases in Latin America: proceedings of the Second Latin American Society for Immunodeficiencies (LASID) Advisory Board. — Leiva LE, Bezrodnik L, Oleastro M, Condino-Neto A, Costa-Carvalho BT, Grumach AS et al. Allergologia et immunopathologia (2011)
    19. [19]
      Critical issues and needs in management of primary immunodeficiency diseases in Latin America. — Condino-Neto A, Franco JL, Trujillo-Vargas C, Espinosa-Rosales FJ, Leiva LE, Rodriguez-Quiroz F et al. Allergologia et immunopathologia (2011)
    20. [20]
      A history of bone marrow transplantation. — de la Morena MT, Gatti RA Immunology and allergy clinics of North America (2010)
    21. [21]
      Use of intravenous immunoglobulin and adjunctive therapies in the treatment of primary immunodeficiencies: A working group report of and study by the Primary Immunodeficiency Committee of the American Academy of Allergy Asthma and Immunology. — Yong PL, Boyle J, Ballow M, Boyle M, Berger M, Bleesing J et al. Clinical immunology (Orlando, Fla.) (2010)
    22. [22]
      Primary immunodeficiency diseases: relevant aspects for pulmonologists. — Roxo Júnior P Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia (2009)
    23. [23]
      Chronic granulomatous disease. — Tipu HN, Ahmed TA, Ali S, Ahmed D, Waqar MA JPMA. The Journal of the Pakistan Medical Association (2008)
    24. [24]
      Building networks for immunodeficiency diseases and immunology training. — Burrows PD, Fischer A Nature immunology (2008)
    25. [25]
      Early indicators of immunodeficiency in adults and children: protocols for screening for primary immunological defects. — Sewell WA, Khan S, Doré PC Clinical and experimental immunology (2006)
    26. [26]
      The discovery of agammaglobulinaemia in 1952. — Hitzig WH European journal of pediatrics (2003)
    27. [27]
      Primary immunodeficiency diseases: dissectors of the immune system. — Buckley RH Immunological reviews (2002)
    28. [28]
      Hyperimmunoglobulin E syndrome. — Salaria M, Poddar B, Parmar V Indian journal of pediatrics (2001)
    29. [29]
      The Hoyeraal-Hreidarsson syndrome: the fourth case of a separate entity with prenatal growth retardation, progressive pancytopenia and cerebellar hypoplasia. — Aalfs CM, van den Berg H, Barth PG, Hennekam RC European journal of pediatrics (1995)
    30. [30]
      Intractable infant diarrhea associated with phenotypic abnormalities and immunodeficiency. — Girault D, Goulet O, Le Deist F, Brousse N, Colomb V, Césarini JP et al. The Journal of pediatrics (1994)
    31. [31]
      Demonstration of Epstein-Barr virus in immunoblastic sarcoma of B-cells arising in a child with primary immunodeficiency disease. — Gartner JG, Murphy MN, Diocee M, deSa DJ, McLain KL The American journal of surgical pathology (1987)
    32. [32]
      Primary immunodeficiency disorders in Sweden: cases among children, 1974-1979. — Fasth A Journal of clinical immunology (1982)
    33. [33]
      T-cell subset analysis by monoclonal antibodies in primary immunodeficiencies. — Phan-Dinh-Tuy F, Durandy A, Griscelli C, Bach MA Scandinavian journal of immunology (1981)
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