Those who have worse symptoms during the earliest stage of HIV infection, called acute retroviral syndrome, are at greater risk for disease progression and should consider immediate antiretroviral (ARV) treatment, according to researchers at the University of Zurich. After studying 280 participants who had documented primary HIV infection (PHI), the investigators presented their findings at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013) in Kuala Lumpur.

The researchers devised a six-category scoring system with which to rate the severity of PHI, and they measured the scores’ correlation with baseline viral load and CD4 count and the viral set point, which is the viral load measured at least two months after infection or treatment interruption. A higher baseline viral load, lower CD4 count and higher viral load set point are predictive of a worse HIV disease progression.

The scoring system, which was on a scale of 0 to 10, assigned three points for severe neurologic symptoms, three for inpatient treatment, one for being 50 years old or older, one for fever, one for sexually transmitted infection, one for elevated liver enzymes and one for low platelets.

The group had an average score of 2.89. Those with a higher score had a lower baseline CD4 count and higher viral load. Among those who did not begin ARVs, a higher score correlated with a higher viral load set point.

To read the IAS abstract, click here.