What treatment should be initiated for a patient diagnosed with acute primary HIV infection?

Initiating combination antiretroviral therapy (cART) for a patient diagnosed with acute primary HIV infection is crucial for several reasons. First and foremost, early treatment with cART has been shown to significantly reduce the viral load, which can lower the risk of transmission to others. It can also help to preserve immune function and improve long-term health outcomes for the patient.

Combination therapy typically includes at least three different antiretroviral medications from at least two different drug classes. This strategy not only helps to effectively suppress the virus but also reduces the risk of developing drug resistance. The rationale behind using multiple agents is to target the virus through different mechanisms, lowering the chance that HIV will mutate and become resistant to therapy.

In contrast, monotherapy options, such as protease inhibitors or single-agent nucleoside reverse transcriptase inhibitors like zidovudine or didanosine, do not provide the same level of viral suppression and are more susceptible to leading to resistance if the virus is allowed to replicate. Therefore, they fall short of the recommended treatment protocols for anyone diagnosed with HIV, especially in the acute phase of infection.

Overall, cART represents the standard of care in managing acute primary HIV infection, aligning with guidelines aimed at improving patient outcomes