HIV infection: The role of primary care

Human immunodeficiency virus infection was first documented in the United States in 1981. Since that time, significant strides have been made in the prevention and treatment of the condition. Screening is paramount in identifying early infection and is now a routine component of primary care. Primary care physicians are also often involved in monitoring patients with the infection. Diagnosis can occur at any stage of human immunodeficiency virus infection. The acute retro-viral syndrome that occurs shortly after infection is characterized by constitutional symptoms and is often difficult to differentiate from common community-acquired viruses. Appropriate management with combination antiretroviral therapy often extends the patient's life, sometimes for many years. Selection of pharmacotherapy is usually based on genotypic or phenotypic resistance testing. Therapy is lifelong and complicated by pill burden, cost, adverse effects, and drug interactions.