We appreciate the comments of Dr Tanvetyanon with respect to our article, "Infrequent Diagnosis of Primary Human Immunodeficiency Virus Infection: Missed Opportunities in Acute Care Settings." We agree that the presenting symptoms and risk factors are commonly encountered in assessing patients with acute care problems, and the cost of screening all such patients would be prohibitive. It is important to note that this study was a retrospective assessment of a cohort of patients who were diagnosed during primary HIV infection and not a prospective study of approaches to this admittedly difficult diagnosis. Thus, it is not possible to provide a measure of the total number of patients screened since we did not attempt to perform routine screening on patients presenting to an acute care setting. Rather we sought to increase awareness of the diagnosis of primary HIV infection since in the majority of instances, primary HIV infection is not part of the initial differential diagnosis.
Hicks C, Weintrob A. Screening for Primary Human Immunodeficiency Virus Infection—Reply. Arch Intern Med. 2004;164(6):679-680. doi:10.1001/archinte.164.6.680-b