AIDS: Recent evidence indicates that very early therapy will improve prognosis and perhaps even eradicate HIV; however, primary HIV infection is not being recognized because the diagnosis is not considered. To aid in early HIV diagnosis, the natural history of Acute Retroviral Syndrome (ARS) is outlined, including clinical presentations. It is known that a large proportion of patients seek medical attention during the acute retroviral infection stage at which time the patient most commonly suffers from either fever, sore throat, fatigue, weight loss, and/or myalgia. Although data are limited, there is a strong case for starting antiretroviral therapy as soon as possible after a patient is diagnosed with ARS. Duration of treatment has yet to be determined. Recommendations for an initial diagnostic and therapeutic approach when a patient presents with possible ARS are provided.