To the Editor: Acute infection with human immunodeficiency virus type 1 (HIV-1) is associated with a self-limited, mononucleosis-like illness in the majority of persons. Symptoms may include fever, pharyngitis, lymphadenopathy, rash, oral and genital ulcerations, orthostasis, and gastrointestinal problems. Although many patients seek medical attention during acute HIV-1 infection, the diagnosis is often missed.¹ In the early symptomatic stage, the standard enzyme-linked immunosorbent assay (ELISA) is negative for HIV-1, but tests for plasma HIV-1 RNA or plasma p24 antigen are positive. We hypothesized that health care providers are likely to perform testing for heterophil antibodies to Epstein–Barr virus in patients . . .