Human immunodeficiency virus (HIV) infection is a worldwide infection and new cases continue to occur. Recognizing features of acute HIV infection and also underlying conditions that might reflect longer-standing infection are key to diagnosis. This allows treatment to be started which can maintain or improve health and prevent further deterioration of immune function. Treatment is indicated for the majority of newly diagnosed cases irrespective of immune function status. Current treatment strategies are so effective and tolerable now compared to early antiretroviral regimens that HIV has become a long-term manageable condition for the majority of newly diagnosed people who are able to access antiretroviral therapy.