Acute Aids Retrovirus Infection

Cooper, D. A.; Maclean, Prudence; Finlayson, Robert; Michelmore, HarryM.; Gold, Julian; Donovan, Basil; Barnes, TimothyG.; Brooke, Peter; Penny, Ronald

doi:10.1016/s0140-6736(85)91205-x

Cited by 612 publications

(47 citation statements)

References 16 publications

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“…There may be an acute illness after which a clinically quiescent state ensues (15). The virus may be cultured from the infected host during this time, in spite of concurrent seropositivity to HTLV-III/LAV (16).…”

Section: Discussionmentioning

confidence: 99%

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

Lui¹,

Lawrence²,

Morgan³

et al. 1986

Proc. Natl. Acad. Sci. U.S.A.

170

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The incubation period, representing the interval between the date of exposure and the date of diagnosis, can be firmly ascertained in transfusion-associated cases of acquired immunodeficiency syndrome (AIDS). However, because the observation period of all transfusion-infected persons may be short compared with the average incubation period for AIDS, many cases with long incubation periods have not yet been diagnosed. Thus, the simple average of 2.6 years tends to underestimate the true mean. To correct for this underestimation bias, we assumed that the underlying distribution of the incubation periods is a member of a broad class of probability densities. Then, by maximum likelihood techniques, the mean incubation period for transfusion-associated AIDS was estimated to be 4.5 years, with the 90% confidence interval ranging from 2.6 to 14.2 years. The logng incubation period has important consequences for infected individuals and implications for public health intervention and prevention policy.Transfusion-associated acquired immunodeficiency syndrome (AIDS) provides a unique opportunity to study the incubation period ofthis disease because the date ofexposure to the virus can be accurately determined through epidemiologic investigations that identify which blood donor, and donation date, was associated with transmission of infection (1). We define the incubation period as the period from transfusion to the diagnosis of the first opportunistic disease associated with AIDS. The date of diagnosis is used as a closure for this period, rather than the more conventional date ofonset of symptoms, because the earliest symptoms are typically nonspecific and their dates of onset are poorly remembered.During the initial phase of a new disease epidemic, use of the simple average of the incubation periods of the observed cases is subject to two types of bias due to length-biased sampling. One bias can result from any omission of patients who had such short incubation periods that their illnesses went undiagnosed as AIDS before the existence of transfusion-associated AIDS was first recognized; this constitutes left censoring in our sample. As a consequence of this bias, the traditional estimate, the mean incubation periods of the observed cases, might tend to overestimate the true mean. On the other hand, another source of bias can arise from the fact that our sample does not include those exposed persons who will have such long incubation periods that they have not yet been diagnosed; this constitutes right censoring, which might cause the traditional estimate to underestimate the true mean.Our estimate would now suggest that the right censoring exerts a greater impact on the estimate and the simple average tends to represent an underestimation. Moreover, immediately following a period when the rate of exposure is increasing, as certainly was occurring with AIDS during 1978-1984, the degree of underestimation due to the right censoring is even greater, since the absolute number of patients with short incubation perio...

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Section: Discussionmentioning

confidence: 99%

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

Lui¹,

Lawrence²,

Morgan³

et al. 1986

Proc. Natl. Acad. Sci. U.S.A.

170

View full text Add to dashboard Cite

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“…Very early in the studies of AIDS, clinical features of acute HIV infection were recognized and have been described in a number of articles, particularly by Cooper and coworkers (202,1181,1183) (Table 6). A recently infected individual can present within 1 to 3 weeks with a viruslike illness.…”

Section: Acute Hiv Infectionmentioning

confidence: 99%

“…A recently infected individual can present within 1 to 3 weeks with a viruslike illness. Symptoms consist of headache, retroorbital pain, muscle aches, sore throat, low-grade or high-grade fever, and swollen lymph nodes, as well as a nonpruritic macular erythematous rash involving the trunk and, later, the extremities (Table 6) (202,764). In some cases, oral candidiasis and ulcerations in the esophagus or anal canal occur (201a, 965), and central nervous system disorders can be seen (e.g., encephalitis) (131).…”

Section: Acute Hiv Infectionmentioning

confidence: 99%

Pathogenesis of Human Immunodeficiency Virus Infection

Levy¹

1989

Annals of the New York Academy of Sciences

222

290

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“…Not infrequently, acute neurological complications of HIV-1 infection develop in tandem with an illness resembling infectious mononucleosis and is characterized by sweats, rigors, arthralgias, myalgias, nausea and vomiting, sore throat, abdominal cramps, and diarrhea. Fever, generalized lymphadenopathy, pharyngeal injection, splenomegaly and splenic tenderness, maculopapular rash, and urticaria are observed on physical examination (64,162). Laboratory studies may reveal transient thrombocytopenia and lymphopenia with an inversion of CD4/CD8 (helper/suppressor) lymphocyte ratio.…”

Section: Clinical Manifestations Of Hiv-1 Infection Of the Central Nementioning

confidence: 99%

Human immunodeficiency virus type 1 infection of the brain

et al. 1993

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Direct infection of the central nervous system by human immunodeficiency virus type 1 (HIV-1), the causative agent of AIDS, was not appreciated in the early years of the AIDS epidemic. Neurological complications associated with AIDS were largely attributed to opportunistic infections that arose as a result of the immunocompromised state of the patient and to depression. In 1985, several groups succeeded in isolating HIV-1 directly from brain tissue. Also that year, the viral genome was completely sequenced, and HIV-1 was found to belong to a neurotropic subfamily of retrovirus known as the Lentivirinae. These findings clearly indicated that direct HIV-1 infection of the central nervous system played a role in the development of AIDS-related neurological disease. This review summarizes the clinical manifestations of HIV-1 infection of the central nervous system and the related neuropathology, the tropism of HIV-1 for specific cell types both within and outside of the nervous system, the possible mechanisms by which HIV-1 damages the nervous system, and the current strategies for diagnosis and treatment of HIV-1-associated neuropathology.

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Acute Aids Retrovirus Infection

Cited by 612 publications

References 16 publications

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome.

Pathogenesis of Human Immunodeficiency Virus Infection

Human immunodeficiency virus type 1 infection of the brain

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