Risk Factors and Clinical Presentation of Acute Primary HIV Infection in India

Abstract

This systematic case-control study of p24 antigen screening in HIV-seronegative patients attending STD clinics in India identified unprotected sex with a CSW and a genital ulcer as independent risk factors associated with newly acquired HIV infection. In addition, p24 antigen positivity identified recent fever, night sweats, and arthralgias as symptoms that may be predictive of recent HIV infection. In a study of patients attending STD clinics in India, screening for p24 antigen in HIV antibody-negative persons was found to be a reliable and effective research method for determining recent risk behavior and identifying clinical signs of acute primary HIV infection.

Early Diagnosis of Human Immunodeficiency Virus Infection by p24 Antigen Detection

“…The other 3 cases were lost to follow-up. Bollinger et al in a study in Pune detected an additional 1.5% of sero-negative STD patients having HIV infection by p24 Ag estimation [9]. The lower rate of positivity by them as compared to our study may be due to the use of standard assay by them, which has a lower sensitivity than the ICD-HIV-p24 Ag assay [3].…”

“…Bollinger et al in their study in Pune had similar findings i.e. 79% seropositive cases with ulcers [9].…”

Acute HIV revisited: new opportunities for treatment and prevention

“…Based on a probabilistic model of the relationship between semen viral burden and probability of HIV transmission (83), increases in semen HIV load during acute HIV infection appear sufficient to account for an eight-to 20-fold increase in the odds of transmission per coital act (27). Other biological influences hypothesized to contribute to elevated individual infectiousness in acute infection include the relative homogeneity in Env (84), the near universal R5 coreceptor usage (35), the absence of antibody in genital fluids (S74), and the frequent presence of other inflammatory or ulcerative STDs that might increase both shedding and partner susceptibility (7,9,27). The notion of cotransmission of STD pathogens suggests one location where acute HIV infection might be best detected: STD clinics.…”

Sexual Behaviour as a Risk Factor in the Transmission of Hiv Infection Among Adolescents and Young Males in India

“…In Switzerland, a campaign for condom use saw its use increase from 40% in 1988 to 64% in 1994 among 17 to 30 years [11]. In India, only 14.3% of esws used condoms [12] compared with 24% ofindividuals attending STD clinics [13].…”