Symptomatic Primary Infection Due to Human Immunodeficiency Virus Type 1: Review of 31 Cases

Loés, Sabine Kinloch-de; Saussure, Philippe de; Saurat, Jean‐Hilaire; Stalder, Hans; Hirschel, Bernard; Perrin, Luc

doi:10.1093/clinids/17.1.59

Cited by 141 publications

(48 citation statements)

References 38 publications

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“…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.…”

Section: Acute Hiv and Clinical Implications A Unique Role For Acute mentioning

confidence: 99%

Acute HIV revisited: new opportunities for treatment and prevention

Pilcher¹,

Eron²,

Galvin³

et al. 2004

J. Clin. Invest.

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Inability to recognize incident infection has traditionally limited both scientific and public health approaches to HIV disease. Recently, some laboratories have begun adding HIV nucleic acid amplification testing to HIV diagnostic testing algorithms so that acute (antibody-negative) HIV infections can be routinely detected within the first 1–3 weeks of exposure. In this review article, we will highlight critical opportunities for HIV treatment and prevention that are presented by these diagnostic strategies

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Section: Acute Hiv and Clinical Implications A Unique Role For Acute mentioning

confidence: 99%

Acute HIV revisited: new opportunities for treatment and prevention

Pilcher¹,

Eron²,

Galvin³

et al. 2004

J. Clin. Invest.

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“…It has been estimated that at least 50% and as many as 90% of patients acutely infected with HIV will experience at least some symptoms of the acute retroviral syndrome (Table XVI) and can thus be identified as candidates for early therapy (16)(17)(18)(19). However, acute HIV infection is often not recognized in the primary care setting because of the similarity of the symptom complex with those of the "flu" or other common illnesses.…”

Section: Acute Hiv Infectionmentioning

confidence: 99%

Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents

1998

Ann Intern Med

800

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SummaryThe availability of an increasing number of antiretroviral agents and the rapid evolution of new information has introduced extraordinary complexity into the treatment of HIV-infected persons. In 1996, the Department of Health and Human Services and the Henry J. Kaiser Family Foundation convened the Panel on Clinical Practices for the Treatment of HIV to develop guidelines for the clinical management of HIV-infected adults and adolescents.This report recommends that care should be supervised by an expert, and makes recommendations for laboratory monitoring with particular emphasis on measurement of plasma levels of HIV RNA. The report also provides guidelines for antiretroviral therapy, including when to start treatment, what drugs to initiate, when to change therapy, and therapeutic options when changing therapy. Special considerations are provided for adolescents and pregnant women. As with treatment of other chronic conditions, therapeutic decisions require a mutual understanding between the patient and the health care provider regarding the benefits and risks of treatment. Like the treatment of most chronic diseases, antiretroviral regimens are complex, have major side effects, pose difficulty with compliance, and carry serious potential consequences with the risk of resistance from non-adherence to the drug regimen or suboptimal levels of antiretroviral agents. Patient education and involvement in therapeutic decisions is important for all medical conditions, but is considered especially critical for HIV infection and its treatment.With regard to specific recommendations, treatment should be offered to all patients with the acute HIV syndrome, those within six months of seroconversion, and all patients with symptoms ascribed to HIV infection. Recommendations for offering antiretroviral therapy in asymptomatic patients depend on virologic and immunologic factors. In general, treatment should be + 3 offered to individuals with fewer than 500 CD4 T cells/mm or plasma HIV RNA levels exceeding 10,000 copies/ml (bDNA assay) or 20,000 copies/ml (RT-PCR assay). The strength of the recommendation to treat asymptomatic patients should be based on the patient's willingness to accept therapy, the probability of adherence with the prescribed regimen, and the prognosis in terms of time to an + AIDS-defining complication as predicted by plasma HIV RNA levels and CD4 T cell counts, which independently help to predict prognosis. Once the decision has been made to initiate antiretroviral therapy, the goal is maximum viral suppression for as long as possible. Results of clinical trials to date indicate that this may currently be best achieved with a potent protease inhibitor (PI) in combination with two nucleoside analogue reverse transcriptase inhibitors (NRTIs). Another option is the combination of saquinavir plus ritonavir combined with one or two NRTIs. Other currently available regimens may be used in selected settings, but are considered by many to be less likely to produce maximum viral suppression. Results of t...

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“…The latter illness is of sudden onset and its commonsymptoms include fever, sore throat, headache, myalgia, malaise, skin rash, and lymphadenopathy (1)(2)(3). Other clinical manifestations of primary HIV-1 infection, such as lymphocytic alveolitis, hepatitis and neurologic disorders such as meningitis, encephalopathy, Guillain-Barre syndrome, and myelopathy, have been reported (3)(4)(5)(6)(7)(8)(9). To our knowledge, however, there has been no report of hepatic encephalopathy caused by primary HIV-1 infection.…”

Section: Introductionmentioning

confidence: 99%

Hepatic Encephalopathy in Primary Human Immunodeficiency Virus Type 1 (HIV-1) Infection.

et al. 2002

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Primary infection of human immunodeficiency virus type 1 (HIV-1) is occasionally associated with commoncold-like symptoms, and rarely with a self-limited illness resembling infectious mononucleosis. Wereport a 32-year-old manwho presented with infectious mononucleosis-like blood picture on admission. Five days after admission he developed hepatic encephalopathy, which was ameliorated by administration of bolus corticosteroid. Based on the results of serologic studies, we diagnosed that he had primary HIV-1 infection. To our knowledge, this is the first published report of hepatic encephalopathy as a clinical manifestation of primary HIV-1 infection.

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Symptomatic Primary Infection Due to Human Immunodeficiency Virus Type 1: Review of 31 Cases

Cited by 141 publications

References 38 publications

Acute HIV revisited: new opportunities for treatment and prevention

Acute HIV revisited: new opportunities for treatment and prevention

Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents

Hepatic Encephalopathy in Primary Human Immunodeficiency Virus Type 1 (HIV-1) Infection.

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