Intended for healthcare professionals

Papers

Does symptomatic primary HIV-1 infection accelerate progression to CDC stage IV disease, CD4 count below 200 × 106/l, AIDS, and death from AIDS?

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6968.1535 (Published 10 December 1994) Cite this as: BMJ 1994;309:1535
  1. Stefan Lindback,
  2. Christina Brostrom,
  3. Anders Karlsson,
  4. Hans Gaines
  1. Department of Infectious Diseases, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
  2. Department of Dermatovenereology, Sodersjukhuset, Karolinska Institute, Stockholm, Sweden.
  3. Department of Clinical Immunology, Swedish Institute for Infectious Disease Control
  4. and Department of Infectious Diseases, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
  1. Correspondence and requests for reprints to: Dr Stefan Lindback, Department of Infectious Diseases, I 56, Huddinge Hospital, S-141 86 Huddinge, Sweden.
  • Accepted 10 October 1994

Abstract

Objective: To investigate the prognostic significance of symptomatic primary HIV-1 infection.

Design: Prospective study of homosexual men seroconverting to HIV in 1985 and 1986. Patients were followed up at least three times yearly with clinical examinations and T cell subset determinations for an average of 7.2 years.

Setting: Research project centred on attenders for treatment and screening for HIV at the Karolinska Institute, Stockholm. Subjects—19 patients presenting with a glandularfever-like illness associated with seroconversion to HIV and 29 asymptomatic seroconverters.

Main outcome measures: Progression to Centers for Disease Control and Prevention stage IV disease, CD4 cell count below 200 × 106/l, AIDS, and death from AIDS.

Results: Symptomatic seroconverters were significantly more likely to develop Centers for Disease Control and Prevention stage IV disease (95% (upsilon) 66%), CD4 cell counts below 200 × 106/l (84% (upsilon) 55%), and AIDS (58% (upsilon) 28%) and die of AIDS (53% (upsilon) 7%).

Conclusion: A glandular-fever-like illness associated with seroconversion to HIV-1 predicts accelerated progression to AIDS and other HIV related diseases.

Footnotes

    View Full Text