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
- Stefan Lindback,
- Christina Brostrom,
- Anders Karlsson,
- Hans Gaines
- Department of Infectious Diseases, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
- Department of Dermatovenereology, Sodersjukhuset, Karolinska Institute, Stockholm, Sweden.
- Department of Clinical Immunology, Swedish Institute for Infectious Disease Control
- and Department of Infectious Diseases, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
- 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
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.