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. 1989 Jul 15;299(6692):154–157. doi: 10.1136/bmj.299.6692.154

Clinical course of primary HIV infection: consequences for subsequent course of infection.

C Pedersen 1, B O Lindhardt 1, B L Jensen 1, E Lauritzen 1, J Gerstoft 1, E Dickmeiss 1, J Gaub 1, E Scheibel 1, T Karlsmark 1
PMCID: PMC1837064  PMID: 2569901

Abstract

OBJECTIVE--To investigate the impact of the clinical course of the primary HIV infection on the subsequent course of the infection. DESIGN--Prospective documenting of seroconversion, follow up at six month intervals, and analysis of disease progression by life tables. PATIENTS--86 Men in whom seroconversion occurred within 12 months. PRIMARY OUTCOME MEASURE--Progression of HIV infection, defined as CD4 lymphocyte count less than 0.5 X 10(9)/l, recurrence of HIV antigenaemia, or progression to Centers for Disease Control group IV. MAIN RESULTS--Median follow up was 670 (range 45-1506) days. An acute illness like glandular fever occurred in 46 (53%) subjects. Three year progression rates to Centers for Disease Control group IV was 78% at three years for those who had longlasting illnesses (duration greater than or equal to 14 days) during seroconversion as compared with 10% for those who were free of symptoms or had mild illness. All six patients who developed AIDS had had longlasting primary illnesses. Three year progression rates to a CD4 lymphocyte count less than 0.5 X 10(9)/l and to recurrence of HIV antigenaemia were significantly higher for those who had longlasting primary illnesses than those who had no symptoms or mild illness (75% v 42% and 55% v 14%, respectively). CONCLUSION--The course of primary infection may determine the subsequent course of the infection.

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Selected References

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  1. Allain J. P., Laurian Y., Paul D. A., Senn D. Serological markers in early stages of human immunodeficiency virus infection in haemophiliacs. Lancet. 1986 Nov 29;2(8518):1233–1236. doi: 10.1016/s0140-6736(86)92673-5. [DOI] [PubMed] [Google Scholar]
  2. Anderson K. C., Gorgone B. C., Marlink R. G., Ferriani R., Essex M. E., Benz P. M., Groopman J. E. Transfusion-acquired human immunodeficiency virus infection among immunocompromised persons. Ann Intern Med. 1986 Oct;105(4):519–527. doi: 10.7326/0003-4819-105-4-519. [DOI] [PubMed] [Google Scholar]
  3. Boyko W. J., Schechter M. T., Craib K. J., Willoughby B., Douglas B., Sestak P., McLeod W. A., O'Shaughnessey M. The Vancouver Lymphadenopathy-AIDS Study: 7. Clinical and laboratory features of 87 cases of primary HIV infection. CMAJ. 1987 Jul 15;137(2):109–113. [PMC free article] [PubMed] [Google Scholar]
  4. Cooper D. A., Gold J., Maclean P., Donovan B., Finlayson R., Barnes T. G., Michelmore H. M., Brooke P., Penny R. Acute AIDS retrovirus infection. Definition of a clinical illness associated with seroconversion. Lancet. 1985 Mar 9;1(8428):537–540. doi: 10.1016/s0140-6736(85)91205-x. [DOI] [PubMed] [Google Scholar]
  5. Goedert J. J., Biggar R. J., Melbye M., Mann D. L., Wilson S., Gail M. H., Grossman R. J., DiGioia R. A., Sanchez W. C., Weiss S. H. Effect of T4 count and cofactors on the incidence of AIDS in homosexual men infected with human immunodeficiency virus. JAMA. 1987 Jan 16;257(3):331–334. [PubMed] [Google Scholar]
  6. Haseltine W. A. Replication and pathogenesis of the AIDS virus. J Acquir Immune Defic Syndr. 1988;1(3):217–240. [PubMed] [Google Scholar]
  7. Ho D. D., Sarngadharan M. G., Resnick L., Dimarzoveronese F., Rota T. R., Hirsch M. S. Primary human T-lymphotropic virus type III infection. Ann Intern Med. 1985 Dec;103(6 ):880–883. doi: 10.7326/0003-4819-103-6-880. [DOI] [PubMed] [Google Scholar]
  8. Hofmann B., Lindhardt B. O., Gerstoft J., Petersen C. S., Platz P., Ryder L. P., Odum N., Dickmeiss E., Nielsen P. B., Ullman S. Lymphocyte transformation response to pokeweed mitogen as a predictive marker for development of AIDS and AIDS related symptoms in homosexual men with HIV antibodies. Br Med J (Clin Res Ed) 1987 Aug 1;295(6593):293–296. doi: 10.1136/bmj.295.6593.293. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lange J. M., Parry J. V., de Wolf F., Mortimer P. P., Goudsmit J. Diagnostic value of specific IgM antibodies in primary HIV infection. AIDS. 1988 Feb;2(1):31–35. doi: 10.1097/00002030-198802000-00005. [DOI] [PubMed] [Google Scholar]
  10. Medley G. F., Anderson R. M., Cox D. R., Billard L. Incubation period of AIDS in patients infected via blood transfusion. Nature. 1987 Aug 20;328(6132):719–721. doi: 10.1038/328719a0. [DOI] [PubMed] [Google Scholar]
  11. Moss A. R., Bacchetti P., Osmond D., Krampf W., Chaisson R. E., Stites D., Wilber J., Allain J. P., Carlson J. Seropositivity for HIV and the development of AIDS or AIDS related condition: three year follow up of the San Francisco General Hospital cohort. Br Med J (Clin Res Ed) 1988 Mar 12;296(6624):745–750. doi: 10.1136/bmj.296.6624.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Pedersen C., Gerstoft J., Lindhardt B. O., Sindrup J. Candida esophagitis associated with acute human immunodeficiency virus infection. J Infect Dis. 1987 Sep;156(3):529–530. doi: 10.1093/infdis/156.3.529-a. [DOI] [PubMed] [Google Scholar]
  13. Pedersen C., Kolby P., Sindrup J. H., Arendrup M., Wulf H. C., Gaub J., Gerstoft J., Lindhardt B. O. Immunological studies in homosexual men with and without antibodies to human T-cell lymphotropic virus type III. Dan Med Bull. 1986 Oct;33(5):270–272. [PubMed] [Google Scholar]
  14. Pedersen C., Nielsen C. M., Vestergaard B. F., Gerstoft J., Krogsgaard K., Nielsen J. O. Temporal relation of antigenaemia and loss of antibodies to core antigens to development of clinical disease in HIV infection. Br Med J (Clin Res Ed) 1987 Sep 5;295(6598):567–569. doi: 10.1136/bmj.295.6598.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Polk B. F., Fox R., Brookmeyer R., Kanchanaraksa S., Kaslow R., Visscher B., Rinaldo C., Phair J. Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men. N Engl J Med. 1987 Jan 8;316(2):61–66. doi: 10.1056/NEJM198701083160201. [DOI] [PubMed] [Google Scholar]
  17. Robert-Guroff M., Goedert J. J., Naugle C. J., Jennings A. M., Blattner W. A., Gallo R. C. Spectrum of HIV-1 neutralizing antibodies in a cohort of homosexual men: results of a 6 year prospective study. AIDS Res Hum Retroviruses. 1988 Oct;4(5):343–350. doi: 10.1089/aid.1988.4.343. [DOI] [PubMed] [Google Scholar]
  18. Rouse B. T., Horohov D. W. Immunosuppression in viral infections. Rev Infect Dis. 1986 Nov-Dec;8(6):850–873. doi: 10.1093/clinids/8.6.850. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Scott G. B., Buck B. E., Leterman J. G., Bloom F. L., Parks W. P. Acquired immunodeficiency syndrome in infants. N Engl J Med. 1984 Jan 12;310(2):76–81. doi: 10.1056/NEJM198401123100202. [DOI] [PubMed] [Google Scholar]
  20. Tindall B., Barker S., Donovan B., Barnes T., Roberts J., Kronenberg C., Gold J., Penny R., Cooper D. Characterization of the acute clinical illness associated with human immunodeficiency virus infection. Arch Intern Med. 1988 Apr;148(4):945–949. [PubMed] [Google Scholar]
  21. Weber J. N., Wadsworth J., Rogers L. A., Moshtael O., Scott K., McManus T., Berrie E., Jeffries D. J., Harris J. R., Pinching A. J. Three-year prospective study of HTLV-III/LAV infection in homosexual men. Lancet. 1986 May 24;1(8491):1179–1182. doi: 10.1016/s0140-6736(86)91160-8. [DOI] [PubMed] [Google Scholar]

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