Acute HIV infection and several AIDS related opportunistic infections
G.M. Bentancourt Copello1, E.B. Angel2, L.B. Ruggieri1, M.S. Salvarredi1, L. Soria3, L. Dulong4, L. Alvarado3, I. Miranda3, V.H. Bittar1
1Hospital Central, Programa Provincial de Sida, Immunodeficiency, Mendoza, Argentina, 2Hopsital Central, Immunodeficiency, Mendoza, Argentina, 3Hospital Central, Programa Provincial de Sida, Clinical Service, Mendoza, Argentina, 4Hosptal Central, Clinical Service, Mendoza, Argentina
Background: Acute HIV infection occurs 1-4 weeks after viral transmission .The symptoms are developed in 40-90%,but are nonspecific and can be confused with other community-acquired infections.Nevertheless,there are a few patients who progress quickly to AIDS.
Objective: To describe our experience about patients with several AIDS related opportunistic infections during acute HIV infection.
Methods: A review of the patients with acute HIV infection admitted in a general Hospital in the last year.
Results: In a general Hospital were admitted 59 patients, 55 patients had HIV infection diagnosis ,and 4 (6.7%)patients had positive ELISA (with P24 antigen)test and Western Blot(WB) test indeterminate.These patients had different symptoms: fever (>three weeks),weight loss,adenopathy,headache,photophobia,nuchal rigidity and Bell´s palsy.The laboratory findings were anemia,leukopenia,lymphopenia,and elevated transaminases.The CD4 cell count was between 25 cell/mm3 and 327 cell/mm3,and viral load test was between 39.157 copies/ml (log4.97) and >500 000 copies/ml(bDNA).Three of them (75%) developed Pneumocystis Jiroveci pneumonia (PJP),and one of them (25%) developed Cryptococcal meningoencephalitis.In all four patients P24 antigen test was positive one month after the transmission, and WB test was positive between the third and fifth months after the transmission.In all the patients there was sexual transmission.One of the transmission happened in the EEUU.The four patients are alive,asymptomatic,and with highly active antiretroviral therapy.
Conclusions: In this general Hospital the 6.7% of the patients admitted developed AIDS related opportunistic infections during acute HIV infection.The HIV transmission was sexual.The late diagnosis based on the development of antibody showed that the serotype of this HIV may be different than the ones that standard diagnosis methods detect .These patients had progress more rapid to AIDS and allowing to start treatment immediately.
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