title: Heterophil-negative mononucleosis-like illnesses with atypical lymphocytosis in patients undergoing seroconversions to the human immunodeficiency virus.
abstract: The authors present data from four patients with acute heterophil-negative mononucleosis-like illnesses who were initially thought to have primary Epstein-Barr virus (EBV) infections but eventually were shown to be seroconverting to the human immunodeficiency virus (HIV). Widespread lymphadenopathy and blood smears indistinguishable from those typically encountered in the acute phase of infectious mononucleosis were present in all cases. There were also varying combinations of fever, sore throat, and malaise, as well as mild abnormalities of hepatic function and elevated cold agglutinins (anti-I). Anti-HIV was detected by both enzyme-linked immunosorbent assay and Western blot techniques in all cases, with increasing titers noted in two of three serially studied cases. In one patient, a dual infection with the hepatitis B virus was also documented. Diagnostic possibilities in patients with acute mononucleosis-like illnesses dominated by prominent lymphadenopathy should include primary seroconversions to HIV.
authors.affiliation: Department of Laboratory Medicine, Mount Sinal Hospital, Minneapolis, Minnesota 55404.
authors.forename: T A
authors.initials: TA
authors.lastname: Steeper
authors.forename: C A
authors.initials: CA
authors.lastname: Horwitz
authors.forename: M
authors.initials: M
authors.lastname: Hanson
authors.forename: W
authors.initials: W
authors.lastname: Henle
authors.forename: G
authors.initials: G
authors.lastname: Henle
authors.forename: H
authors.initials: H
authors.lastname: Rosenstein
authors.forename: L
authors.initials: L
authors.lastname: Peterson
authors.forename: T W
authors.initials: TW
authors.lastname: Amsden
authors.forename: M
authors.initials: M
authors.lastname: Belzer
mesh_terms: D000910:Antibodies, Heterophile / Q000032:analysis*; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007244:Infectious Mononucleosis / Q000097:blood / Q000150:complications* / Q000276:immunology; D008214:Lymphocytes / Q000473:pathology*; D008218:Lymphocytosis / Q000209:etiology*
chemical_list: D000910:Antibodies, Heterophile