Does symptomatic primary HIV-1 infection accelerate progression to CDC stage IV disease, CD4 count below 200 x 10(6)/l, AIDS, and death from AIDS?
OBJECTIVE
To investigate the prognostic significance of symptomatic primary HIV-1 infection.


METHODS
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.


METHODS
Research project centred on attenders for treatment and screening for HIV at the Karolinska Institute, Stockholm.


METHODS
19 patients presenting with a glandular-fever-like illness associated with seroconversion to HIV and 29 asymptomatic seroconverters.


METHODS
Progression to Centers for Disease Control and Prevention stage IV disease, CD4 cell count below 200 x 10(6)/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% v 66%), CD4 cell counts below 200 x 10(6)/l (84% v 55%), and AIDS (58% v 28%) and die of AIDS (53% v 7%).


CONCLUSIONS
A glandular-fever-like illness associated with seroconversion to HIV-1 predicts accelerated progression to AIDS and other HIV related diseases.
Lindbäck
S
S
Department of Infectious Diseases, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
Broström
C
C
Karlsson
A
A
Gaines
H
H
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000401:mortality; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology / Q000401:mortality*; D006679:HIV Seropositivity; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology; D016176:T-Lymphocyte Subsets; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000276:immunology / Q000401:mortality