title: Predictors of rapid progression to AIDS in HIV-1 seroconverters.
abstract: OBJECTIVE
  To determine whether at the time of HIV-1 seroconversion rapid progressors to AIDS and a low CD4+ count can be distinguished by the clinical presentation of primary HIV-1 infection and serological and immunological characteristics.
  
  
  METHODS
  Prospective cohort study on HIV-1 infection in homosexual men.
  
  
  METHODS
  The Municipal Health Service, Amsterdam, The Netherlands.
  
  
  METHODS
  One hundred and eight men who seroconverted for HIV-1 during follow-up.
  
  
  METHODS
  Progression to AIDS and progression to a CD4+ lymphocyte count < 200 x 10(6)/l.
  
  
  RESULTS
  Symptomatic primary HIV infection with fever and skin rash, absence of anti-HIV core and transient HIV p24 antigenemia were independent predictors of progression to AIDS at the time of HIV-1 seroconversion. A low CD4+ count immediately after seroconversion and the calendar year were independent predictors of progression to a low CD4+ count at the time of HIV-1 seroconversion.
  
  
  CONCLUSIONS
  Even in the earliest stage of HIV-1 infection a small group of individuals at high risk for rapid progression to AIDS can be recognized by the clinical presentation of primary HIV infection, the presence of HIV p24 antigenaemia and the absence of a serological response to HIV core protein.
authors.affiliation: Municipal Health Service, Department of Public Health and Environment, Amsterdam, The Netherlands.
authors.forename: I P
authors.initials: IP
authors.lastname: Keet
authors.forename: P
authors.initials: P
authors.lastname: Krijnen
authors.forename: M
authors.initials: M
authors.lastname: Koot
authors.forename: J M
authors.initials: JM
authors.lastname: Lange
authors.forename: F
authors.initials: F
authors.lastname: Miedema
authors.forename: J
authors.initials: J
authors.lastname: Goudsmit
authors.forename: R A
authors.initials: RA
authors.lastname: Coutinho
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D015331:Cohort Studies; D016655:HIV Core Protein p24 / Q000097:blood; D006679:HIV Seropositivity / Q000097:blood / Q000453:epidemiology / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D016655:HIV Core Protein p24