The acute retroviral syndrome and the pathogenesis of HIV-1 infection.
The acute retroviral syndrome associated with primary HIV-1 infection is characterized by clinical signs of immune activation, multi-system dysfunction, and high levels of cell-associated and plasma viremia, p24 antigenemia, and proviral burden. Clinical abnormalities associated with acute HIV-1 infection and measures of viral burden and replication generally decline in concert with seroconversion. Despite clearance of virus, patients experiencing severe forms of the acute retroviral syndrome appear to have a poorer prognosis than patients with asymptomatic primary infection. This accelerated natural history may be due to the virulence of strains causing symptomatic infection, sequelae of initial high-titer viremia and consequent high viral burden, or immune depletion through immunopathologic mechanisms accelerated by strong antigenic stimulus in primary infection. Early intervention with anti-retroviral and immune modulatory agents has the potential to alter the natural history of patients with this syndrome.
Clark
S J
SJ
Department of Medicine, University of Alabama, Birmingham 35294.
Shaw
G M
GM
D000208:Acute Disease; D003588:Cytopathogenic Effect, Viral; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D015497:HIV-1 / Q000276:immunology / Q000302:isolation & purification / Q000472:pathogenicity / Q000502:physiology; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000382:microbiology; D011379:Prognosis; D011533:Proviruses / Q000302:isolation & purification; D014766:Viremia / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D014774:Virulence; D014779:Virus Replication
D016655:HIV Core Protein p24