title: Clinical and epidemiologic features of primary HIV infection.
abstract: BACKGROUND
  The acute clinical events surrounding the acquisition of human immunodeficiency virus (HIV) have not been well characterized.
  
  
  OBJECTIVE
  To further define the clinical and epidemiologic presentation of primary HIV infection.
  
  
  METHODS
  Descriptive cohort study.
  
  
  METHODS
  University research clinic.
  
  
  METHODS
  46 adults (43 men and 3 women) with primary HIV infection who enrolled in the study a median of 51 days after HIV seroconversion.
  
  
  METHODS
  Documentation of recent HIV seroconversion. Standardized collection of demographic characteristics and sexual contact history, results of tests for HIV RNA, HIV culture, and T-cell subsets.
  
  
  RESULTS
  41 of 46 patients (89%) developed an acute retroviral syndrome. Primary HIV infection was infrequently diagnosed at the initial medical encounter, even in persons enrolled in routine HIV screening programs. Median numbers of sexual partners 6 months and 1 month before acquisition of HIV were three and one, respectively; 21 patients (46%) reported having had only one partner in the month before seroconversion. Of the 12 patients who could identify the precise date of and activity leading to seroconversion, 4 reported having only oral-genital contact.
  
  
  CONCLUSIONS
  Primary HIV infection causes a recognizable clinical syndrome that is often underdiagnosed, even in persons enrolled in a program of routine surveillance for HIV infection. Frequency of sexual contact and overall numbers of sexual partners in this group of homosexual men who acquired HIV were markedly lower than those seen a decade ago. Acquisition of HIV does occur, even in persons with relatively few sexual partners. Increased attention to oral-genital contact as a means of acquiring HIV appears to be warranted.
authors.affiliation: University of Washington, Seattle, USA.
authors.forename: T
authors.initials: T
authors.lastname: Schacker
authors.forename: A C
authors.initials: AC
authors.lastname: Collier
authors.forename: J
authors.initials: J
authors.lastname: Hughes
authors.forename: T
authors.initials: T
authors.lastname: Shea
authors.forename: L
authors.initials: L
authors.lastname: Corey
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D006678:HIV / Q000235:genetics; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000276:immunology / Q000635:transmission; D006679:HIV Seropositivity / Q000453:epidemiology; D006716:Homosexuality; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology
chemical_list: D016655:HIV Core Protein p24; D012367:RNA, Viral