Acute human immunodeficiency virus type 1 disease as a mononucleosis-like illness: is the diagnosis too restrictive?
The purpose of this study was to describe the frequency and duration of clinical features at the time of acute human immunodeficiency virus type 1 (HIV-1) disease in 218 patients with documented symptomatic primary HIV-1 infection. The mean duration of acute HIV-1 disease was 25.1 days (median, 20.0 days) and did not differ by gender, age, and risk factor. The frequency and mean duration of clinical features occurring in >50% of patients were as follows: fever, 77.1% and 16.9 days; lethargy, 65.6% and 23.7 days; cutaneous rash, 56.4% and 15 days; myalgia, 54.6% and 17.7 days; and headache, 50.9% and 25.8 days. Only 15.6% of patients presented with a typical mononucleosis-like illness (MLI) defined as fever, pharyngitis or sore throat, and cervical adenopathy, and 10% had no features of an MLI. A meningitis-like syndrome occurred in 20 patients (9.2%). Acute HIV-1 disease is more diverse than previously reported, and the absence of fever or other MLI features does not rule out acute HIV-1 disease.
Vanhems
P
P
Hôtel-Dieu de Montréal, and Département de Médecine Sociale et Préventive, Université de Montréal, Quebec, Canada.
Allard
R
R
Cooper
D A
DA
Perrin
L
L
Vizzard
J
J
Hirschel
B
B
Kinloch-de Löes
S
S
Carr
A
A
Lambert
J
J
D000208:Acute Disease; D000328:Adult; D015331:Cohort Studies; D003937:Diagnosis, Differential; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000503:physiopathology; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors