Severity and prognosis of acute human immunodeficiency virus type 1 illness: a dose-response relationship.
This study examined the relationship between the severity of acute human immunodeficiency virus type 1 (HIV-1) illness and disease progression and death. The population included 218 patients with acute HIV-1 illness and 41 asymptomatic patients who underwent HIV-1 seroconversion; the patients were followed up prospectively. We analyzed progression to Centers for Disease Control and Prevention clinical categories B and C (AIDS-defining conditions) and death according to an additive clinical score (CS) based on six predictive clinical features at the time of acute HIV-1 infection. Compared with patients with a CS of 0 (asymptomatic patients), those with a CS of 3-4 and 5-6 had faster progression to category B disease (adjusted hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.01-1.92; and HR, 1.80; 95% CI, 1.34-2.40; respectively); those with a CS of 5-6 had faster progression to category C disease (HR, 1.37; 95% CI, 1.01-1.89) and death (HR, 2.05; 95% CI, 1.27-3.32). Thus, the number of symptoms and signs at the time of acute HIV-1 illness affects disease progression and survival, even in symptomatic patients who have undergone seroconversion.
Vanhems
P
P
Hôtel-Dieu de Montréal, and the Department of Social and Preventive Medicine, University of Montreal, Quebec, Canada.
Lambert
J
J
Cooper
D A
DA
Perrin
L
L
Carr
A
A
Hirschel
B
B
Vizzard
J
J
Kinloch-de Loës
S
S
Allard
R
R
D000208:Acute Disease; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D015497:HIV-1; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index