Primary human immunodeficiency virus type 1 infection: clinical manifestations among women in Mombasa, Kenya.
The occurrence of clinical manifestations associated with primary human immunodeficiency virus type 1 (HIV-1) infection was evaluated in a prospective cohort study of female sex workers in Mombasa, Kenya. Among 103 women who seroconverted to HIV-1, fever, vomiting, diarrhea, headache, arthralgia, myalgia, skin rash, swollen lymph nodes, extrainguinal lymphadenopathy, inguinal lymphadenopathy, and vaginal candidiasis were noted significantly more frequently at visits in which seroconversion first became evident. Eighty-one percent of seroconverting women had >/=1 of these 11 symptoms or signs. Among 44% of the women, the acute illness was severe enough to prevent them from working. Having >/=2 of 6 selected symptoms and signs yielded a sensitivity of 51%, specificity of 83%, positive likelihood ratio of 3.2, and negative likelihood ratio of 0.5 for acute HIV-1 infection. The recognition of primary HIV-1-infection illness in high-risk populations and subsequent risk-reduction counseling could potentially reduce secondary HIV-1 transmission during this highly infectious period.
Lavreys
L
L
Departments of Epidemiology, Medicine, and Biostatistics, University of Washington, Seattle, WA 98104-2499, USA.
Thompson
M L
ML
Martin
H L
HL
Mandaliya
K
K
Ndinya-Achola
J O
JO
Bwayo
J J
JJ
Kreiss
J
J
D015331:Cohort Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016013:Likelihood Functions; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011477:Sex Work
D015483:HIV Antibodies