title: A patient with primary human immunodeficiency virus infection for whom highly active antiretroviral therapy was successful.
abstract: We report the case of a 25-year-old male Japanese homosexual with primary human immunodeficiency virus (HIV)-1 infection and early stage syphilis. Approximately 60 days after HIV exposure by sex with another man, the patient abruptly had high fever, after which he experienced a variety of severe, prolonged symptoms such as painful oral mucosa ulcerations, rash, lymphadenopathy, splenomegaly, and a 5.5-kg weight loss. Serum lactate dehydrogenase and liver biochemical test values were elevated. Antibodies to HIV by both enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) test were negative at the time of symptom onset, but serum HIV-1 RNA level was 1 585 000 copies/ml. Antibody seroconversions were found on day 9 after the onset of symptoms by ELISA and on day 16 by WB test, suggesting primary HIV infection. Within 2 weeks of starting highly active antiretroviral therapy (HAART), all symptoms except lymphadenopathy were resolved, and the serum HIV-1 RNA level dramatically decreased to 5011 copies/ml, eventually becoming undetectable by the standard method. The patient has remained asymptomatic for the 18 months since symptom resolution after HAART, and HIV-1 RNA remains undetectable.
authors.affiliation: Department of General Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan. furusyo@genmedpr.med.kyushu-u.ac.jp
authors.forename: Norihiro
authors.initials: N
authors.lastname: Furusyo
authors.forename: Iwao
authors.initials: I
authors.lastname: Ariyama
authors.forename: Yong
authors.initials: Y
authors.lastname: Chong
authors.forename: Masao
authors.initials: M
authors.lastname: Harada
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nabeshima
authors.forename: Arahito
authors.initials: A
authors.lastname: Mitsutake
authors.forename: Seizaburo
authors.initials: S
authors.lastname: Kashiwagi
authors.forename: Jun
authors.initials: J
authors.lastname: Hayashi
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015497:HIV-1; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood
chemical_list: D012367:RNA, Viral