Primary human immunodeficiency virus type 1 infection: clinical, virological and immunological characteristics of 75 patients (1997-2003).
OBJECTIVE
To describe the epidemiological and clinical characteristics and the evolution of a cohort of patients with primary HIV-1 infection from the Barcelona area.


METHODS
Prospective cohort study of HIV-infected patients diagnosed with primary HIV infection in a tertiary hospital in Barcelona (Spain) from 1997 through 2003. Descriptive analysis of epidemiological and clinical characteristics and effect of highly active antiretroviral treatment (HAART) on outcome.


RESULTS
A total of 75 patients were diagnosed, accounting for 2.9% of the total of newly diagnosed HIV patients during the same time period. Eighty-one percent of the patients were males and the median age was 30 years (IQR 26-38). The most frequent transmission route was homosexual (72%), followed by heterosexual (17%) and intravenous drug abuse (11%). Seventy-seven percent of patients presented symptoms, the most frequent being fever (98%), asthenia (86%), arthralgia-myalgia (65%), lymphadenopathy (55%), night sweats (48%) and rash. Sixty-five percent started HAART, although the proportion of patients that received HAART decreased from 79% during the period 1997-2000 to 49% during the period 2001-2003 (p < 0.01). After a median follow-up of 37 months (IQR 26-66), one patient died and eight cases were lost to follow-up. The patients who did not receive HAART had a higher probability of immunological or clinical deterioration during the follow-up when compared to the group that received HAART (42.3% versus 12.3%; p < 0.001). In treated patients, dyslipidemia and lipodystrophy were diagnosed in 58% and 37% of cases, respectively.


CONCLUSIONS
Primary HIV-1 infection was diagnosed more frequently in homosexual males, and its clinical characteristics were similar to those observed in previous studies. HAART given during primary HIV infection was effective, but was associated with a high percentage of adverse effects.
Sued
Omar
O
Servicios de Enfermedades Infecciosas, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Villaroel 170, 08036 Barcelona, Spain.
Miró
José M
JM
Alquezar
Aitor
A
Claramonte
Xavier
X
García
Felipe
F
Plana
Montserrat
M
Arnedo
Mireia
M
de Lazzari
Elisa
E
Gil
Cristina
C
Manzardo
Christian
C
Blanco
José L
JL
Martínez
Esteban
E
Mallolas
Josep
J
Joseph
Joan
J
Pumarola
Tomás
T
Gallart
Teresa
T
Gatell
José M
JM
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001247:Asthenia / Q000453:epidemiology / Q000209:etiology; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D042241:Early Diagnosis; D005076:Exanthema / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008206:Lymphatic Diseases / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013030:Spain; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D016896:Treatment Outcome; D019562:Viral Load