Fever after a stay in the tropics: clinical spectrum and outcome in HIV-infected travelers and migrants.
OBJECTIVE
To investigate the epidemiology and clinical spectrum of fever in HIV-infected returning travelers and migrants.


METHODS
From April 2000 to December 2006, we explored prospectively, at our referral travel/HIV clinics, the etiology and outcome of febrile illnesses developing within 3 months after a stay in the tropics. For this study, we compared the morbidity profile between HIV-infected individuals and all other cases tested HIV negative.


RESULTS
Of the 1850 adults (15 years and older) evaluated for 1921 fever episodes, 93 (5%) had HIV infection, including 5 presenting with primary infection. HIV prevalence was 2% in western travelers or expatriates, 11% in travelers "visiting friends and relatives," and 24% in foreign visitors/migrants. Fever episodes (n = 104) occurring in the HIV-infected individuals were mainly due to opportunistic infections (23%, including tuberculosis), respiratory tract infections (20%), sexually transmitted infections (9%), and noninfectious diseases (7%). All these conditions were more frequently diagnosed than in HIV-negative travelers (1035 fever episodes), although tropical infections (mostly malaria) were proportionally less prevalent. Morbidity (rate and duration of hospitalization) was more considerable in HIV-infected patients than in HIV-negative individuals.


CONCLUSIONS
HIV infection was frequent in returning travelers and migrants presenting with fever at our setting and affected strongly the diagnostic spectrum and overall morbidity.
Bottieau
Emmanuel
E
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. ebottieau@itg.be
Florence
Eric
E
Clerinx
Jan
J
Vlieghe
Erika
E
Vekemans
Marc
M
Moerman
Filip
F
Lynen
Lut
L
Colebunders
Robert
R
Van Gompel
Alfons
A
Van den Ende
Jef
J
D000293:Adolescent; D000328:Adult; D054242:Emigrants and Immigrants; D005334:Fever / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D015658:HIV Infections / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D015995:Prevalence; D011446:Prospective Studies; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D014195:Travel; D014329:Tropical Climate