title: Fever after a stay in the tropics: clinical spectrum and outcome in HIV-infected travelers and migrants.
abstract: 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.
authors.affiliation: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium. ebottieau@itg.be
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bottieau
authors.forename: Eric
authors.initials: E
authors.lastname: Florence
authors.forename: Jan
authors.initials: J
authors.lastname: Clerinx
authors.forename: Erika
authors.initials: E
authors.lastname: Vlieghe
authors.forename: Marc
authors.initials: M
authors.lastname: Vekemans
authors.forename: Filip
authors.initials: F
authors.lastname: Moerman
authors.forename: Lut
authors.initials: L
authors.lastname: Lynen
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
authors.forename: Alfons
authors.initials: A
authors.lastname: Van Gompel
authors.forename: Jef
authors.initials: J
authors.lastname: Van den Ende
mesh_terms: 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