title: Acute HIV infection with rapid progression to AIDS.
abstract: Acute HIV infection is rarely recognized as the signs and symptoms are normally unspecific and can persist for days or weeks. The normal HIV course is characterized by a progressive loss of CD4+ cells, which normally leads to severe immunodeficiency after a variable time interval. The mean time from initial infection to development of clinical AIDS is approximately 8-10 years, but it is variable among individuals and depends on a complex interaction between virus and host. Here we describe an extraordinary case of a man who developed Pneumocisits jiroveci pneumonia within one month after sexual exposure to HIV-1, and then presented with 3 consecutive CD4 counts bellow 200 cells/mm³ within 3 months, with no other opportunistic disease. Although antiretroviral therapy (AZT+3TC+ATZ/r) was started, with full adherence of the patient, and genotyping indicating no primary antiretroviral resistance mutations, he required more than six months to have a CD4 restoration to levels above 200 cells/mm³ and 10 months to HIV-RNA to become undetectable.
authors.affiliation: Universidade Federal da Bahia, Brazil. oliveiras_m@yahoo.com.br
authors.forename: Marcio de Oliveira
authors.initials: Mde O
authors.lastname: Silva
authors.forename: Milena
authors.initials: M
authors.lastname: Bastos
authors.forename: Eduardo Martins
authors.initials: EM
authors.lastname: Netto
authors.forename: Nancy Alves de Lima
authors.initials: NA
authors.lastname: Gouvea
authors.forename: Alex Jose Leite
authors.initials: AJ
authors.lastname: Torres
authors.forename: Esper
authors.initials: E
authors.lastname: Kallas
authors.forename: David I
authors.initials: DI
authors.lastname: Watkins
authors.forename: Marcus
authors.initials: M
authors.lastname: Altfeld
authors.forename: Carlos
authors.initials: C
authors.lastname: Brites
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000473:pathology*; D000208:Acute Disease; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D015658:HIV Infections / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000473:pathology*; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents