title: Acute retroviral syndrome and high baseline viral load are predictors of rapid HIV progression among untreated Argentinean seroconverters.
abstract: BACKGROUND
  Diagnosis of primary HIV infection (PHI) has important clinical and public health implications. HAART initiation at this stage remains controversial.
  
  
  METHODS
  Our objective was to identify predictors of disease progression among Argentinean seroconverters during the first year of infection, within a multicentre registry of PHI-patients diagnosed between 1997 and 2008. Cox regression was used to analyze predictors of progression (LT-CD4 < 350 cells/mm3, B, C events or death) at 12 months among untreated patients.
  
  
  RESULTS
  Among 134 subjects, 74% presented with acute retroviral syndrome (ARS). Seven opportunistic infections (one death), nine B events, and 10 non-AIDS defining serious events were observed. Among the 92 untreated patients, 24 (26%) progressed at 12 months versus three (7%) in the treated group (p = 0.01). The 12-month progression rate among untreated patients with ARS was 34% (95% CI 22.5-46.3) versus 13% (95% CI 1.1-24.7) in asymptomatic patients (p = 0.04). In univariate analysis, ARS, baseline LT-CD4 < 350 cells/mm3, and baseline and six-month viral load (VL) > 100,000 copies/mL were associated with progression. In multivariate analysis, only ARS and baseline VL > 100,000 copies/mL remained independently associated; HR: 8.44 (95% CI 0.97-73.42) and 9.44 (95% CI 1.38-64.68), respectively.
  
  
  CONCLUSIONS
  In Argentina, PHI is associated with significant morbidity. HAART should be considered in PHI patients with ARS and high baseline VL to prevent disease progression.
authors.affiliation: Hospital J.A. Fernández, Cerviño 3356, Buenos Aires, Argentina. eugenia_socias@yahoo.com.ar
authors.forename: M Eugenia
authors.initials: ME
authors.lastname: Socías
authors.forename: Omar
authors.initials: O
authors.lastname: Sued
authors.forename: Natalia
authors.initials: N
authors.lastname: Laufer
authors.forename: María E
authors.initials: ME
authors.lastname: Lázaro
authors.forename: Horacio
authors.initials: H
authors.lastname: Mingrone
authors.forename: Daniel
authors.initials: D
authors.lastname: Pryluka
authors.forename: Carlos
authors.initials: C
authors.lastname: Remondegui
authors.forename: María I
authors.initials: MI
authors.lastname: Figueroa
authors.forename: Carina
authors.initials: C
authors.lastname: Cesar
authors.forename: Ana
authors.initials: A
authors.lastname: Gun
authors.forename: Gabriela
authors.initials: G
authors.lastname: Turk
authors.forename: María B
authors.initials: MB
authors.lastname: Bouzas
authors.forename: Ravi
authors.initials: R
authors.lastname: Kavasery
authors.forename: Alejandro
authors.initials: A
authors.lastname: Krolewiecki
authors.forename: Héctor
authors.initials: H
authors.lastname: Pérez
authors.forename: Horacio
authors.initials: H
authors.lastname: Salomón
authors.forename: Pedro
authors.initials: P
authors.lastname: Cahn
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D001118:Argentina; D018450:Disease Progression; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000473:pathology* / Q000821:virology*; D006801:Humans; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents