title: Rapid HIV progression during acute HIV-1 subtype C infection in a Mozambican patient with atypical seroconversion.
abstract: Acute human immunodeficiency virus (HIV) infection (AHI) refers to the period between viral transmission and development of an adaptive immune response to HIV antigens (seroconversion) usually lasting 6-8 weeks. Rare cases have been described in which HIV-infected patients fail to seroconvert and instead, develop rapid HIV-mediated clinical decline. We report the case of a Mozambican woman with AHI and malaria coinfection who showed atypical seroconversion and experienced rapid deterioration and death within 14 weeks of diagnosis with AHI. Atypical seroconversion may be associated with rapid progression. Fourth generation rapid tests could lead to earlier identification and intervention for this vulnerable subgroup.
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain.
authors.forename: Cesar
authors.initials: C
authors.lastname: Velasco
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain.
authors.forename: Erica
authors.initials: E
authors.lastname: Parker
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pastor
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain.
authors.forename: Abel
authors.initials: A
authors.lastname: Nhama
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain.
authors.forename: Salesio
authors.initials: S
authors.lastname: Macuacua
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain.
authors.forename: Inácio
authors.initials: I
authors.lastname: Mandomando
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain.
authors.forename: Julià
authors.initials: J
authors.lastname: Blanco
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Department of Preventive Medicine and Epidemiology, Hospital Clinic, Barcelona, Spain; School of Paediatrics and Child Health, University of Western Australia, Perth, Australia; IrsiCaixa Institute for AIDS Research, Institut Germans Trias i Pujol (IGTP), Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, UAB, Badalona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique; Universitat de Vic- Universitat Central de Catalunya, Vic, Spain dsuzanne@clinic.ub.es.
authors.forename: Denise
authors.initials: D
authors.lastname: Naniche
mesh_terms: D000208:Acute Disease; D000328:Adult; D060085:Coinfection; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000276:immunology* / Q000821:virology; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D016778:Malaria, Falciparum / Q000150:complications* / Q000188:drug therapy; D009073:Mozambique