title: [The clinical characteristics of twenty-five cases of acute HIV-1 infection in China].
abstract: OBJECTIVE
  To summarize the clinical features, immunological and virological characteristics of HIV-1 infected patients in the acute phase for the sake of improving the understanding of acute HIV-1 infection and early diagnosis.
  
  
  METHODS
  To retrospectively analyze the clinical manifestation and laboratory data of 25 patients with acute HIV infection, who were admitted to the Department of Infectious Diseases, Peking Union Medical College Hospital from 2006 to 2013.
  
  
  RESULTS
  Among the total 25 patients, 19 (76%) patients were sexually transmitted, including 17 (68%) of whom were homosexual. Twenty two (88%) patients presented significant symptoms. Common symptoms consisted of fever (15 patients, 60%), cervical lymphoadenopathy (8 patients, 32%), skin rashes (6 patients, 24%), diarrhea (5 patients, 20%), shortness of breath (3 patients, 12%), sore throat (3 patients, 12%), and cough (3 patients, 12%), while only one case represented as Guillain-Barr syndrome, upper arm cellulitis, headache and vomiting, and perianal abscess. Laboratory examination indicated elevated peripheral lymphocytes (13 patients, 52%), abnormal liver function (11 patients, 44%), thrombocytopenia (1 patients, 4%). Notably, 2 patients (8%) revealed negative results of HIV antibody, who were diagnosed with positive plasma viral load. The average viral load was (4.68 ± 0.83) lg copies/ml. CD(+)(4) T cell count was 473 (343,621) cells/µl. CD(+)(8) T cell count was 1 296 (997, 2 177) cells/µl with maximal value of 7 984 cells/µl. The CD₄/CD₈ ratio was 0.33 (0.22, 0.53) including 24 (96%) patients with obvious inverted ratio. The positive rates of immune activation markers HLA-DR and CD38 on the surface of CD(+)(8) T cells were (74.9 ± 16.1) % and (84.9 ± 12.5) % respectively. The viral load had a significant positive correlation with the expression of HLA-DR and CD₃₈.
  
  
  CONCLUSIONS
  The most common symptoms of acute HIV-1 infection are fever, cervical lymphadenopathy, skin rashes and diarrhea. Significantly elevated CD(+)(8) T cell count, inverted CD₄/CD₈ ratio and abnormal immune activation markers contribute to the early diagnosis of acute HIV infection.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Fuping
authors.initials: F
authors.lastname: Guo
authors.forename: Guanqun
authors.initials: G
authors.lastname: Li
authors.forename: Yang
authors.initials: Y
authors.lastname: Han
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.forename: Yanling
authors.initials: Y
authors.lastname: Li
authors.forename: Ting
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China; Email: litsh@263.net.
authors.forename: Taisheng
authors.initials: T
authors.lastname: Li
mesh_terms: D000068476:Beijing; D016516:CD4-CD8 Ratio; D018414:CD8-Positive T-Lymphocytes; D015658:HIV Infections / Q000175:diagnosis* / Q000473:pathology*; D015497:HIV-1; D006801:Humans; D018655:Lymphocyte Count; D012189:Retrospective Studies; D019562:Viral Load