title: Higher HIV RNA Viral Load in Recent Patients with Symptomatic Acute HIV Infection in Lyon University Hospitals.
abstract: BACKGROUND
  Increased human immunodeficiency virus (HIV) virulence at infection has been suggested by a meta-analysis based on viral load and CD4 T lymphocytes (CD4) count during acute infection. This result was obtained after secondary analyses of large databases, facilitating the detection of differences. Similar finding in cohorts of more modest sample size would indicate that the effect could be more substantial.
  
  
  METHODS
  Change from initial CD4 count and HIV viral load after acute HIV infection by calendar year was explored in patients treated at Lyon University hospitals. All patients admitted to our hospitals with acute HIV infection between 1996 and 2013 were included in our study. Initial CD4 count and viral load before the start of anti-retroviral treatment were analyzed. Trends over time were assessed in linear models.
  
  
  RESULTS
  Initial CD4 count remained similar over time. However, in 2006-2013, initial viral load rose significantly (+1.12 log10/ml/year, p = 0.01).
  
  
  CONCLUSIONS
  Our data, obtained from a single hospital cohort, confirmed findings from a large meta-analysis, showed increased initial viremia at acute HIV infection since 2006 and suggesting potentially higher HIV virulence in recent years.
authors.affiliation: Infection Control and Epidemiology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Girerd-Genessay
authors.affiliation: Infection Control and Epidemiology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Baratin
authors.affiliation: Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Ferry
authors.affiliation: Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Chidiac
authors.affiliation: Infection Control and Epidemiology Unit, Hôpital Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Ronin
authors.affiliation: Infection Control and Epidemiology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.|Emerging Pathogens Laboratory, Fondation Mérieux, Centre International de Recherche en Infectiologie, INSERM U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 21, Avenue Tony Garnier, Lyon, 69007, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Vanhems
mesh_terms: D000208:Acute Disease; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D015658:HIV Infections / Q000175:diagnosis / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006785:Hospitals, University; D006801:Humans; D012367:RNA, Viral / Q000097:blood / Q000235:genetics*; D012698:Serologic Tests; D019562:Viral Load; D014766:Viremia
chemical_list: D012367:RNA, Viral