title: Acute HIV infection presenting as hemophagocytic syndrome with an unusual serological and virological response to ART.
abstract: BACKGROUND
  HIV clinical presentation in the acute stage is variable and some of its virological and immunological aspects are not completely understood. Most cases of HIV- associated reactive hemophagocytic syndrome have been reported in patients with advanced stages of HIV and to our knowledge, there are only 8 cases in the English literature presenting during acute HIV infection, most in East Asia, being this the first case in a European patient.
  
  
  METHODS
  We report a case of a European Caucasian 27- year old woman with a primary HIV- infection presenting with extremely low CD4+ T cell count who developed a haemophagocytic syndrome after starting ART and in whom we documented a very unusual serological and virological response, characterized by an impaired HIV- antibody production and a 12 month time frame to reach an undetectable viral load, despite no evidence of resistance.
  
  
  CONCLUSIONS
  This case report apart from describing an unusual clinical presentation of an acute HIV infection as hemophagocytic syndrome provides useful information that might contribute for understanding some subtle issues in acute HIV infection, namely the dynamics of virological and immunological aspects after antiretroviral therapy initiation.
authors: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal. ferrazrit@gmail.com.|Instituto de Inovação e Investigação em Saúde (I3S). Grupo de I&D em Nefrologia e Doenças Infeciosas. Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal. ferrazrit@gmail.com.
authors: Rita Veiga
authors: RV
authors: Ferraz
authors: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal.|Instituto de Inovação e Investigação em Saúde (I3S). Grupo de I&D em Nefrologia e Doenças Infeciosas. Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors: Ana Cláudia
authors: AC
authors: Carvalho
authors: Transfusion Medicine and Hematology Department, Centro Hospitalar de São João, Porto, Portugal.
authors: Fernando
authors: F
authors: Araújo
authors: Transfusion Medicine and Hematology Department, Centro Hospitalar de São João, Porto, Portugal.
authors: Carmo
authors: C
authors: Koch
authors: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal.|Instituto de Inovação e Investigação em Saúde (I3S). Grupo de I&D em Nefrologia e Doenças Infeciosas. Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors: Cândida
authors: C
authors: Abreu
authors: Infectious Diseases Department, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, Porto, Portugal.|Instituto de Inovação e Investigação em Saúde (I3S). Grupo de I&D em Nefrologia e Doenças Infeciosas. Instituto Nacional de Engenharia Biomédica (INEB), Porto, Portugal.
authors: António
authors: A
authors: Sarmento
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000139:chemically induced*; D013997:Time Factors; D019562:Viral Load / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents
keywords: Acute infection; HIV; Haemophagocytic syndrome