|Title:||Clinical features of acute human immunodeficiency virus infection in Taiwan: A multicenter study||Authors:||Lin T.-Y.
for the Taiwan HIV Study Group
|Issue Date:||2019||Publisher:||Elsevier Ltd||Journal Volume:||52||Journal Issue:||5||Start page/Pages:||700-709||Source:||Journal of Microbiology, Immunology and Infection||Abstract:||
Background/purpose: Acute HIV infection is characterized by a high concentration of HIV RNA in the plasma and rapid depletion of the CD4 cell count. This multicenter, retrospective observational study aimed to characterize the manifestations of acuteHIV infection in Taiwan. Methods: Between 1 January 2012 and 31 December 2016, all patients aged 20 years or greater who presented with acute HIV infection were included. Demographic and clinical characteristics of the patients at diagnosis were collected. Baseline laboratory assessment included hemogram, CD4 count, plasma HIV RNA load (PVL), serologic markers of syphilis and hepatitis A, B, and C viruses, and serum biochemistry. Results: The proportion of acute HIV infection was 6.9% among the patients with newly diagnosed HIV infection during the study period. The most common presenting symptoms of acute HIV infection were fever, fatigue, and myalgia. The median PVL at diagnosis was 5.9 log10 copies/ml, and median CD4 count was 307 cells/mm3. A total of 68 patients (27%) had baseline CD4 count less than 200 cells/mm3. Multiple logistic regression analysis, showed that the baseline CD4 count (OR, 4.02; p = 0.013) and aspartate aminotransaminase levels (OR, 3.49; p = 0.002) were associated with high PVL (>5 log10 copies/ml); and high baseline PVL (OR, 2.64; p = 0.002) was associated with symptomatic acute HIV infection. Conclusions: Manifestations of acute HIV infection are nonspecific and of wide spectrum ranging from fever to severe illness. A higher proportion of patients with initial CD4 counts of 200 cells/mm3 or less during acute HIV infection warrants early, timely diagnosis and treatment to prevent rapid disease progression. ? 2018
|ISSN:||1684-1182||DOI:||10.1016/j.jmii.2018.01.005||SDG/Keyword:||alanine aminotransferase; aspartate aminotransferase; bilirubin; creatinine; hemoglobin; Human immunodeficiency virus proteinase inhibitor; integrase inhibitor; nonnucleoside reverse transcriptase inhibitor; RNA directed DNA polymerase inhibitor; virus RNA; anti human immunodeficiency virus agent; virus RNA; acute HIV infection; adult; antiretroviral therapy; arthralgia; Article; aseptic meningitis; aspartate aminotransferase blood level; blood biochemistry; body weight loss; candidiasis; CD4 lymphocyte count; chlamydiasis; clinical feature; cohort analysis; combination drug therapy; condyloma; coughing; cryptococcosis; demography; diarrhea; disease association; fatigue; female; fever; genital ulcer; gonorrhea; headache; Hepatitis A virus; Hepatitis B virus; Hepatitis C virus; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; laboratory test; leukocyte count; lymphadenopathy; major clinical study; male; mixed infection; mouth ulcer; myalgia; nausea; night sweat; observational study; pharyngitis; plasma; platelet count; pneumocystosis; rash; retrospective study; salmonellosis; syphilis; syphilis serology; Taiwan; urea nitrogen blood level; virus load; vomiting; aseptic meningitis; blood; clinical trial; complication; Human immunodeficiency virus infection; mononucleosis; multicenter study; pathophysiology; regression analysis; statistical model; young adult; Adult; Anti-HIV Agents; CD4 Lymphocyte Count; Fatigue; Female; Fever; HIV Infections; Humans; Infectious Mononucleosis; Logistic Models; Male; Meningitis, Aseptic; Myalgia; Regression Analysis; Retrospective Studies; RNA, Viral; Syphilis; Taiwan; Viral Load; Young Adult
|Appears in Collections:||醫學系|
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