OBJECTIVE: To estimate the frequency of acute retroviral syndrome associated with HIV infection among injecting drug users (IDU), and to determine the extent to which acute retroviral syndrome predicts a faster rate of progression to AIDS and immunosuppression in this population. DESIGN: Prospective study of HIV seroconverters (median follow-up, 50.5 months). SETTING: Sixteen clinical centres throughout Italy established to study the natural history of HIV infection. PATIENTS: Three hundred and ninety-one IDU for whom the date of HIV seroconversion was established with a 9-month precision. MAIN OUTCOME MEASURES AND METHODS: Incidence of acute retroviral syndrome with signs and symptoms that included fever (temperature > 38 degrees C) occurring within 6 months prior to the time of first positive HIV test, progression to AIDS, crude and adjusted relative hazard of AIDS using survival analysis techniques, and trajectories of CD4+ cell counts using a piece-wise linear regression model incorporating the degree of dependency of within-person measurements. RESULTS: Of 391 HIV seroconverters, 39 (10.0%) were diagnosed with acute retroviral syndrome. During follow-up, 13 seroconverters with acute retroviral syndrome and 24 asymptomatic seroconverters developed AIDS. The Kaplan-Meier estimates for the cumulative AIDS incidence during 4.5 years of follow-up were 26.8 and 6.5%, respectively; the relative hazard of developing AIDS for acute retroviral syndrome was 5.59 (95% confidence interval, 2.79-11.20) after adjustment for age, sex and year of seroconversion. Although CD4+ level within the first year from seroconversion was similar, the rate of CD4+ cell decline after 1 year from seroconversion was faster in individuals with acute retroviral syndrome than in those without this syndrome (P < 0.001). CONCLUSIONS: Among HIV-infected IDU, a distinct acute retroviral syndrome is apparent and associated with a faster rate of clinical progression to AIDS and HIV-related immunosuppression.
OBJECTIVE: To estimate the frequency of acute retroviral syndrome associated with HIV infection among injecting drug users (IDU), and to determine the extent to which acute retroviral syndrome predicts a faster rate of progression to AIDS and immunosuppression in this population. DESIGN: Prospective study of HIV seroconverters (median follow-up, 50.5 months). SETTING: Sixteen clinical centres throughout Italy established to study the natural history of HIV infection. PATIENTS: Three hundred and ninety-one IDU for whom the date of HIV seroconversion was established with a 9-month precision. MAIN OUTCOME MEASURES AND METHODS: Incidence of acute retroviral syndrome with signs and symptoms that included fever (temperature > 38 degrees C) occurring within 6 months prior to the time of first positive HIV test, progression to AIDS, crude and adjusted relative hazard of AIDS using survival analysis techniques, and trajectories of CD4+ cell counts using a piece-wise linear regression model incorporating the degree of dependency of within-person measurements. RESULTS: Of 391 HIV seroconverters, 39 (10.0%) were diagnosed with acute retroviral syndrome. During follow-up, 13 seroconverters with acute retroviral syndrome and 24 asymptomatic seroconverters developed AIDS. The Kaplan-Meier estimates for the cumulative AIDS incidence during 4.5 years of follow-up were 26.8 and 6.5%, respectively; the relative hazard of developing AIDS for acute retroviral syndrome was 5.59 (95% confidence interval, 2.79-11.20) after adjustment for age, sex and year of seroconversion. Although CD4+ level within the first year from seroconversion was similar, the rate of CD4+ cell decline after 1 year from seroconversion was faster in individuals with acute retroviral syndrome than in those without this syndrome (P < 0.001). CONCLUSIONS: Among HIV-infected IDU, a distinct acute retroviral syndrome is apparent and associated with a faster rate of clinical progression to AIDS and HIV-related immunosuppression.
Authors: Trevor A Crowell; Donn J Colby; Suteeraporn Pinyakorn; James L K Fletcher; Eugène Kroon; Alexandra Schuetz; Shelly J Krebs; Bonnie M Slike; Louise Leyre; Nicolas Chomont; Linda L Jagodzinski; Irini Sereti; Netanya S Utay; Robin Dewar; Rungsun Rerknimitr; Nitiya Chomchey; Rapee Trichavaroj; Victor G Valcour; Serena Spudich; Nelson L Michael; Merlin L Robb; Nittaya Phanuphak; Jintanat Ananworanich Journal: Clin Infect Dis Date: 2018-05-02 Impact factor: 9.079
Authors: Paul Volberding; Lisa Demeter; Ronald J Bosch; Evgenia Aga; Carla Pettinelli; Martin Hirsch; Mary Vogler; Ana Martinez; Susan Little; Elizabeth Connick Journal: AIDS Date: 2009-09-24 Impact factor: 4.177
Authors: Marco Gelpi; Hans J Hartling; Kristina Thorsteinsson; Jan Gerstoft; Henrik Ullum; Susanne D Nielsen Journal: BMC Infect Dis Date: 2016-10-21 Impact factor: 3.090
Authors: Trevor A Crowell; Justin Ritz; Robert W Coombs; Lu Zheng; Joseph J Eron; John W Mellors; Joan Dragavon; Gert U van Zyl; Javier R Lama; Kiat Ruxrungtham; Beatriz Grinsztejn; Roberto C Arduino; Lawrence Fox; Jintanat Ananworanich; Eric S Daar Journal: Clin Infect Dis Date: 2021-08-02 Impact factor: 20.999
Authors: Dominique L Braun; Roger Kouyos; Corinna Oberle; Christina Grube; Beda Joos; Jacques Fellay; Paul J McLaren; Herbert Kuster; Huldrych F Günthard Journal: PLoS One Date: 2014-12-09 Impact factor: 3.240
Authors: Amin S Hassan; Jonathan Hare; Kamini Gounder; Jamirah Nazziwa; Sara Karlson; Linnéa Olsson; Claire Streatfield; Anatoli Kamali; Etienne Karita; William Kilembe; Matt A Price; Persephone Borrow; Per Björkman; Pontiano Kaleebu; Susan Allen; Eric Hunter; Thumbi Ndung'u; Jill Gilmour; Sarah Rowland-Jones; Joakim Esbjörnsson; Eduard J Sanders Journal: Clin Infect Dis Date: 2021-09-07 Impact factor: 9.079